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Neurosurgical Focus

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https://www.readbyqxmd.com/read/28042726/hybrid-cervical-disc-arthroplasty
#1
Tsung-Hsi Tu, Jau-Ching Wu, Henrich Cheng, Praveen V Mummaneni
For patients with multilevel cervical stenosis at nonadjacent segments, one of the traditional approaches has included a multilevel fusion of the abnormal segments as well as the intervening normal segment. In this video we demonstrate an alternative treatment plan with tailored use of a combination of anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) with an intervening skipped level. The authors present the case of a 72-year-old woman with myeloradiculopathy and a large disc herniation with facet joint degeneration at C3-4 and bulging disc at C5-6...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28042725/stepwise-illustration-of-teeth-fixation-semi-constrained-cervical-disc-arthroplasty
#2
Chih-Chang Chang, Jau-Ching Wu, Peng-Yuan Chang, Mei-Yin Yeh, Yi-Hsuan Kuo, Li-Yu Fay, Tsung-Hsi Tu, Wen-Cheng Huang, Henrich Cheng
There are many kinds of artificial discs available for cervical disc arthroplasty (CDA), with various designs of fixation and articulation mechanisms. Each of these designs has different features and theoretically fits most optimally in selected types of patients. However, there has been insufficient literature to guide individualized selection among these CDA devices. Since CDA aims to restore the joint function rather than arthrodesis, tailor-made size, shape, and mechanical properties should be taken into account for each candidate's target disc...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28042724/cervical-arthroplasty
#3
William T Couldwell
No abstract text is available yet for this article.
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28042723/two-level-cervical-arthroplasty-using-a-no-distraction-technique
#4
Deshpande Rajakumar, Ankit Sharma, Akshay Hari, Subhas Konar, Murali Krishna
Cervical arthroplasty is being recognized as an emerging alternative to anterior cervical fusion with comparable or superior outcomes. The authors describe the surgical nuances of 2-level cervical arthroplasty in a case of 2-level degenerative disease. In this surgical technique, conventional vertebral body distraction has been avoided to prevent facet distraction, which can be a cause of persistent postoperative neck pain. Good motion preservation was observed at the 1-year follow-up examination. The video can be found here: https://youtu...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28042722/m6-c-artificial-disc-placement
#5
Domagoj Coric, John Parish, Margaret O Boltes
There has been a steady evolution of cervical total disc replacement (TDR) devices over the last decade resulting in surgical technique that closely mimics anterior cervical discectomy and fusion as well as disc design that emphasizes quality of motion. The M6-C TDR device is a modern-generation artificial disc composed of titanium endplates with tri-keel fixation as well as a polyethylene weave with a polyurethane core. Although not yet approved by the FDA, M6-C has finished a pilot and pivotal US Investigational Device Exemption (IDE) study...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28042721/surgical-technique-for-revision-surgery-of-cervical-artificial-disc-replacements
#6
Julia Onken, Bernhard Meyer, Peter Vajkoczy
OBJECTIVE Cervical artificial disc replacement (C-ADR) is a widely used procedure with low risk at implantation. Few cases have been reported about the surgical techniques of C-ADR revision. The authors describe their surgical experience with the explantation of a Galileo C-ADR. METHODS Revision surgery was performed in a 58-year-old patient. Patient positioning and surgical opening techniques were performed as appropriate for anterior cervical decompression. RESULTS Revision surgery via the initial anterior approach was successful following an atraumatic removal of the implant...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28042720/resection-of-uncovertebral-joints-and-posterior-longitudinal-ligament-for-cervical-disc-arthroplasty
#7
Tsung-Hsi Tu, Chih-Chang Chang, Jau-Ching Wu, Li-Yu Fay, Wen-Cheng Huang, Henrich Cheng
The most commonly accepted indications for cervical disc arthroplasty (CDA) are 1- and 2-level cervical disc herniation or spondylosis causing radiculopathy or myelopathy that is refractory to medical management. Unlike anterior cervical discectomy and fusion (ACDF), which eliminates motion, CDA aims to restore the physiological range of motion of the indexed joint. Thus, the effect of indirect decompression gained by the insertion of a sufficiently large interbody graft and incorporation into arthrodesis after ACDF cannot be duplicated for CDA...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041330/quality-of-life-after-different-surgical-procedures-for-the-treatment-of-spinal-metastases-results-of-a-single-center-prospective-case-series
#8
Godard C W de Ruiter, Claudine O Nogarede, Jasper F C Wolfs, Mark P Arts
OBJECTIVE The performance of surgery for spinal metastases is rapidly increasing. Different surgical procedures, ranging from stabilization alone to stabilization combined with corpectomy, are thereby performed for various indications. Little is known about the impact of these different procedures on patient quality of life (QOL), but this factor is crucial when discussing the various therapeutic options with patients and their families. Thus, the authors of this study investigated the effect of various surgical procedures for spinal metastases on patient QOL...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041329/the-impact-of-histology-and-delivered-dose-on-local-control-of-spinal-metastases-treated-with-stereotactic-radiosurgery
#9
Yoshiya Yamada, Evangelia Katsoulakis, Ilya Laufer, Michael Lovelock, Ori Barzilai, Lily A McLaughlin, Zhigang Zhang, Adam M Schmitt, Daniel S Higginson, Eric Lis, Michael J Zelefsky, James Mechalakos, Mark H Bilsky
OBJECTIVE An analysis of factors contributing to durable radiographic control of spinal metastases was undertaken, drawing from a large single-institution database in an attempt to elucidate indications and dose requirements for successful treatment. METHODS All patients treated at a single institution with stereotactic radiosurgery (SRS) of the spine as first-line therapy were assessed for local progression of the treated site, defined as radiographic enlargement of the treated tumor and/or biopsy-proven evidence of active tumor cells...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041328/image-guided-stereotactic-radiosurgery-for-treatment-of-spinal-hemangioblastoma
#10
James Pan, Allen L Ho, Myreille D'Astous, Eric S Sussman, Patricia A Thompson, Armine T Tayag, Louisa Pangilinan, Scott G Soltys, Iris C Gibbs, Steven D Chang
OBJECTIVE Stereotactic radiosurgery (SRS) has been an attractive treatment option for hemangioblastomas, especially for lesions that are surgically inaccessible and in patients with von Hippel-Lindau (VHL) disease and multiple lesions. Although there has been a multitude of studies examining the utility of SRS in intracranial hemangioblastomas, SRS has only recently been used for spinal hemangioblastomas due to technical limitations. The purpose of this study is to provide a long-term evaluation of the effectiveness of image-guided radiosurgery in halting tumor progression and providing symptomatic relief for spinal hemangioblastomas...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041327/bone-graft-options-for-spinal-fusion-following-resection-of-spinal-column-tumors-systematic-review-and-meta-analysis
#11
Benjamin D Elder, Wataru Ishida, C Rory Goodwin, Ali Bydon, Ziya L Gokaslan, Daniel M Sciubba, Jean-Paul Wolinsky, Timothy F Witham
OBJECTIVE With the advent of new adjunctive therapy, the overall survival of patients harboring spinal column tumors has improved. However, there is limited knowledge regarding the optimal bone graft options following resection of spinal column tumors, due to their relative rarity and because fusion outcomes in this cohort are affected by various factors, such as radiation therapy (RT) and chemotherapy. Furthermore, bone graft options are often limited following tumor resection because the use of local bone grafts and bone morphogenetic proteins (BMPs) are usually avoided in light of microscopic infiltration of tumors into local bone and potential carcinogenicity of BMP...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041326/pathological-characteristics-of-spine-metastases-treated-with-high-dose-single-fraction-stereotactic-radiosurgery
#12
Evangelia Katsoulakis, Ilya Laufer, Mark Bilsky, Narasimhan P Agaram, Michael Lovelock, Yoshiya Yamada
OBJECTIVE Spine radiosurgery is increasingly being used to treat spinal metastases. As patients are living longer because of the increasing efficacy of systemic agents, appropriate follow-up and posttreatment management for these patients is critical. Tumor progression after spine radiosurgery is rare; however, vertebral compression fractures are recognized as a more common posttreatment effect. The use of radiographic imaging alone posttreatment may makeit difficult to distinguish tumor progression from postradiation changes such as fibrosis...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041325/editorial-focusing-on-the-future
#13
William T Couldwell
No abstract text is available yet for this article.
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041324/frequency-of-symptomatic-vertebral-body-compression-fractures-requiring-intervention-following-single-fraction-stereotactic-radiosurgery-for-spinal-metastases
#14
Michael S Virk, James E Han, Anne S Reiner, Lily A McLaughlin, Daniel M Sciubba, Eric Lis, Yoshiya Yamada, Mark Bilsky, Ilya Laufer
OBJECTIVE The purpose of this study was to determine the rate of symptomatic vertebral body compression fractures (VCFs) requiring kyphoplasty or surgery in patients treated with 24-Gy single-fraction stereotactic radiosurgery (SRS). METHODS This retrospective analysis included all patients who had been treated with 24-Gy, single-fraction, image-guided intensity-modulated radiation therapy for histologically confirmed solid tumor metastases over an 8-year period (2005-2013) at Memorial Sloan Kettering Cancer Center...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041323/impact-of-cervicothoracic-region-stereotactic-spine-radiosurgery-on-adjacent-organs-at-risk
#15
Mayur Sharma, Elizabeth E Bennett, Gazanfar Rahmathulla, Samuel T Chao, Hilary K Koech, Stephanie N Gregory, Todd Emch, Anthony Magnelli, Antonio Meola, John H Suh, Lilyana Angelov
OBJECTIVE Stereotactic radiosurgery (SRS) of the spine is a conformal method of delivering a high radiation dose to a target in a single or few (usually ≤ 5) fractions with a sharp fall-off outside the target volume. Although efforts have been focused on evaluating spinal cord tolerance when treating spinal column metastases, no study has formally evaluated toxicity to the surrounding organs at risk (OAR), such as the brachial plexus or the oropharynx, when performing SRS in the cervicothoracic region. The aim of this study was to evaluate the radiation dosimetry and the acute and delayed toxicities of SRS on OAR in such patients...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041322/introduction-spinal-radiosurgery
#16
Mark H Bilsky, Steven D Chang, Peter C Gerszten, Steven Kalkanis
No abstract text is available yet for this article.
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041321/spine-radiosurgery-lessons-learned-from-the-first-100-treatment-sessions
#17
Ran Harel, Raphael Pfeffer, Daphne Levin, Efrat Shekel, Dan Epstein, Lev Tsvang, Maoz Ben Ayun, Dror Alezra, Leor Zach
OBJECTIVE Local therapy to spine tumors has been shown to be effective in selected cases. Spinal radiosurgery (SRS) is an evolving radiotherapy regimen allowing for noninvasive, highly efficacious local treatment. The learning curve can compromise the results of any newly employed technology and should be studied to minimize its effects. In this paper the first 100 SRSs performed at several medical centers are presented and analyzed for the effects of the learning curve on outcome. METHODS A retrospective analysis was undertaken to evaluate data from patients treated with SRS at Sheba Medical Center and Assuta Medical Centers in the period from September 2011 to February 2016...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041320/image-guided-resection-of-aggressive-sacral-tumors
#18
Doniel Drazin, Neil Bhamb, Lutfi T Al-Khouja, Ari D Kappel, Terrence T Kim, J Patrick Johnson, Earl Brien
OBJECTIVE The aim of this study was to identify and discuss operative nuances utilizing image guidance in the surgical management of aggressive sacral tumors. METHODS The authors report on their single-institution, multi-surgeon, retrospective case series involving patients with pathology-proven aggressive sacral tumors treated between 2009 and 2016. They also reviewed the literature to identify articles related to aggressive sacral tumors, their diagnosis, and their surgical treatment and discuss the results together with their own experience...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041319/rapid-and-complete-radiological-resolution-of-an-intradural-cervical-cord-lung-cancer-metastasis-treated-with-spinal-stereotactic-radiosurgery-case-report
#19
E Emily Bennett, Camille Berriochoa, Ghaith Habboub, Scott Brigeman, Samuel T Chao, Lilyana Angelov
Stereotactic radiosurgery (SRS) has emerged as a treatment option for patients with spinal metastatic disease. Although SRS has been shown to be successful in a multitude of extradural metastatic tumors causing cord compression, very few cases of intradural treatment have been reported. The authors present a rare case of an intradural extramedullary metastatic small cell lung cancer lesion to the cervical spine resulting in cord compression in an area that had also been extensively pretreated with conventional external-beam radiation therapy...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28041318/dynamic-contrast-enhanced-magnetic-resonance-imaging-of-osseous-spine-metastasis-before-and-1-hour-after-high-dose-image-guided-radiation-therapy
#20
Eric Lis, Atin Saha, Kyung K Peck, Joan Zatcky, Michael J Zelefsky, Yoshiya Yamada, Andrei I Holodny, Mark H Bilsky, Sasan Karimi
OBJECTIVE High-dose image-guided radiation therapy (HD IGRT) has been instrumental in mitigating some limitations of conventional RT. The recent emergence of dynamic contrast-enhanced (DCE) MRI to investigate tumor physiology can be used to verify the response of human tumors to HD IGRT. The purpose of this study was to evaluate the near-immediate effects of HD IGRT on spine metastases through the use of DCE MRI perfusion studies. METHODS Six patients with spine metastases from prostate, thyroid, and renal cell carcinoma who underwent HD IGRT were studied using DCE MRI prior to and 1 hour after HD IGRT...
January 2017: Neurosurgical Focus
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