Abstract:
:Sixteen patients referred for atlantoaxial fixation failures were treated surgically with revision procedures during the past decade. Of these 16 patients, atlantoaxial instability occurred because of rheumatoid arthritis in five, as odontoideum in seven, transverse ligament disruption in two, and odontoid fracture nonunion in two. The 16 individuals (10 men, six women; mean age 43.7 years; age range 20-77 years) had undergone a total of 20 C1-2 internal fixation procedures that failed. Surgical strategies for definitive revision of the nonunions in these 16 subjects included 10 rigid internal fixations with transarticular screws, three revised C1-2 fixations with autogenous bone struts and wire or cables, and three extended fixations with occipitocervical instrumentation. Autogenous grafts were used in all revisions. A postoperative halo brace was used in five individuals with osteoporotic bone; all patients wore a restrictive postoperative cervical orthosis. Postoperatively, 15 patients (94%) had a stable construct (mean follow up 35 months; range 12-79 months), which included 13 osseous unions and two stable fibrous unions. One patient had nonunion; he fractured his anterior C1-2 transarticular screws 2 years postoperatively. He had occipital radicular pain without myelopathy but refused further surgery. Atlantoaxial pseudarthroses were effectively treated by addressing the pathological, biomechanical, and technical reasons for failed fusion. Successful fusion after reoperation was improved by using autologous bone grafts, adequately controlling atlantoaxial motion (with rigid transarticular screws internally or externally with a halo vest), compressing the bone grafts between the arches of C-1 and C-2 with wire cables, meticulously preparing the fusion bed, and by optimizing the pharmacological and clinical parameters to promote bone healing.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Dickman CA,Sonntag VKdoi
10.3171/jns.1995.83.2.0248subject
Has Abstractpub_date
1995-08-01 00:00:00pages
248-53issue
2eissn
0022-3085issn
1933-0693journal_volume
83pub_type
杂志文章abstract::OBJECTIVE Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) (World Federation of Neurosurgical Societies Grade IV or V) are often considered for decompressive craniectomy (DC) as a rescue therapy for refractory intracranial hypertension. The authors performed a systematic review and meta-analysis to a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,meta分析
doi:10.3171/2016.9.JNS161383
更新日期:2017-12-01 00:00:00
abstract::OBJECTIVE Access to the third ventricle is a veritable challenge to neurosurgeons. In this context, anatomical and morphometric studies are useful for establishing the limitations and advantages of a particular surgical approach. The transchoroidal approach is versatile and provides adequate exposure of the middle and...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.8.JNS16403
更新日期:2017-07-01 00:00:00
abstract::Intraoperative recordings of conducted bipolar epidural somatosensory evoked potentials (SEP's) generated by unilateral common peroneal nerve stimulation have been obtained in 27 patients. The SEP's were multiphasic, 0.3 to 1.5 microV in amplitude, and recorded in 100% of patients with normal cords or in patients with...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.57.3.0349
更新日期:1982-09-01 00:00:00
abstract::Ventricular asymmetries after shunt surgery were studied. Right and left ventricular areas from pre-and postoperative computerized tomography scans were measured with a computer digitizing technique, and the respective areas were expressed as a ratio. Measurements were made from the scans of 15 hydrocephalic children ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.2.0183
更新日期:1981-08-01 00:00:00
abstract:OBJECT:The supplementary motor area (SMA) plays an important role in planning, initiation, and execution of motor acts. Patients with SMA lesions are impaired in various kinematic parameters, such as velocity and duration of movement. However, the relationships between neuronal activity and these parameters in the huma...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.10.JNS08466
更新日期:2009-06-01 00:00:00
abstract::The authors report seven cases of thoracic spinal stenosis caused by thickening of the laminar arch and facet joints. Claudication was a prominent clinical feature of this disorder. Motor and sensory abnormalities were found in all cases with either segmental or peripheral distribution. Diagnosis was best made from th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.68.1.0037
更新日期:1988-01-01 00:00:00
abstract::The current management of malignant gliomas is unsatisfactory compared to that of other solid tumors; the expected median survival period is less than 1 year with the patient undergoing conventional surgery, radiotherapy, and chemotherapy treatment. Immunological reagents could be a useful adjunct. Human monoclonal an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.76.4.0660
更新日期:1992-04-01 00:00:00
abstract::One major risk of intraoperative stimulation mapping is the production of stimulation-evoked seizures. Cold Ringer's lactate solution was applied directly to the irritated cortex in 22 patients with stimulation-induced seizures that occurred during intraoperative brain mapping procedures. The irrigation rapidly and re...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.2.0349
更新日期:1998-02-01 00:00:00
abstract::Although they are excellent clinical tools, Caspar anterior cervical plates have not been studied closely with regard to their mechanisms of failure. As more extensive operations are contemplated on older, sicker patients, it is imperative to know when a plating system might be prone to failure and what the mechanism ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.84.6.0957
更新日期:1996-06-01 00:00:00
abstract:OBJECT:Neurogenesis continues throughout the life of mammals in the subventricular zone (SVZ) of the lateral ventricles and the dentate gyrus (DG) of the hippocampus. The authors tested the potential of the neuropeptide substance P (SP) acting via the neurokinin-1 receptor (NK1R) in promoting the proliferation of adult...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/09/0593
更新日期:2007-09-01 00:00:00
abstract::Plateau waves, characterized by acute transient rises of the intracranial pressure (ICP), are accompanied by a marked decrease of the cerebral perfusion pressure. Patients with plateau waves, however, often show no clinical symptoms of ischemia of the brain stem, such as vasopressor response or impairment of conscious...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.4.0556
更新日期:1985-10-01 00:00:00
abstract:OBJECT:Arterial embolization reduces blood loss in patients undergoing surgery for hypervascular spinal tumors. The objectives of this study were twofold: 1) to evaluate the role of magnetic resonance (MR) imaging in predicting tumor vascularity and 2) to assess the effectiveness of preoperative embolization in devascu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.98.2.0156
更新日期:2003-03-01 00:00:00
abstract::OBJECTIVERebleeding remains a frequent and catastrophic event leading to poor outcome after subarachnoid hemorrhage (SAH). Reduced platelet function after the initial bleed is associated with higher risk of early rebleeding. Desmopressin (DDAVP) is a well-known hemostatic agent, and recent guidelines already suggest i...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.7.JNS17990
更新日期:2018-01-01 00:00:00
abstract::Two episodes of massive bleeding from a sutured arteriotomy were observed within 30 hours after carotid endarterectomy. The patient had received anticoagulation therapy with heparin for 72 hours prior to surgery. A platelet count of 93,000/cu mm was demonstrated following the second hemorrhage. The potential problem o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.4.0632
更新日期:1988-10-01 00:00:00
abstract::A 55-year-old man, who had previously had a left atrial myxoma excised, developed recurrent hematomas of the left occipital lobe. Microscopic examination revealed the presence of metastatic myxoma. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1990.72.2.0295
更新日期:1990-02-01 00:00:00
abstract::Cerebral blood flow (CBF) was measured at different times during the first 150 minutes following an experimental space-occupying lesion produced with a 50-microliter microballoon in rats. Local CBF was measured with the carbon-14-labeled iodoantipyrine quantitative autoradiographic technique. A region of local ischemi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.5.0732
更新日期:1987-11-01 00:00:00
abstract:OBJECT:Cochlear neurons are inevitably exposed to traumatic stress during surgical removal of an acoustic neuroma; that event is an important cause of postoperative cochlear neuronal degeneration, with subsequent loss of spiral ganglion cells (SGCs). The object of this study was to investigate whether preoperative phar...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.1.0090
更新日期:2000-07-01 00:00:00
abstract:OBJECT:The aims of this study were to determine the following: whether there are sex differences in intracerebral hemorrhage (ICH) induced brain injury in rats, whether delayed administration of 17beta-estradiol can reduce ICH-induced brain damage, and whether these effects are estrogen receptor (ER)-dependent. METHOD...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.103.1.0097
更新日期:2005-07-01 00:00:00
abstract:OBJECT:The optimal approach for the surgical treatment of craniopharyngiomas is still debated. In all cases involving the sella turcica, the authors have exclusively used transsphenoidal surgery (TSS), assuming that this approach is less traumatic than an intracranial one. Moreover, TSS was also performed in some cases...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.100.3.0445
更新日期:2004-03-01 00:00:00
abstract::Head trauma, intracerebral hematoma formation, and hemorrhagic cerebral infarction cause extravasation of the intravascular contents, red blood cell (RBC) hemolysis, hemosiderin deposition within the neuropil, and an increased incidence of epilepsy. Reports conflict regarding the efficacy of the administration of prop...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.3.0467
更新日期:1984-03-01 00:00:00
abstract:OBJECT:Adjusting electrical parameters used in deep brain stimulation (DBS) for dystonia remains time consuming and is currently based on clinical observation alone. The goal of this study was to visualize electrical parameters around the electrode, to correlate these parameters with the anatomy of the globus pallidus ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.103.6.0949
更新日期:2005-12-01 00:00:00
abstract::The metabolic rate was determined in the rat brain during the immediate concussive response to standardized impact accelerations of 7 and 9 m/sec velocity. In one series, the metabolic state was determined in freeze-clamped cortical and brain-stem tissue 20 seconds after the impact. The metabolic rate was calculated f...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.2.0274
更新日期:1977-08-01 00:00:00
abstract:OBJECT:Spinal cord injury without radiological abnormality (SCIWORA) was defined in the era when magnetic resonance (MR) images were not popularly used as diagnostic tools. Although it is generally accepted that MR imaging can effectively illustrate the level and severity of spinal cord injury in the acute phase of tra...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.103.1.0017
更新日期:2005-07-01 00:00:00
abstract::Intravascular papillary endothelial hyperplasia (IPEH), commonly known as Masson's tumor, is a benign lesion that manifests as an excessive proliferation of endothelial cells within a vessel wall. IPEH is extremely rare in the brain, with only 36 intracranial cases previously described in the literature. It is commonl...
journal_title:Journal of neurosurgery
pub_type:
doi:10.3171/2019.8.JNS191767
更新日期:2019-11-01 00:00:00
abstract:OBJECT:The treatment of solitary vestibular schwannomas by performing Gamma Knife surgery is well established. It has been reported that decreasing the surface dose reduces patient morbidity, especially facial weakness and numbness. The authors of this retrospective study examine patient data from a single center to de...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/sup.2006.105.7.154
更新日期:2006-12-01 00:00:00
abstract::The authors studied 31 comatose head-injured patients to assess the clinical usefulness of laser Doppler flowmetry (LDF) in continuous autoregulation monitoring. The LDF probes were placed on the surface of the cerebral cortex. Data on LDF, intracranial pressure (ICP), and arterial blood pressure (ABP) were recorded a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.86.3.0438
更新日期:1997-03-01 00:00:00
abstract::Autologous blood (0.3 to 5.0 ml) was introduced into the lumbar subarachnoid space of nine monkeys. Serial spinal cord arteriography was performed at frequent intervals over a 24-hour period. Magnification techniques permitted direct measurement of the anterior spinal artery and posterior spinal vein. Neither immediat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.1.0064
更新日期:1977-07-01 00:00:00
abstract:OBJECT:The aim of this study was to describe the similarity of configuration between the arachnoid complex in the posterior half of the incisural space and the Liliequist membrane. METHODS:Microsurgical dissection and anatomical observation were performed in 20 formalin-fixed adult cadaver heads. The origin, distribut...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.3.JNS132206
更新日期:2014-08-01 00:00:00
abstract::Unusual pathological findings were encountered in a temporal lobectomy specimen from a 9-year-old boy with intractable complex partial seizures. Magnetic resonance imaging revealed an enlarged left temporal lobe, with diffuse high signal intensity over the cortex and poor gray-white differentiation on T2-weighted imag...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.4.0654
更新日期:1993-04-01 00:00:00
abstract::With the goal of developing a practical method of performing noninvasive measurements of flow in cerebrospinal fluid (CSF) shunts, transcutaneous thermal convection CSF shunt flow measurement was investigated using dimensional analysis, numerical modeling, and bench testing. Using appropriate manufacturing practices a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.103.4.0366
更新日期:2005-10-01 00:00:00