Abstract:
STUDY DESIGN:The paper describes a technique for complete vertebrectomy and spinal cord decompression, followed by a formal anterior column reconstruction, using endoscopic instruments. This procedure is indicated for patients with radioresistant metastasis of the thoracic spine, particularly those involving the upper thoracic segments where a thoracotomy is difficult and carries a high morbidity, and for patients with pulmonary disease who cannot tolerate a standard thoracotomy. Results in nine consecutive cases are reported. OBJECTIVES:To demonstrate the feasibility and benefits of endoscopically assisted decompression and stabilization through a single, extrapleural, posterolateral approach. SETTING:The Cleveland Clinic, Cleveland, Ohio, USA. METHODS:Posterolateral decompression of the thoracic spinal cord offers potential advantages over traditional combined procedures (anterior thoracotomy and posterior instrumentation), including reduced operative time, decreased morbidity, and reduced hospital stay. Previous studies have not demonstrated the same neurological benefit for posterolateral decompression as for anterior vertebrectomy and decompression, however, Surgical indications, rationale and technique for an improved posterolateral approach, augmented by endoscopic methods, are provided, and initial clinical results are described. RESULTS:Drawbacks to the traditional posterolateral decompressions have included poor visualization of the spinal cord and anterior tumor, poor access to tumor on the side contralateral to the approach, and the need to manipulate the spinal cord to completely remove both adjacent tumor and tumor adherent to the dura. Transpedicular decompression using endoscopy is described in nine patients. The mean operative time for the combined procedure was 6.0 h, with a mean blood loss of 1677 cc. Neurological recovery and maintenance were excellent. Inpatient days averaged 6.5, and ICU days averaged 1.4. Two patients died of disease eight and 14 months post-op, and seven were living, with disease, 3-36 months after surgery. CONCLUSIONS:Endoscopically assisted decompression can reduce morbidity, hospitalization, and treatment costs while matching the efficacy of traditional combined procedures. Endoscopy provides a readily available and easily applied tool that dramatically improves the surgeon's vision, providing light, magnification, and a direct view of remote structures.
journal_name
Spinal Cordjournal_title
Spinal cordauthors
McLain RFdoi
10.1038/sj.sc.3101194subject
Has Abstractpub_date
2001-09-01 00:00:00pages
482-7issue
9eissn
1362-4393issn
1476-5624journal_volume
39pub_type
杂志文章相关文献
SPINAL CORD文献大全abstract:STUDY DESIGN:We present a case report describing the multidisciplinary treatment of a tetraplegic spinal cord injury (SCI) patient who developed an acute exacerbation of chronic central pain. OBJECTIVE:To bring further awareness to the importance of using a comprehensive, multidisciplinary approach in treating acute e...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sc.2014.12
更新日期:2014-06-01 00:00:00
abstract::The aim of this study was to quantify the energy cost and the cardiorespiratory response while walking at free speed with an Advanced Reciprocating Gait Orthosis (ARGO). The study was conducted on a group of six male paraplegic patients, age range 16-31 years (median = 22.50), with complete traumatic injuries ranging ...
journal_title:Spinal cord
pub_type: 临床试验,杂志文章
doi:10.1038/sj.sc.3100564
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to investigate the pharmacological effects of long-term oral tadalafil treatment on the corpus cavernosum function in rats subjected to experimental spinal cord transection (SCT). METHODS:Thirty young adult, male Sprague–Dawley rats were randomly divided into five groups (n¼ 6, eac...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sc.2013.61
更新日期:2013-09-01 00:00:00
abstract:STUDY DESIGN:Retrospective cohort study. OBJECTIVES:To analyze magnetic resonance imaging (MRI) evaluator agreement in dogs with spinal cord injury (SCI) caused by intervertebral disk herniation (IVDH) using semiautomated and manual lesion segmentation and to analyze the associations between MRI and functional outcome...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sc.2014.244
更新日期:2015-04-01 00:00:00
abstract:STUDY DESIGN:Histopathological study of the human spinal cord. SETTING:International Collaboration on Repair Discoveries, Vancouver, BC, Canada. RATIONALE:In animals, primary dorsal root afferent fibers, which are immunoreactive for calcitonin gene-related peptide (CGRP), sprout following spinal cord injury (SCI) int...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sj.sc.3102020
更新日期:2007-10-01 00:00:00
abstract:STUDY DESIGN:Psychometric study. OBJECTIVES:Evaluate the intra-rater and inter-rater reliability of the Penn Spasm Frequency Scale (PSFS) in people with chronic traumatic spinal cord injury (SCI). SETTING:Community setting. METHODS:Participants with chronic traumatic SCI were administered the PSFS, a self-reported s...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/s41393-018-0063-5
更新日期:2018-06-01 00:00:00
abstract:STUDY DESIGN:In vitro studies using isolated guinea pig spinal cord white matter. OBJECTIVES:To determine whether lack of oxygen can cause irreversible impairment of electrical impulse conduction. SETTING:Department of Basic Medical Sciences, Purdue University, West Lafayette, Indiana, USA. METHODS:The hypoxic injur...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sj.sc.3101901
更新日期:2006-11-01 00:00:00
abstract:STUDY DESIGN:The rat's acellular spinal cord scaffold (ASCS) and spinal cord neurons were prepared in vitro to explore their biocompatibility. OBJECTIVES:The preparation of ASCS and co-culture with neuron may lay a foundation for clinical treatment of spinal cord injury (SCI). SETTING:Tianjin Medical University Gener...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sc.2016.144
更新日期:2017-04-01 00:00:00
abstract:STUDY DESIGN:A case report. SETTING:Department of Orthopaedic Surgery, Shiga University of Medical Science, Japan. PATIENT:A 13-year-old woman presented progressive weakness in the lower extremities, with predominance on the right. Magnetic resonance (MR) imaging revealed a huge syrinx. The patient also showed scolio...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sj.sc.3101607
更新日期:2004-09-01 00:00:00
abstract:STUDY DESIGN:One cross-sectional study. OBJECTIVES:To examine the extent to which a sample of adults with spinal cord injury (SCI) meet the SCI-specific physical activity guidelines and to identify potential demographic, injury and motivational characteristics related to participation. SETTING:Quebec, Canada. METHOD...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sc.2016.181
更新日期:2017-05-01 00:00:00
abstract:STUDY DESIGN:Retrospective study. OBJECTIVES:To examine the value of operative fracture stabilization by means of the ring fixator in fractures of the lower extremity in the presence of chronic paralysis caused by transverse lesions of the spinal cord. SETTING:A specialist center for the treatment of spinal cord inju...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sj.sc.3101397
更新日期:2003-03-01 00:00:00
abstract::The importance of urinary tract infection (UTI) in patients with spinal cord injury cannot be understated. Many patients with significant bacteriuria are considered to be colonised rather than infected, and treatment should be reserved for those with clinical symptoms or other signs of infection. Published research on...
journal_title:Spinal cord
pub_type: 杂志文章,评审
doi:10.1038/sj.sc.3100382
更新日期:1997-04-01 00:00:00
abstract::Previous studies have estimated that between 25% and 45% of people with spinal cord injury report severe levels of chronic pain. Few studies have examined this longitudinally. This study examines the primary pain sites, intensity and variability of perceived pain in 76 patients, 6 weeks post injury and 45 patients fro...
journal_title:Spinal cord
pub_type: 临床试验,杂志文章
doi:10.1038/sj.sc.3100569
更新日期:1997-12-01 00:00:00
abstract:STUDY DESIGN:Retrospective study OBJECTIVES: To compare the accuracy of estimated serum creatinine (Cre)-based glomerular filtration rates (eGFRcre) and serum cystatin C (CysC)-based eGFR (eGFRcys) for determining renal function in patients with spinal cord injury (SCI). SETTING:Department of Urology, Tohoku Rosai Hos...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/s41393-017-0045-z
更新日期:2018-05-01 00:00:00
abstract:STUDY DESIGN:Experimental animal study. OBJECTIVE:The current study aims to test whether the blood flow within the contused spinal cord can be assessed in a rodent model via the acoustic window of the laminectomy utilizing transcutaneous ultrasound. SETTING:Department of Neurological Surgery, University of Washington...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/s41393-020-0415-9
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:A case of lumbosacral plexopathy (LSP) following operation for mesenteric thrombosis. DESIGN:Case report of a 64-year-old man who developed weakness and numbness of the distal legs after an operation for mesenteric thrombosis. SETTING:Department of Physical Medicine and Rehabilitation, University Hospital L...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sj.sc.3100865
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVES:Noxious stimuli activate small to medium-sized dorsal root ganglion (DRG) neurons. Intense noxious stimuli result in the release of substance P (SP) from the central terminals of these neurons. It binds to the neurokinin type 1 receptor (NK1r) and sensitises the dorsal horn neurons. SP is also released from ...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sc.2015.206
更新日期:2016-03-01 00:00:00
abstract:STUDY DESIGN:A case report of intraradicular disc herniation. Intraradicular disc herniation is a special type of intradural disc herniations. In this report, we present the tenth case of intraradicular lumbar disc herniation and suggest a new classification for intradural disc herniations. CASE REPORT:A 32-year-old m...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sj.sc.3101204
更新日期:2001-10-01 00:00:00
abstract:STUDY DESIGN:Survey. OBJECTIVES:Describe and compare the organisation and delivery of rehabilitation services and systems of care for patients with spinal cord injury (SCI). SETTING:International. Nine spinal rehabilitation units that manage traumatic SCI and non-traumatic SCI (NTSCI) patients. METHODS:Survey based ...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sc.2012.82
更新日期:2013-01-01 00:00:00
abstract::We report a case of a 32-year old woman with radicular symptoms associated with a low cervical chordoma. According to our knowledge this is the 10th case of low cervical chordoma reported in the literature. ...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sc.1996.65
更新日期:1996-06-01 00:00:00
abstract:STUDY DESIGN:Self-reported survey. OBJECTIVE:Our purpose was to identify the predictors of pain medication misuse (PMM) among participants with spinal cord injury (SCI). SETTING:A medical university in the southeastern United States. METHODS:A total of 919 adults with impairment from traumatic SCI of at least 1-year...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sc.2015.42
更新日期:2015-08-01 00:00:00
abstract::Epidural spinal cord stimulation has been used to decrease spasticity and spasms in spinal cord injury patients. However, the long-term benefits of this procedure have not been determined. We therefore conducted a retrospective study of the possible long-term efficacy of the epidural spinal cord stimulator for the rel...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sj.sc.3100532
更新日期:1998-03-01 00:00:00
abstract:STUDY DESIGN:Cross-sectional study. OBJECTIVES:Determine dietary, lifestyle, and clinical factors associated with plasma 25-hydroxyvitamin D [25(OH)D] levels in persons with chronic spinal cord injury (SCI). SETTING:Veterans Affairs Medical Center in Boston, MA. METHODS:174 participants completed food frequency and ...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/s41393-018-0148-1
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To evaluate rehabilitation outcome in a representative sample of older and younger SCI patients. DESIGN:Case series, consecutive sample, survey. SETTING:Tertiary care, spinal cord injury unit (National Spinal Injuries Centre), Stoke Mandeville Hospital. PARTICIPANTS:One hundred and forty-seven male and 45 ...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sj.sc.3101386
更新日期:2003-01-01 00:00:00
abstract:STUDY DESIGN:A qualitative study with an emergent design using semi-structured interviews in focus groups. OBJECTIVES:To explore the expectations, experiences and desires among individuals who are prescribed drugs for spinal cord injury (SCI) neuropathic pain (NP). SETTING:SCI rehabilitation centre. METHODS:Eighteen...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/s41393-020-00553-w
更新日期:2020-09-25 00:00:00
abstract:STUDY DESIGN:Retrospective chart review. OBJECTIVE:To analyze the role of sonography in detecting heterotopic ossification (HO) following spinal cord injury (SCI). SETTING:Department of Spinal Cord Injury and Department of General and Trauma Surgery, BG University Hospital Bergmannsheil Bochum, Ruhr University Bochum...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sc.2016.93
更新日期:2017-01-01 00:00:00
abstract:STUDY DESIGN:Retrospective study. OBJECTIVES:The purpose of this investigation was to review the outcomes and safety of retrograde ureteroscopic laser lithotripsy (URS) for the treatment of urolithiasis in the spinal cord injury (SCI) population. SETTING:Virginia, USA. METHODS:All patients with SCI who underwent URS...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sc.2012.86
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To draw attention to inadequate care received by some spinal cord injury patients after discharge from the regional spinal injury center. SETTING:Regional Spinal Injuries Centre, Southport, UK. METHODS:Presence of the urethral stricture was not recognised in a 69-year-old male with T-3 paraplegia, who atten...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/sj.sc.3101576
更新日期:2004-08-01 00:00:00
abstract:STUDY DESIGN:Cross-sectional. OBJECTIVES:To determine the obesity cutoff values for body mass index (BMI) and waist circumference (WC) in Korean men with motor complete spinal cord injury (SCI). SETTING:Tertiary level hospital in Seoul, Korea. METHODS:BMI (kg/m2) was calculated and WC (cm) was measured in each parti...
journal_title:Spinal cord
pub_type: 杂志文章
doi:10.1038/s41393-018-0172-1
更新日期:2019-02-01 00:00:00
abstract:STUDY DESIGN:Multicenter, open, prospective, before-after study. OBJECTIVE:To assess the efficacy and safety of sildenafil therapy for erectile dysfunction in patients with spinal cord injury, and the association between the response to sildenafil and factors such as causes and levels of spinal cord injury, grade of A...
journal_title:Spinal cord
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1038/sj.sc.3101210
更新日期:2001-12-01 00:00:00