keyword
https://read.qxmd.com/read/38161918/functional-outcomes-after-discectomy-for-recurrent-lumbar-herniation-using-the-destandau-endospine-system-a-retrospective-study-of-44-patients
#21
JOURNAL ARTICLE
Paresh C Dey, Saurav N Nanda, Saswat Samant, Ashok Gachhayat
Background Recurrent disc herniation is a major cause of morbidity and surgical failure after disc surgery. This study aimed to investigate the feasibility, safety, and effectiveness of the Destandau endospine system (DES) for treating recurrent lumbar disc herniation (LDH). Methodology A total of 44 patients who underwent minimally invasive Destandau endoscopic lumbar discectomy (DELD) for recurrent LDH were included in this study. All data were collected retrospectively. The preoperative and postoperative visual analog scale (VAS) score was used for the evaluation and gradation of pain...
November 2023: Curēus
https://read.qxmd.com/read/38161614/postoperative-csf-leak-blood-patch-a-new-avenue
#22
JOURNAL ARTICLE
Geover Lobo, Sarita R J Lobo
Introduction  Cerebrospinal fluid leak (CSF) after a neurosurgical procedure is a known complication that may result in bad outcomes (1). The incidence of CSF leak varies based on the site involved; it ranges from 4 to 32% for transsphenoidal to posterior fossa procedures. The costs involved in treating postoperative CSF leaks increases exponentially that becomes a barrier in continuing optimum treatment. There are many studies that compare the different treatment modalities and even use of sealing agents but none give an algorithm of management...
December 2023: Asian Journal of Neurosurgery
https://read.qxmd.com/read/38158597/pedicle-subtraction-osteotomy-versus-multilevel-anterior-lumbar-interbody-fusion-and-lateral-lumbar-interbody-fusion-in-the-treatment-of-adult-spinal-deformity-trends-outcomes-and-cost
#23
JOURNAL ARTICLE
Jialun Chi, Yi Zhang, Andrew Fontaine, Zhichang Zhang, Jesse Wang, Lawal Labaran, Xudong Li
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The aim of this study was to compare the outcomes of pedicle subtraction osteotomy (PSO) with multilevel anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF) in posterior long-segment fusion. BACKGROUND: PSO and ALIF/LLIF are 2 techniques used to restore lumbar lordosis and correct sagittal alignment, with each holding its unique advantages and disadvantages...
December 28, 2023: Clinical Spine Surgery
https://read.qxmd.com/read/38153461/use-of-bonescalpel-ultrasonic-bone-dissector-in-anterior-clinoidectomy-and-posterior-fossa-surgery-technical-note
#24
JOURNAL ARTICLE
Giuseppe Emmanuele Umana, Gianluca Scalia, Salvatore Cicero, Angelo Spitaleri, Marco Fricia, Santino Ottavio Tomasi, Giovanni Federico Nicoletti, Massimiliano Visocchi
BackgroundFirst popularized by Dolenc, anterior clinoidectomies were performed with rongeurs, before the adoption of modern high-speed drills. We describe a novel application of the piezoelectric BoneScalpel™ in anterior skull base and posterior fossa surgeries. In the literature, to date, there are no mentions of anterior clinoidectomies performed with piezosurgical devices.MethodsWe reported a total of 12 patients, 8 affected by posterior fossa tumors and 4 treated for anterior skull base oncologic and vascular pathologies...
2023: Acta Neurochirurgica. Supplement
https://read.qxmd.com/read/38073177/practical-methods-of-assessing-coronal-alignment-and-outcomes-in-adult-spinal-deformity-surgery-a-comparative-analysis
#25
JOURNAL ARTICLE
Yong Shen, Zeeshan M Sardar, Gabriella Greisberg, Prerana Katiyar, Matan Malka, Fthimnir Hassan, Justin Reyes, Scott L Zuckerman, Gerard Marciano, Joseph M Lombardi, Ronald A Lehman, Lawrence G Lenke
STUDY DESIGN: Asymptomatic cohort: prospective, cross-sectional, multi-center. Symptomatic: retrospective, multi-surgeon, single-center. OBJECTIVE: To assess the association between cranial coronal alignment and adult spinal deformity (ASD) surgical risk and outcomes. SUMMARY OF BACKGROUND DATA: ASD leads to decreased quality of life. Studies have shown that coronal malignment (CM) is associated with worse surgical outcomes. METHODS: 468 adult participants were prospectively enrolled in the asymptomatic cohort...
December 11, 2023: Spine
https://read.qxmd.com/read/38047642/the-sandwich-extended-pedicle-subtraction-osteotomy-for-the-treatment-of-fixed-sagittal-malalignment-technical-description-case-series-and-early-results-with-2-year-outcomes
#26
JOURNAL ARTICLE
Joshua Bakhsheshian, Fthimnir M Hassan, Gabriella Greisberg, Andrew Platt, Scott L Zuckerman, Lawrence G Lenke
BACKGROUND AND OBJECTIVES: Adult spinal deformity (ASD) with fixed sagittal malalignment (FSM) may require a pedicle subtraction osteotomy (PSO) for greater focal lordosis and restoration of global alignment. Despite growing trends in minimizing PSOs given their associated high risks, a considerable portion of patients with ASD still require a lumbar PSO most commonly because of iatrogenic flat back deformity. The purpose of this article is to describe a modified extended PSO technique with additional anterior column support coined the "sandwich" extended PSO (SE-PSO) to promote arthrodesis and report the outcomes in a consecutive case series...
December 4, 2023: Operative Neurosurgery (Hagerstown, Md.)
https://read.qxmd.com/read/38025939/transforaminal-lumbar-interbody-fusion-with-an-expandable-interbody-device-two-year-clinical-and-radiographic-outcomes
#27
JOURNAL ARTICLE
Marc A Weinstein, Giovanni A Ayala, Raúl Roura, Kaitlyn N Christmas, Deborah H Warren, Peter Simon
BACKGROUND: The use of interbody cages as an adjunct to lumbar spinal fusion remains an important technique to enhance segmental stability, promote solid arthrodesis, maintain neuroforaminal decompression, and preserve/improve segmental lordosis. Appropriate segmental lumbar lordosis and sagittal balance is well-known to be critical for long-term patient outcomes. This study sought to evaluate the radiographic and clinical results of TLIF in patients using an articulating, expandable cage...
December 2023: N Am Spine Soc J
https://read.qxmd.com/read/38020997/management-of-incidental-durotomies-in-an-integrated-orthopaedic-and-neurosurgical-spinal-unit
#28
JOURNAL ARTICLE
D Rodríguez, U Amin, D Bartolomé, A Pont, A Del Arco, G Saló, G Vilá, A Isart, D Manzano, J Lafuente
INTRODUCTION: Incidental durotomy (ID) is an intraoperative event associated to prolonged bed rest and hospital stay, antibiotic use, higher patient dissatisfaction, and leg pain among other complications of its postoperative course. Several repair techniques and postsurgical care have been proposed for its management. This study was designed to develop an agreed protocol in cases of ID among Orthopaedic Surgeons (OS) and Neurosurgeons (NS) integrated into a Spinal Surgery Unit. RESEARCH QUESTION: Incidental durotomies management protocol...
2023: Brain Spine
https://read.qxmd.com/read/38011541/enhanced-dural-repair-using-biodegradable-sealants-based-on-photocurable-hyaluronic-acid
#29
JOURNAL ARTICLE
Hyeseon Lee, Sijoon Lee, Keum-Yong Seong, Subin Kang, Min-Soo Seo, Su Ryon Shin, Kyung Hyup Nam, Seung Yun Yang
Cerebrospinal fluid (CSF) leakage is a common complication of intradural surgery or incidental durotomy in neurosurgery. Dural suturing is a common method for durotomy repair, but this technique requires a long operation time and include risk of CSF leakage by incomplete sealing. Glue-type sealants are effective for watertight dural closure. However, unresolved shortcomings include insufficient sealing performance, poor biocompatibility, and excessive swelling. Here, we report dural sealant using light-activated hyaluronic acid (HA) with multi-networks (HA photosealant) that provides fast sealing performance and high biocompatibility...
November 27, 2023: Macromolecular Bioscience
https://read.qxmd.com/read/37989906/early-ambulation-versus-prolonged-bed-rest-for-incidental-durotomies-in-spine-procedures-a-systematic-review-and-meta-analysis
#30
REVIEW
Fernando Cotrim Gomes, Anna Laura Lima Larcipretti, Francisco Alfonso Rodriguez Elvir, Jordana Borges Camargo Diniz, Tiago Muniz Vieira de Melo, Laís Silva Santana, Helen Michaela de Oliveira, Douglas Carneiro Barroso, Allan Dias Polverini
Incidental durotomies are frequent complications of spine surgery associated with cerebrospinal fluid (CSF) leak-related symptoms. Management typically involves prolonged bed rest to reduce CSF pressure at the durotomy site. However, early ambulation may be a safer, effective alternative. PubMed, Web of Science, Embase, Cochrane, and Scopus were systematically searched for studies comparing early ambulation (bed rest ≤ 24 h) with prolonged bed rest (> 24 h) for patients with incidental durotomies in spine surgeries...
November 22, 2023: Neurosurgical Review
https://read.qxmd.com/read/37965963/complications-have-not-improved-with-newer-generation-robots
#31
JOURNAL ARTICLE
Daniel Farivar, Terrence T Kim, Christopher A Sy, Eli M Baron, Edward K Nomoto, Corey T Walker, David L Skaggs
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The purpose of this study was to see whether upgrades in newer generation robots improve safety and clinical outcomes following spine surgery. METHODS: All patients undergoing robotic-assisted spine surgery with the Mazor X Stealth EditionTM (Medtronic, Minneapolis, MN) from 2019 to 2022 at a combined orthopedic and neurosurgical spine service were retrospectively reviewed. Robot related complications were recorded...
November 15, 2023: Global Spine Journal
https://read.qxmd.com/read/37910308/intraoperative-application-of-triamcinolone-a-risk-factor-for-delayed-csf-fistula-formation
#32
JOURNAL ARTICLE
Nikolaus Kögl, Konstantin Brawanski, Claudius Thomé, Ondra Petr
PURPOSE: Cerebrospinal fluid (CSF) leaks are a well-known complication in spinal surgery, caused mostly by incidental durotomy (ID). However, delayed pseudomeningocele formation has been described in patients following an unremarkable surgery - without ID. Intraoperative and epidural triamcinolone application has been suspected to be a potential risk factor. This study was conducted to evaluate the management of ID and identify further risk factors for secondary CSF fistula formation...
November 1, 2023: Acta Neurochirurgica
https://read.qxmd.com/read/37890770/subfascial-lumbar-spine-drain-output-does-not-affect-outcomes-after-incidental-durotomies-in-elective-spine-surgery
#33
JOURNAL ARTICLE
Tariq Z Issa, Delano Trenchfield, Aditya S Mazmudar, Yunsoo Lee, Michael A McCurdy, Ameer A Haider, Mark J Lambrechts, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder
OBJECTIVE: Postoperative drains have long been regarded as a preventive measure to mitigate the risks of complications such as neurological impairment by reducing hematoma formation following spine surgery. Our study aims to contribute to the existing body of knowledge by examining the impact of postoperative drain output on 90-day postoperative outcomes for patients who experienced incidental durotomies following lumbar decompression procedures, with or without fusion. METHODS: All patients older than or equal to 18 years of age with an incidental durotomy from spinal decompression ± fusion surgery between 2017 and 2021 were retrospectively identified...
October 25, 2023: World Neurosurgery
https://read.qxmd.com/read/37878474/anterior-petrosectomy-with-intertentorial-approach
#34
JOURNAL ARTICLE
Daniele Starnoni, David Peters, Lorenzo Giammattei, Arianna Fava, Hugues Cadas, Sami Schranz, Sara Sabatasso, Mahmoud Messerer, Roy T Daniel
BACKGROUND AND OBJECTIVES: The extradural anterior petrosal approach (EAPA) can present a challenge because it deals with critical structures in a narrow, confined corridor. It is associated with several potential approach-related risks including temporal lobe and venous injuries. Tentorial peeling has the potential to largely eliminate these risks during the approach and may offer more options for tailoring the dural opening to the anatomic region that one wants to expose. METHODS: Anatomic dissections of five adult injected non-formalin-fixed cadaveric heads were performed...
October 25, 2023: Operative Neurosurgery (Hagerstown, Md.)
https://read.qxmd.com/read/37869493/case-report-traumatic-hemorrhagic-cervical-myelopathy-in-a-dog
#35
Koen M Santifort, Ines Carrera, Simon Platt
A 1.5-year-old female entire French bulldog was referred for neurological evaluation, further diagnostic tests, and treatment 24 h after a road traffic accident. Initial emergency treatment, diagnostic tests, and stabilization had been performed by the referring veterinarian. Neurological examination revealed severe spastic non-ambulatory tetraparesis and was consistent with a C1-5 myelopathy. A magnetic resonance imaging (MRI) study revealed an irregular to elongated ovoid intramedullary lesion centered over the body of C2...
2023: Frontiers in Veterinary Science
https://read.qxmd.com/read/37859943/location-specific-technical-nuances-of-spinal-meningioma-resection-an-operative-video-case-series
#36
JOURNAL ARTICLE
Wilson A M Fisher, Cheerag Upadhyaya, Michael Galgano
The objective of this video was to demonstrate technical nuances of intradural spinal meningioma (ISM) resection through a high-quality surgical video. The authors describe 3 patients with ISM in the cervicomedullary, cervical, and thoracic regions. Patients underwent surgery in the prone position with laminectomy, dorsal durotomy, and then resection of the mass. Case 1 required a suboccipital craniectomy and dissection of the tumor away from the vertebral artery. In case 2, special emphasis is placed on sectioning the dentate ligament with cord rotation...
October 2023: Neurosurgical focus: Video
https://read.qxmd.com/read/37810299/thecal-sac-ligation-in-the-setting-of-thoracic-spondyloptosis-with-complete-cord-transection
#37
JOURNAL ARTICLE
Sima Vazquez, John K Houten, Zehavya T Stadlan, Jacob D Greisman, Grigori Vaserman, Eris Spirollari, Tolga Sursal, Jose F Dominguez, Merritt D Kinon
BACKGROUND: Traumatic spondyloptosis (TS) with complete spinal cord transection and unrepairable durotomy is particularly rare and can lead to a difficult-to-manage cerebrospinal fluid (CSF) leak. METHODS: We performed a systematic review of the literature on TS and discuss the management strategies and outcomes of TS with cord transection and significant dural tear. We also report a novel case of a 26-year-old female who presented with thoracic TS with complete spinal cord transection and unrepairable durotomy with high-flow CSF leak...
2023: Surgical Neurology International
https://read.qxmd.com/read/37802396/effects-of-duroplasty-with-bovine-pericardium-on-fibrosis-and-extent-of-spinal-cord-injury-an-experimental-study-in-pigs
#38
JOURNAL ARTICLE
L M Romero-Muñoz, A Barriga-Martín, P Del Cerro de Pablo, A Rodríguez de Lope, A Alves-Sampaio, J Collazos-Castro
INTRODUCTION: Traumatic spinal cord injury (SCI) leads to increased intraspinal pressure that can be prevented by durotomy and duroplasty. The aim of the study was to evaluate fibrosis and neural damage in a porcine model of SCI after duroplasty and application of hyaluronic acid (HA) in the tissue cavity. EXPERIMENTAL STUDY: We created a porcine SCI model by durotomy and spinal cord hemisection of a cervical segment (1 cm).Six pigs (Sus scrofa domestica) were used to evaluate three surgical scenarios:1) Control injury with dural reparative microsurgery,2)duroplasty using bovine pericardium (BPD),and 3)previous method plus HA applied at the lesion...
October 4, 2023: Revista Española de Cirugía Ortopédica y Traumatología
https://read.qxmd.com/read/37798970/predictors-of-cerebrospinal-fluid-leak-following-dural-repair-in-spinal-intradural-surgery
#39
JOURNAL ARTICLE
Lei Jiang, Alexandru Budu, Muhammad Shuaib Khan, Edward Goacher, Angelos Kolias, Rikin Trivedi, Jibin Francis
OBJECTIVE: We aim to compare the effectiveness of dural closure techniques in preventing cerebrospinal fluid (CSF) leaks following surgery for intradural lesions and seek to identify additional factors associated with CSF leaks. Surgical management of spinal intradural lesions involves durotomy which requires a robust repair to prevent postoperative CSF leakage. The ideal method of dural closure and the efficacy of sealants has not been established in literature. METHODS: We performed a retrospective analysis of all intradural spinal cases performed at a tertiary spine centre from 1 April 2015 to 29 January 2020 and collected data on patient bio-profile, dural repair technique, and CSF leak rates...
September 2023: Neurospine
https://read.qxmd.com/read/37798790/minimally-invasive-tubular-microdiscectomy-for-recurrent-lumbar-disc-herniation-step-by-step-technical-description-with-safe-scar-dissection
#40
JOURNAL ARTICLE
Khaled Fares AlAli
INTRODUCTION: Recurrent lumbar disc herniation (RLDH) is one of the most common reasons for re-operation after primary lumbar disc herniation with an incidence ranging from 5 to 23%. Numerous RLDH studies have been conducted; however, no available studies have provided a specific description of the use of the tubular retractor discectomy technique for RLDH emphasizing safe scar dissection. The objective of this study is to describe a detailed step-by-step technique for RLDH. MATERIAL AND METHODS: A surgical technique reporting on our experience from the year 2013-2021 in 9 patients with RLDH at the same level and same side was included in the study...
October 5, 2023: Journal of Orthopaedic Surgery and Research
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