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Journal of Neurosurgery. Spine

Maged D Fam, Royce W Woodroffe, Logan Helland, Jennifer Noeller, Nader S Dahdaleh, Arnold H Menezes, Patrick W Hitchon
OBJECTIVE: Adult spinal arachnoid cysts (SACs) are rare entities of indistinct etiology that present with pain or myelopathy. Diagnosis is made on imaging studies with varying degrees of specificity. In symptomatic cases, the standard treatment involves surgical exploration and relief of neural tissue compression. The aim of this study was to illustrate features of SACs in adults, surgical management, and outcomes. METHODS: The authors searched medical records for all SACs in adults in the 10-year period ending in December 2016...
September 28, 2018: Journal of Neurosurgery. Spine
Ahmed Jorge, Michael D White, Nitin Agarwal
OBJECTIVE: Individuals with a spinal cord injury (SCI) in socioeconomically disadvantaged settings (e.g., rural or low income) have different outcomes than their counterparts; however, a contemporary literature review identifying and measuring these outcomes has not been published. Here, the authors' aim was to perform a systematic review and identify these parameters in the hope of providing tangible targets for future clinical research efforts. METHODS: A systematic review was performed to find English-language articles published from 2007 to 2017 in the PubMed/MEDLINE, EMBASE, and SCOPUS databases...
September 28, 2018: Journal of Neurosurgery. Spine
Myung Soo Youn, Jong Ki Shin, Tae Sik Goh, Seung Min Son, Jung Sub Lee
OBJECTIVE: Various minimally invasive techniques have been described for the decompression of lumbar spinal stenosis (LSS). However, few reports have described the results of endoscopic posterior decompression (EPD) with laminectomy performed under local anesthesia. This study aimed to evaluate the clinical and radiological outcomes of EPD performed under local anesthesia in patients with LSS and to compare the procedural outcomes in patients with and without preoperative spondylolisthesis...
September 28, 2018: Journal of Neurosurgery. Spine
Sanghyun Han, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
OBJECTIVE: Posterior column osteotomy (PCO) has been known to provide an angular change (AC) of approximately 10° in sagittal plane deformity. However, whether PCO can actually obtain an AC of ≥ 10° depending on the particular level in the lumbar spine and which factors can effect a gain of ≥ 10° AC after PCO remain to be elucidated. The aim of this study was to identify the factors that effect a gain of ≥ 10° AC through PCO by comparing radiographic measurements between an AC group and a control group before and after adult spinal deformity (ASD) surgery...
September 28, 2018: Journal of Neurosurgery. Spine
Krzysztof Zapałowicz, Maciej Radek
OBJECTIVE: The objective of the present study was to determine experimentally the distribution of lesions caused in the cadaveric brachial plexus (BP) by excessive stretching. The authors attempted to delineate the correlation between the direction of stretching and sites of lesions. METHODS: Fifteen specimens (each comprised the spinal segment C4-T2 with 2 BPs) were harvested from adult cadavers. Each BP was stretched in a mechanical testing machine at a constant speed of 200 mm/min...
September 28, 2018: Journal of Neurosurgery. Spine
Manabu Sasaki, Shunji Asamoto, Masao Umegaki, Katsumi Matsumoto
OBJECTIVE: This study aimed to investigate the characteristics of cervical degeneration in Japanese professional wrestlers and its relationship with the risk of cervical spine injury (CSI). METHODS: Since 2012, 27 Japanese male wrestlers belonging to a professional wrestling association have undergone periodical medical examinations of the cervical spine. If neurological symptoms were observed in the wrestlers, the resident trainers urged them to undergo a brief examination at the authors' institutions...
September 21, 2018: Journal of Neurosurgery. Spine
Hannah E Gilder, Ross C Puffer, Mohamad Bydon, Robert J Spinner
OBJECTIVE: In this study, the authors sought to compare tumors with intradural extension to those remaining in the epidural or paraspinal space with the hypothesis that intradural extension may be a mechanism for seeding of the CSF with malignant cells, thereby resulting in higher rates of CNS metastases and shorter overall survival. METHODS: The authors searched the medical record for cases of malignant peripheral nerve sheath tumors (MPNSTs) identified from 1994 to 2017...
September 21, 2018: Journal of Neurosurgery. Spine
Linda S Aglio, Muhammad M Abd-El-Barr, Vwaire Orhurhu, Grace Y Kim, Jie Zhou, Laverne D Gugino, Lisa J Crossley, James L Gosnell, John H Chi, Michael W Groff
OBJECTIVE Preemptive administration of analgesic medication is more effective than medication given after the onset of the painful stimulus. The efficacy of preoperative or preemptive pain relief after thoracolumbosacral spine surgery has not been well studied. The present study was a double-blind, placebo-controlled randomized trial of preemptive analgesia with a single-shot epidural injection in adult patients undergoing spine surgery. METHODS Ninety-nine adult patients undergoing thoracolumbosacral operations via a posterior approach were randomized to receive a single shot of either epidural placebo (group 1), hydromorphone alone (group 2), or bupivacaine with hydromorphone (group 3) before surgery at the preoperative holding area...
September 14, 2018: Journal of Neurosurgery. Spine
Sameer Kitab, Bryan S Lee, Edward C Benzel
OBJECTIVE Using an imaging-based prospective comparative study of 709 eligible patients that was designed to assess lumbar spinal stenosis (LSS) in the ages between 16 and 82 years, the authors aimed to determine whether they could formulate radiological structural differences between the developmental and degenerative types of LSS. METHODS MRI structural changes were prospectively reviewed from 2 age cohorts of patients: those who presented clinically before the age of 60 years and those who presented at 60 years or older...
September 14, 2018: Journal of Neurosurgery. Spine
Morenikeji Buraimoh, Azam Basheer, Kevin Taliaferro, Jonathan H Shaw, Sameah Haider, Gregory Graziano, Eugene Koh
Every day, spine surgeons call for instruments named after surgical pioneers. Few know the designers or the histories behind their instruments. In this paper the authors provide a historical perspective on the Penfield dissector, Leksell rongeur, Hibbs retractor, Woodson elevator, Kerrison rongeur, McCulloch retractor, Caspar pin retractor system, and Cloward handheld retractor, and a biographical review of their inventors. Historical data were obtained by searching the HathiTrust Digital Library, PubMed, Google Scholar, Google Books, and Google, and personal communications with relatives, colleagues, and foundations of the surgeon-designers...
September 14, 2018: Journal of Neurosurgery. Spine
Daniel B Herrick, Joseph E Tanenbaum, Marc Mankarious, Sagar Vallabh, Eitan Fleischman, Swamy Kurra, Shane M Burke, Marie Roguski, Thomas E Mroz, William F Lavelle, Jeffrey E Florman, Ron I Riesenburger
OBJECTIVE Use of surgical site drains following posterior cervical spine surgery is variable, and its impact on outcomes remains controversial. Studies of drain use in the lumbar spine have suggested that drains are not associated with reduction of reoperations for wound infection or hematoma. There is a paucity of studies examining this relationship in the cervical spine, where hematomas and infections can have severe consequences. This study aims to examine the relationship between surgical site drains and reoperation for wound-related complications following posterior cervical spine surgery...
September 14, 2018: Journal of Neurosurgery. Spine
Benjamin F Mundell, Marcus J Gates, Panagiotis Kerezoudis, Mohammed Ali Alvi, Brett A Freedman, Ahmad Nassr, Samuel F Hohmann, Mohamad Bydon
OBJECTIVE From 1994 to 2006 outpatient spinal surgery increased 5-fold. The perceived cost savings with outcomes comparable to or better than those achieved with inpatient admission for the same procedures are desirable in an era where health expenditures are scrutinized. The increase in outpatient spine surgery is also driven by the proliferation of ambulatory surgery centers. In this study, the authors hypothesized that the total savings in outpatient spine surgery is largely driven by patient selection and biases toward healthier patients...
September 14, 2018: Journal of Neurosurgery. Spine
Sarah F Eby, Tricia St Hilaire, Michael Glotzbecker, John Smith, Klane K White, A Noelle Larson
OBJECTIVE Surgery for severe congenital defects, such as congenital diaphragmatic hernia, congenital heart defects, and tracheoesophageal disorders, are life-saving treatments for many infants. However, the incidence of scoliosis following thoracoabdominal surgery has been reported to range from 8% to 50%. Little is known about severe scoliosis that occurs after chest wall procedures in infants. The authors sought to determine the prevalence of thoracogenic scoliosis, disease severity, and need for scoliosis surgery in patients who underwent chest wall procedures in early childhood...
September 7, 2018: Journal of Neurosurgery. Spine
Da Liu, Jun Sheng, Hong-Hua Wu, Xia Kang, Qing-Yun Xie, Yang Luo, Jiang-Jun Zhou, Wei Zheng
OBJECTIVE The purpose of this study was to compare stability of injectable hollow pedicle screws with different numbers of holes using different volumes of polymethylmethacrylate (PMMA) in severely osteoporotic lumbar vertebrae and analyze the relationship between screw stability and distribution and volume of PMMA. METHODS Forty-eight severely osteoporotic cadaveric lumbar vertebrae were randomly divided into 3 groups-groups A, B, and C (16 vertebrae per group). The screws used in group A had 4 holes (2 pairs of holes, with the second hole of each pair placed 180° further along the thread than the first)...
September 7, 2018: Journal of Neurosurgery. Spine
Ziev B Moses, John H Chi, Ram V S R Chavali
The authors report on a 47-year-old woman with a symptomatic thoracic spinal arachnoid cyst (SAC) who underwent a novel procedure that involves direct puncture of the SAC to visualize, diagnose, and potentially treat these rare spinal lesions. The method described utilizes 3D fluoroscopy to gain access to the SAC, followed by injection of myelographic contrast into the cyst. A characteristic "jellyfish sign" was observed that represents the containment of the contrast within the superior aspect of the cyst and a clear block of cranial flow of contrast, resulting in an undulating pattern of movement of contrast within the cyst...
September 7, 2018: Journal of Neurosurgery. Spine
Jamie Toms, David L Boyer, Craig R Kelman, Rafael A Vega
Traumatic spondylolisthesis is a known occurrence in trauma, but complete cord transection is relatively rare. Moreover, complete cord transection at a site distant from the traumatic spondylolisthesis without spondyloptosis is exceedingly rare. In this report, authors describe the first case of thoracic cord avulsion following a traumatic grade II lumbar spondylolisthesis. The unusual presentation of this case highlights the importance of further evaluating patients with neurological symptoms out of proportion with the injuries seen on initial imaging...
September 7, 2018: Journal of Neurosurgery. Spine
Lorenzo Nigro
No abstract text is available yet for this article.
September 7, 2018: Journal of Neurosurgery. Spine
Sebastian Ruetten, Patrick Hahn, Semih Oezdemir, Xenophon Baraliakos, Harry Merk, Georgios Godolias, Martin Komp
OBJECTIVE Acute or progressive myelopathy may necessitate direct anterior decompression of the craniocervical junction and odontoidectomy. Different techniques with individual advantages and disadvantages can be used. In addition to the gold standard-the transoral approach-there is also increasing experience with the endoscopic transnasal technique. Other alternative methods are also being developed to reduce technical and perioperative problems. The aim of this anatomical study was to investigate the feasibility of the full-endoscopic uniportal technique with a retropharyngeal approach for decompression of the craniocervical junction, taking into consideration the specific advantages and disadvantages compared with conventional methods and the currently available data in the literature...
September 7, 2018: Journal of Neurosurgery. Spine
Michael D Staudt, Doron Rabin, Ali A Baaj, Neil R Crawford, Neil Duggal
OBJECTIVE There are limited data regarding the implications of revision posterior surgery in the setting of previous cervical arthroplasty (CA). The purpose of this study was to analyze segmental biomechanics in human cadaveric specimens with and without CA, in the context of graded posterior resection. METHODS Fourteen human cadaveric cervical spines (C3-T1 or C2-7) were divided into arthroplasty (ProDisc-C, n = 7) and control (intact disc, n = 7) groups. Both groups underwent sequential posterior element resections: unilateral foraminotomy, laminoplasty, and finally laminectomy...
August 31, 2018: Journal of Neurosurgery. Spine
Jeffery R Head, George N Rymarczuk, Kevin D He, James S Harrop
Lateral approaches to the spine are becoming increasingly popular methods for decompression, restoration of alignment, and arthrodesis. Although individual cases of intraoperative injuries to the renal vasculature and the ureters have been documented as rare complications of lateral approaches to the spine, the authors report the first known case of postoperative renal injury due to the delayed extrusion of the screw of a lateral plate/screw construct directly into the renal parenchyma. The migration of the screw from the L1 vertebra into the superior pole of the left kidney occurred nearly 5 years after the index procedure, and presented as painless hematuria...
August 31, 2018: Journal of Neurosurgery. Spine
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