Abstract：
BACKGROUND:The short pars and the narrowed surgical corridor for far lateral L5S1 herniation make the transpars approach challenging. The aim of this study is to determine the feasibility, efficacy and safety of the transpars microscopic approach for the treatment of L5-S1 foraminal and extraforaminal lumbar disc herniation. METHODS:From 2015 to 2019, patients with L5-S1 far lateral lumbar disc herniation were prospectively recruited. Drug intake, working days lost, NRS-leg, NRS-back, nerve-root palsy, Oswestry disability-index, Macnab criteria were recorded before surgery and at follow-up. Patients were seen at 1-6-12 months after surgery. Lumbar dynamic x-rays were performed at 6-12 months after surgery and again at 2-4 years after surgery. Key-steps of surgery are described. RESULTS:Fourteen patients were enrolled. NRS-leg and NRS-back scores significantly improved (from 7.93 to 1.43 and from 3.2 to 0.6, respectively-p<0.0001). Oswestry score significantly decreased (from 63.14 to 19.36 at 12 months; p<0.0001). L5 Root palsy improved in all cases (from 3.72/5 to 5/5; p<0.0001). At 12-months, excellent or good outcome (Macnab criteria) was achieved in 12 (85.7%) and 2 (14.3%) patients, respectively. All patients who were not retired returned to work within 30 days after surgery. No recurrence, instability or re-operations occurred. CONCLUSIONS:The trans pars microscopic approach is feasible, safe and effective for L5-S1 foraminal and extraforaminal disc herniation. During surgery, the key-point is the oblique working angle, directed caudally, parallel to L5 pedicle. The iliac crest does not seem to constitute an obstacle.
journal_name
J Neurosurg Scijournal_title
Journal of neurosurgical sciencesauthors
De Bonis P,Musio A,Mongardi L,Lofrese G,La Marca F,Visani J,Cavallo MA,Scerrati Adoi
10.23736/S0390-5616.20.05165-6subject
Has Abstractpub_date
2020-12-09 00:00:00eissn
0390-5616issn
1827-1855pii
S0390-5616.20.05165-6pub_type
杂志文章abstract：BACKGROUND:A radical surgery of spine metastases is not possible in many cases, especially by elder multi morbid patients. The modern CAVITY/coblation method offers a very good therapeutic alternative for such patients. The goal of this paper was to evaluate and present the method as well as the results of the treatmen...
journal_title：Journal of neurosurgical sciences
pub_type： 临床试验,杂志文章
doi：10.23736/S0390-5616.16.03690-0
更新日期：2017-12-01 00:00:00
abstract：INTRODUCTION:Management of spontaneous intracerebral hemorrhage (ICH) remains controversial despite efforts to produce high level evidence in the past few years. We systematically examined the pooled literature data on the natural history and surgical management of ICH. EVIDENCE ACQUISITION:A systematic review was per...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：10.23736/S0390-5616.20.04940-1
更新日期：2020-12-01 00:00:00
abstract：:It has been recently observed that arachidonic acid (AA) metabolites may modulate many of the mechanisms involved in tumor growth and metastasis. In order to clarify the role played in human brain tumors, authors have determined AA metabolic profiles in 63 surgical specimen of human intracranial tumors (mostly neuroep...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章,评审
doi：
更新日期：1989-01-01 00:00:00
abstract：:The case of a 53-year-old woman with adult-onset neurological dysfunction secondary to spinal dysraphia and lumbosacral lipoma is presented. This condition not only affects children, but may produce neurological troubles also in adult age. This observation confirms that lumbosacral lipomas do not represent a static co...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：1987-01-01 00:00:00
abstract：:A case of a giant aneurysm of the internal carotid artery which ruptured during cerebral angiography is reported. 30 other cases from literature of the last 35 years are reviewed. The majority of aneurysms ruptured during angiography was located at the internal carotid artery. 21 out of 30 patients were females. Fatal...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章,评审
doi：
更新日期：1988-10-01 00:00:00
abstract：:Four cases of acute spontaneous subdural haematoma are described. A review of the literature reveals the rarity of this pathology. The several etiological possibilities are discussed. The clinical onset may simulate other cerebrovascular diseases. The prognosis is correlate to the neurological findings at the operatio...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章,评审
doi：
更新日期：1991-04-01 00:00:00
abstract：:A 22-year-old male with unilateral facial, cochlear and glossopharyngeal cranial nerve dysfunction and ataxia that was slowly progressive over one year is described. Although clinically it was considered he probably had an acoustic neuroma, surgery revealed a pontine glioblastoma exophytic into the cerebellopontine an...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：1997-12-01 00:00:00
abstract：:(1) In a total of 100 patients with traumatic coma who were admitted to the intensive care unit of our Department of Neurosurgery we examined the effect of Encephabol after intravenous administration. (2) Compared to patients with the same clinico-neurological conditions who were, however, not treated with Encephabol,...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：1980-01-01 00:00:00
abstract：:The authors present the results of a long-term follow up of 52 juvenile head-injured patients who showed early epileptic seizures. The purpose of this study is to stress the role of long-term prognosis in the early seizures and to determine in which cases a treatment preventing late seizures is eligible. They consider...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：1979-04-01 00:00:00
abstract：AIM:The aim of this study was to study the effect of preconditioning with hyperbaric oxygen on neural cell apoptosis after spinal cord injury in rats at different times, and to study the mechanism of neuroprotection with hyperbaric oxygen preconditioning after spinal cord injury. METHODS:Fifty-five adult Sprague-Dawle...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：2013-09-01 00:00:00
abstract：:The traditional dilemma making surgery for diffuse low-grade gliomas (DLGGs) challenging is underlain by the need to optimize tumor resection in order to significantly increase survival versus the risk of permanent neurological morbidity. Development of neuroimaging led neurosurgeons to achieve tumorectomy according t...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章,评审
doi：
更新日期：2015-12-01 00:00:00
abstract：:Precise identification of tumor margins is of the utmost importance in neuro-oncology. Confocal microscopy is capable of rapid imaging of fresh tissues at cellular resolution and has been miniaturized into handheld probe-based systems suitable for use in the operating room. We aimed to perform a literature review to p...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章,评审
doi：10.23736/S0390-5616.18.04553-8
更新日期：2018-12-01 00:00:00
abstract：BACKGROUND:Adjacent-level disease after anterior cervical discectomy and fusion (ACDF) occurs in a significant proportion of patients and frequently requires revision operation. Methods using traditional plates typically require removal of the plate with anecdotally increased operative-time and morbidity. We review our...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：10.23736/S0390-5616.18.04172-3
更新日期：2020-10-01 00:00:00
abstract：BACKGROUND:Economical studies on surgery of intracranial aneurysms have considered only the significant benefit of surgical approach on unruptured aneurysms and no studies have been performed comparing cost/benefit analysis of early vs delayed surgery. The present study was retrospectively performed in order to verify ...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：1998-06-01 00:00:00
abstract：:A 49-year-old male, with a relatively uncommon multiple neurilemmoma, exhibited symptoms of cauda equina compression. Following a diagnosis of multiple tumor of the cauda equina and extradural cyst, based on myelography and CTM, the tumors at L1-L2, the left S1 nerve root, and left hip were resected. Three years after...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：1991-07-01 00:00:00
abstract：:Between 1985 and 1993, we treated seven cases of optic nerve sheath meningiomas. The median age at onset of their symptoms was 42.14 years. All of the patients were aged between 27 and 60 females with a slowly progressive lesion. Computed tomography and/or magnetic resonance imaging were used as diagnostic procedure i...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：1994-09-01 00:00:00
abstract：BACKGROUND:The availability of Flow Diverters and new endovascular techniques has greatly reduced the need and indications for bypass surgery. Nevertheless, there are situations where a bypass is the best option for a complex cerebrovascular problem. METHODS:Generally typical indications are giant aneurysms with a wid...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：2016-01-20 00:00:00
abstract：:Multidisciplinary efforts are being made to provide surgical teams with sensitive and specific tasks for language mapping in awake surgery. Researchers and clinicians have elaborated different tasks over time. A fair amount of work has been directed to study the neurofunctional correlates of some of these tasks, and t...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章,评审
doi：
更新日期：2015-12-01 00:00:00
abstract：: ...
journal_title：Journal of neurosurgical sciences
pub_type： 信件
doi：10.23736/S0390-5616.17.04043-7
更新日期：2019-02-01 00:00:00
abstract：:Cavernous angiomas of the orbit are benign vascular growths, commonly occurring in adults and usually causing a slowly progressive proptosis from their mass effect. These lesions have behavioural and radiological findings different from those of brain cavernous angiomas, probably due to their particular origin and str...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：1995-12-01 00:00:00
abstract：:Cavernous malformations are vascular lesions that occur in all parts of the central nervous system but most commonly in the cerebral hemispheres; unusually they may be found along the midline (basal ganglia, pineal region or brain stem), into the ventricle possibly encroaching upon the fourth and third ventricle. We r...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：1998-12-01 00:00:00
abstract：:Isolated abducens nerve palsy following lumbar puncture is a very rare condition. In this case we discussed the probable causes of abducens nerve palsy and review the mechanism of action in anatomical relevant literature. A 53-year old hypertensive female patient with a saccular aneursym on the left middle cerebral ar...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章,评审
doi：
更新日期：2010-09-01 00:00:00
abstract：:The brainstem is an uncommon site for a brain abscess. It accounts for less than 4% of all posterior cranial fossa abscesses, and less than 1% of all intracranial abscesses. The pons is the most common site for these abscesses. The aim of the present report was to describe the case of a Brazilian Amazon man with a bra...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：2011-12-01 00:00:00
abstract：:Interferon-beta (IFN-B) plus thymostimulin (Th) were administered for eight weeks, intravenously and by intramuscular route to eight patients with metastatic brain tumors. No patient had a complete response. One had a stable disease and seven a progressive disease during that time. The mechanisms of the action of IFN-...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：1994-03-01 00:00:00
abstract：:The paper reports two cases of supratentorial neuroepithelial cysts, also called ependymal cysts. One of them was extracerebral and the other intracerebral. The preoperative diagnosis was made by determination of attenuation values of consecutive sections of cyst on computed tomography. The ultrastructure of the cyst ...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：1984-04-01 00:00:00
abstract：BACKGROUND:Identification of the central sulcus can require inspection of subtle differences or require certain pulse sequences. This study identifies the central sulcus by signal intensity on Double Inversion Recovery (DIR) images in multiple anatomic locations and imaging planes. METHODS:49 patients (98 hemispheres)...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：10.23736/S0390-5616.19.04634-4
更新日期：2019-04-02 00:00:00
abstract：:The filum terminale is an exceptional location for isolated hemangioblastoma. Only five cases are reported in literature, prior to the magnetic resonance imaging era. A 57-year-old man was referred to our Department with a prolonged history of progressive back pain, particularly severe when recumbent, and recurrent un...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：2001-03-01 00:00:00
abstract：:Tumor related fractures of the spine frequently dictate surgical management. The most critical factors influencing the need and type of surgery are degree of epidural cord compression, radiosensitivity of the tumor, presence of spinal instability and patient medical status/ estimated survivorship. There is a wide spec...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章,评审
doi：
更新日期：2012-06-01 00:00:00
abstract：BACKGROUND:The results of randomized trials indicate that carotid endarterectomy, performed with a low morbidity-mortality perioperative risk, is the best therapeutic option both for patients with high-grade symptomatic and asymptomatic stenosis. Since the main operative risk is represented by embolic or hemodynamic ce...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：2001-09-01 00:00:00
abstract：BACKGROUND:The aim of this study is to evaluate the prognostic parameters and treatment modalities of malignant melanoma patients with brain metastases. METHODS: EXPERIMENTAL DESIGN:a retrospective study with a mean follow-up of 46 months. SETTING:specialized Cancer Center. PATIENTS:the charts of 136 patients, trea...
journal_title：Journal of neurosurgical sciences
pub_type： 杂志文章
doi：
更新日期：2000-12-01 00:00:00
