Abstract:
:Approximately 12 million Americans undergo spinal manipulation therapy (SMT) every year. Renewed interest in this method requires an analysis of its reported risks and possible benefits. This review describes two patients with spinal cord injuries associated with SMT and establishes the risk/benefit ratios for patients with lumbar or cervical pain. The first case is a man who underwent SMT for recurrent sciatica 4 years after chemonucleolysis. During therapy, he developed bilateral sciatica with urinary hesitancy. After self-referral, myelography demonstrated a total block; he underwent urgent discectomy with an excellent result 3 months after surgery. The second patient with an indwelling Broviac catheter and a history of lumbar osteomyelitis underwent SMT for neck pain. Therapy continued for 3 weeks despite the development of severe quadriparesis. After self-referral, he underwent an urgent anterior cervical decompression and removal of necrotic bone and an epidural abscess with partial neurological recovery. An analysis of these cases and 138 cases reported in the literature demonstrates six risk factors associated with complications of SMT. These include misdiagnosis, failure to recognize the onset or progression of neurological signs or symptoms, improper technique, SMT performed in the presence of a coagulation disorder or herniated nucleus pulposus, and manipulation of the cervical spine. Clinical trials of SMT have been summarized in several recent articles.(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Powell FC,Hanigan WC,Olivero WCdoi
10.1227/00006123-199307000-00011subject
Has Abstractpub_date
1993-07-01 00:00:00pages
73-8; discussion 78-9issue
1eissn
0148-396Xissn
1524-4040journal_volume
33pub_type
历史文章,杂志文章,评审相关文献
NEUROSURGERY文献大全abstract:OBJECTIVE:Carotid endarterectomy with a patch graft (Patch CEA) has been our standard treatment for patients with carotid artery stenosis, but carotid artery stenting (CAS) has emerged as an alternative. The purpose of this study was to compare the postoperative changes in the configurations and the flow velocities of ...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1227/01.NEU.0000358952.12917.DF
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Intraoperative electrocorticography (ECoG) has been utilized in patients with tumor-associated seizures; however, its effectiveness for seizure control remains controversial. OBJECTIVE:To evaluate clinical outcomes in pediatric patients undergoing lesionectomy with or without ECoG. METHODS:Patients undergo...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyy342
更新日期:2019-09-01 00:00:00
abstract::A case of hemipontine hematoma from the rupture of a cryptic vascular malformation presenting as a cerebellopontine angle tumor is reported. The clinical features of and surgical approaches to partial pontine hematomas are briefly reviewed. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198607000-00023
更新日期:1986-07-01 00:00:00
abstract:BACKGROUND:In both academic and private practice, noncompete clauses are common in many neurological surgery contracts. Noncompete agreements vary, depending on various factors, including the surgeon's subspecialty, location, and business-related considerations. Each individual state's law on contracts determines the e...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa426
更新日期:2020-10-22 00:00:00
abstract:OBJECTIVE:A quantitative analysis of intraoperative cortical shift and deformation was performed to gain a better understanding of the nature and extent of this problem and the resultant loss of spatial accuracy in surgical procedures coregistered to preoperative imaging studies. METHODS:Three-dimensional feature trac...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199810000-00010
更新日期:1998-10-01 00:00:00
abstract::The management of 15 cases of bilateral locked facets of the cervical spine is reviewed. The C-6, C-7 interspace was the most common interspace involved. There were 4 females and 11 males who were 16 to 63 years old (average, 26 years). Thirteen patients had a complete spinal cord lesion with loss of function below th...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198102000-00002
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND AND IMPORTANCE:As the use of flow-diverting stents (FDSs) for intracranial aneurysms expands, a small number of case reports have described the successful treatment of blister aneurysms of the internal carotid artery with flow diversion. Blister aneurysms are uncommon and fragile lesions that historically ha...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000001412
更新日期:2016-11-01 00:00:00
abstract::Premature infants weighing under 1500 g are now surviving because of technical and medical advances in the field of neonatology. Up to 70% of these babies will have intracranial hemorrhages. The management of posthemorrhagic hydrocephalus in these children with multiple other medical problems has thus become quite sig...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198011000-00007
更新日期:1980-11-01 00:00:00
abstract:OBJECTIVE:In meningioma surgery, the completeness of resection is of great importance with regard to prognosis and recurrence. This is more difficult in meningiomas en plaque and cranial base meningiomas, which often involve the bone of the cranial base. We present a case in which radioguided resection of a meningioma ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000336309.14805.F5
更新日期:2009-03-01 00:00:00
abstract::Seventy-five patients older than 60 years of age underwent surgical resection of intracranial meningiomas during a 10-year period at a single institution. All patients had a computed tomographic scan preoperatively, and all were followed for at least 3 months postoperatively. There were 50 patients 61 to 70 years of a...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198904000-00011
更新日期:1989-04-01 00:00:00
abstract::Since the advent of magnetic resonance imaging, there has been renewed interest in disorders of cortical migration in the cause of focal epilepsy. The function of dysplastic cortex is poorly understood. We report a 46-year-old woman in whom this was assessed by intraoperative stimulation. This left-handed patient had ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199511000-00020
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Hypertrophic neuropathy of the cauda equina (HNCE) is a rare form of peripheral neuropathy. The diagnosis is complicated by an insidious clinical presentation and complex radiographic images. We present a case of HNCE caused by chronic inflammatory demyelinating polyneuropathy with symptomatic ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000103492.19663.ef
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Ten-year follow-up data from the US Food and Drug Administration investigational device exemption trial comparing BRYAN® Cervical Disc (Medtronic, Dublin, Ireland) arthroplasty to anterior cervical discectomy and fusion (ACDF) demonstrated that disc arthroplasty maintained range of motion and improvements in...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/neuros/nyy118
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:The superior ophthalmic vein (SOV) provides an alternative venous access for the treatment of carotid-cavernous fistulae. Its direct surgical exposure and cannulation can be difficult. This study was performed to identify anatomic landmarks to facilitate localization and exposure of the SOV. METHODS:The vasc...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000340781.34122.A2
更新日期:2009-05-01 00:00:00
abstract::Systematic reviews and meta-analyses in the neurosurgical literature have surged in popularity over the last decade. It is our concern that, without a renewed effort to critically interpret and appraise these studies as high or low quality, we run the risk of the quality and value of evidence-based medicine in neurosu...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa027
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Surgery for degenerative cervical spine disease has escalated since the 1990s. Fusion has become the mainstay of surgery despite concerns regarding adjacent segment degeneration. The patient-specific trends in reoperations have not been studied previously. OBJECTIVE:To analyze the occurrence, risk factors, ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa464
更新日期:2020-12-28 00:00:00
abstract::A review of the existing models of legislation and state statutes pertaining to the definition of death is presented. Twenty-four states have statutory provision for brain death. Concern still exists about the need for and the form of statutory definitions. Medical criteria are not considered in detail, but the propos...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-197910000-00026
更新日期:1979-10-01 00:00:00
abstract::Clinical recovery after central nervous system (CNS) trauma or ischemia may be limited by a neural injury process that is triggered and perpetuated at the cellular level, rather than by a lesion amenable to surgical repair. It is widely thought that one such process, a fundamental pathological mechanism initiated by C...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-199606000-00028
更新日期:1996-06-01 00:00:00
abstract::Arteriovenous malformation (AVM) draining vein pressure (DVP) may have an influence on both the natural history of the disease and treatment outcome. The purposes of this study were to assess the relationship between DVP and other clinical and physiological variables and to characterize the transmission of arterial pr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199409000-00005
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND AND IMPORTANCE:Because of their rarity, the pathogenesis and clinical features of isolated spinal artery aneurysms are still unclear, and their diagnoses and treatments are challenging. We report a case of an isolated posterior spinal artery aneurysm and review previous reports thoroughly to identify the gen...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/NEU.0b013e31825ea539
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Though the Pipeline Embolization Device (Medtronic) is approved for use in adults 22 yr and older, the high efficacy and long-term durability of the device is attractive for treatment of intracranial aneurysms in younger patients who often have aneurysms less amenable to traditional endovascular treatments. ...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1093/neuros/nyz380
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The energy index (EI) is a measure of dose homogeneity within a target volume calculated by the integral dose divided by the product of prescription dose and tumor volume. OBJECTIVE:To assess whether a higher EI is associated with greater local control for brain metastases (BMs) treated by Gamma Knife radio...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000750
更新日期:2015-07-01 00:00:00
abstract::The aim of the present study was to evaluate the influence of previous treatment on outcome and sensory disturbance after a retrogasserian glycerol injection for trigeminal neuralgia. Ninety-nine patients with trigeminal neuralgia underwent a retrogasserian glycerol rhizotomy. Fifty-three of those patients experienced...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199502000-00009
更新日期:1995-02-01 00:00:00
abstract::Intervertebral disc space infection can be a serious and disabling complication of any procedure that affords entry for bacteria into the susceptible disc space. Most disc space infections occur after cervical or lumbar laminectomies. Discitis has been reported after myelography, lumbar puncture, paravertebral injecti...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198605000-00017
更新日期:1986-05-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to investigate the use of proton magnetic resonance spectroscopic imaging as a prognostic indicator in gamma knife radiosurgery of recurrent gliomas. METHODS:Thirty-six patients with recurrent gliomas were studied with proton magnetic resonance spectroscopic imaging at the time of ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200002000-00011
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Minimally invasive surgery procedures, including stereotactic catheter aspiration and clearance of intracerebral hemorrhage (ICH) with recombinant tissue plasminogen activator hold a promise to improve outcome of supratentorial brain hemorrhage, a morbid and disabling type of stroke. A recently completed Pha...
journal_title:Neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1093/neuros/nyz077
更新日期:2019-06-01 00:00:00
abstract::Nine pineal area lesions were operated upon by the infratentorial-supracerebellar approach. There was one operative death and one death due to disseminated germinoma recurrence 2 1/2 years postoperatively. The remaining seven patients have shown no sign of recurrence and are neurologically normal. The surgical method ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-197707000-00008
更新日期:1977-07-01 00:00:00
abstract:OBJECTIVE:Despite apparent gross total resection, olfactory groove meningiomas have a high rate of late recurrence (average, 23%). In this retrospective study, we confirmed that the sites of these recurrences are the cranial base and paranasal sinuses. We postulated that these recurrences stem from conservative handlin...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000079484.19821.4a
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Focal or diffuse corpus callosal changes can occur in patients with active hydrocephalus who undergo shunting procedures. The neural compression caused by active hydrocephalus and the conditions that follow ventricular shunting may contribute to the development of these changes. CLINICAL PRESE...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199708000-00037
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:Diffuse arteriovenous malformations (AVM) have non-compact niduses, irregular margins, and intervening brain parenchyma. Deep perforating arteries often contribute to the ragged border of these diffuse AVMs. We hypothesized that diffuseness and deep perforator supply increase the difficulties and risks associ...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1227/01.NEU.0000255401.46151.8A
更新日期:2007-04-01 00:00:00