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radiation spinal cord compression

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https://www.readbyqxmd.com/read/28917256/postoperative-stereotactic-body-radiotherapy-for-spinal-metastases
#1
Majed Alghamdi, Chia-Lin Tseng, Sten Myrehaug, Pejman Maralani, Chris Heyn, Hany Soliman, Young Lee, Mark Ruschin, Leodante Da Costa, Victor Yang, Mikki Campbell, Arjun Sahgal
Spine is a common site of metastases in cancer patients. Spine surgery is indicated for select patients, typically those with mechanical instability and/or malignant epidural spinal cord (or cauda equina) compression. Although post-operative conventional palliative external beam radiation therapy has been the standard of care, technical improvements in radiation planning and image-guided radiotherapy have allowed for the application of stereotactic body radiotherapy (SBRT) to the spine. Spine SBRT is intended to ablate residual tumor and optimize local control by delivering several fold greater biologically effective doses...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28881124/minimally-invasive-anterior-decompression-technique-without-instrumented-fusion-for-huge-ossification-of-the-posterior-longitudinal-ligament-in-the-thoracic-spine-technical-note-and-literature-review
#2
Jae Won Yu, Sang-O Yun, Chang-Sheng Hsieh, Sang-Ho Lee
OBJECTIVE: Several surgical methods have been reported for treatment of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. Despite rapid innovation of instruments and techniques for spinal surgery, the postoperative outcomes are not always favorable. This article reports a minimally invasive anterior decompression technique without instrumented fusion, which was modified from the conventional procedure. The authors present 2 cases of huge beak-type OPLL...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28881116/surgical-roles-for-spinal-involvement-of-hematological-malignancies
#3
Sang-Il Kim, Young-Hoon Kim, Kee-Yong Ha, Jae-Won Lee, Jin-Woo Lee
OBJECTIVE: Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. METHODS: From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28868185/t2-vertebrectomy-with-combined-anterior-and-posterior-arthrodesis-for-treatment-of-a-solitary-plasmacytoma
#4
Gordon Preston, Toomas Anton
BACKGROUND: Plasma cell neoplasmas are a heterogenous group of neoplastic tumor lesions occurring secondary to disordered proliferation of cells from a monocyte lineage. Plasmacytoma is a rare lesion that accounts for 5% of all plasma cell neoplasms. The current recommended treatment for solitary plasmacytoma is moderate dose radiation therapy. For patients who are suffering from axial back pain, spinal instability, radiculopathy, or bowel/bladder dysfunction secondary to spinal cord compression, surgical intervention with spinal decompression and stabilization can be used as an adjuvant to radiation therapy...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28868027/recurrent-meningioma-of-the-cervical-spine-successfully-treated-with-liposomal-doxorubicin
#5
William L Read, Felicia Williams
There is no standard systemic treatment for persons with recurrent meningioma who have exhausted surgery and radiation options. Liposomal doxorubicin is a cytotoxic chemotherapy which is sustainable and tolerable, with activity against a range of solid tumors. There exists one reported case of metastatic meningioma effectively treated with liposomal doxorubicin. We report a second case. Our patient, a 35-year-old man with recurrent meningioma compressing the cervical spinal cord received liposomal doxorubicin for 22 months with clinical improvement, minimal toxicity, and slow regression of his tumor...
May 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28863223/management-of-metastatic-spinal-cord-compression
#6
REVIEW
Quaovi Sodji, Joseph Kaminski, Christopher Willey, Nathan Kim, Waleed Mourad, John Vender, Byron Dasher
Cancer metastasis is a key event in tumor progression associated not only with mortality but also significant morbidity. Metastatic disease can promote end-organ dysfunction and even failure through mass effect compression of various vital organs including the spinal cord. In such cases, prompt medical attention is needed to restore neurological function, relieve pain, and prevent permanent damage. The three therapeutic approaches to managing metastatic spinal cord compression include corticosteroids, surgery, and radiation therapy...
September 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28795286/diagnostic-and-therapeutic-strategies-for-patients-with-malignant-epidural-spinal-cord-compression
#7
REVIEW
Dilan A Patel, Jian L Campian
Malignant epidural spinal cord compression (MESCC) is an oncologic emergency with the potential for devastating consequences for patients if not promptly diagnosed and treated. MESCC is diagnosed by imaging. MRI is by far the most sensitive test, preferably with gadolinium. Once the diagnosis of MESCC is suspected, patients with neurologic deficits should receive prompt administration of dexamethasone with a 10-mg IV loading dose followed by 4 mg every 6 h. Quick taper is recommended once the definitive treatment is established...
August 10, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28781913/nursing-review-section-of-surgical-neurology-international-evaluation-of-cervical-disc-disease-and-when-surgery-is-warranted
#8
REVIEW
Nancy E Epstein, Renee D Hollingsworth
BACKGROUND: Patients with cervical disc disease may present with radiculopathy (root compression), myelopathy (cord compression), or myeloradiculopathy. These complaints must be correlated with x-ray, magnetic resonance (MR) imaging, and computed tomographic (CT) scans. Although most patients can be managed nonsurgically, those with significant neurological deficits and larger disc herniations may require surgery. METHODS: The symptoms of cervical radiculopathy include pain radiating down one or both arms, while myelopathy may result in more diffuse numbness tingling or weakness in the upper and/or lower extremities...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28754642/symptomatic-thoracic-nerve-root-herniation-into-an-extradural-arachnoid-cyst-case-report-and-review-of-the-literature
#9
Nagesh C Shanbhag, Ruurd F Duyff, Rob J M Groen
BACKGROUND: Spinal extradural arachnoid cysts (SEACs) are relatively rare and usually asymptomatic. They preferentially are situated in the thoracic extradural space and almost always dorsal. SEACs may present with back pain and/or cord compression symptoms. Needle aspiration, needle fenestration, or open surgical resection/fenestration have been reported as treatment modalities. CASE DESCRIPTION: We present a 35-year-old woman who complained of radiating pain from the right lower thoracic region of her back toward the right inguinal region, which was aggravated upon defecation and straining...
July 25, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28718323/modern-approaches-to-the-management-of-metastatic-epidural-spinal-cord-compression
#10
Zain A Husain, Arjun Sahgal, Eric L Chang, Pejman Jabehdar Maralani, Charlotte D Kubicky, Kristin J Redmond, Charles Fisher, Ilya Laufer, Simon S Lo
Metastatic epidural spinal cord compression (MESCC) is an oncologic emergency requiring prompt treatment to maximize neurologic function, ambulatory function and local control. Traditionally, options for MESCC included external beam radiation therapy with or without surgery. Surgery has usually been reserved for the patient with optimal performance status, single level MESCC or mechanical instability. Advances in external beam radiation therapy such as the development of stereotactic body radiation therapy have allowed for the delivery of high-dose radiation, allowing for both long-term pain and local control...
July 18, 2017: CNS Oncology
https://www.readbyqxmd.com/read/28673511/reirradiation-of-the-spine-with-stereotactic-radiosurgery-efficacy-and-toxicity
#11
David Boyce-Fappiano, Erinma Elibe, Bo Zhao, M Salim Siddiqui, Ian Lee, Jack Rock, Samuel Ryu, Farzan Siddiqui
PURPOSE: To determine the potential benefits and adverse effects associated with reirradiating the spinal cord when at least 1 course of radiation therapy (RT) is stereotactic radiosurgery (SRS). METHODS AND MATERIALS: This institutional review board-approved retrospective review included 162 patients (237 reirradiated spine lesions). All patients received SRS at our institution between 2001 and 2013. Electronic medical records were reviewed for clinical exams and radiologic tests (computed tomography/magnetic resonance imaging)...
May 25, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28673383/preoperative-embolization-in-surgical-treatment-of-metastatic-spinal-cord-compression
#12
Caroline Clausen
An increasing number of patients develop symptomatic spinal metastasis and increasing evidence supports the benefit of surgical decompression and spinal stabilization combined with radiation therapy. However, surgery for metastatic spinal disease is known to be associated with a risk of substantial intraoperative blood loss and perioperative allogenic blood transfusion. Anemia is known to increase morbidity and mortality in patients undergoing surgery, but studies also indicate that transfusion with allogenic red blood cells (RBC) may lead to worse outcomes...
July 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28665472/hypofractionated-radiotherapy-for-complicated-bone-metastases-in-patients-with-poor-performance-status-a-phase-ii-international-trial
#13
Mauricio F Silva, Gustavo N Marta, Felipe P C Lisboa, Guilherme Watte, Fabio Trippa, Ernesto Maranzano, Neiro W da Motta, Marko Popovic, Tuan Ha, Bryan Burmeister, Edward Chow
PURPOSE: To evaluate the efficacy and safety of hypofractionated radiotherapy (16 Gy in 2 fractions, 1 week apart) in patients with complicated bone metastases and poor performance status. METHODS: A prospective single-arm phase II clinical trial was conducted from July 2014 to May 2016. The primary endpoint was pain response as defined in the International Consensus on Palliative Radiotherapy Endpoints. Secondary endpoints included quality of life as measured by quality of life questionnaire (QLQ) PAL-15 and QLQ-BM22 European Organisation for Research and Treatment of Cancer guidelines, pain flare, adverse events, re-irradiation, and skeletal complications...
June 20, 2017: Tumori
https://www.readbyqxmd.com/read/28579359/evolution-in-treatment-strategy-for-metastatic-spine-disease-presently-evolving-modalities
#14
REVIEW
N Kumar, R Malhotra, A S Zaw, K Maharajan, N Naresh, A Kumar, B Vellayappan
The advent of minimally invasive surgery (MIS) in the surgical management armamentarium and stereotactic radiosurgery in the domain of radiotherapy, has led to a major evolution in treatment of metastatic spine disease (MSD). We reviewed the recent literature to discuss evolution from open to MIS approaches in MSD and the concurrent evolution in radiotherapy. This will provide a sound base for further development and understanding of treatment paradigms in MSD. Literature review showed that evolution of surgery can be traced from inappropriate open surgery (i...
September 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28541420/surgical-decompression-of-high-grade-spinal-cord-compression-from-hormone-refractory-metastatic-prostate-cancer
#15
Muhammad Omar Chohan, Sweena Kahn, Gustav Cederquist, Anne S Reiner, Joseph Schwab, Ilya Laufer, Mark Bilsky
BACKGROUND: Spine and nonspine skeletal metastases occur in more than 80% of patients with prostate cancer. OBJECTIVE: To examine the characteristics of the patient population undergoing surgery for the treatment of prostate cancer metastatic to the spine. METHODS: A retrospective chart review was performed on all patients treated at our institution from June 1993 to August 2014 for surgical management of metastatic spine disease from prostate cancer...
May 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28507888/spine-stereotactic-body-radiotherapy-indications-outcomes-and-points-of-caution
#16
Chia-Lin Tseng, Wietse Eppinga, Raphaele Charest-Morin, Hany Soliman, Sten Myrehaug, Pejman Jabehdar Maralani, Mikki Campbell, Young K Lee, Charles Fisher, Michael G Fehlings, Eric L Chang, Simon S Lo, Arjun Sahgal
STUDY DESIGN: A broad narrative review. OBJECTIVES: The objective of this article is to provide a technical review of spine stereotactic body radiotherapy (SBRT) planning and delivery, indications for treatment, outcomes, complications, and the challenges of response assessment. The surgical approach to spinal metastases is discussed with an overview of emerging minimally invasive techniques. METHODS: A comprehensive review of the literature was conducted on the techniques, outcomes, and developments in SBRT and surgery for spinal metastases...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28478911/epithelioid-hemangioendothelioma-of-the-craniocervical-junction-case-report-and-review
#17
Ali Ender Ofluoglu, Mehmet Aydogan, Uzay Erdogan, Onder Ofluoglu
Epithelioid hemangioendotheliomas are uncommon vascular neoplasms and their spinal location is even rarer. We report clinical course of a 31-year-old man with an epithelioid hemangioendothelioma at the cranio-cervical junction. A cervical magnetic resonance imaging revealed tumor that caused posterior cervical cord compression. C1,2,3 total laminectomy and surgical excision of the tumor was performed. Postoperative external beam radiation was performed on the surgical field especially around the right vertebral artery...
May 3, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28458948/primary-atypical-teratoid-rhabdoid-tumor-in-the-adult-spine
#18
Michael McGinity, Huma Siddiqui, Gulpreet Singh, Fermin Tio, Ahmed Shakir
BACKGROUND: Atypical teratoid/rhabdoid tumor (ATRT) is a highly aggressive tumor of the central nervous system (WHO grade IV), which is most frequently found intracranially in young children and infants. Only three prior cases of primary ATRT involving the adult spine were found following a literature review, and the average survival for these patients was only 20 postoperative months. CASE DESCRIPTION: A 43 year-old female presented with an acute exacerbation of chronic neck pain...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28437208/considerations-for-quality-improvement-in-radiation-oncology-therapy-for-patients-with-uncomplicated-painful-bone-metastases
#19
Anne M Walling, Phillip J Beron, Tania Kaprealian, Patrick A Kupelian, Neil S Wenger, Susan A McCloskey, Christopher R King, Michael Steinberg
BACKGROUND: There is an increasing need for evidence-based efficiency in providing a growing amount of cancer care. One example of a quality gap is the use of multiple-fraction palliative radiation for patients with advanced cancer who have uncomplicated bone metastases; evidence suggests similar pain outcomes for treatment regimens with a lower burden of treatments. METHODS: During the first phase of quality improvement work, we used RAND/UCLA appropriateness methodology to understand how radiation oncologists at one academic medical center rate the appropriateness of different treatment regimens for painful uncomplicated bone metastases...
February 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28409420/single-fraction-spine-stereotactic-ablative-body-radiotherapy-with-volumetric-modulated-arc-therapy
#20
Matthew M Gestaut, Nitika Thawani, Sangroh Kim, Veera R Gutti, Sameer Jhavar, Niloyjyoti Deb, Andrew Morrow, Russell A Ward, Jason H Huang, Mehul Patel
This study investigated a single institution's experience with volumetric modulated arc therapy (VMAT) directed stereotactic ablative body radiotherapy (SABR) for vertebral metastases. From 2010 to 2014, 95 lesions of spinal metastases in 73 patients were treated with SABR using VMAT. Clinical local control, pain level, and use of steroid medication were employed to evaluate treatment responses. The majority (79%) of patients were treated with a radiation dose of 20 Gy in a single fraction. However, when normal tissue constraints could not be achieved, the dose was reduced to 18 Gy (11%) or 16 Gy (8%) in 1 fraction...
April 13, 2017: Journal of Neuro-oncology
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