Abstract:
:OBJECTIVE Sagittal malalignment decreases patients' quality of life and may require surgical correction to achieve realignment goals. High-risk posterior-based osteotomy techniques are the current standard treatment for addressing sagittal malalignment. More recently, anterior lumbar interbody fusion, anterior column realignment (ALIF ACR) has been introduced as an alternative for correction of sagittal deformity. The objective of this paper was to report clinical and radiographic results for patients treated using the ALIF-ACR technique. METHODS A retrospective study of 39 patients treated with ALIF ACR was performed. Patient demographics, operative details, radiographic parameters, neurological assessments, outcome measures, and preoperative, postoperative, and mean 1-year follow-up complications were studied. RESULTS The patient population comprised 39 patients (27 females and 12 males) with a mean follow-up of 13.3 ± 4.7 months, mean age of 66.1 ± 11.6 years, and mean body mass index of 27.3 ± 6.2 kg/m2. The mean number of ALIF levels treated was 1.5 ± 0.5. Thirty-three (84.6%) of 39 patients underwent posterior spinal fixation and 33 (84.6%) of 39 underwent posterior column osteotomy, of which 20 (60.6%) of 33 procedures were performed at the level of the ALIF ACR. Pelvic tilt, sacral slope, and pelvic incidence were not statistically significantly different between the preoperative and postoperative periods and between the preoperative and 1-year follow-up periods (except for PT between the preoperative and 1-year follow-up, p = 0.018). Sagittal vertical axis, T-1 spinopelvic inclination, lumbar lordosis, pelvic incidence-lumbar lordosis mismatch, intradiscal angle, and motion segment angle all improved from the preoperative to postoperative period and the preoperative to 1-year follow-up (p < 0.05). The changes in motion segment angle and intradiscal angle achieved in the ALIF-ACR group without osteotomy compared with the ALIF-ACR group with osteotomy at the level of ACR were not statistically significant. Total visual analog score, Oswestry Disability Index, and Scoliosis Research Society-22 scores all improved from preoperative to postoperative and preoperative to 1-year follow-up. Fourteen patients (35.9%) experienced 26 complications (15 major and 11 minor). Eleven patients required reoperation. The most common complication was proximal junctional kyphosis (6/26 complications, 23%) followed by vertebral body/endplate fracture (3/26, 12%). CONCLUSIONS This study showed satisfactory radiographic and clinical outcomes at the 1-year follow-up. Proximal junctional kyphosis was the most common complication followed by fracture, complications that are commonly associated with sagittal realignment surgery and may not be mitigated by the anterior approach.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Hosseini P,Mundis GM Jr,Eastlack RK,Bagheri R,Vargas E,Tran S,Akbarnia BAdoi
10.3171/2017.8.FOCUS17423subject
Has Abstractpub_date
2017-12-01 00:00:00pages
E6issue
6issn
1092-0684journal_volume
43pub_type
杂志文章abstract::The most commonly accepted indications for cervical disc arthroplasty (CDA) are 1- and 2-level cervical disc herniation or spondylosis causing radiculopathy or myelopathy that is refractory to medical management. Unlike anterior cervical discectomy and fusion (ACDF), which eliminates motion, CDA aims to restore the ph...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.1.FocusVid.16380
更新日期:2017-01-01 00:00:00
abstract::Incidental findings pose considerable management dilemmas for the treating physician and psychological burden for the respective patient. With an aging population, more patients will be diagnosed with asymptomatic internal carotid artery stenosis. Patients will have to be counseled with regard to treatment options acc...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.9.FOCUS11222
更新日期:2011-12-01 00:00:00
abstract::Cysticercosis is the most common parasitic infection of the central nervous system. It infrequently affects the spine, but when it does, it can present with symptoms similar to other more common spinal diseases. The authors present a case of isolated intramedullary cysticercosis of the cervical spine and review the li...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.12.6.11
更新日期:2002-06-15 00:00:00
abstract:OBJECT:Tumors of the lateral ventricle can be removed via two major approaches: the transcallosal or the transcortical route. The purpose of this study is to discuss the techniques and outcomes in transcortical surgery of tumors located in the lateral ventricle. METHODS:An experience with 29 consecutive lateral ventri...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2001.10.6.3
更新日期:2001-06-15 00:00:00
abstract::The Quality Outcomes Database (QOD), formerly known as the National Neurosurgery Quality Outcomes Database (N2QOD), was established by the NeuroPoint Alliance (NPA) in collaboration with relevant national stakeholders and experts. The overarching goal of this project was to develop a centralized, nationally coordinate...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.2.FOCUS207
更新日期:2020-05-01 00:00:00
abstract:OBJECT:The middle third of the clivus and the region around the petrous internal carotid artery (ICA) is a difficult area of the skull base in terms of access. This is a deep area rich with critical neurovascular structures, which is often host to typical skull base diseases. Expanded endoscopic endonasal approaches of...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:2005-07-15 00:00:00
abstract::In the treatment of acoustic neuroma, operative results have improved greatly during recent years, with high rates of functional cranial nerve preservation. Because of this, it has become more important to consider issues of patient satisfaction and quality of life (QOL) following treatment for these lesions. The auth...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:1998-09-15 00:00:00
abstract:OBJECTIVE:Establishing the neurological localization doctrine for the contralateral hemispheric control of motor functions in the second half of the 19th century, researchers faced the challenge of recognizing false localizing signs, in particular paradoxical or ipsilateral hemiparesis (IH). Despite tremendous progress...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2019.6.FOCUS19337
更新日期:2019-09-01 00:00:00
abstract::Arteriovenous malformation (AVM) presenting with epilepsy significantly impacts patient quality of life, and it should be considered very much a seizure disorder. Although hemorrhage prevention is the primary treatment aim of AVM surgery, seizure control should also be at the forefront of therapeutic management. Sever...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.1.FOCUS19899
更新日期:2020-04-01 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::Cellular replacement therapy attempts to improve functioning of the diseased human central nervous system (CNS). In this second installment of a 2-part review, the authors discuss the major challenges to the translation of in vitro and animal studies of neural stem cell (NSC) therapy in the clinical setting. This anal...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/24/3-4/E22
更新日期:2008-01-01 00:00:00
abstract::Trepanation is the process by which a hole is drilled into the skull, exposing the intracranial contents for either medical or mystical purposes. It represents one of the oldest surgical procedures, and its practice was widespread in many ancient cultures and several parts of the world. Trepanation was used in ancient...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章,评审
doi:10.3171/foc.2007.23.1.11
更新日期:2007-01-01 00:00:00
abstract::OBJECT Bevacizumab (Avastin), an antibody to vascular endothelial growth factor (VEGF), alone or in combination with irinotecan (Camptosar [CPT-11]), is a promising treatment for recurrent glioblastoma. However, the intravenous (IV) administration of bevacizumab produces a number of systemic side effects, and the incr...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.1.FOCUS14743
更新日期:2015-03-01 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::The retrosigmoid approach is a work-horse approach to the cerebellopontine angle (CPA), providing access from the foremen magnum to the tentorium. Indications for this approach are variable such as resection of meningiomas, acoustic neuromas and epidermoid tumors, treatment of vascular lesions of vertebrobasilar syste...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.V1.FOCUS13445
更新日期:2014-01-01 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:OBJECT:The authors conducted a study to review their experience with tentorial dural arteriovenous fistulas (DAVFs) treated with transarterial endovascular embolization in which Onyx was used. METHODS:The authors reviewed prospectively collected data in 9 patients with tentorial DAVFs treated with Onyx embolization be...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2011.12.FOCUS11323
更新日期:2012-05-01 00:00:00
abstract::Lumbar discectomy is the most common surgical procedure performed in neurosurgery clinics. Such a large number of procedures underscore not only the prevalence of conditions such as intervertebral disc herniation, but also the strong belief of surgeons that the operation does provide benefits to patients suffering fro...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2001.11.5.9
更新日期:2001-11-15 00:00:00
abstract::OBJECT Spinal tumor resection has historically been performed via open approaches, although minimally invasive approaches have recently been found to be effective in small cohort series. The authors compare surgical characteristics and clinical outcomes of surgery in patients undergoing mini-open and open approaches f...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.5.FOCUS15187
更新日期:2015-08-01 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:OBJECT:Intraneural ganglia are nonneoplastic mucinous cysts contained within the epineurium of peripheral nerves. Their pathogenesis has been controversial. Historically, the majority of authors have favored de novo formation (degenerative theory). Because of their rarity, intraneural ganglia affecting the upper limb h...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC.2009.26.2.E10
更新日期:2009-02-01 00:00:00
abstract::Deep brain stimulation (DBS) has a record of safety and efficacy for an expanding range of indications. Recently,the Food and Drug Administration provided approval through a Humanitarian Device Exemption for DBS of the globus pallidus internus and subthalamic nucleus for the treatment of dystonia. There is increasing ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2004.17.1.1
更新日期:2004-07-15 00:00:00
abstract::Herniated thoracic discs, unlike their lumbar counterparts, are difficult to read and safely resect using traditional posterior approaches. Historically, the use of a laminectomy for thoracic disc resection has yielded poor clinical outcomes. Posterolateral and anterolateral approaches have become the standard surgica...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2001.10.1.9
更新日期:2001-01-15 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::Traditionally, surgical division of the terminal filum (filum terminale) has been reserved for patients with imaging-apparent spinal cord tethering. The occurrence of medically refractory voiding dysfunction of neurogenic origin, without magnetic resonance (MR) imaging documentation of abnormality in the spine, has be...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC-07/08/E1
更新日期:2007-01-01 00:00:00
abstract:OBJECT:The authors investigated immunogene therapy for malignant glioma to determine whether its therapeutic efficacy could be improved. METHODS:Four groups of 203-glioma-bearing mice were treated with injections of phosphate-buffered saline, Semliki Forest virus (SFV)-LacZ, retrovirus vector DFG-interleukin (IL)-12, ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2000.9.6.8
更新日期:2000-12-15 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::The contemporary management of projectile head injuries owes much to the lessons neurosurgeons have distilled from their experiences in war. Through early investigation and an increasingly detailed account of wartime clinical experience, neurosurgeons--including the field's early giants--began to gain a greater unders...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2010.2.FOCUS1038
更新日期:2010-05-01 00:00:00
abstract::Aquaporin-4 (AQP4) channels play an important role in brain water homeostasis. Water transport across plasma membranes has a critical role in brain water exchange of the normal and the diseased brain. AQP4 channels are implicated in the pathophysiology of hydrocephalus, a disease of water imbalance that leads to CSF a...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2016.7.FOCUS16191
更新日期:2016-09-01 00:00:00
abstract::Cerebral cavernous malformations (CCMs) are common vascular lesions of the CNS that may lead to seizures, focal neurological deficits, and fatal hemorrhagic stroke. Human genetic studies have identified 3 genes associated with CCM, and biochemical and molecular studies in mice have elucidated signaling pathways with i...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2010.6.FOCUS10135
更新日期:2010-09-01 00:00:00