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 anterior access to the thoracolumbar junction may involve open thoracotomy, which can cause significant morbidity. The authors describe the treatment of 12 patients in whom a mini-open thoracoscopic-assisted approach (mini-open TAA) to the thoracolumbar junction was used to treat metastatic disease, with an analysis of outcomes. Methods:The authors reviewed a retrospective cohort of patients treated for thoracolumbar junction metastatic disease with mini-open TAA between 2004 and 2016. Data collection included operative time, estimated blood loss, length of stay, follow-up duration, and pre- and postoperative visual analog scale scores and Frankel grades. Results:Twelve patients underwent a mini-open TAA procedure for metastatic disease at the thoracolumbar junction. The mean age of patients was 59 years (range 53-77 years), mean estimated blood loss was 613 ml, and the mean duration of the mini-open TAA procedure was 234 minutes (3.8 hours). The median length of stay in the hospital was 7.5 days (range 5-21 days). All 12 patients had significant improvement in their postoperative pain scores in comparison with their preoperative pain scores (p < 0.001). No patients suffered from worsening neurological function after surgery, and of 7 patients who presented with neurological dysfunction, 6 (86%) had an improvement in their Frankel grade after surgery. No patients experienced delayed hardware failure requiring reoperation over a mean follow-up of 10 months (range 1-45 months). Conclusions:The mini-open TAA to the thoracolumbar junction for metastatic disease is a durable procedure that has a reduced morbidity rate compared with traditional open thoracotomy for ventral decompression and fusion. It compares well with traditional and novel posterior approaches to the thoracolumbar junction. The authors found a significant improvement in preoperative pain and neurological symptoms that supports greater use of the mini-open TAA for the treatment of complex metastatic disease at the thoracolumbar junction.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Ravindra VM,Brock A,Awad AW,Kalra R,Schmidt MHdoi
10.3171/2016.5.FOCUS16162subject
Has Abstractpub_date
2016-08-01 00:00:00pages
E16issue
2issn
1092-0684journal_volume
41pub_type
杂志文章abstract::Germ line and somatic mutations in the neurofibromatosis Type 2 (NF2) tumor suppressor gene predispose individuals to tumors of the nervous system, including schwannomas and meningiomas. Since identification of the NF2 gene more than a decade ago, a large body of information has been collected on the nature and conseq...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2005.19.5.7
更新日期:2005-11-15 00:00:00
abstract::Correction of rigid scoliotic deformities involving the thoracic spine has required that a thoracotomy be performed to obtain anterior release to mobilize the deformity, as well as placement of corrective spinal instrumentation either via a separate posterior or anterior thoracic approach. To the best of the author's ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1999.7.5.2
更新日期:1999-11-15 00:00:00
abstract::Fifty years before a report on the complete bitemporal lobectomy syndrome in primates, known as the Klüver-Bucy syndrome, was published, 2 talented investigators working at the University College in London, England-neurologist Sanger Brown and physiologist Edward Schäfer-also made this discovery. The title of their wo...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:10.3171/2017.6.FOCUS17265
更新日期:2017-09-01 00:00:00
abstract:OBJECT:Anterior cervical discectomy and fusion had been considered a safe and effective procedure for radiculopathy and myelopathy in the cervical spine, but degeneration in adjacent spinal levels has been a problem in some patients after fusion. Since 2002, cervical disc arthroplasty has been established as an alterna...
journal_title:Neurosurgical focus
pub_type: 杂志文章,meta分析,评审
doi:10.3171/2010.3.FOCUS1032
更新日期:2010-06-01 00:00:00
abstract::Endoscopic surgery represents a new and very useful modality of treatment for intracranial cysts. The authors review the cases of 19 patients with intracranial malformative CSF cysts (seven intraventricular, six paraventricular, and six arachnoid) who underwent endoscopic fenestration by using a burr-hole approach. Th...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:1999-04-15 00:00:00
abstract::Intravenous and intraarterial recombinant tissue plasminogen activator remains underutilized in the treatment of acute ischemic stroke, largely due to strict adherence to the concept of the therapeutic time window for administration. Recent efforts to expand the number of patients eligible for thrombolysis have been m...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.4.FOCUS10296
更新日期:2011-06-01 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::Hypothalamic hamartomas (HHs) are developmental malformations associated with a range of neurological problems, including intractable seizures. There is increasing evidence of the epileptogenicity of the hamartoma and of the inhomogeneous distribution of the epileptic abnormalities within the malformation. The managem...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.11.FOCUS10241
更新日期:2011-02-01 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:OBJECT:Minimally invasive lumbar discectomy is a refinement of the standard open microsurgical discectomy technique. Proponents of the minimally invasive technique suggest that it improves patient outcome, shortens hospital stay, and decreases hospital costs. Despite these claims there is little support in the literatu...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/25/8/E20
更新日期:2008-01-01 00:00:00
abstract::Spine surgery is a key target for cost reduction within the United States health care system. One possible strategy involves the transition of inpatient surgeries to the ambulatory setting. Lumbar laminectomy with or without discectomy, lumbar fusion, anterior cervical discectomy and fusion, and cervical disc arthropl...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.2.FOCUS17790
更新日期:2018-05-01 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::Several cases of congenital or acquired temporal encephaloceles have been reported in the literature as the causative mechanism of simple and/or complex partial seizures. In this report the authors describe a rare case of spontaneous parietal encephalocele presenting with simple partial seizures and progressively incr...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2005.19.3.11
更新日期:2005-09-15 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::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 retrospectiv...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.3.FOCUS1638
更新日期:2016-06-01 00:00:00
abstract::Neuromodulation and deep brain stimulation (DBS) have been increasingly used in many neurological ailments, including essential tremor, Parkinson's disease, epilepsy, and more. Yet for many patients and practitioners the desire to utilize these therapies is met with caution, given the need for craniotomy, lead inserti...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.4.FOCUS18130
更新日期:2018-08-01 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::Laser interstitial thermal therapy (LITT) is a minimally invasive procedure used to treat a variety of intracranial lesions. Utilization of robotic assistance with stereotactic procedures has gained attention due to potential for advantages over conventional techniques. The authors report the first case in which robot...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.4.FOCUS1622
更新日期:2016-10-01 00:00:00
abstract:OBJECT:The authors describe their experience with a technique for robotic implantation of depth electrodes in patients concurrently undergoing craniotomy and placement of subdural monitoring electrodes for the evaluation of intractable epilepsy. METHODS:Patients included in this study underwent evaluation in the Dartm...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC/2008/25/9/E19
更新日期:2008-09-01 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:OBJECT:In this study the authors address the efficacy and safety of frameless stereotaxy in transsphenoidal surgery. METHODS:One thousand transsphenoidal operations were performed at the authors' institution between June 2000 and July 2005. This series consists of a retrospective review of 176 patients entered in a pr...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2006.20.2.10
更新日期:2006-02-15 00:00:00
abstract::Neuroimaging is an indispensable tool in the workup and management of patients with neurological disorders. Arterial spin labeling (ASL) is an imaging modality that permits the examination of blood flow and perfusion without the need for contrast injection. Noninvasive in nature, ASL provides a feasible alternative to...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2019.9.FOCUS19567
更新日期:2019-12-01 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::Spine surgery carries an inherent risk of damage to critical neural structures. Intraoperative neurophysiological monitoring (IONM) is frequently used to improve the safety of spine surgery by providing real-time assessment of neural structures at risk. Evidence-based guidelines for safe and efficacious use of IONM ar...
journal_title:Neurosurgical focus
pub_type: 杂志文章,meta分析,评审
doi:10.3171/2012.9.FOCUS12235
更新日期:2012-11-01 00:00:00
abstract::OBJECTIVE The objective of this study was to compare postoperative sagittal alignment among 3 rod constructs with different rigidity profiles. METHODS This was a dual-center retrospective cohort study involving 2 consecutive cohorts in which patients were surgically treated for adolescent idiopathic scoliosis. Lenke T...
journal_title:Neurosurgical focus
pub_type: 杂志文章,多中心研究
doi:10.3171/2017.7.FOCUS17351
更新日期:2017-10-01 00:00:00
abstract::Anterior screw fixation of Type II odontoid fractures provides immediate stabilization of the cervical spine while preserving C1-2 motion. This technique has a high fusion rate, but can be technically challenging. The authors identify key points that should be taken into account to maximize the chance for a favorable ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.7.FOCUS11135
更新日期:2011-10-01 00:00:00
abstract:OBJECT:This paper describes a consecutive series of skull base meningiomas resected using an endoscopic endonasal approach through various corridors at a single institution over 7 years. The impact of case selection and experience, the presence of a cortical cuff between the tumor and surrounding vessels, and brain ede...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.7.FOCUS14321
更新日期:2014-01-01 00:00:00
abstract::OBJECTIVE Robot-guided pedicle screw placement is an established technique for the placement of pedicle screws. However, most studies have focused on degenerative disease. In this paper, the authors focus on metastatic spinal disease, which is associated with osteolysis. The associated lack of dense bone may potential...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.3.FOCUS1710
更新日期:2017-05-01 00:00:00
abstract::Epidermoid cysts or tumors comprise 1% of intracranial tumors with a predilection for the cerebellopontine angle or parasellar cisterns. These tumors are derived from an ectopic ectodermal implant seeded between fusing ectodermal surfaces. This results in a benign proliferation of stratified squamous epithelium along ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.1.FocusVid.15466
更新日期:2016-01-01 00:00:00
abstract::Intraoperative optical imaging (IOI) is a marker-free, contactless, and noninvasive imaging technique that is able to visualize metabolic changes of the brain surface following neuronal activation. Although it has been used in the past mainly for the identification of functional brain areas under general anesthesia, t...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.11.FOCUS19759
更新日期:2020-02-01 00:00:00