Abstract:
:OBJECTIVE This study was performed to describe the incidence and predictors of perioperative complications following central corpectomy (CC) in 468 consecutive patients with cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL). METHODS The authors performed a retrospective review of a cohort of patients who had undergone surgery for CSM (n = 338) or OPLL (n = 130) performed by a single surgeon over a 15-year period. All patients underwent uninstrumented CC with autologous iliac crest or fibular strut grafting. Preoperative clinical and imaging details were collected, and the type and incidence of complications were studied. Univariate and multivariate analyses were performed to establish risk factors for the development of perioperative complications. RESULTS Overall, 12.4% of patients suffered at least 1 complication following CC. The incidence of major complications was as follows: C-5 radiculopathy, 1.3%; recurrent laryngeal nerve injury, 0.4%; dysphagia, 0.8%; surgical-site infection, 3.4%; and dural tear, 4.3%. There was 1 postoperative death (0.2%). On multivariate analysis, patients in whom the corpectomy involved the C-4 vertebral body (alone or as part of multilevel CC) were significantly more likely to suffer complications (p = 0.004). OPLL and skip corpectomy were risk factors for dural tear (p = 0.015 and p = 0.001, respectively). No factors were found to be significantly associated with postoperative C-5 palsy, dysphagia, or acute graft extrusion on univariate or multivariate analysis. Patients who underwent multilevel CC were predisposed to surgical-site infections, with a slight trend toward statistical significance (p = 0.094). The occurrence of a complication after surgery significantly increased the mean duration of postoperative hospital stay from 5.0 ± 2.3 days to 8.9 ± 6 days (p < 0.001). CONCLUSIONS Complications following CC for CSM or OPLL are infrequent, but they significantly prolong hospital stay. The most frequent complication following CC is dural tear, for which a diagnosis of OPLL and a skip corpectomy are significant risk factors.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Sarkar S,Nair BR,Rajshekhar Vdoi
10.3171/2016.3.FOCUS1638subject
Has Abstractpub_date
2016-06-01 00:00:00pages
E10issue
6issn
1092-0684journal_volume
40pub_type
杂志文章abstract:OBJECTIVE:Tractography is a useful technique that is standardly applied to visualize subcortical pathways. However, brain shift hampers tractography use during the course of surgery. While intraoperative MRI (ioMRI) has been shown to be beneficial for use in oncology, intraoperative tractography can rarely be performed...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.10.FOCUS20774
更新日期:2021-01-01 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:OBJECT:The DIAM is a polyester-encased silicone interspinous dynamic stabilization device that can unload the anterior column and reestablish the functional integrity of the posterior column. METHODS:The DIAM was implanted in 104 patients between May 1, 2001 and October 30, 2001. A retrospective evaluation was perform...
journal_title:Neurosurgical focus
pub_type: 杂志文章,多中心研究
doi:10.3171/foc.2007.22.1.6
更新日期:2007-01-15 00:00:00
abstract::Deep brain stimulation (DBS) is the treatment of choice for otherwise healthy patients with advanced Parkinson disease who are suffering from disabling dyskinesias and motor fluctuations related to dopaminergic therapy. As DBS is an elective procedure, it is essential to minimize the risk of morbidity. Further, precis...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.4.FOCUS10103
更新日期:2010-08-01 00:00:00
abstract::OBJECTIVEPituitary adenomas occur in a heterogeneous patient population with diverse perioperative risk factors, endocrinopathies, and other tumor-related comorbidities. This heterogeneity makes predicting postoperative outcomes challenging when using traditional scoring systems. Modern machine learning algorithms can...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.8.FOCUS18268
更新日期:2018-11-01 00:00:00
abstract:Objective:Treatment advances have resulted in improved survival for many cancer types, and this, in turn, has led to an increased incidence of metastatic disease, specifically to the vertebral column. Surgical decompression and stabilization prior to radiation therapy have been shown to improve functional outcomes, but...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.5.FOCUS16162
更新日期:2016-08-01 00:00:00
abstract::In this article, the author provides a brief description of the role of hypoxia in the tumorigenesis of gliomas and suggests potential ways of exploiting this role to design treatment modalities. Tumor hypoxia predicts the likelihood of metastases, tumor recurrence, resistance to chemotherapy and radiation therapy, in...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2006.20.4.16
更新日期:2006-04-15 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:OBJECT:The direct transnasal transsphenoidal approach to the sellar region has become a widely adopted surgical procedure among neurosurgeons and ear, nose, and throat specialists. Nasal complications and their incidence have been investigated, but a systematic testing of olfactory disturbance has not previously been p...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.7.FOCUS10162
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:Convection-enhanced delivery (CED) and osmotic pump delivery both have been promoted as promising techniques to deliver drugs to pediatric diffuse intrinsic pontine gliomas (DIPGs). Correspondingly, the aim of this study was to understand how infusate molecular weight (MW), duration of delivery, and mechanism...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.10.FOCUS19703
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Confocal laser endomicroscopy (CLE) is an established tool in basic research for tissue imaging at the level of microstructures. Miniaturization and refinement of the technology have made this modality available for operative imaging with a handheld device. Sufficient image contrast is provided by the preoper...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.11.FOCUS20783
更新日期:2021-01-01 00:00:00
abstract:OBJECT:Using strict biochemical remission criteria, the authors assessed surgical outcomes after endoscopic transsphenoidal resection of growth hormone (GH)-secreting pituitary adenomas and identified preoperative factors that significantly influence the rate of remission. METHODS:A retrospective review of a prospecti...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.7.FOCUS10153
更新日期:2010-10-01 00:00:00
abstract::Surgical removal remains one of the key treatment modalities for vestibular schwannomas. A team approach between a neurotologist and a neurosurgeon offers the patient the expertise of both specialties and maximizes the chances for an optimal outcome. Vestibular schwannomas can typically be resected through 1 of 3 main...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2012.6.FOCUS12190
更新日期:2012-09-01 00:00:00
abstract:Objective:The aim of this study was to investigate the diagnostic potential of the inflammatory markers interleukin-6 (IL-6), total leukocyte count (TLC), and protein in the CSF and IL-6, C-reactive protein, and white blood cell count in the serum for the early diagnosis of ventriculitis in patients with traumatic brai...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.8.FOCUS19407
更新日期:2019-11-01 00:00:00
abstract::For decades, lumbar disc herniation and lumbar stenosis have been treated surgically via traditional open techniques. With recent emphasis on minimally invasive approaches in spine surgery, a number of new techniques has been introduced that are aimed at treating these 2 common pathological conditions. Currently the m...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/25/8/E11
更新日期:2008-01-01 00:00:00
abstract::Focal cortical dysplasias (FCDs) are congenital malformations of cortical development that are a frequent cause of refractory epilepsy in both children and adults. With advances in structural and functional neuroimaging, these lesions are increasingly being identified as a cause of intractable epilepsy in patients und...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/25/9/E6
更新日期:2008-09-01 00:00:00
abstract::Frontal sinus fractures are heterogeneous, and management of these fractures is often modified based on injury pattern and institutional experience. The optimal initial treatment of frontal sinus fractures is controversial. Treatment strategies are aimed at correcting cosmetic deformity, as well as at preventing delay...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2012.3.focus1266
更新日期:2012-06-01 00:00:00
abstract:OBJECT:Previous methods to determine stroke prevalence, such as nationwide surveys, are labor-intensive endeavors. Recent advances in search engine query analytics have led to a new metric for disease surveillance to evaluate symptomatic phenomenon, such as influenza. The authors hypothesized that the use of search eng...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2011.2.FOCUS1124
更新日期:2011-06-01 00:00:00
abstract:OBJECT:The authors performed a retrospective study to assess the impact of functional neuronavigation and intraoperative MRI (iMRI) on surgery of extratemporal epileptogenic lesions on postsurgical morbidity and seizure control. METHODS:Twenty-five patients (14 females and 11 males) underwent extratemporal resections ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2013.2.FOCUS12397
更新日期:2013-04-01 00:00:00
abstract::OBJECTIVE The aim of this study was to identify and discuss operative nuances utilizing image guidance in the surgical management of aggressive sacral tumors. METHODS The authors report on their single-institution, multi-surgeon, retrospective case series involving patients with pathology-proven aggressive sacral tumo...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2016.6.FOCUS16125
更新日期:2017-01-01 00:00:00
abstract::Cerebral venous sinus thrombosis (CVST) is characterized by formation of widespread thrombus within the cerebral venous sinus system. CVST can cause venous hypertension, venous infarcts, hemorrhage and seizures. It is managed in most cases with systemic anticoagulation through the use of heparin to resolve the thrombu...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.V2.FOCUS14186
更新日期:2014-07-01 00:00:00
abstract::Spinal epidural lipomatosis is most commonly observed in patients receiving long-term exogenous steroid therapy, but can also be seen in patients with endogenous steroid overproduction, obesity, or idiopathic disease. With this condition, there is hypertrophy of the epidural adipose tissue, causing a narrowing of the ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2004-04-15 00:00:00
abstract::Venous interruption through surgical clip ligation is the gold standard treatment for ethmoidal dural arteriovenous fistula (e-dAVF). Their malignant natural history is attributable to the higher predilection for retrograde cortical venous drainage. This video illustrates an e-dAVF in a 70-year-old man with progressiv...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.2.FocusVid.18702
更新日期:2019-04-01 00:00:00
abstract::OBJECTIVE Isolated acute subdural hematoma (aSDH) is increasing in older populations and so is the use of oral anticoagulant therapy (OAT). The dramatic increase of OAT-with direct oral anticoagulants (DOACs) as well as with conventional anticoagulants-is leading to changes in the care of patients who present with aSD...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.8.FOCUS17421
更新日期:2017-11-01 00:00:00
abstract::The benefits of anterior interbody arthrodesis in deformity surgery are well known and include load sharing and increased fusion rates. A minimally invasive lateral transpsoas approach to the anterior lumbar spine is a promising alternative to traditional interbody techniques for the treatment of adult degenerative sc...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2013.V2.FOCUS13198
更新日期:2013-07-01 00:00:00
abstract::Revision spinal surgery is usually indicated in cases of persistent or recurrent symptoms related to neural compression, spinal deformity, or construct failure. An understanding of fundamental biomechanical principles of both spinal decompression and reconstructive strategies is essential to avoid unnecessary subseque...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2003.15.3.2
更新日期:2003-09-15 00:00:00
abstract::Iatrogenic intervertebral disc space infection is encountered following microsurgical discectomy, percutaneous laser disc decompression, automated percutaneous lumbar nucleotomy operations, and discography. The purpose of this paper is to present a case report and review the literature on the uncommon origins of pyoge...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2004-06-15 00:00:00
abstract::OBJECTIVE Many reports have successfully demonstrated that cervical disc arthroplasty (CDA) can preserve range of motion after 1- or 2-level discectomy. However, few studies have addressed the extent of changes in segmental mobility after CDA or their clinical correlations. METHODS Data from consecutive patients who u...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.10.FOCUS16411
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:Incidental aneurysms pose a challenge for physicians, who need to weigh the rupture risk against the risks associated with treatment and its complications. A statistical model could potentially support such treatment decisions. A recently developed aneurysm rupture probability model performed well in the US d...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.4.FOCUS19145
更新日期:2019-07-01 00:00:00
abstract::Traumatic intracranial aneurysms are rare, occurring in fewer than 1% of patients with cerebral aneurysms. They can occur following blunt or penetrating head trauma and are more common in the pediatric population. Traumatic aneurysms can be categorized histologically as true, false, or mixed, with false aneurysms bein...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2000.8.1.1829
更新日期:2000-01-15 00:00:00