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spinal microsurgery

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https://www.readbyqxmd.com/read/28637119/disco-vertebral-osteomyelitis-causing-intradural-spinal-abscess-with-cauda-equina-compression
#1
Anan Shtaya, Samantha Hettige
Intradural extramedullary spinal infections causing cauda equina compression are uncommon. We report an Escherichia coli bacteraemia causing lumbar discitis and an intracanalicular collection compressing the cauda equina: initially thought to be an epidural empyema, however microsurgery revealed an intradural location. Decompression, drainage, antibiotics, and neuropathy treatment are essential management.
March 3, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28592077/-clinical-effects-of-microsurgery-in-spinal-cord-anaplastic-astrocytoma
#2
L Zhang, W Q Jia, D S Kong, Z F Zhang, J Yang
Objective: To investigate the surgical outcomes and prognosis of spinal cord anaplastic astrocytoma (AA). Methods: A total of 27 consecutive patients diagnosed as spinal cord AA between January 2008 and May 2015 in Department of Neurosurgery of Beijing Tiantan Hospital were retrospectively reviewed. There were 18 males and 9 females, the mean age was (30.7±13.0) years (ranging from 5 to 52 years). The lesions were located at cervical level in 8 patients, at thoracic level in 9 patients, at cervicothoracic level in 3 patients, and at thoracolumbar level in 7 patients, the average number of vertebral was 3...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28552136/epidemiology-clinical-presentation-diagnostic-evaluation-and-prognosis-of-spinal-arteriovenous-malformations
#3
Alp Ozpinar, Gregory M Weiner, Andrew F Ducruet
Spinal arteriovenous malformations (sAVM) are rare vascular pathologies whose natural history remains incompletely understood. Advances in diagnostic imaging, coupled with the evolution of endovascular and microsurgical techniques have led to the description of a number of classification schemes for these lesions. An updated method has changed AVM classification from five categories of lesion based on source and location of feeder vessels to three categories based on pathophysiology. These categories include extradural arteriovenous fistulae (AVFs), intradural AVFs, extradural-intradural AVFs, intramedullary AVMs, and conus medullaris AVM each with individual subclassifications...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28515372/spinal-arteriovenous-shunts-angioarchitecture-and-historical-changes-in-classification
#4
Keisuke Takai
The purposes of this study were to review historical changes in the classification of spinal arteriovenous (AV) shunts and to propose a practical classification system. The associated literature regarding the classification of spinal AV shunts was reviewed in the angiography era between 1967 and 2015. The classification systems of spinal AV shunts and a proposed classification system were presented with neuroradiological imaging and medical illustrations. There have been seven major classification systems based on the evolution of diagnostic methods as well as treatments for spinal AV shunts: the first description of spinal AV shunts diagnosed and classified using spinal angiography in 1971; the second classification based on a case report of intradural direct perimedullary arteriovenous fistulas (AVFs) treated by microsurgery in 1987; the third classification based on a case series of intradural perimedullary AVFs treated by endovascular interventions in 1993; the fourth and fifth classification systems based on a case series of spinal AVFs and arteriovenous malformations (AVMs) treated by microsurgery or endovascular interventions in 2002; the sixth classification based on a case series of cranio-spinal dural AV shunts in 2009; and the seventh classification based on a case series of extradural AVFs treated by microsurgery and endovascular interventions in 2011...
May 18, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28153626/contralateral-interlaminar-keyhole-percutaneous-endoscopic-lumbar-surgery-in-patients-with-unilateral-radiculopathy
#5
Jae Ha Hwang, Woo Min Park, Cheul Woong Park
OBJECTIVE: Percutaneous endoscopic surgery is increasingly used as an alternative to open microsurgery for treating lumbar spinal diseases. The purpose of this study was to determine the feasibility and efficacy of contralateral keyhole endoscopic surgery for treating unilateral radiculopathy. METHODS: We performed percutaneous endoscopic sublaminar decompression via the contralateral interlaminar approach in 14 patients with unilateral radiculopathy. All procedures were performed under epidural anesthesia...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27951615/endoscopic-management-of-spinal-intradural-extramedullary-tumors
#6
Vijay Singh Parihar, Nishtha Yadav, Yad Ram Yadav, Shailendra Ratre, Jitin Bajaj, Yatin Kher
Introduction Posterior midline laminectomy is associated with risks of postoperative instability, spinal deformity, extensive bilateral subperiosteal muscle stripping, partial or total facetectomy especially in foraminal tumor extension, increased cerebrospinal fluid leakage, and wound infection. Minimally invasive approaches with the help of a microscope or endoscope using hemilaminectomy have been found to be safe and effective. We report our initial experience of 18 patients using the endoscopic technique...
December 12, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27916035/-microsurgical-management-and-outcomes-of-intramedullary-spinal-arteriovenous-malformations-a-report-of-14-cases
#7
L Zhang, W Q Jia, J Yang
Objective: To investigate the clinical features, microsurgical management and outcomes of intramedullary spinal arteriovenous malformations (AVM). Methods: A series of 14 patients (10 male, 4 female; mean age (39.1±17.2) years ranged from 16 to 72 years) with intramedullary spinal AVM who underwent microsurgical treatment from November 2008 to April 2015 in Department of Neurosurgery at Beijing Tiantan Hospital were retrospectively reviewed. The location of the AVM included cervical (n=6), thoracic (n=3), cervicothoracic (n=2), and conus medullaris (n=3)...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27890764/spontaneous-spinal-epidural-hematoma-a-study-of-55-cases-focused-on-the-etiology-and-treatment-strategy
#8
Jia-Xing Yu, Jiang Liu, Chuan He, Li-Yong Sun, Si-Shi Xiang, Yong-Jie Ma, Li-Song Bian, Tao Hong, Jian Ren, Peng-Yu Tao, Jing-Wei Li, Gui-Lin Li, Feng Ling, Hong-Qi Zhang
BACKGROUND: Spontaneous spinal epidural hematoma (SSEH) is a rare neurologic emergency of the spinal cord. Its cause and treatment strategy remain controversial. This study aimed to evaluate a significant cause of SSEH and to discuss the treatment strategy according to the clinical outcomes of patients in 2 institutions. METHODS: Fifty-five cases of SSEH treated at our institutions between February 2002 and February 2016 were retrospectively analyzed. RESULTS: The mean age of the first SSEH onset was 31...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27861396/surgical-treatments-on-adult-tethered-cord-syndrome-a-retrospective-study
#9
Jun Gao, Xiangyi Kong, Zhimin Li, Tianyu Wang, Yongning Li
To investigate effects of surgical treatment on adult tethered cord syndrome (TCS).A retrospective analysis of 82 adult patients (17 male cases, 82% and 24 female cases, 59%) with TCS treated by surgery was conducted between March, 2005 and December, 2015, with an average age of 31.6 years and average disease course of 6.7 years. All the 82 cases of patients received nerve electrophysiology monitoring assisted microsurgery. After surgery, all patients were followed up for an average of 2.5 years. Surgical effects were evaluated according to Hoffman grading system...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27631206/hyperbaric-oxygen-therapy-for-postoperative-spinal-dural-arterio-venous-fistula-patients-an-observational-cohort-study
#10
MULTICENTER STUDY
Sichang Chen, Yongjie Ma, Peipeng Liang, Xiaohui Wang, Chao Peng, Lisong Bian, Jiang Liu, Jianzhang Ding, Hongqi Zhang, Feng Ling
Spinal dural arterio-venous fistula (SDAVF) is a common type of spinal vascular malformation. Surgical obliteration of the fistula can cure SDAVF anatomically, but the functional outcome is unsatisfactory.The aim of the study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) on the functional recovery of postoperative SDAVF patients.This prospective cohort study included postoperative SDAVF patients. Patients were divided into control and HBOT groups. Patients in control group received conventional treatment, whereas those in the HBOT group received conventional treatment plus HBOT (2...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27593843/predictive-factors-of-the-management-of-spinal-cord-arterio-venous-fistulas-center-experience-with-literature-review
#11
Ahmed Sultan, Tamer Hassan, Waseem Aziz, Tamer Ibrahim, Ahmed Yehia, Osama Mansour
BACKGROUND: spinal cord arterio-venous fistulas are rare cause of progressive myelopathy. The predictive factors of their outcome after endovascular or surgical treatment are still controversial. MATERIALS AND METHODS: Twenty patients were diagnosed with spinal arterio-venous fistulas; 13 of them had dural and 7 had perimedullary fistulas (1 Dorsal and 6 Ventral). Surgery, endovascular or both treatment were used. RESULTS: Ten of the 13 patients in the dural group were surgically treated, while 2 were managed by embolization and one combined...
July 1, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27566748/diskogenic-microspurs-as-a-major-cause-of-intractable-spontaneous-intracranial-hypotension
#12
Jürgen Beck, Christian T Ulrich, Christian Fung, Jens Fichtner, Kathleen Seidel, Michael Fiechter, Kety Hsieh, Michael Murek, David Bervini, Niklaus Meier, Marie-Luise Mono, Pasquale Mordasini, Ekkehard Hewer, Werner J Z'Graggen, Jan Gralla, Andreas Raabe
OBJECTIVE: To visualize and treat spinal dural CSF leaks in all patients with intractable spontaneous intracranial hypotension (SIH) who underwent spinal microsurgical exploration. METHODS: Patients presenting between February 2013 and July 2015 were included in this consecutive case series. The workup included spinal MRI without and with intrathecal contrast, dynamic myelography, postmyelography CT, and microsurgical exploration. RESULTS: Of 69 consecutive patients, 15 had intractable symptoms...
September 20, 2016: Neurology
https://www.readbyqxmd.com/read/27345977/generation-of-kcl026-research-grade-human-embryonic-stem-cell-line-carrying-a-mutation-in-smn1-gene
#13
Heema Hewitson, Victoria Wood, Neli Kadeva, Glenda Cornwell, Stefano Codognotto, Emma Stephenson, Dusko Ilic
The KCL026 human embryonic stem cell line was derived from an embryo donated for research that carried a mutation in the SMN1 gene encoding survival of motor neuron 1, telomeric (exons 7 and 8 deletion). Mutations in this gene are associated with spinal muscular atrophy. The ICM was isolated using laser microsurgery and plated on γ-irradiated human foreskin fibroblasts. Both the derivation and cell line propagation were performed in an animal product-free environment. Pluripotent state and differentiation potential were confirmed by in vitro assays...
March 2016: Stem Cell Research
https://www.readbyqxmd.com/read/27206345/evaluation-of-infraspinatus-reinnervation-and-function-following-spinal-accessory-nerve-to-suprascapular-nerve-transfer-in-adult-traumatic-brachial-plexus-injuries
#14
Heather L Baltzer, Eric R Wagner, Michelle F Kircher, Robert J Spinner, Allen T Bishop, Alexander Y Shin
PURPOSE: Our objective was to determine the prevalence and quality of restored external rotation (ER) in adult brachial plexus injury (BPI) patients who underwent spinal accessory nerve (SAN) to suprascapular nerve (SSN) transfer, and to identify patient and injury factors that may influence results. METHODS: Fifty-one adult traumatic BPI patients who underwent SAN to SSN transfer between 2000 and 2013, all treated less than 1 year after injury with >1 year follow-up...
July 2017: Microsurgery
https://www.readbyqxmd.com/read/27180757/-the-clinical-characteristics-and-microsurgery-treatment-of-patients-with-spinal-cord-glioblastoma
#15
Shupeng Zhao, Bao Yang, Hai Liu, Wenqing Jia, Yulun Xu, Jun Yang
OBJECTIVE: The aim is to explore the clinical characteristics of spinal cord glioblastoma and the therapeutic effect of microsurgery. METHODS: The clinical data of 18 patients with spinal cord glioblastoma from January 2011 to December 2014 in Beijing Tiantan Hospital were retrospectively analyzed including the clinical characteristics, the microsurgery treatment and the postoperative radiochemotherapy. RESULTS: There were 12 cases for subtotal resection, 4 cases for partial resection and 2 cases for biopsy of the intraspinal tumors under microscope...
May 10, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27075861/spinal-vascular-malformations-treatment-strategies-and-outcome
#16
REVIEW
Bruno C Flores, Daniel R Klinger, Jonathan A White, H Hunt Batjer
Spinal vascular malformations (SVMs) are a heterogeneous group that can cause acute, subacute, or chronic spinal cord dysfunction. The majority of the patients present to neurosurgical attention after a protracted course with severe neurological dysfunction. Spinal vascular lesions comprise approximately 3-4 % of all intradural spinal lesions. They are pathologically similar to their intracranial counterparts, but their clinical impact is often comparatively worse. Early, correct recognition of the pathology is mandatory to halt the progression of the disease and minimize permanent spinal cord injury...
January 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/27016317/validation-of-an-endovascular-first-approach-to-spinal-dural-arteriovenous-fistulas-an-intention-to-treat-analysis
#17
Bradley A Gross, Felipe C Albuquerque, Karam Moon, Cameron G McDougall
BACKGROUND/OBJECTIVE: Spinal dural arteriovenous fistulas (SDAVFs) require pretreatment angiography; embolization can be performed in the same session. To validate this approach, obliteration and morbidity rates of 'endovascular-first' (embolization and microsurgery in the case of embolization failures) must be compared with rates for 'microsurgery-first' (microsurgical ligation without attempted embolization) approaches. METHODS: We reviewed our institutional database (January 1998-October 2015) for SDAVFs, performing an intention-to-treat analysis comparing endovascular-first and microsurgery-first approaches...
January 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27015132/combined-surgical-and-endovascular-treatment-of-complex-high-flow-conus-medullaris-arteriovenous-fistula-associated-with-parkes-weber-syndrome-case-report
#18
Arya N Bagherpour, Gustavo J Rodriguez, Chetan Moorthy, Todd T Trier, Alberto Maud
Parkes Weber syndrome (PWS) is a congenital overgrowth disorder characterized by unilateral limb and axial hypertrophy, capillary malformations of the skin, and high-flow arteriovenous fistulas (AVFs). Spinal AVFs in the setting of PWS are challenging vascular lesions that often contain multiple arteriovenous (AV) shunts. The present case report highlights an adolescent girl with PWS who presented with a ruptured complex high-flow conus medullaris AVF. She was successfully treated with endovascular embolization and microsurgery...
August 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/26973804/training-medical-novices-in-spinal-microsurgery-does-the-modality-matter-a-pilot-study-comparing-traditional-microscopic-surgery-and-a-novel-robotic-optoelectronic-visualization-tool
#19
Marc Moisi, R Shane Tubbs, Jeni Page, Alexandra Chapman, Brittni Burgess, Tyler Laws, Haylie Warren, Rod J Oskouian
The operative microscope has been a staple instrument in the neurosurgical operating room over the last 50 years. With advances in optoelectronics, options such as robotically controlled high magnification have become available. Such robotically controlled optoelectronic systems may offer new opportunities in surgical technique and teaching. However, traditionally trained surgeons may find it hard to accept newer technologies due to an inherent bias emerging from their previous background. We, therefore, studied how a medically naïve population in a pilot study would meet set microsurgical goals in a cadaver experiment using either a conventional operative microscope or BrightMatter™ Servo system, ​a robotically controlled optoelectronic system (Synaptive Medical, Toronto, Ontario, Canada)...
2016: Curēus
https://www.readbyqxmd.com/read/26926050/influence-of-indocyanine-green-angiography-on-microsurgical-treatment-of-spinal-perimedullary-arteriovenous-fistulas
#20
Keisuke Takai, Hiroki Kurita, Takayuki Hara, Kensuke Kawai, Makoto Taniguchi
OBJECTIVE: The microvascular anatomy of spinal perimedullary arteriovenous fistulas (AVFs) is more complicated than that of dural AVFs, and occlusion rates of AVF after open microsurgery or endovascular embolization are lower in patients with perimedullary AVFs (29%-70%) than they are in those with dural AVF (97%-98%). Reports of intraoperative blood flow assessment using indocyanine green (ICG) video angiography in spinal arteriovenous lesions have mostly been for spinal dural AVFs. No detailed reports on spinal perimedullary AVFs are available...
March 2016: Neurosurgical Focus
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