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Neurological surgery

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https://www.readbyqxmd.com/read/29342427/reconstructive-aortic-valve-surgery-in-the-elderly-techniques-and-outcomes
#1
Paul P Urbanski, Atanas Jankulovski, Kiril Doldurov, Xiaochun Zhan, Ayman Sodah, Michael Zacher, Anno Diegeler
OBJECTIVES: The aim of the study was to evaluate operative techniques and long-term results after aortic valve or root repair in patients aged 75 years or more. METHODS: Between November 2002 and January 2016, a total of 815 patients underwent aortic valve or root repair. Among them were 100 patients aged 75 years or more (mean, 78 ± 3; range, 75-88 years), including 17 patients operated on an emergency basis because of acute aortic dissection. None/trivial, mild, moderate, and severe insufficiency grades were presented in 9, 23, 27, and 41 patients, respectively...
December 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29341941/cauda-equina-syndrome-due-to-lumbar-disc-herniation-a-review-of-literature
#2
Stylianos Kapetanakis, Constantinos Chaniotakis, Constantinos Kazakos, Jannis V Papathanasiou
Cauda equina syndrome (CES) is a rare neurologic condition that is caused by compression of the cauda equina. Cauda equina consists of spinal nerves L2-L5, S1-S5 and the coccygeal nerve. The compression of these nerve roots can be caused mainly by lumbar disc herniation (45% of all causes). The diagnosis consists of two critical points: a) detailed history and physical examination and b) MRI or CT. The gold standard of the treatment of this syndrome is the surgical approach in combination with the timing of onset of symptoms...
December 20, 2017: Folia Medica
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#3
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29338912/-surgical-outcomes-of-traumatic-cervical-fractures-in-patients-with-ankylosing-spondylitis
#4
Alberto Isla Guerrero, Beatriz Mansilla Fernández, Borja Hernández Garcia, Álvaro Gómez de la Riva, María Luisa Gandía González, Elena Isla Paredes
OBJECTIVE: Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies. METHODS: Between January 2004 and December 2014, 6 patients with ankylosing spondylitis and neurological complications after injuries were treated...
January 12, 2018: Neurocirugía
https://www.readbyqxmd.com/read/29337168/aggressive-resection-of-congenital-lumbosacral-lipomas-in-adults-indications-techniques-and-outcomes-in-122-patients
#5
S C Bai, B Z Tao, L K Wang, X G Yu, B N Xu, A J Shang
OBJECTIVE: The authors reviewed the treatment of adult patients with congenital intraspinal lipomas with total/near-total resection and discussed their preoperative characteristics, prognostic factors and surgical outcomes. METHODS: Medical records of 122 adult patients with congenital lumbosacral lipomas undergoing total/near-total resection were systematically analyzed. The cohort was subdivided into three groups depending on symptom onset age: Group 1 (≤5 years, n = 40), Group 2 (>5 years but <18 years, n = 33), and Group 3 (>18 years, n = 49)...
January 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29336403/superior-vena-cava-clamping-during-thoracic-surgery-implications-for-the-anesthesiologist
#6
Monish S Raut, Swetanka Das, Rohitash Sharma, Elvin Daniel, Amit Motihar, Arvind Verma, Sibashankar Kar, Arun Maheshwari, Ganesh Shivnani, Arvind Kumar
Resection and reconstruction of the SVC is a challenging Intraoperative situation owing to the potential complications after clamping a patent vessel. Hemodynamic imbalance and neurological effects of SVC clamping can be life threatening. These complications can be prevented by careful intraoperative monitoring and management. Anaesthesiologist must be aware of different options to manage such challenging situations.
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29336393/cardiac-surgery-in-a-patient-with-implanted-vagal-nerve-stimulator
#7
Aashish Jain, Dheeraj Arora, Yatin Mehta
The prevalence of epilepsy worldwide is around 0.5%-2% of the population. Antiepileptic medications are the first line of treatment in most of the cases but approximately 25%-30% epilepsy patients are refractory to the single or combination therapy. The surgical option for temporal lobe epilepsy is temporal lobectomy, which has its inherent risk of neurological deficits after the surgery. Patients who are either refractory to combination therapy or do not want surgical temporal lobectomy are the candidates for electrical stimulation therapy...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29335903/anterior-cervical-corpectomy-and-fusion-versus-posterior-laminoplasty-for-the-treatment-of-oppressive-myelopathy-owing-to-cervical-ossification-of-posterior-longitudinal-ligament-a-meta-analysis
#8
Rongqing Qin, Xiaoqing Chen, Pin Zhou, Ming Li, Jie Hao, Feng Zhang
PURPOSE: The purpose of this research is to compare the clinical efficacy, postoperative complication and surgical trauma between anterior cervical corpectomy and fusion versus posterior laminoplasty for the treatment of oppressive myelopathy owing to cervical ossification of the posterior longitudinal ligament (OPLL). STUDY DESIGN: Systematic review and meta-analysis. METHODS: An comprehensive search of literature was implemented in three electronic databases (Embase, Pubmed, and the Cochrane library)...
January 15, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29334957/vertebral-column-decancellation-in-pott-s-deformity-use-of-surgimap-spine-for-preoperative-surgical-planning-retrospective-review-of-18-patients
#9
Wenhao Hu, Xuesong Zhang, Jiayi Yu, Fanqi Hu, Hao Zhang, Yan Wang
BACKGROUND: In the late stage of Spinal tuberculosis, the bony destruction and vertebral collapse often leads to significant kyphosis, presenting clinically as a painful gibbus deformity, with increased instability, vertebral body translations and increased risk of neurologic involvement. Vertebral column decancellation is thought to be suitable for most patients with severe rigid kyphosis. Surgimap Spine, could offer a pragmatic graphical method for the surgical planning of osteotomies...
January 15, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29334774/three-column-osteotomy-for-adult-spine-deformity-comparison-of-outcomes-and-complications-between-kyphosis-and-kyphoscoliosis
#10
Jun Qiao, Lingyan Xiao, Xu Sun, Zhen Liu, Zezhang Zhu, Bangping Qian, Yong Qiu
BACKGROUND: To compare the surgical outcomes and complications between kyphosis and kyphoscoliosis when using three-column osteotomies. METHODS: Adult spine deformity (ASD) patients with three column osteotomies from March 2005 to December 2014 in our center were retrospectively reviewed. Pre- and postoperative standing postero-anterior and lateral radiographs of the entire spine were obtained. Scoliosis Research Society-22 questionnaire [SRS-22] and Oswestry Disability Index [ODI] were administered preoperatively, postoperatively (surveys within 2 months after surgery), and at final follow-up...
January 15, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29333814/morbidity-in-congenital-heart-surgery-in-a-public-hospital-in-argentina
#11
María Althabe, Ricardo Rodríguez R, María Balestrini, Alberto Charroqui, Mariela Krynski, Ana M Lenz, Mercedes Montonati, Guillermo Moreno, María L Pilan, Ricardo Magliola, Pablo García Delucis
OBJECTIVE: To describe the complications associated with heart surgery, compare them to a reference population, and identify mortality risk factors. PATIENTS AND METHODS: Retrospective and descriptive study. All patients who underwent surgery at Hospital Garrahan in the 2013-2015 period were included. Age, weight, procedure, mechanical ventilation, length of stay in days, morbidity, and course were recorded. Renal failure requiring dialysis, neurological deficit, permanent pacemaker, circulatory support, phrenic nerve or vocal cord palsy, reoperation, wound infection, chylothorax, and tracheotomy were considered morbidities...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29333421/brain-metastasis-from-colorectal-cancer-a-single-center-experience
#12
Dong-Yeop Kim, Chun-Geun Ryu, Eun-Joo Jung, Jin-Hee Paik, Dae-Yong Hwang
Purpose: The detection rate of brain metastasis (BM) from colorectal cancer (CRC) is increasing. This study was designed to analyze the clinical features of BM and prognosis according to the therapeutic modalities. Methods: A total of 19 cases were collected in this study between November 2008 and December 2015. We reviewed the patients' demographic data and the clinical features of BM retrospectively and investigated their prognostic significance. Results: Nineteen patients included 8 male and 11 female patients...
January 2018: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29332784/air-transport-of-a-patient-with-impending-cerebral-herniation-from-tension-pneumocephalus
#13
Etzer Augustin, Michael Karsy, Jim Bryan, Jian Guan, Richard H Schmidt
Tension pneumocephalus is a rare but dangerous complication of craniotomy, sinus surgery, and traumatic cranial injury. Compared with simple pneumocephalus, which often resolves spontaneously over the course of a few days, tension pneumocephalus tends to increase with ongoing cerebrospinal fluid leak and requires immediate neurosurgical treatment to prevent cerebral herniation. Air transport of patients with tension pneumocephalus for neurosurgical care entails a risk of neurologic worsening because of changes in ambient air pressure with altitude and cabin pressurization...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29330748/surgery-in-elderly-patients-with-intracranial-meningioma-neuropsychological-functioning-during-a-long-term-follow-up
#14
Andrea Di Cristofori, Barbara Zarino, Giulio Bertani, Marco Locatelli, Paolo Rampini, Giorgio Carrabba, Manuela Caroli
Surgical treatment of elderly patients with meningioma is has proved to be safe, especially when patients are selected using dedicated surgical scores. These scores take into account tumor size, edema, location and patient's co-morbidities. Neuropsychological functioning (NPF) of this kind of patients has been poorly studied in literature and it is not taken into account by these scores. Aim of our study was to describe the long-term outcome in terms of NPF of elderly patients undergoing surgery. Patients older than 70 years of age affected by intracranial meningioma and selected with the Clinical-Radiological Grading Score were included in our study...
January 12, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29330575/a-new-technique-for-minimal-invasive-complete-spinal-cord-injury-in-minipigs
#15
Elena E Foditsch, Gratian Miclaus, Irina Patras, Ioan Hutu, Karin Roider, Sophina Bauer, Günter Janetschek, Ludwig Aigner, Reinhold Zimmermann
BACKGROUND: The aim of this study was to develop a minimal invasive complete spinal cord injury (SCI) minipig model for future research applications. The minipig is considered a translationally relevant model for SCI research. However, a standardized minimal invasive complete SCI model for pigs has not yet been established. METHODS: Adult Göttingen minipigs were anesthetized and placed in extended prone position. After initial computed tomography (CT) scan, the skin was incised, a needle placed in the epidural fatty tissue...
January 12, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29328004/thoracolumbar-injury-classification-and-severity-score-in-children-a-reliability-study
#16
Ross L Dawkins, Joseph H Miller, Omar I Ramadan, Michael C Lysek, Elizabeth N Kuhn, Brandon G Rocque, Michael J Conklin, R Shane Tubbs, Beverly C Walters, Bonita S Agee, Curtis J Rozzelle
OBJECTIVE There are many classification systems for injuries of the thoracolumbar spine. The recent Thoracolumbar Injury Classification and Severity Score (TLICS) has been shown to be a reliable tool for adult patients. The aim of this study was to assess the reliability of the TLICS system in pediatric patients. The validity of the TLICS system is assessed in a companion paper. METHODS The medical records of pediatric patients with acute, traumatic thoracolumbar fractures at a single Level 1 trauma center were retrospectively reviewed...
January 12, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29328000/conscious-sedation-with-dexmedetomidine-compared-with-asleep-awake-asleep-craniotomies-in-glioma-surgery-an-analysis-of-180-patients
#17
Eric Suero Molina, Stephanie Schipmann, Isabelle Mueller, Johannes Wölfer, Christian Ewelt, Matthias Maas, Benjamin Brokinkel, Walter Stummer
OBJECTIVE Awake craniotomies have become a feasible tool over time to treat brain tumors located in eloquent regions. Different techniques have been applied in neurooncology centers. Both "asleep-awake-asleep" (asleep) and "conscious sedation" were used subsequently at the authors' neurosurgical department. Since 2013, the authors have only performed conscious sedation surgeries, predominantly using the α2-receptor agonist dexmedetomidine as the anesthetic drug. The aim of this study was to compare both mentioned techniques and evaluate the clinical use of dexmedetomidine in the setting of awake craniotomies for glioma surgery...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29327973/fluoroscopy-guided-percutaneous-vertebroplasty-for-symptomatic-loosened-pedicle-screw-and-instrumentation-associated-vertebral-fracture-an-evaluation-of-initial-experiences-and-technical-note
#18
Tsai-Sheng Fu, Yun-Da Li
OBJECTIVE For symptomatic loosened pedicle screws and instrumentation-associated vertebral fracture, extensive surgery to remove the pedicle screws and extend the instrumentation, along with the reinsertion of more pedicle screws, is usually the treatment of choice. After such a surgery, however, similar complications will still be encountered. In this study the authors propose minimally invasive percutaneous cement augmentation under fluoroscopic guidance as a salvage procedure that eliminates the inherent risks of conventional extensive surgery...
January 12, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29327223/one-bone-forearm-osteodesis-and-biceps-re-routing-to-correct-severe-supination-contracture-in%C3%A2-a-paediatric-patient-with-late-obstetric-brachial-plexus-palsy
#19
Ricardo Monreal
PURPOSE: The one-bone forearm arthrodesis has been performed to change the position of the forearm in children with fixed supination deformity due to upper extremity neurologic deficit. In this article, we present a retrospective review of children with late obstetric brachial plexus palsy who underwent palliative surgery to correct severe supination contracture by one-bone forearm osteodesis and biceps re-routing. This technique has not been described previously. MATERIALS AND METHODS: In this retrospective study, four consecutive patients with upper extremity weakness and severe supination contracture who underwent forearm osteodesis in neutral or slight pronation and biceps re-routing...
January 12, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29326765/pneumocephalus-following-combined-spinal-epidural-anaesthesia-for-total-knee-arthroplasty-a-case-report
#20
Y W Chew, V K Suppan, S R Ashutosh, M M Tew, J H Jimmy-Tan
The authors describe a case of pneumocephalus following epidural anaesthesia for total knee arthroplasty. Multiple attempts in locating the epidural space for the anaesthesia and the use of loss of resistance to air (LORA) technique were identified as the source of air entry. Supportive management was given including high flow oxygenation therapy and spontaneous reabsorption of air was noted five days after surgery. The presence of pneumocephalus should be kept in mind if patient develops neurological complications postoperatively following epidural anaesthesia...
November 2017: Malaysian Orthopaedic Journal
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