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Myelotomy

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https://www.readbyqxmd.com/read/29101071/subarachnoid-to-subarachnoid-shunt-for-correction-of-nonfunctioning-baclofen-pump-in-a-severe-case-of-chronic-debilitating-post-spinal-cord-injury-spasticity
#1
Adewale A Bakare, Jonathan Weyhenmeyer, Albert Lee
BACKGROUND AND IMPORTANCE: Perhaps the most disabling condition seen in patients with spinal cord injury is spasticity. Spasticity is characterized as hyperreflexia and hypertonicity as a result of damage to the supraspinal tracts in the aftermath of SCI. Intrathecal baclofen (ITB) is the mainstay therapy for spasticity unresponsive to oral baclofen. One of the problems associated with post-SCI spasticity unresponsive to ITB is development of scar tissue that prevents the diffusion of baclofen in the desired spinal cord area...
October 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29057365/a-rare-case-of-intramedullary-solitary-juvenile-xanthogranuloma-of-the-lumbar-spine-in-the-adult-a-case-report
#2
Vania Pirillo, Andrea Prontera, Paolo Rizzo, Paolo Cipriano Cecchi, Martin Maffei, Andreas Schwarz
Solitary juvenile xanthogranuloma (SJX) of the spine is an extremely rare proliferative histiocytic disorder with only few cases reported in literature. We present the first case of intramedullary spinal SJX. A 22-year-old male presented with a nine-month history of progressively worsening sphincteric disturbances and saddle hypoesthesia. Magnetic resonance imaging showed an intra-axial lesion located in the conus medullaris; T1 hypointense, T2 iso-hyperintense and uniformly enhancing after contrast administration...
September 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28922881/intraoperative-flow-800-analysis-for-intramedullary-cystic-lesion-a-technical-case-report
#3
Masahiro Sawada, Toshihiro Munemitsu, Masato Hojo
BACKGROUND AND IMPORTANCE: During intramedullary lesion surgery, the lesion site and the posterior median sulcus (PMS) should be accurately identified prior to myelotomy to avoid severe injury of the posterior funiculus. However, intramedullary lesions are fundamentally invisible until the myelotomy is performed. Furthermore, the PMS location is frequently unclear due to lesion-induced swelling or distortion of the spinal cord. Intraoperative indocyanine green videoangiography (ICG-VA) followed by FLOW 800 analysis, which shows vascularization of the spinal parenchyma, may provide a solution for these problems in specific cases...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28899037/new-clinical-pathological-classification-of-intraspinal-injury-following-traumatic-acute-complete-thoracic-spinal-cord-injury-postdurotomy-myelotomy-observations-from-the-inspire-trial
#4
Richard T Layer, Thomas R Ulich, Domagoj Coric, Paul M Arnold, James D Guest, Robert H Heary, Patrick C Hsieh, Arthur L Jenkins, Kee D Kim, K Stuart Lee, Lorianne K Masuoka, Kristin M Neff, Wilson Z Ray, Nicholas Theodore, Michael G Fehlings
No abstract text is available yet for this article.
September 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28866064/surgical-outcomes-of-posterolateral-sulcus-approach-for-spinal-intramedullary-tumors-tumor-resection-and-functional-preservation
#5
Toshihiro Takami, Kentaro Naito, Toru Yamagata, Shinichi Kawahara, Kenji Ohata
BACKGROUND: Selection of the access myelotomy is a key issue in surgery for spinal intramedullary tumors. This study focused on surgical outcomes with the posterolateral sulcus (PLS) approach, equivalent to dorsal root entry zone myelotomy. METHODS: This retrospective study of the 10-year period from 2007 to 2016 included 90 cases of spinal intramedullary lesions (99 operations). A PLS approach was indicated for intramedullary lesions situated laterally in the spinal cord showing no contact with the spinal cord surface...
August 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28618974/cystic-dilation-of-a-ventriculus-terminalis-case-report-and-review-of-the-literature
#6
Masoud Zeinali, Hosein Safari, Saleh Rasras, Reza Bahrami, Mahdi Arjipour, Nima Ostadrahimi
The ventriculus terminalis (VT) is a small ependyma-lined cavity within the conus medullaris that is in direct continuity with the central canal of the spinal cord. Cystic dilatation of the ventriculus terminalis on its own is an extremely rare pathological event in adults whose pathogenesis is uncertain. VT has been described in children as a normal developmental phenomenon. These lesions are often diagnosed incidentally during imaging and are in most cases asymptomatic, especially in children. Symptomatic dilatation of VT in adults is a rare condition with 61cases being reported to date...
June 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28616260/the-therapeutic-effects-of-ablative-neurosurgical-procedures-on-the-spinal-cord-for-intractable-spinal-spasticity
#7
Bunpot Sitthinamsuwan, Pornchai Khumsawat, Luckchai Phonwijit, Sarun Nunta-Aree, Akkapong Nitising, Sirilak Suksompong
STUDY DESIGN: This research is a retrospective study. OBJECTIVE: To study the therapeutic effects of operative procedures, including dorsal longitudinal myelotomy (DLM) and dorsal root entry zone lesion (DREZL) on spasticity and associated aspects. SETTING: Tertiary university hospital in Bangkok, Thailand. METHODS: Eighteen patients with refractory spasticity of spinal origin who underwent the operations were recruited...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28512616/surgical-management-of-syringomyelia-associated-with-spinal-adhesive-arachnoiditis-a-late-complication-of-tuberculous-meningitis-a-case-report
#8
Jun Seok Lee, Geun Sung Song, Dong Wuk Son
Syringomyelia associated with tuberculous meningitis is an extremely rare condition. Only a few studies have reported clinical experience with syringomyelia as a late complication of tuberculous meningitis. Twenty-six years after a tuberculous meningitis episode, a 44-year-old man presented with progressively worsening spastic paresis of the lower limbs and impaired urinary function for 2 years. Radiological examination revealed syringomyelia extending from the level of C2 to T9 and arachnoiditis with atrophy of the spinal cord between C2 and T3...
April 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/28512052/cystic-dilation-of-the-ventriculus-terminalis-report-of-6-surgical-cases-treated-with-cyst-subarachnoid-shunting-using-a-t-catheter
#9
Liang Zhang, Zhifeng Zhang, Wuyang Yang, Wenqing Jia, Yulun Xu, Jun Yang
BACKGROUND: Cystic dilation of the ventriculus terminalis (CDVT) is a rare anatomic variation that and may become symptomatic. Literature regarding CDVT is limited, and thus the clinical characteristics and management strategy of CDVT are unclear. Here we report 6 cases of CDVT seen in our institution, and provide a review of the current literature. METHODS: The study cohort comprised 6 patients with CDVT seen at Beijing Tiantan Hospital between September 2010 and June 2015...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28414769/creation-of-an-intramedullary-cavity-by-hemorrhagic-necrosis-removal-24-h-after-spinal-cord-contusion-in-rats-for-eventual-intralesional-implantation-of-restorative-materials
#10
Gabriel Guizar-Sahagun, Angelina Martinez-Cruz, Rebecca E Franco-Bourland, Eduardo Cruz-García, Alvaro Corona-Juarez, Araceli Diaz-Ruiz, Israel Grijalva, Horacio J Reyes-Alva, Ignacio Madrazo
Intramedullary hemorrhagic necrosis occurs early after spinal cord injury at the site of injury and adjacent segments. It is considered harmful because of its potential to aggravate secondary injury, and to interfere with axonal regeneration; it might also lead to an unfavorable environment for intralesional implants. Removal of hemorrhagic necrosis has been attempted before with variable results. The invasive nature of these procedures carries the risk of exacerbating damage to the injured cord. The overall objective for this study was to test several strategies for non-damaging removal of hemorrhagic necrosis and characterize the resulting cavity looking for a space for future intralesional therapeutic implants in rats with acute cord injury...
2017: PloS One
https://www.readbyqxmd.com/read/27916035/-microsurgical-management-and-outcomes-of-intramedullary-spinal-arteriovenous-malformations-a-report-of-14-cases
#11
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/27777155/shunting-of-syringomyelic-cavities-by-using-a-myringotomy-tube-technical-note-and-long-term-results
#12
Dorota Tassigny, Basel Abu-Serieh, Daniella Tsague Fofe, Jacques Born, Germain Milbouw
BACKGROUND: Syringomyelia is a progressive cerebrospinal fluid disorder that can lead to irreversible spinal cord injury. To date, the optimal management of syringomyelic cavities remains controversial. Multiple studies have emphasized the importance of the craniocervical decompression or shunting procedures; however, except for syrinx related to Chiari malformation, nearly one-half of patients need to undergo reoperation. The purpose of the present study was to describe a simple and efficient surgical technique and to report the long-term radioclinical outcomes...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27713065/using-intraoperative-ultrasonography-for-spinal-cord-tumor-surgery
#13
Marcel Ivanov, Alexandru Budu, Hugh Sims-Williams, Ion Poeata
BACKGROUND: Our aim was to evaluate the usefulness of modern intraoperative ultrasonography (iUS) in the resection of a wide variety of spinal intradural pathologic entities. METHODS: We evaluated patients with spinal cord disease treated between January 2006 and September 2015. Intraoperative standard B-mode images were acquired using a 3.5-MHz to 12-MHz ultrasonographic probes (linear and curvilinear) on various ultrasound machines. The benefits and disadvantages of iUS were assessed for each case...
January 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27621952/neurological-outcomes-after-human-umbilical-cord-patch-for-in-utero-spina-bifida-repair-in-a-sheep-model
#14
Ramesha Papanna, Lovepreet K Mann, Saul Snowise, Yisel Morales, Sanjay P Prabhu, Scheffer C G Tseng, Raymond Grill, Stephen Fletcher, Kenneth J Moise
OBJECTIVES: The objective of our study was to test the hypothesis that in utero repair of surgically created spina bifida in a sheep model using cryopreserved human umbilical cord (HUC) patch improves neurological outcome. METHODS: Spina bifida with myelotomy was surgically created in timed pregnant ewes at gestational day (GD) 75. The fetuses were randomly assigned to unrepaired versus HUC and treated at GD 95 and then delivered at GD 140. Neurological evaluation was performed using the Texas Spinal Cord Injury Scale (TSCIS), bladder control using ultrasound, and the hindbrain herniation...
July 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27309344/first-human-implantation-of-a-bioresorbable-polymer-scaffold-for-acute-traumatic-spinal-cord-injury-a-clinical-pilot-study-for-safety-and-feasibility
#15
Nicholas Theodore, Randall Hlubek, Jill Danielson, Kristin Neff, Lou Vaickus, Thomas R Ulich, Alexander E Ropper
BACKGROUND AND IMPORTANCE: A porous bioresorbable polymer scaffold has previously been tested in preclinical animal models of spinal cord contusion injury to promote appositional healing, spare white matter, decrease posttraumatic cysts, and normalize intraparenchymal tissue pressure. This is the first report of its human implantation in a spinal cord injury patient during a pilot study testing the safety and feasibility of this technique (ClinicalTrials.gov Identifier: NCT02138110). CLINICAL PRESENTATION: A 25-year-old man had a T11-12 fracture dislocation sustained in a motocross accident that resulted in a T11 American Spinal Injury Association Impairment Scale (AIS) grade A traumatic spinal cord injury...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/26776665/intramedullary-hemangioblastoma-microsurgical-resection-technique
#16
M Messerer, G Cossu, E Pralong, R T Daniel
Spinal hemangioblastomas are benign and highly vascular tumors accounting for 1-5% of intramedullary spinal tumors in surgical series. Surgery is curative in sporadic cases. We present the description of a surgical technique to safely resect an intramedullary hemangioblastoma. A dorsal midline myelotomy provides an excellent exposure of the tumor and identification of the feeding arteries. Interruption of these arteries and precise dissection of the tumor from the cord tissue followed by division of the venous drainage allow the in toto excision of the tumor...
November 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/26557165/acute-onset-of-postoperative-syringohydromyelia
#17
K Santosh Mohan Rao, Chidambaram Balasubramaniam, K Subramaniam
Syringohydromyelia is a frequent finding in cases of tethered cord syndrome. The classical teaching is that the development and progression of a syrinx is a chronic process. We present a case report of an acute onset syringomyelia in an infant, who underwent an excision of a lumbosacral transitional lipoma and detethering of the cord. Immediately after recovery, the infant was found to have flaccid paraplegia. An emergency magnetic resonance imaging revealed a large acute onset syringomyelia for which he underwent an emergency midline myelotomy and release of fluid from the syrinx...
July 2015: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/26552643/brca2-positive-spinal-intramedullary-ovarian-metastatic-disease-case-report
#18
REVIEW
Vijay M Ravindra, Marcus D Mazur, Meghan Driscoll, Sara McEvoy, Meic H Schmidt
BACKGROUND CONTEXT: Ovarian cancer is the fourth leading cause of cancer death in women, but advances in treatment have led to longer survival among these patients. Tied to these advances and increased survival, however, have been new patterns of metastatic spread. PURPOSE: The authors discuss the management and surgical decision making in patients with intramedullary ovarian metastatic disease using a case illustration and relevant literature. STUDY DESIGN/SETTING: A case report was used...
March 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/26380823/intraoperative-neurophysiological-monitoring-in-spinal-surgery
#19
REVIEW
Jong-Hwa Park, Seung-Jae Hyun
Recently, many surgeons have been using intraoperative neurophysiological monitoring (IOM) in spinal surgery to reduce the incidence of postoperative neurological complications, including level of the spinal cord, cauda equina and nerve root. Several established technologies are available and combined motor and somatosensory evoked potentials are considered mandatory for practical and successful IOM. Spinal cord evoked potentials are elicited compound potentials recorded over the spinal cord. Electrical stimulation is provoked on the dorsal spinal cord from an epidural electrode...
September 16, 2015: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/26143129/treatment-of-selected-syringomyelias-with-syringo-pleural-shunt-the-experience-with-a-consecutive-26-cases
#20
Tao Fan, XinGang Zhao, HaiJun Zhao, Cong Liang, YinQian Wang, QiFei Gai, Fangyi Zhang
OF BACKGROUND DATA: It is well established that syringomyelia can cause neurological symptoms and deficit by accumulation of fluid within syrinx cavities that lead to internal compression within the spinal cord. When other intervention treating the underlying etiology failed to yield any improvement, the next option would be a procedure to divert the fluid from the syrinx cavity, such as syringo-subarachnoid, syringo-peritoneal or syringo-pleural shunting. The indications and long term efficacy of these direct shunting procedures are still questionable and controversial...
October 2015: Clinical Neurology and Neurosurgery
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