Abstract:
OBJECTIVE:To examine the effects of chronic preoperative steroid therapy on 30-day perioperative complications after anterior lumbar fusion (ALF). METHODS:We retrospectively analyzed data from the American College of Surgeons National Surgical Quality Improvement Program between 2008 and 2015. Adult patients who underwent ALF were included and divided into 2 groups: steroids and no steroids. We compared baseline patient demographics, comorbidities, and operative variables between these 2 groups and then performed a multivariate regression analysis to determine complications that were independently associated with chronic steroid therapy. We also performed a subgroup analysis of the steroid group to identify additional risk factors that further predispose these patients to postoperative complications. RESULTS:A total of 9483 patients were included, of whom 289 (3.0%) were on chronic steroid therapy. Univariate analysis showed that chronic steroid use was independently associated with 4 perioperative complications, including deep surgical site infection (odds ratio [OR], 2.78; confidence interval [CI], 1.09-7.10; P = 0.033), pulmonary complications (OR, 1.98; CI, 1.02-3.86; P = 0.044), blood transfusion (OR, 1.60; CI, 1.15-2.23; P = 0.005), and extended length of stay (OR, 1.58; CI, 1.17-2.16; P = 0.003). In patients on chronic steroid therapy, pulmonary comorbidity and extended operative time were additional risk factors that further predisposed to perioperative complications, including deep surgical site infection, blood transfusion, and extended length of stay. CONCLUSIONS:Chronic preoperative steroid therapy is associated with perioperative complications after ALF. Decisions about the discontinuing or holding steroid therapy preoperatively should be determined through an interdisciplinary approach between the medical and surgical teams.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
White SJW,Carrillo O,Cheung ZB,Ranson WA,Cho SKdoi
10.1016/j.wneu.2019.02.048subject
Has Abstractpub_date
2019-06-01 00:00:00pages
e314-e322eissn
1878-8750issn
1878-8769pii
S1878-8750(19)30459-0journal_volume
126pub_type
杂志文章abstract:BACKGROUND:Neuronavigation has become a common means of placing pedicle screws in vertebral arthrodesis, because it reduces the incidence of complications related to poor screw positioning. OBJECTIVE:The To evaluate the accuracy of pedicle screw placement during lumbar arthrodesis performed with the new ROSA Spine rob...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.05.118
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:A critical step in the far lateral approach (FLA) is exposure of the V3 segment of the vertebral artery, located deep in the suboccipital triangle (SOT). Safe exposure of the SOT is achieved by means of a plane-by-plane dissection, which carries the risk of devascularization. A suitable alternative is to lif...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.090
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:The nucleus tractus solitarius and paratrigeminal nucleus, which are implicated in the processing of airway-derived sensory information, are found in the dorsal medulla. The mechanism and localization of higher-order processing of urge to cough is poorly understood, and much of the existing anatomical locali...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.09.096
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:We sought to report the operative techniques of the endoscopic supracerebellar transtentorial approach (ESTA) to the atrium of the lateral ventricle, especially focusing on the role of the endoscope and analyzing optically related issues. METHODS:A retrospective data review was performed on 5 patients with l...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.093
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:To compare perioperative, radiographic, and Scoliosis Research Society-22 (SRS-22) outcomes of consecutive, interval, and skipped pedicle screw techniques in patients with moderate Lenke type 1 adolescent idiopathic scoliosis (AIS). METHODS:We retrospectively reviewed 65 consecutive moderate Lenke type 1 AIS...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.11.064
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:The benefit of endovascular treatment (EVT) for acute ischemic stroke patients with mild deficits is unknown. We sought to evaluate the natural history of patients with a low National Institute of Health Stroke Score (NIHSS) and an intracranial occlusion. METHODS:We included patients with a computed tomogra...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.09.080
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Intracranial-intracranial bypass is a valuable cerebral revascularization option. Despite several advantages, one of the main shortcomings of the intracranial-intracranial bypass is the possibility of ischemic complications of the donor artery. However, when sacrificed, the temporopolar artery (TPA) is not a...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.04.142
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Minimally invasive techniques in spine surgery have continued to advance as robotic technology has evolved over several generations. Although traditional techniques for placing pedicle screws are still widespread in practice, newer technology has increased the reliability of accurately placing instrumentatio...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.10.010
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:This paper reports the case of a giant saddle area lymphoid epithelial carcinoma as reference for clinical diagnosis and treatment. The clinical data of 1 patient who suffered from giant saddle area lymphoid epithelial carcinoma that invaded the bilateral cavernous sinus and surrounding internal carotid arte...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.05.176
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:The aim of this systematic literature review is to evaluate recent attempts in creating a standardized multidisciplinary approach combining tumor treatment with current vertebral stabilization techniques for palliative treatment of vertebral metastasis in patients who do not fall into the NOMS (neurologic, on...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.042
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:The pathophysiology of spinal cord injury (SCI) with the information obtained to date has not been elucidated fully. A safe drug or treatment protocol that results in cell regeneration for SCI remains unknown. Neuroprotective and neuroregenerative effects of riluzole, administered after a SCI, have been shown...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.171
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:Shot-within-shot (SWS) optimization is a new planning technique that relies on various combinations of shot weighting and prescription isodose line (IDL) to reduce beam-on time. The method differs from other planning techniques that incorporate mixed collimation, multiple stereotactic coordinates, and traditi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.11.140
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Laser interstitial thermal therapy (LITT) is an alternative, less-invasive, and, in some circumstances, effective treatment for patients with intracranial pathology including epilepsy and some tumors. For intracranial lesions in eloquent areas, resection by conventional craniotomy proves often to be a challe...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.09.074
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To provide anatomic evidence of preoperative assessment of oblique lumbar interbody fusion (OLIF) for Chinese patients. METHODS:From the hospital picture archiving and communication system, 400 lumbar magnetic resonance imaging studies of adults performed between November 2016 and January 2017 were selected....
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.244
更新日期:2019-08-01 00:00:00
abstract::Endoscopic endonasal transsphenoidal surgery for pituitary tumors has been the standard therapy for decades. This approach offers surgeons an effective, safe, and wide exposure to the pituitary gland, with a relatively low mortality rate and acceptable complication rates. However, severe complications, including cereb...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.04.043
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:The nasoseptal flap (NSF) has been shown to be a mainstay in the reconstruction of skull base defects. We evaluated the efficacy and complications of NSF in patients with a history of septal surgery who had the potential risk of tearing and poor vascularity. METHODS:We performed a retrospective chart and vid...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.06.006
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Medical implications of 3-dimensional (3D) printing technology have evolved and are increasingly used. Surgical spine oncology involves at times complex resection using various surgical approaches and unique spinal reconstruction. As high general complication rates, including hardware failure, are reported, ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.09.002
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Granular cell tumor (GCT) is a relatively uncommon predominantly benign lesion that usually presents as a solitary, painless cutaneous or submucosal nodule. Most of these tumors are found in the tongue. Although GCT is believed to have a Schwann cell origin, reports of GCT in peripheral and spinal nerves are...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2015.10.012
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:To describe percutaneous balloon compression (PBC) of the trigeminal rootlets as treatment for trigeminal neuralgia (TN), including history, operative techniques, outcomes, side effects, and some recent findings increasing the likelihood of a positive outcome. METHODS:PBC is indicated in patients with TN in ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2012.03.014
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Visual loss can be encountered in the immediate, early, or even delayed postoperative period after resection of skull base meningiomas involving the optic apparatus. Various mechanisms for visual loss can include mechanical injury, vascular insult, optic nerve and chiasm edema, and vasospasm of the blood sup...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.06.052
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:This report describes 2 techniques for controlling otherwise difficult-to-control hemorrhage from choanoid bony foramina. METHODS:Medical records of 3 patients in whom vigorous and difficult-to-control bleeding from choanoid cranial foramina was successfully halted are reviewed. RESULTS:In 2 patients, vigor...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.01.128
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Cervical sagittal alignment parameters are essential to plan stages of surgery. The aims of this study were to evaluate the relationship between cervical sagittal alignment parameters and surgical outcomes after anterior cervical arthrodesis; to identify parameters linked to a better outcome; to determine th...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.09.110
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Osteoblastoma is a benign bone-forming tumor, sometimes locally invasive, that may involve any bone. The highest incidence is between 20 and 30 years of age, and there are no cases described in the elderly. METHODS:We report a case of an elderly patient with a lesion in the lumbar spine in which osteoblasto...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.01.180
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To analyze the clinical impact of extubation failure (EF) in patients with good-grade subarachnoid hemorrhage (SAH), in whom a good clinical course usually is expected. PATIENTS AND METHODS:We reviewed the clinical data from 141 patients with SAH and 1) initial Hunt & Hess grade 1-3; 2) induction of general ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.027
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:A standard post-concomitant radiochemotherapy involving adjuvant temozolomide (TMZ) was stopped after 6 cycles for high-grade gliomas (HGG). Several studies demonstrated that prolonged TMZ treatment increased survival for these patients. METHODS:This retrospective study aimed to compare changes in tumor vol...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.03.078
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Occipitocervical fusion is an important surgical procedure to treat instability of the upper cervical and craniocervical junction. Fixation to the dense cortical bone of the occiput, contemporaneously typically accomplished with a plate and screws, is known to be strong and durable, but there are many compet...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.159
更新日期:2021-01-07 00:00:00
abstract:BACKGROUND:Dysplastic gangliocytoma is a sporadic cerebellar benign tumor with the characteristics of hamartoma and true tumor, also known as Lhermitte-Duclos disease (LDD). Bone fibrous dysplasia (FD) is a slowly progressive self-limited benign bone tissue disease. Cowden syndrome, an autosomal dominant genetic disord...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2020.06.071
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:When it comes to evacuating intracranial hemorrhagic lesions in patients with traumatic brain injury (TBI), neurosurgeons perform either a craniotomy or a decompressive craniectomy (DC). The aim of the present study was to estimate the impact of DC on outcomes in elderly patients. METHODS:This retrospective...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.01.071
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:We performed a rigorous statistical analysis of the complications and outcomes of patients with ruptured or unruptured intracranial aneurysms. Our emphasis was on the potential predictive factors when both surgical and endovascular management are offered by a team with balanced microsurgical and endovascular...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.10.094
更新日期:2019-02-01 00:00:00
abstract::When used in medicine, endoscopy describes a procedure used to see inside various parts of the body, such as the interior surfaces of an organ, by inserting a tube through a natural or created orifice. The instrument may have a rigid (borescope) or flexible (fiberscope) tube; it provides an image for visual inspection...
journal_title:World neurosurgery
pub_type: 历史文章,杂志文章,评审
doi:10.1016/j.wneu.2012.02.033
更新日期:2013-02-01 00:00:00