Abstract:
OBJECT:Diagnosis of cervical spinal injury (CSI) is an essential aspect of the trauma evaluation. This task is especially difficult in patients who are not clinically able to be evaluated (unevaluable) because of distracting painful injuries, intoxication, or concomitant head injury. For this population, the appropriate use of advanced imaging techniques for cervical spinal clearance remains undetermined. This study was undertaken to estimate the prevalence of unstable CSI, particularly among patients in whom clinical evaluation is impossible or unreliable. METHODS:Estimates of the prevalence of CSI in populations consisting of all trauma patients, alert patients only, and clinically unevaluable patients only were determined by variance-weighted pooling of data from 65 publications (281,864 patients) that met criteria for review. RESULTS:The overall prevalence of CSI among all trauma patients was 3.7%. The prevalence of CSI in alert patients was 2.8%, whereas unevaluable patients were at increased risk of CSI with a prevalence of 7.7% (p = 0.007). Overall, 41.9% of all CSI cases were considered to exhibit instability. CONCLUSIONS:Trauma patients who are clinically unevaluable have a higher prevalence of CSI than alert patients. Knowledge of the prevalence and risk of such injuries may help establish an evidence-based approach to the detection and management of clinically occult CSI.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Milby AH,Halpern CH,Guo W,Stein SCdoi
10.3171/FOC.2008.25.11.E10subject
Has Abstractpub_date
2008-01-01 00:00:00pages
E10issue
5issn
1092-0684journal_volume
25pub_type
杂志文章,评审abstract::OBJECTIVE Stereotactic needle biopsies are usually performed for histopathological confirmation of intracranial lymphomas to guide adequate treatment. During biopsy, intraoperative histopathology is an effective tool to avoid acquisition of nondiagnostic samples. In the last years, 5-aminolevulinic acid (5-ALA)-induce...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.3.FOCUS1859
更新日期:2018-06-01 00:00:00
abstract:OBJECT:Convection-enhanced delivery (CED) is an increasingly used novel local/regional delivery method targeted directly to tissue. It relies on a continuous pressure gradient for distribution of therapeutic agents into the interstitial space, with administration of the infusate over a few days. Cintredekin besudotox (...
journal_title:Neurosurgical focus
pub_type: 临床试验,杂志文章
doi:
更新日期:2006-04-15 00:00:00
abstract:OBJECT:A more comprehensive understanding of the epigenetic abnormalities associated with meningioma tumorigenesis, growth, and invasion may provide useful targets for molecular classification and development of targeted therapies for meningiomas. METHODS:The authors performed a review of the current literature to ide...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2013.10.FOCUS13360
更新日期:2013-12-01 00:00:00
abstract::For a physician has the worth of many other warriors, both for the excision of arrows and for the administration of soothing drugs. Homer, Iliad XI.514-515 Ever since armed conflict has been used as a means to settle disputes among men, there have been those who have been tasked to mend the wounds that ravage a soldie...
journal_title:Neurosurgical focus
pub_type: 历史文章
doi:10.3171/2010.3.FOCUSMar2010Intro
更新日期:2010-05-01 00:00:00
abstract::Spine surgery has been disproportionately impacted by medical liability and malpractice litigation, with the majority of claims and payouts related to procedural error. One common area for the potential avoidance of malpractice claims and subsequent payouts involves misplaced pedicle and/or lateral mass instrumentatio...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.8.FOCUS20600
更新日期:2020-11-01 00:00:00
abstract::OBJECTIVE The microscopic transoral, endoscopic transnasal, and endoscopic transoral approaches are used alone and in combination for a variety of craniovertebral junction (CVJ) pathologies. The endoscopic transoral approach provides a more direct exposure that is not restricted by the nasal cavity, pterygoid plates, ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.11.FOCUS15498
更新日期:2016-02-01 00:00:00
abstract:OBJECT:Arachnoid cysts are commonly encountered fluid collections in the central nervous system. Recent advances in neuroimaging have translated into an increased detection of these cysts; that is, diagnoses can be made more frequently at earlier stages. Significant advances have also been made in the surgical manageme...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.2.7
更新日期:2007-02-15 00:00:00
abstract::OBJECTIVE The treatment of cervical spinal metastases represents a controversial issue regarding the type, extent, and invasiveness of interventions. In the lumbar and thoracic spine, kypho- and vertebroplasties have been established as minimally invasive procedures for patients with metastases to the vertebral bodies...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.5.FOCUS17175
更新日期:2017-08-01 00:00:00
abstract::This video demonstrates a surgical technique of resecting dorsum sellae meningioma using a combined interhemispheric translamina terminalis approach and pterional approach with clinoidectomy. The tumor, 5 cm in maximum diameter, originated from the dorsum sellae, compressed the third ventricle and the midbrain, and di...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.10.FocusVid.17302
更新日期:2017-10-01 00:00:00
abstract::Medulloblastoma and primitive neuroectodermal tumors (PNETs) are the most common malignant brain tumors in children. The concern for late sequelae of neuraxis irradiation and the obligation to improve disease-free survival in children who harbor malignant brain tumors has led to the additional provision of systemic ch...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1999.7.2.3
更新日期:1999-08-15 00:00:00
abstract::Stereotactic radiosurgery (SRS) with the Gamma Knife and linear accelerator has revolutionized neurosurgery over the past 20 years. The most common indications for radiosurgery today are tumors and arteriovenous malformations of the brain. Functional indications such as treatment of movement disorders or intractable p...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC-07/12/E3
更新日期:2007-01-01 00:00:00
abstract::Lumbosacral interbody fusion may be indicated to treat degenerative disc disease at L5-S1, instability or spondylolisthesis at that level, and severe neural foraminal stenosis resulting from loss of disc space height. In addition, L5-S1 interbody fusion may provide anterior support to a long posterior fusion construct...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2014.2.FOCUS13467
更新日期:2014-05-01 00:00:00
abstract::The authors describe a new piece of equipment that enables simultaneous monitoring of the endoscopic image and unilateral microscopic image; that is, "picture-in-picture" images for endoscope-assisted microsurgery. The system is simple and purely optical, consisting of light-weight semi-rigid fibers and a special adap...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1999.6.4.13
更新日期:1999-04-15 00:00:00
abstract:OBJECT:In this report the authors review the role of bioinformatics in the design of a research project in which the molecular genetics of malignant glioma were studied. A project to characterize Pokemon expression in malignant glioma was developed, refined, and implemented using bioinformatics methods. METHODS:Using ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2005.19.4.9
更新日期:2005-10-15 00:00:00
abstract::Chiari malformation is a developmental disorder that is often associated with other abnormalities of the cerebrospinal axis. Despite widespread recognition of this association, there is relatively little information on the treatment of these coexisting disorders in the setting of cerebellar tonsillar ectopia. In an ef...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1999.6.6.5
更新日期:1999-06-15 00:00:00
abstract:OBJECTIVE:The recognition that neurosurgeons harbor great potential to advocate for the care of individuals with neural tube defects (NTDs) globally has sounded as a clear call to action; however, neurosurgical care and training in low- and middle-income countries (LMICs) present unique challenges that must be consider...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.12.FOCUS19448
更新日期:2020-03-01 00:00:00
abstract::Although the expectation of monetary compensation has been associated with failures in lumbar discectomy, the issue has not been investigated in patients undergoing cervical disc surgery. The authors analyzed the relationship between economic forms of secondary gain and surgical outcome in a group of patients with a c...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1998.5.2.9
更新日期:1998-08-15 00:00:00
abstract::High-flow microinfusion is a novel technique for delivery of compounds directly into the brain parenchyma, bypassing the blood-brain barrier. The feasibility of this technique has been demonstrated with low-molecular-weight compounds, macromolecular dyes, and proteins. Delivery of antisense oligonucleotides into the b...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1997.3.5.7
更新日期:1997-11-15 00:00:00
abstract::Interventional neuroradiology is a less invasive modality than open neurosurgery for the treatment of a wide range of neurovascular disorders. Refinements in technique and improvements in the design of microcatheters, guide wires, and embolic materials have yielded superior clinical outcomes and provided an impetus to...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2003.15.4.7
更新日期:2003-10-15 00:00:00
abstract::Peritumoral cysts (those arising immediately adjacent to the tumor mass) are frequently associated with benign and malignant tumors of the brain and spinal cord (syringomyelia). The cystic component of central nervous system (CNS) tumors and associated peritumoral cysts are often the cause of clinical symptoms. Becaus...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.5.10
更新日期:2007-05-15 00:00:00
abstract::Central skull base lesions in the upper retroclival and petroclival regions can be challenging to access because of their location anterior to the brainstem. Several transpetrosal approaches have been developed to access the petroclival junction, including anterior petrosal (anterior petrosectomy), posterior petrosal ...
journal_title:Neurosurgical focus
pub_type: 临床试验,杂志文章
doi:10.3171/FOC.2008.25.12.E5
更新日期:2008-01-01 00:00:00
abstract:OBJECT:Bell palsy remains the most common cause of facial paralysis. Unfortunately, this term is often erroneously applied to all cases of facial paralysis. METHODS:The authors performed a retrospective review of data obtained in 11 patients who were treated at a university-based referral practice between July 1988 an...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.5.3
更新日期:2002-05-15 00:00:00
abstract:OBJECT:This review summarizes the continuous study of low-power laser radiation treatment of a severely injured peripheral nerve. Laser phototherapy was applied as a supportive factor for accelerating and enhancing axonal growth and regeneration after injury or a reconstructive peripheral nerve procedure. In nerve cell...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC.2009.26.2.E8
更新日期:2009-02-01 00:00:00
abstract::In this paper, the authors' aim is to provide an evidence-based review of primary and secondary ischemic stroke prevention guidelines covering most of the common risk factors and stroke etiologies for the practicing neurosurgeon. The key to stroke prevention is in the identification and treatment of the major risk fac...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.2.FOCUS1164
更新日期:2011-06-01 00:00:00
abstract::OBJECTIVE The accuracy of robot-guided pedicle screw placement has been proven to be high, but little is known about the impact of such guidance on clinical outcomes such as the rate of revision surgeries for screw malposition. In addition, there are very few data about the impact of robot-guided fusion on patient-rep...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.3.FOCUS16534
更新日期:2017-05-01 00:00:00
abstract:OBJECT:Positional plagiocephaly (PP) has been on the rise in recent years. In this review, the authors' aim was to assess the effectiveness of current recommendations to parents on this exceedingly common problem through a comprehensive literature search. Additionally, the current treatment options and the most recent ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,meta分析,评审
doi:10.3171/2013.8.FOCUS13261
更新日期:2013-10-01 00:00:00
abstract::From February 4 to 11, 1945, President Franklin D. Roosevelt of the United States, Soviet Union Premier Joseph Stalin, and British Prime Minister Winston Churchill met near Yalta in Crimea to discuss how post-World War II (WWII) Europe should be organized. Within 2 decades of this conference, all 3 men had died. Presi...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:10.3171/2016.4.FOCUS1575
更新日期:2016-07-01 00:00:00
abstract:OBJECT:The percentage of patients responding to conservative treatment for cervical radiculopathy secondary to nerve root compression is not well quantified. To clarify this question, the authors retrospectively reviewed the records obtained over a 4-year period in patients with cervical radiculopathy to determine thei...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.2.4
更新日期:2002-02-15 00:00:00
abstract::OBJECTIVE The American Association of Neurological Surgeons launched the Quality Outcomes Database (QOD), a prospective longitudinal registry that includes demographic, clinical, and patient-reported outcome (PRO) data, to measure the safety and quality of neurosurgical procedures, including spinal surgery. Differing ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.10.FOCUS17553
更新日期:2018-01-01 00:00:00
abstract::Cellular therapy has been evaluated in small animals, subhuman primates, and now humans for the potential repair of brain injury due to stroke. Experimental striate stroke models have proven useful for the purpose of evaluating different treatment paradigms. Early clinical trials involving neuronal transplantation in ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.13.5.2
更新日期:2002-11-15 00:00:00