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Journal of Neurosurgery. Spine

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https://www.readbyqxmd.com/read/29219781/a-novel-duraplasty-technique-following-fenestration-of-a-massive-lumbar-arachnoid-cyst-in-a-patient-with-scoliosis-technical-case-report
#1
Matthew T Neal, Randall J Hlubek, Alexander E Ropper, U Kumar Kakarla
When a dural defect is encountered during spine surgery, the dura mater must be reconstituted to minimize the occurrence of minor or major life-threatening sequelae. The neurosurgical literature lacks strategies for managing large dural defects encountered during surgery. The authors describe a 24-year-old man who developed cauda equina syndrome secondary to altered CSF flow in a large thoracolumbar arachnoid cyst. Surgical decompression and fenestration of the arachnoid cyst were performed, and the large dural defect was treated using a multilayer closure with collagen matrix, titanium mesh, and methylmethacrylate...
December 8, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29219780/anatomical-and-technical-factors-associated-with-superior-facet-joint-violation-in-lumbar-fusion
#2
Alisson R Teles, Michael Paci, Gabriel Gutman, Fahad H Abduljabbar, Jean A Ouellet, Michael H Weber, Jeff D Golan
OBJECTIVE The aim of this study was to evaluate the anatomical and surgical risk factors for screw-related facet joint violation at the superior level in lumbar fusion. METHODS The authors conducted a retrospective review of a consecutive series of posterior lumbar instrumented fusions performed by a single surgeon. Inclusion criteria were primary lumbar fusion of 1 or 2 levels for degenerative disorders. The following variables were analyzed as possible risk factors: surgical technique (percutaneous vs open screw placement), depth of surgical field, degree of anterior slippage of the superior level, pedicle and facet angle, and facet degeneration of the superior level...
December 8, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29219779/metastases-of-spinal-myxopapillary-ependymoma-unique-characteristics-and-clinical-management
#3
Theresa Kraetzig, Lily McLaughlin, Mark H Bilsky, Ilya Laufer
OBJECTIVE Myxopapillary ependymoma is a benign WHO Grade I tumor most commonly located in the conus-cauda equina region of the spine. Although this tumor is defined by an overall excellent survival, dissemination throughout the whole neuraxis occurs frequently. The current study evaluated the clinical characteristics and significance of myxopapillary ependymoma metastases. METHODS Patients who underwent surgery from 2005 to 2015 for treatment of spinal myxopapillary ependymoma were included in the study. Charts were reviewed for primary tumor symptoms and initial treatment, local recurrence, response to salvage therapy, and presence and behavior of distant metastases...
December 8, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29192880/negative-pressure-dressing-management-of-recurrent-postoperative-epidural-hematoma-and-uncontrollable-intraoperative-hemorrhage-in-posterior-spine-surgery-report-of-4-cases
#4
Kenneth C Foxx, Addisu Mesfin, Robert Molinari
There is a paucity of literature describing the management of recurrent symptomatic postoperative epidural hematoma or uncontrollable intraoperative hemorrhage in posterior spine surgery. Traditional management with hematoma evacuation and wound closure over suction drains may not be effective in certain cases, and it can lead to recurrence and neurological injury. The authors report 3 cases of recurrent symptomatic postoperative epidural hematoma successfully managed with novel open-wound negative-pressure dressing therapy (NPDT), as well as 1 case of uncontrollable intraoperative hemorrhage that was primarily managed with the same technique...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29192879/pedicle-screw-placement-accuracy-using-ultra-low-radiation-imaging-with-image-enhancement-versus-conventional-fluoroscopy-in-minimally-invasive-transforaminal-lumbar-interbody-fusion-an-internally-randomized-controlled-trial
#5
Gautam Nayar, Daniel J Blizzard, Timothy Y Wang, Steven Cook, Adam G Back, David Vincent, Isaac O Karikari
OBJECTIVE A previous study found that ultra-low radiation imaging (ULRI) with image enhancement significantly decreases radiation exposure by roughly 75% for both the patient and operating room personnel during minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) (p < 0.001). However, no clinical data exist on whether this imaging modality negatively impacts patient outcomes. Thus, the goal of this randomized controlled trial was to assess pedicle screw placement accuracy with ULRI with image enhancement compared with conventional, standard-dose fluoroscopy for patients undergoing single-level MIS-TLIF...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29192878/motion-preserving-2-stage-transoral-and-posterior-treatment-of-an-unstable-jefferson-fracture-in-a-professional-football-player
#6
Gerald E Rodts, Griffin R Baum, Fermin G Stewart, John G Heller
The authors report the case of a patient who suffered a Jefferson fracture during a professional football game. The C-1 (atlas) fracture was widely displaced anteriorly, but the transverse ligament was intact. In an effort to enable a return to play and avoid intersegmental (C1-2) fusion, the patient underwent a transoral approach for open reduction and internal fixation of the fracture. The associated posterior ring fracture displacement widened after this procedure, and a subsequent posterior arthrodesis and fixation of the fracture site was performed 6 months later when the fracture failed to heal with rigid collar immobilization...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29192877/impact-of-body-mass-index-on-surgical-outcomes-narcotics-consumption-and-hospital-costs-following-anterior-cervical-discectomy-and-fusion
#7
Ankur S Narain, Fady Y Hijji, Brittany E Haws, Krishna T Kudaravalli, Kelly H Yom, Jonathan Markowitz, Kern Singh
OBJECTIVE Given the increasing prevalence of obesity, more patients with a high body mass index (BMI) will require surgical treatment for degenerative spinal disease. In previous investigations of lumbar spine pathology, obesity has been associated with worsened postoperative outcomes and increased costs. However, few studies have examined the association between BMI and postoperative outcomes following anterior cervical discectomy and fusion (ACDF) procedures. Thus, the purpose of this study was to compare surgical outcomes, postoperative narcotics consumption, complications, and hospital costs among BMI stratifications for patients who have undergone primary 1- to 2-level ACDF procedures...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29192876/posterior-inferior-cerebellar-artery-with-an-extradural-origin-from-the-v3-segment-higher-incidence-on-the-nondominant-vertebral-artery
#8
Taiki Isaji, Muneyoshi Yasuda, Reo Kawaguchi, Masahiro Aoyama, Aichi Niwa, Takahiro Nakura, Naoki Matsuo, Masakazu Takayasu
OBJECTIVE The posterior inferior cerebellar artery (PICA) and the vertebral artery (VA) often exhibit anatomical variations at the craniovertebral junction (CVJ). An example of this is the PICA originating extradurally from the V3 segment of the VA. To date, some cadaveric investigations have been reported, but the incidence and relationship of this variation to the VA and the atlas as observed on clinical imaging have not been discussed. This study evaluated the prevalence of PICAs originating from the V3 on CT scanning...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29192875/circumferential-dural-resection-technique-and-reconstruction-for-the-removal-of-giant-calcified-transdural-herniated-thoracic-discs
#9
Corey T Walker, M Yashar S Kalani, Mark E Oppenlander, Jakub Godzik, Nikolay L Martirosyan, Robert J Standerfer, Nicholas Theodore
OBJECTIVE The authors report a novel paradigm for resection of the disc or dural complex to treat giant calcified transdural herniated thoracic discs, and they describe a technique for the repair of dural defects. These herniated thoracic discs are uncommon, complicated lesions that often require a multidisciplinary team for effective treatment. The intradural component must be removed to effectively decompress the spinal cord. The opening of the friable dura mater, which frequently adheres to the extradural component of the disc, can result in large defects and difficult-to-manage CSF leaks...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29171797/health-related-quality-of-life-outcomes-in-complex-adult-spinal-deformity-surgery
#10
Max S Riley, Keith H Bridwell, Lawrence G Lenke, Jonathan Dalton, Michael P Kelly
OBJECTIVE Significant health-related quality of life (HRQOL) benefits have been observed for patients undergoing primary and revision adult spinal deformity (ASD) surgery. The purpose of this study was to report changes in HRQOL measures in a consecutive series of patients undergoing complex spinal reconstructive surgery, using Scoli-RISK-1 (SR-1) inclusion criteria. METHODS This was a single-center, retrospective cohort study. The SR-1 inclusion criteria were used to define patients with complex ASD treated between June 1, 2009, and June 1, 2011...
November 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29171793/preoperative-skin-antisepsis-with-chlorhexidine-gluconate-versus-povidone-iodine-a-prospective-analysis-of-6959-consecutive-spinal-surgery-patients
#11
George M Ghobrial, Michael Y Wang, Barth A Green, Howard B Levene, Glen Manzano, Steven Vanni, Robert M Starke, George Jimsheleishvili, Kenneth M Crandall, Marina Dididze, Allan D Levi
OBJECTIVE The aim of this study was to determine the efficacy of 2 common preoperative surgical skin antiseptic agents, ChloraPrep and Betadine, in the reduction of postoperative surgical site infection (SSI) in spinal surgery procedures. METHODS Two preoperative surgical skin antiseptic agents-ChloraPrep (2% chlorhexidine gluconate and 70% isopropyl alcohol) and Betadine (7.5% povidone-iodine solution)-were prospectively compared across 2 consecutive time periods for all consecutive adult neurosurgical spine patients...
November 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29171791/voice-and-swallowing-outcomes-following-reoperative-anterior-cervical-discectomy-and-fusion-with-a-2-team-surgical-approach
#12
Matthew S Erwood, Beverly C Walters, Timothy M Connolly, Amber S Gordon, William R Carroll, Bonita S Agee, Bradley R Carn, Mark N Hadley
OBJECTIVE Dysphagia and vocal cord palsy (VCP) are common complications after anterior cervical discectomy and fusion (ACDF). The reported incidence rates for dysphagia and VCP are variable. When videolaryngostroboscopy (VLS) is performed to assess vocal cord function after ACDF procedures, the incidence of VCP is reported to be as high as 22%. The incidence of dysphagia ranges widely, with estimates up to 71%. However, to the authors' knowledge, there are no prospective studies that demonstrate the rates of VCP and dysphagia for reoperative ACDF...
November 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29171788/endovascular-retrieval-of-a-migrating-pedicle-screw-within-the-inferior-vena-cava-after-instrumented-spinal-surgery-case-report
#13
Cheng-Yo Yen, Shih-Chieh Yang, Hung-Shu Chen, Yuan-Kun Tu
During L3-5 instrumented spinal surgery for degenerative spondylolisthesis in a 75-year-old woman, the right L-3 pedicle screw was accidentally pushed into the retroperitoneum and then migrated to the inferior vena cava (IVC). The patient was transferred to the surgical intensive care unit, and after careful discussion with cardiology specialists, a minimally invasive endovascular technique was used to remove the migrating pedicle screw within the IVC and thus salvage this critical case. Pedicle screw instrumentation is an effective procedure, but not risk free...
November 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29148933/surgical-strategies-for-the-treatment-of-os-odontoideum-with-atlantoaxial-dislocation
#14
Xinghuo Wu, Kirkham B Wood, Yong Gao, Shuai Li, Jing Wang, Ting Ge, Boming Zhao, Zengwu Shao, Shuhua Yang, Cao Yang
OBJECTIVE This study aimed to compare the clinical results of using posterior fixation and fusion with or without anterior decompression to treat os odontoideum with atlantoaxial dislocation. METHODS Twenty-five consecutive patients with os odontoideum were included in this study. Sixteen patients with reducible atlantoaxial dislocation were treated by single-level posterior fusion and stabilization; the other 9 were treated with posterior fusion and stabilization combined with transoral decompression. Pre- and postoperative CT scans and MR images were obtained...
November 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29125433/a-points-based-algorithm-for-prognosticating-clinical-outcome-of-chiari-malformation-type-i-with-syringomyelia-results-from-a-predictive-model-analysis-of-82-surgically-managed-adult-patients
#15
Sumit Thakar, Laxminadh Sivaraju, Kuruthukulangara S Jacob, Aditya Atal Arun, Saritha Aryan, Dilip Mohan, Narayanam Anantha Sai Kiran, Alangar S Hegde
OBJECTIVE Although various predictors of postoperative outcome have been previously identified in patients with Chiari malformation Type I (CMI) with syringomyelia, there is no known algorithm for predicting a multifactorial outcome measure in this widely studied disorder. Using one of the largest preoperative variable arrays used so far in CMI research, the authors attempted to generate a formula for predicting postoperative outcome. METHODS Data from the clinical records of 82 symptomatic adult patients with CMI and altered hindbrain CSF flow who were managed with foramen magnum decompression, C-1 laminectomy, and duraplasty over an 8-year period were collected and analyzed...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29125432/association-between-baseline-cognitive-impairment-and-postoperative-delirium-in-elderly-patients-undergoing-surgery-for-adult-spinal-deformity
#16
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jared Fialkoff, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Postoperative delirium is common in elderly patients undergoing spine surgery and is associated with a longer and more costly hospital course, functional decline, postoperative institutionalization, and higher likelihood of death within 6 months of discharge. Preoperative cognitive impairment may be a risk factor for the development of postoperative delirium. The aim of this study was to investigate the relationship between baseline cognitive impairment and postoperative delirium in geriatric patients undergoing surgery for degenerative scoliosis...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29125431/the-timing-of-venous-thromboembolic-events-after-spine-surgery-a-single-center-experience-with-6869-consecutive-patients
#17
Michael B Cloney, Benjamin Hopkins, Ekamjeet S Dhillon, Nader S Dahdaleh
OBJECTIVE Venous thromboembolic events (VTEs), including both deep venous thrombosis (DVT) and pulmonary embolism, are a major cause of morbidity and mortality after spine surgery. Prophylactic anticoagulation, or chemoprophylaxis, can prevent VTE. However, the timing of VTEs after spine surgery and the effect of chemoprophylaxis on VTE timing remain underinvestigated. METHODS The records of 6869 consecutive spine surgeries were retrospectively examined. Data on patient demographics, surgical variables, hospital course, and timing of VTEs were collected...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29125430/cortical-bone-trajectory-screw-fixation-versus-traditional-pedicle-screw-fixation-for-2-level-posterior-lumbar-interbody-fusion-comparison-of-surgical-outcomes-for-2-level-degenerative-lumbar-spondylolisthesis
#18
Hironobu Sakaura, Toshitada Miwa, Tomoya Yamashita, Yusuke Kuroda, Tetsuo Ohwada
OBJECTIVE The cortical bone trajectory (CBT) screw technique is a new nontraditional pedicle screw (PS) insertion method. However, the biomechanical behavior of multilevel CBT screw/rod fixation remains unclear, and surgical outcomes in patients after 2-level posterior lumbar interbody fusion (PLIF) using CBT screw fixation have not been reported. Thus, the purposes of this study were to examine the clinical and radiological outcomes after 2-level PLIF using CBT screw fixation for 2-level degenerative lumbar spondylolisthesis (DS) and to compare these outcomes with those after 2-level PLIF using traditional PS fixation...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29125429/graft-subsidence-as-a-predictor-of-revision-surgery-following-stand-alone-lateral-lumbar-interbody-fusion
#19
Zachary J Tempel, Michael M McDowell, David M Panczykowski, Gurpreet S Gandhoke, D Kojo Hamilton, David O Okonkwo, Adam S Kanter
OBJECTIVE Lateral lumbar interbody fusion (LLIF) is a less invasive surgical option commonly used for a variety of spinal conditions, including in high-risk patient populations. LLIF is often performed as a stand-alone procedure, and may be complicated by graft subsidence, the clinical ramifications of which remain unclear. The aim of this study was to characterize further the sequelae of graft subsidence following stand-alone LLIF. METHODS A retrospective review of prospectively collected data was conducted on consecutive patients who underwent stand-alone LLIF between July 2008 and June 2015; 297 patients (623 levels) met inclusion criteria...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29125428/schwann-cells-and-mesenchymal-stem-cells-in-laminin-or-fibronectin-aligned-matrices-and-regeneration-across-a-critical-size-defect-of-15-mm-in-the-rat-sciatic-nerve
#20
Francisco Gonzalez-Perez, Joaquim Hernández, Claudia Heimann, James B Phillips, Esther Udina, Xavier Navarro
OBJECTIVE Artificial nerve guides are being developed to substitute for autograft repair after peripheral nerve injuries. However, the use of conduits is limited by the length of the gap that needs to be bridged, with the success of regeneration highly compromised in long gaps. Addition of aligned proregenerative cells and extracellular matrix (ECM) components inside the conduit can be a good strategy to achieve artificial grafts that recreate the natural environment offered by a nerve graft. The purpose of this study was to functionalize chitosan devices with different cell types to support regeneration in limiting gaps in the rat peripheral nerve...
November 10, 2017: Journal of Neurosurgery. Spine
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