Peripheral nervous system injury after high-dose single-fraction image-guided stereotactic radiosurgery for spine tumors.

Abstract:

:OBJECTIVE The object of this study was to determine the percentage of high-dose (1800-2600 cGy) single-fraction stereotactic radiosurgery (SF-SRS) treatments to the spine that result in peripheral nervous system (PNS) injury. METHODS All patients treated with SF-SRS for primary or metastatic spine tumors between January 2004 and May 2013 and referred to the Rehabilitation Medicine Service for evaluation and treatment of neuromuscular, musculoskeletal, or functional impairments or pain were retrospectively identified. RESULTS Five hundred fifty-seven SF-SRS treatments in 447 patients resulted in 14 PNS injuries in 13 patients. All injures resulted from SF-SRS delivered to the cervical or lumbosacral spine at 2400 cGy. The overall percentage of SF-SRS treatments resulting in PNS injury was 2.5%, increasing to 4.5% when the thoracic spine was excluded from analysis. The median time to symptom onset following SF-SRS was 10 months (range 4-32 months). The plexus (cervical, brachial, and/or lumbosacral) was affected clinically and/or electrophysiologically in 12 (86%) of 14 cases, the nerve root in 2 (14%) of 14, and both in 6 (43%) of 14 cases. All patients experienced pain and most (93%) developed weakness. Peripheral nervous system injuries were CTCAE Grade 1 in 14% of cases, 2 in 64%, and 3 in 21%. No dose relationship between SF-SRS dose and PNS injury was detected. CONCLUSIONS Single-fraction SRS to the spine can result in PNS injury with major implications for function and quality of life.

journal_name

Neurosurg Focus

journal_title

Neurosurgical focus

authors

Stubblefield MD,Ibanez K,Riedel ER,Barzilai O,Laufer I,Lis E,Yamada Y,Bilsky MH

doi

10.3171/2016.11.FOCUS16348

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

E12

issue

3

issn

1092-0684

journal_volume

42

pub_type

杂志文章
  • Prognosis in patients presenting with brain metastasis from an undiagnosed primary tumor.

    abstract:OBJECT:The aim of this study was to test the validity of the hypothesis that patients in whom brain metastasis is the first indication of an undiagnosed primary tumor have a better chance of survival than similar patients with a known primary lesion. METHODS:Between January 1983 and December 1998, 342 patients with co...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.2007.22.3.8

    authors: D'Ambrosio AL,Agazzi S

    更新日期:2007-03-15 00:00:00

  • Approach-related complications after decompression for cervical ossification of the posterior longitudinal ligament.

    abstract::The surgical management of compressive cervical ossification of the posterior longitudinal ligament (OPLL) can be challenging. Traditionally, approach indications for decompression of cervical spondylotic myelopathy have been used. However, the postoperative complication profile after cervical OPLL decompression is un...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2011.1.FOCUS10278

    authors: Cardoso MJ,Koski TR,Ganju A,Liu JC

    更新日期:2011-03-01 00:00:00

  • Dural relationships of Meckel cave and lateral wall of the cavernous sinus.

    abstract:OBJECT:The purpose of this study was to elucidate the anatomy of the trigeminal nerve (cranial nerve [CN] V), Meckel cave (MC), and lateral wall of the cavernous sinus (CS). METHODS:Ten fresh cadaver heads (20 sides) and 2 middle fossa embalmed specimens were removed, decalcified, sectioned, stained, and studied micro...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/FOC.2008.25.12.E2

    authors: Janjua RM,Al-Mefty O,Densler DW,Shields CB

    更新日期:2008-01-01 00:00:00

  • Intraoperative monitoring of cerebral blood flow by laser speckle contrast analysis.

    abstract:OBJECT:Currently, reliable low-cost and noninvasive techniques to assess cerebral perfusion in the operating room are not available. The authors report on their first clinical experience with laser speckle contrast analysis (LASCA) as a complementary imaging tool for the noninvasive and dynamic assessment of cerebral b...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2009.8.FOCUS09148

    authors: Hecht N,Woitzik J,Dreier JP,Vajkoczy P

    更新日期:2009-10-01 00:00:00

  • Pretemporal trans-Meckel's cave transtentorial approach for large petroclival meningiomas.

    abstract::OBJECTIVE Despite the advances in skull base techniques, large petroclival meningiomas (PCMs) still pose a challenge to neurosurgeons. The authors' objective of this study was to describe a pretemporal trans-Meckel's cave transtentorial approach for large PCMs and to report the surgical outcomes. METHODS From 2014 to ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2018.1.FOCUS17733

    authors: Liao CH,Wang JT,Lin CF,Chen SC,Lin CJ,Hsu SPC,Chen MH

    更新日期:2018-04-01 00:00:00

  • Percival Bailey and the classification of brain tumors.

    abstract::Throughout his illustrious career, Percival Bailey made numerous contributions to the fields of neurology, neuroanatomy, psychiatry, neuropathology, and, of course, neurosurgery. His expertise, his curiosity about the nervous system, and his desire to examine it from all angles were unique. With the exception of Harve...

    journal_title:Neurosurgical focus

    pub_type: 传,历史文章,杂志文章,评审

    doi:10.3171/foc.2005.18.4.8

    authors: Ferguson S,Lesniak MS

    更新日期:2005-04-15 00:00:00

  • Expanding indications for the extended endoscopic endonasal approach to hypothalamic gliomas: preliminary report.

    abstract::Object In the last decade the indications for the endoscopic endonasal approach have been progressively expanded to include lesions that have not been traditionally considered amenable to resection through the transsphenoidal route. In this study, the authors analyze their experience with hypothalamic gliomas treated ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2014.7.FOCUS14317

    authors: Zoli M,Mazzatenta D,Valluzzi A,Marucci G,Acciarri N,Pasquini E,Frank G

    更新日期:2014-01-01 00:00:00

  • A comparison of minimally invasive posterior cervical decompression and open anterior cervical decompression and instrumented fusion in the surgical management of degenerative cervical myelopathy.

    abstract::OBJECTIVE Minimally invasive posterior cervical decompression (miPCD) has been described in several case series with promising preliminary results. The object of the current study was to compare the clinical outcomes between patients undergoing miPCD with anterior cervical discectomy and instrumented fusion (ACDFi). M...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2016.3.FOCUS1650

    authors: Abbas SF,Spurgas MP,Szewczyk BS,Yim B,Ata A,German JW

    更新日期:2016-06-01 00:00:00

  • Early outcomes of stereoelectroencephalography followed by MR-guided laser interstitial thermal therapy: a paradigm for minimally invasive epilepsy surgery.

    abstract::OBJECTIVE Stereoelectroencephalography (sEEG) and MR-guided laser interstitial thermal therapy (MRgLITT) have both emerged as minimally invasive alternatives to open surgery for the localization and treatment of medically refractory lesional epilepsy. Although some data are available about the use of these procedures ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2018.6.FOCUS18209

    authors: Cobourn K,Fayed I,Keating RF,Oluigbo CO

    更新日期:2018-09-01 00:00:00

  • Posterior fossa arteriovenous malformations.

    abstract::Arteriovenous malformations (AVMs) of the posterior fossa are complex neurovascular lesions that are less common than their supratentorial counterparts, accounting for < 15% of all AVMs. The majority of patients with these lesions present with intracranial hemorrhage, a factor that has been consistently shown to incre...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2009.2.FOCUS0914

    authors: Arnaout OM,Gross BA,Eddleman CS,Bendok BR,Getch CC,Batjer HH

    更新日期:2009-05-01 00:00:00

  • Operative intracranial infection following craniotomy.

    abstract:OBJECT:Postoperative infection after cranial surgery is a serious complication that requires immediate recognition and treatment. In certain cases such as postoperative meningitis, the patient can be treated with antibiotics only. In cases that involve a bone flap infection, subdural empyema, or cerebral abscess, howev...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/FOC/2008/24/6/E10

    authors: Dashti SR,Baharvahdat H,Spetzler RF,Sauvageau E,Chang SW,Stiefel MF,Park MS,Bambakidis NC

    更新日期:2008-01-01 00:00:00

  • Mini-open lateral retropleural/retroperitoneal approaches for thoracic and thoracolumbar junction anterior column pathologies.

    abstract:OBJECTIVE:Advancements in less invasive lateral retropleural/retroperitoneal approaches aim to address the limitation of posterolateral approaches and avoid complications associated with anterior open thoracotomy or thoracoabdominal approaches. METHODS:Consecutive patients treated with a mini-open lateral approach for...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2020.6.FOCUS20360

    authors: Christiansen PA,Huang S,Smith JS,Shaffrey ME,Uribe JS,Yen CP

    更新日期:2020-09-01 00:00:00

  • Selective embolization of ruptured feeding artery aneurysm followed by resection of arteriovenous malformation.

    abstract::This is the case of a man in his 40s who suffered sudden collapse into a deep coma as a result of a ruptured arteriovenous malformation (AVM) feeding artery aneurysm within the lateral ventricle. The ruptured aneurysm was successfully treated with Onyx embolization of the feeding pedicle. The AVM and the feeding arter...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2017.7.FocusVid.17127

    authors: Walcott BP,Russin JJ,Babadjouni R,Mack WJ

    更新日期:2017-07-01 00:00:00

  • Stereotactic navigation for the prepsoas oblique lateral lumbar interbody fusion: technical note and case series.

    abstract::The prepsoas retroperitoneal approach is a minimally invasive technique used for anterior lumbar interbody fusion. The approach may have a more favorable risk profile than the transpsoas approach, decreasing the risks that come with dissecting through the psoas muscle. However, the oblique angle of the spine in the pr...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2017.5.FOCUS17168

    authors: DiGiorgio AM,Edwards CS,Virk MS,Mummaneni PV,Chou D

    更新日期:2017-08-01 00:00:00

  • The history of brain retractors throughout the development of neurological surgery.

    abstract::Early neurosurgical procedures dealt mainly with treatment of head trauma, especially skull fractures. Since the early medical writings by Hippocrates, a great deal of respect was given to the dura mater, and many other surgeons warned against violating the dura. It was not until the 19th century that neurosurgeons st...

    journal_title:Neurosurgical focus

    pub_type: 历史文章,杂志文章

    doi:10.3171/2014.2.FOCUS13564

    authors: Assina R,Rubino S,Sarris CE,Gandhi CD,Prestigiacomo CJ

    更新日期:2014-04-01 00:00:00

  • Prophylaxis for deep venous thrombosis in neurosurgical oncology: review of 2779 admissions over a 9-year period.

    abstract:OBJECT:Management of disease in patients undergoing neurosurgical treatment for tumors requires balancing the competing risks of hemorrhage and thrombosis. The authors compared the incidence of clinically apparent deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients admitted for treatment of intracrania...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.2004.17.4.4

    authors: Smith SF,Simpson JM,Sekhon LH

    更新日期:2004-10-15 00:00:00

  • Surgical techniques for investigating the role of the insula in epilepsy: a review.

    abstract::Intracranial electroencephalography monitoring of the insula is an important tool in the investigation of the insula in medically intractable epilepsy and has been shown to be safe and reliable. Several methods of placing electrodes for insular coverage have been reported and include open craniotomy as well as stereot...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2012.1.FOCUS11325

    authors: Desai A,Bekelis K,Darcey TM,Roberts DW

    更新日期:2012-03-01 00:00:00

  • Motion-related vascular abnormalities at the craniocervical junction: illustrative case series and literature review.

    abstract::The craniocervical junction (CCJ) functions within a complicated regional anatomy necessary to protect and support vital neurovascular structures. In select instances, vascular pathology can be attributed to this complicated interplay of motion and structure found within this narrow space. The authors report 3 cases o...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2015.1.FOCUS14826

    authors: Ravindra VM,Neil JA,Mazur MD,Park MS,Couldwell WT,Taussky P

    更新日期:2015-04-01 00:00:00

  • The genetic predisposition to and histogenesis of neurofibromas and neurofibrosarcoma in neurofibromatosis type 1.

    abstract::The author addresses the issue of neurofibroma classification and implications for treatment. He emphasizes the importance of understanding that not all neurofibromas are the same and that the key differences between the types of neurofibromas involve which portions of the nerve sheath contribute to the distinctive be...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2007.22.6.4

    authors: Riccardi VM

    更新日期:2007-06-15 00:00:00

  • Outcomes after a purely endoscopic transsphenoidal resection of growth hormone-secreting pituitary adenomas.

    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

    authors: Campbell PG,Kenning E,Andrews DW,Yadla S,Rosen M,Evans JJ

    更新日期:2010-10-01 00:00:00

  • Two-level anterior cervical discectomy and cage-assisted fusion without plates.

    abstract:OBJECT:Anterior cervical discectomy (ACD) is an effective and safe treatment for nerve root or spinal cord compression caused by disc herniation or spondylosis. Cervical interbody fusion allows preservation of the physiological lordosis and stability of the cervical spine. Based on data reported in the literature, fusi...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.2002.12.1.4

    authors: Assietti R,Beretta F,Arienta C

    更新日期:2002-01-15 00:00:00

  • Significance of cerebrospinal fluid inflammatory markers for diagnosing external ventricular drain-associated ventriculitis in patients with severe traumatic brain injury.

    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

    authors: Lenski M,Biczok A,Neufischer K,Tonn JC,Briegel J,Thon N

    更新日期:2019-11-01 00:00:00

  • The genetic basis of intradural spinal tumors and its impact on clinical treatment.

    abstract::Genetic alterations in the cells of intradural spinal tumors can have a significant impact on the treatment options, counseling, and prognosis for patients. Although surgery is the primary therapy for most intradural tumors, radiochemothera-peutic modalities and targeted interventions play an ever-evolving role in tre...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2015.5.FOCUS15143

    authors: Karsy M,Guan J,Sivakumar W,Neil JA,Schmidt MH,Mahan MA

    更新日期:2015-08-01 00:00:00

  • Treatment of patients with a pituitary adenoma: one clinician's experience.

    abstract::The diagnosis and treatment of a patient with a pituitary adenoma or another type of pituitary lesion requires a team approach involving the neurosurgeon, endocrinologist, primary care physician, and, in some patients, an ophthalmologist and radiation therapist. The diagnosis of excessive pituitary hormone secretion a...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2004.16.4.2

    authors: Vance ML

    更新日期:2004-04-15 00:00:00

  • Surgical treatment of intractable epilepsy associated with focal cortical dysplasia.

    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

    authors: Diaz RJ,Sherman EM,Hader WJ

    更新日期:2008-09-01 00:00:00

  • Endovascular strategies for carotid cavernous and intracerebral dural arteriovenous fistulas.

    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

    authors: Ng PP,Higashida RT,Cullen S,Malek R,Halbach VV,Dowd CF

    更新日期:2003-10-15 00:00:00

  • Paracervical abscesses as life-threatening complications of outpatient pain treatment. Report of three cases.

    abstract::The authors present three cases of iatrogenic paracervical abscesses caused by infiltration therapy of pain medications used in conservative treatment in patients with chronic cervicobrachialgia. All three patients had received this therapy several times before presenting with clinical signs of a local infection. The ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.2004.17.6.13

    authors: Schütze M,Piek J

    更新日期:2004-12-15 00:00:00

  • Arachnoid cysts: case series and review of the literature.

    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

    authors: Pradilla G,Jallo G

    更新日期:2007-02-15 00:00:00

  • Comparison between anterior and posterior decompression with instrumentation for cervical spondylotic myelopathy: sagittal alignment and clinical outcome.

    abstract:OBJECT:A variety of anterior, posterior, and combined approaches exist to decompress the spinal cord, restore sagittal alignment, and avoid kyphosis, but the optimal surgical strategy remains controversial. The authors compared the anterior and posterior approach used to treat multilevel cervical spondylotic myelopathy...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2010.1.FOCUS09253

    authors: Cabraja M,Abbushi A,Koeppen D,Kroppenstedt S,Woiciechowsky C

    更新日期:2010-03-01 00:00:00

  • Facial nerve outcomes after surgery for large vestibular schwannomas: do surgical approach and extent of resection matter?

    abstract:OBJECT:The object of this study was to evaluate facial nerve outcomes in the surgical treatment of large vestibular schwannomas (VSs; ≥ 2.5 cm maximal or extrameatal cerebellopontine angle diameter) based on both the operative approach and extent of tumor resection. METHODS:A PubMed search was conducted of English lan...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2012.7.FOCUS12199

    authors: Gurgel RK,Dogru S,Amdur RL,Monfared A

    更新日期:2012-09-01 00:00:00