Luis M. Tumialán

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BACKGROUND CONTEXT The use of recombinant bone morphogenetic protein-2 (rh-BMP-2) is effective in augmenting lumbar spinal fusions. A safe, effective dosage of rh-BMP-2 in the cervical spine has yet to be determined. Use of rh-BMP-2 is currently being evaluated and is only indicated for use in the cervical spine on Investigational Device Exempt cases. (More)
STUDY DESIGN Case report. OBJECTIVE To review the management of a patient with progressive osteolysis of the vertebral body after undergoing cervical arthroplasty for management of a refractory radiculopathy. SUMMARY OF BACKGROUND DATA Since the Food and Drug Administration's (FDA) approval of cervical arthroplasty devices in 2007, many surgeons have(More)
The authors report on 32-year-old woman with a history of a previously resected suprasellar clear cell meningioma (CCM), who returned to their institution after 3 years suffering from progressively worsening leg and back pain associated with leg weakness and bowel and bladder dysfunction. A magnetic resonance image of the thoracic and lumbar spine(More)
The widespread use of instrumentation in the lumbar spine has led to high rates of fusion. This has been accompanied by a marked rise in adjacent-segment disease, which is considered to be an increasingly common and significant consequence of lumbar or lumbosacral fusion. Numerous biomechanical studies have demonstrated that segments fused with rigid(More)
In contrast to cervical and lumbar fusion procedures, the principal aim of disk arthroplasty is to recapitulate the normal kinematics and biomechanics of the spinal segment affected. Following decompression of the neural elements, disk arthroplasty allows restoration of disk height and maintenance of spinal alignment. Based on clinical observations and(More)
OBJECT The goal in this study was to demonstrate the safety and efficacy of anterior cervical discectomy and fusion ([ACDF]; single- or multilevel procedure) performed using titanium plates and polyetheretherketone (PEEK) spacers filled with recombinant human bone morphogenetic protein-2 (rhBMP-2) impregnated in a type I collagen sponge to achieve fusion.(More)
BACKGROUND Arthrodesis is optimized when the structural graft occupies most of the surface area within a disc space. The transforaminal corridor inherently limits interbody size. OBJECTIVE To evaluate the biomechanical implications of nested interbody spacers (ie, a second curved cage placed behind a first) to increase disc space coverage in(More)
BACKGROUND Nonfunctioning pituitary adenomas (NFPAs) are among the most common pituitary lesions and may present with hypopituitarism and/or hyperprolactinemia. OBJECTIVE To review the existing literature as it pertains to preoperative endocrine assessment in the workup for NFPAs. METHODS A systematic review methodology was utilized to identify and(More)
STUDY DESIGN Case report. OBJECTIVE To review the management of a neurologically intact patient with complete cervical spondyloptosis with particular attention to the role and timing of closed preoperative cervical traction and subsequent stabilization. SUMMARY OF BACKGROUND DATA Traumatic cervical spondyloptosis is typically associated with complete(More)
The authors report the case of a 53-year-old woman in whom a T1-T2 spinal arachnoid cyst with associated arachnoiditis developed, compressing the thoracic spinal cord 1 year after the patient had suffered a Hunt and Hess Grade IV subarachnoid hemorrhage (SAH). Development of spinal arachnoiditis with or without an arachnoid cyst is a rare complication of(More)