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https://www.readbyqxmd.com/read/28648003/-curative-effect-analysis-of-15-cases-of-cervical-intra-and-extra-spinal-tumors-by-microsurgical-resection
#1
Y Han, X L Zheng, L Li, Z Q Jiang, F Y Lou, S J Zhang
Objective: To explore the curative effect of microsurgical treatment of cervical intra- and extra-spinal tumors. Methods: The clinical data of 15 patients with cervical intra-and extra-spinal tumors in Department of Neurosurgery, the First Affiliated Hospital of Bengbu Medical College from January 2013 to February 2017 were retrospectively analyzed. According to Shaw's tumor stage: 6 cases in stage Ⅰ, 5 cases in stage Ⅱ, 3 cases in stage Ⅲ, and 1 case in stage Ⅳ. About the surgical methods: 9 cases were treated via posterior median semi-laminectomy approach, of which were internal fixation in 2 cases, and via posterior median approach spinous process and vertebral plate complex orthotopic replantation to spinal canal plasty in 3 cases, other 3 cases were operated via anterior cervical approach, including internal fixation in 1 case...
June 20, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647656/delayed-retroclival-and-cervical-spinal-subdural-hematoma-complicated-by-pre-existing-chiari-malformation-in-an-adult-trauma-patient
#2
Ha Nguyen, Hoon Choi, Shekar Kurpad, Hesham Soliman
INTRODUCTION: Traumatic spinal subdural hematoma involving the retroclival region and upper cervical spine is a rare pathology. To our knowledge, there have only been two prior cases in an adult trauma patient. We describe a patient with pre-existing Chiari 1 malformation, who recently sustained a unilateral Type 1 OCF (occipital condyle fracture) with associated disruption of the tectorial membrane and transverse ligament, that returned with a retroclival subdural hematoma extending down to C7, causing spinal cord compression and symptomatic obstructive hydrocephalus...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28642180/obese-bmi-30-patients-have-greater-functional-improvement-and-reach-equivalent-outcomes-at-12-months-following-decompression-surgery-for-symptomatic-lumbar-stenosis
#3
Galal Elsayed, Matthew C Davis, Esther C Dupépé, Samuel G McCluggage, Paul Szerlip, Beverly C Walters, Mark N Hadley
OBJECTIVE: Here we evaluate the effect of obesity on 12-month functional outcomes following surgery for lumbar stenosis in an adult population. METHODS: Data were collected prospectively on patients treated with lumbar laminectomy for symptomatic lumbar spinal stenosis as part of an observational registry at a single institution from 2012 through 2014, and analyzed using a retrospective cohort study design. Patients with BMI>30 were compared to patients with BMI <30 with respect to baseline, 3-month, and 12-month functional status, adjusted for potential confounders...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28637109/closing-the-dura-dural-hitching-versus-surgicel-and-tisseel-overlay-graft-in-craniocervicaldecompression-for-chiari-1-malformation
#4
Michael Tonkins, Naeem Farooqi, Rohan Ahmed, Saurabh Sinha, Debapriya Bhattacharyya
BACKGROUND: This study compares dural hitching to surgicel and tisseel overlay graft following craniocervical decompression and C1 laminectomy with simple durotomy for Chiari I malformation. Outcome measures were syrinx decompression, headache resolution and complication rates. METHODS: A retrospective analysis of case notes was conducted. Patients who had undergone craniocervical decompression (CCD) were grouped by method of dural closure. Outcomes compared were rates of syrinx decompression, headache resolution, and post-operative complications...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28634709/incidental-durotomy-in-decompression-for-lumbar-spinal-stenosis-incidence-risk-factors-and-effect-on-outcomes-in-the-spine-tango-registry
#5
Christian Herren, Rolf Sobottke, Anne F Mannion, Thomas Zweig, Everard Munting, Philippe Otten, Tim Pigott, Jan Siewe, Emin Aghayev
PURPOSE: The three aims of this Spine Tango registry study of patients undergoing decompression for spinal stenosis were to: report the rate of dural tear (DT) stratified by treatment centre; find factors associated with an increased likelihood of incurring a DT; and compare treatment outcomes in relation to DT (none vs. repaired vs. unrepaired DT). METHODS: Multivariate logistic regression was used to assess the association between DT and patient and treatment characteristics...
June 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28633540/benign-ependymoma-with-extensive-intracranial-and-spinal-cerebrospinal-fluid-dissemination-case-report-and-literature-review
#6
Fangmei Zhu, Jurong Ding, Yumei Li, Dewang Mao, Xianglei He, Wanyuan Chen, Lin Lou, Zhongxiang Ding
Myxopapillary ependymoma (MPE) is a rare variant of ependymoma that is most commonly located in the cauda equina and filum terminale. We present a case of 23-year-old man diagnosed with MPE in the fourth ventricle and sacral canal area with extensive disseminated lesions along the cerebrospinal ventricular system. Additionally, a molecular pathological diagnosis was performed. The patient underwent a craniotomy and a lumbar laminectomy. In the course of 18 months of follow-up, the patient have recovered very well...
June 21, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28633411/surgeon-level-variability-in-outcomes-cost-and-comorbidity-adjusted-cost-for-elective-lumbar-decompression-and-fusion
#7
Silky Chotai, Ahilan Sivaganesan, John A Sielatycki, Kristin R Archer, Richard Call, Matthew J McGirt, Clinton J Devin
BACKGROUND: The costs and outcomes following degenerative spine surgery may vary from surgeon to surgeon. Patient factors such as comorbidities may increase the health care cost. These variations are not well studied. OBJECTIVE: To understand the variation in outcomes, costs, and comorbidity-adjusted cost for surgeons performing lumbar laminectomy and fusions surgery. METHODS: A total of 752 patients undergoing laminectomy and fusion, performed by 7 surgeons, were analyzed...
June 14, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28632550/suture-choice-in-lumbar-dural-closure-contributes-to-variation-in-leak-pressures-experimental-model
#8
George M Ghobrial, Christopher M Maulucci, Matthew J Viereck, Sara Beygi, Ameet Chitale, Srinivas Prasad, Jack Jallo, Joshua Heller, Ashwini D Sharan, James S Harrop
STUDY DESIGN: Open-label laboratory investigational study; non-animal surgical simulation. OBJECTIVE: The authors perform a comparison of dural closure strength in a durotomy simulator across 2 different suture materials. SUMMARY OF BACKGROUND DATA: Incidental durotomy leading to persistent cerebrospinal fluid leak adds considerable morbidity to spinal procedures, often complicating routine elective lumbar spinal procedures. Using an experimental durotomy simulation, the authors compare the strength of closure using Gore-Tex with other suture types and sizes, using various closure techniques...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28628969/comparative-induction-of-controlled-hypotension-by-electroacupuncture-at-du20-acupoint-and-remifentanil-in-lumbar-laminectomy
#9
Mehdi Ghaemi, Majid Ansari, Kourosh Amini
Hypotensive anesthesia is utilized to reduce bleeding during orthopedic surgery. One of the various drugs that have been used to reduce blood pressure is remifentanil. This study was an attempt to compare the effect of remifentanil with that of electroacupuncture (EA) at DU20 on reducing blood pressure. In this randomized controlled clinical trial, 54 patients undergoing lumbar laminectomy were allocated to two groups. Hypotensive anesthesia was performed through infusion of remifentanil 100 μg/kg/min for the control group, and EA at DU20 acupoint with a frequency of 2-10 Hz and intensity of 1-5 mA for the intervention group...
June 30, 2017: Chinese Journal of Physiology
https://www.readbyqxmd.com/read/28621617/intrathoracic-meningocele-associated-with-neurofibromatosis-type-1-and-a-novel-technique-for-surgical-repair-case-report
#10
Paramita Das, Tarini Goyal, Matthew A Hunt
Neurofibromatosis Type 1 (NF1) is a neurocutaneous disorder that can have associated spinal abnormalities related to both bone and dural dysplasia. Thoracic meningoceles are one spine anomaly associated with NF1, although they are a fairly uncommon pathology. Surgical techniques to treat these meningoceles, usually undertaken only when the patient is symptomatic, are targeted at decreasing the size of the protrusion and improving lung capacity. Surgical interventions discussed in the literature include shunting the pseudomeningocele, primary repair with laminectomy, thoracoscopic plication, and reinforcement of the closure with cement, muscle, or fascia...
June 16, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28618974/cystic-dilation-of-a-ventriculus-terminalis-case-report-and-review-of-the-literature
#11
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/28617531/controlled-release-mitomycin-c-polylactic-acid-film-prevents-epidural-scar-hyperplasia-after-laminectomy-by-inducing-fibroblast-autophagy-and-regulating-the-expression-of-mirnas
#12
B-B Wang, H Xie, T Wu, N Xie, J Wu, Y Gu, F Tang, J Liu
OBJECTIVE: To design a new controlled-release MMC-PLA film and explore whether and how this film could prevent epidural scar hyperplasia and adhesion in a post-laminectomy rat model. MATERIALS AND METHODS: All procedures were performed under the approval and supervision of the Institutional Animal Care and Use Committee (IACUC) of Nanjing Medical University. A total of 120 Sprague-Dawley (SD) rats were randomly placed into four groups after laminectomy (each group=30 rats)...
May 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28614233/discordant-lumbar-epidural-hematoma-after-caudal-steroid-injection-a-case-report-care-compliant
#13
Jung Ju Choi, Young Jin Chang, Wol Seon Jung, Kyung Cheon Lee, Ju Ho Kim, Youn Yi Jo
RATIONALE: Caudal epidural injection is one of the conventional treatments of chronic back pain. Even though spinal epidural hematoma after caudal epidural injection is rare but it can cause serious neurologic complication. PATIENT CONCERNS: An 83-year-old woman taking cilostazol received caudal epidural steroid injection because of her chronic back pain. Six hours later, she experienced an acute hip pain which worsened with time. DIAGNOSIS: Magnetic resonance image showed acute cord compression due to a spinal epidural hematoma at L2-S1 level with concomitant central canal compromise at L2/3, L3/4 level...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28607826/socioeconomic-and-regional-differences-in-the-treatment-of-cervical-spondylotic-myelopathy
#14
Sheri K Palejwala, Anand I Rughani, G Michael Lemole, Travis M Dumont
BACKGROUND: Cervical spondylotic myelopathy (CSM) is the leading cause of spinal cord dysfunction in the world. Surgical treatment is both medically and economically advantageous, and can be achieved through multiple approaches, with or without fusion. We used the Nationwide Inpatient Sample (NIS) database to better elucidate regional and socioeconomic variances in the treatment of CSM. METHODS: The NIS database was queried for elective admissions with a primary diagnosis of CSM (ICD-9 721...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28606580/comparison-of-operative-time-with-conventional-fluoroscopy-versus-spinal-neuronavigation-in-instrumented-spinal-tumor-surgery
#15
James A Miller, Andrew J Fabiano
OBJECTIVE: Spinal neuronavigation improves accuracy of pedicle screw placement but may increase operative time, and its use in oncological operations remains relatively unstudied. We compared the use of 2-dimensional (2D) fluoroscopy and 3-dimensional (3D) spinal neuronavigation relative to operative time in instrumented oncology procedures. METHODS: Consecutive instrumented oncologic spinal operations for multiple myeloma or metastatic disease performed between 2012 and 2014 were retrospectively reviewed...
June 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28605134/impact-of-direct-epispinal-stimulation-on-bladder-and-bowel-functions-in-pigs-a-feasibility-study
#16
Thomas Guiho, Claire Delleci, Christine Azevedo-Coste, Charles Fattal, David Guiraud, Jean-Rodolphe Vignes, Luc Bauchet
AIMS: This study assesses the potential of epispinal (subdural) stimulation application in the treatment of urinary and bowel neurological disorders. Acute experiments were performed on a large animal model - the domestic pig - to develop a new methodology facilitating future results and technology transfers to human. METHODS: After rectal and bladder catheterization, four Landrace pigs (45-50 kg) underwent spinal cord surgery - that is, lumbosacral incision, laminectomy [L4-S4], dural opening and microsurgical arachnoid dissection...
June 12, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28600008/lumbar-radiculopathy-in-the-setting-of-degenerative-scoliosis-mis-decompression-and-limited-correction-are-better-options
#17
REVIEW
Ricardo B Fontes, Richard G Fessler
Surgery for adult spinal deformity (ASD) has emerged as an efficient treatment alternative, but it is fraught with potential perioperative morbidity, incompletely mitigated by emerging minimally invasive surgical techniques. In mild-to-moderate ASD balanced in the sagittal plane, there are situations in which the counterintuitive simple decompression through a foraminotomy or laminectomy, or even a short-segment fusion may be an attractive treatment. This article presents a case example and the authors' treatment rationale and reviews the limited available literature supporting it...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28598927/intraoperative-analgesia-nociception-index-guided-fentanyl-administration-during-sevoflurane-anesthesia-in-lumbar-discectomy-and-laminectomy-a-randomized-clinical-trial
#18
Henry D Upton, Guy L Ludbrook, Andrew Wing, Jamie W Sleigh
BACKGROUND: The "Analgesia Nociception Index" (ANI; MetroDoloris Medical Systems, Lille, France) is a proposed noninvasive guide to analgesia derived from an electrocardiogram trace. ANI is scaled from 0 to 100; with previous studies suggesting that values ≥50 can indicate adequate analgesia. This clinical trial was designed to investigate the effect of intraoperative ANI-guided fentanyl administration on postoperative pain, under anesthetic conditions optimized for ANI functioning...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28593199/analysis-of-instrumentation-failures-after-three-column-osteotomies-of-the-spine
#19
Niranjan Kavadi, Richard A Tallarico, William F Lavelle
BACKGROUND: Correction of fixed spinal imbalance in a sagittal and/or coronal plane frequently needs a tricolumnar wedge resection when the deformity is rigid. Complications associated with deformity correction surgery are pseudoarthrosis and implant failure located along the construct. The purposes of this study were to assess comparative rates of pseudoarthrosis (implant failure) at weaker points along lumbosacral junction and level of osteotomy, estimate overall incidence of implant failure, and comparatively analyze failures at different points along the construct...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28591037/different-surgical-approaches-for-the-treatment-of-adjacent-segment-diseases-after-anterior-cervical-fusion-a-retrospective-study-of-49-patients
#20
Feng Wang, Peng Wang, De-Chao Miao, Wei Du, Yong Shen
Studies in the literature have not delineated the surgical approaches of symptomatic adjacent segment diseases (ASDs) in patients undergoing reoperation after an initial anterior cervical fusion (ACF). The purpose of this study was to determine the optimal surgical approaches of ASD and the incidence of the dysphagia after reoperation.This was a retrospective study of 49 patients with ASD after an initial ACF surgery, which had undergone a reoperation at our medical center between January 2010 and December 2014...
June 2017: Medicine (Baltimore)
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