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spinal microsurgery

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)
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
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
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
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...
May 21, 2016: Microsurgery
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]
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...
April 13, 2016: Neurosurgical Review
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...
March 25, 2016: Journal of Neurointerventional Surgery
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
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
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
James L Stone, Paul M Arnold, Shakeel A Chowdhry, Fady Charbel
UNLABELLED: In the 1970's many neurosurgeons gradually adapted microsurgical techniques to spine surgery as the benefits of magnification, illumination, and use of fine instruments in cranial surgery became apparent. In the early 1970 s, Robert W. Williams, а neurosurgeon in private practice in Las Vegas, Nevada, independently began to devise spinal microneurosurgical techniques with the goal of improving surgical outcome in lumbar and cervical surgery. Much of his initial work with microlumbar discectomies and microcervical foraminotomies was presented at annual meetings of the American Association of Neurological Surgeons and Congress of Neurological Surgeons in the 1970s and 1980s...
August 15, 2016: Spine
Xuezhen Li, Jianzhen Wang, Jianxing Niu, Jiakang Hong, Yaohui Feng
Spinal cord hemangioblastomas are rare benign tumors, with difficult surgical management and poor prognosis due to high vascularization. We aim to evaluate the diagnostic methods and microsurgical treatment of spinal cord hemangioblastoma. This retrospective study assessed 25 patients treated for spinal hemangioblastoma using microsurgery at Beijing Tiantan Hospital and Department of Neurosurgery, The General Hospital of Chinese People's Armed Police Forces, between October 2008 and October 2013. Clinical, imaging, and treatment data were collected...
June 2016: Neurological Sciences
Keda Wang, Yibing Su, Yan Zhang, Bo Jin, Hanbin Wang, Longqi Liu
OBJECTIVE: To summarize the clinical experience of microsurgical treatment for giant invasive spinal schwannoma assisted by three-dimensional navigation. METHODS: A total of 15 cases of giant invasive spinal schwannoma were retrospectively analyzed from 2013 to 2014 in Beijing Jishuitan Hospital.All patients were performed microsurgery assisted by three-dimensional navigation and were followed up for at least 12 months.A modified McCormick Scale was used to assess the patients' neurologic status and change...
January 19, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Zahir Kizilay, Ali Yilmaz, Sevilay Gurcan, Osman Berber, Yelda Ozsunar, Nuket Eliyatkın
The synovial and ganglion cysts originating from the facet joint have been named under the name of the Juxtafacet cyst by the several researchers. They put forward that the synovial cyst originated from the synovial joint. But, they failed to clarify the pathophysiology of the formation of the ganglion cyst. In this case report, we reported a 67-year-old male patient was referred to the emergency from another center with the complaint of a left leg pain and weakness in the left foot and patient was treated with microchirurgical technique...
2015: Neurologia i Neurochirurgia Polska
Leonel Ampie, Winward Choy, Ryan Khanna, Zachary A Smith, Nader S Dahdaleh, Andrew T Parsa, Orin Bloch
Spinal hemangioblastomas (HB) are relatively rare neoplasms with a high degree of vascularity. Therapy for symptomatic tumors involves total resection when possible. Due to the enriched blood supply of these neoplasms, there is a high risk of significant intraoperative blood loss, which can lead to perioperative complications. Preoperative embolization of HB has been suggested to reduce blood loss and operative morbidity, but its use remains controversial. Data on the risks and benefits of preoperative embolization for this tumor remains limited...
February 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
G D Bittner, D R Sengelaub, R C Trevino, J D Peduzzi, M Mikesh, C L Ghergherehchi, T Schallert, W P Thayer
Traumatic injuries to PNS and CNS axons are not uncommon. Restoration of lost behaviors following severance of mammalian peripheral nerve axons (PNAs) relies on regeneration by slow outgrowths and is typically poor or nonexistent when after ablation or injuries close to the soma. Behavioral recovery after severing spinal tract axons (STAs) is poor because STAs do not naturally regenerate. Current techniques to enhance PNA and/or STA regeneration have had limited success and do not prevent the onset of Wallerian degeneration of severed distal segments...
March 2016: Journal of Neuroscience Research
Chen Chunmei, Cai Gangfeng, Wang Rui, Zhang Weiqiang, Chen Yan, Li Feng, Wang Chunhua, Wang Fan, Chen Zhijie, Shi Songsheng, Yang Weizhong
OBJECTIVE: To evaluate the clinical outcomes and operative techniques of microsurgical resection of lumbar intraspinal tumors through paraspinal approach by percutaneous tubular retractor system. METHODS: A retrospective study was conducted to analyze 21 patients with lumbar intraspinal tumors between November 2011 and February 2014, including Schwannoma (n = 19) and meningioma (n = 2) without lumbar instability on preoperative images. The length of tumors was 0...
April 7, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Alfredo Pompili, Fabrizio Caroli, Francesco Crispo, Maddalena Giovannetti, Laura Raus, Antonello Vidiri, Stefano Telera
BACKGROUND: Spinal intradural tumors are usually removed with laminectomy/laminotomy with a midline dural incision. Pain, discomfort, postoperative kyphosis, and instability may be minimized with unilateral microsurgery. METHODS: Seventy patients with schwannoma (73 tumors) and 27 patients with meningioma (29 tumors) were operated on with unilateral hemilaminectomy (June 2000 to March 2014). Surgery was generally kept to 1 or 2 levels, removing all the craniocaudal ligamentum flavum...
January 2016: World Neurosurgery
Mehmet Demirayak, Lokman Şişman, Faik Türkmen, Duran Efe, Oğuzhan Pekince, Recep Gani Göncü, Cem Sever
STUDY DESIGN: A single-center, retrospective patient review of clinical and radiological outcomes of microsurgical posterior lumbar interbody fusion and decompression, without posterior instrumentation, for the treatment of lateral recess stenosis. PURPOSE: This study documented the clinical and radiological results of microsurgical posterior lumbar interbody fusion and decompression of the lateral recess using interbody cages without posterior instrumentation for the treatment of lateral recess stenosis...
October 2015: Asian Spine Journal
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