What Is the More Appropriate Proximal Fusion Level for Adult Lumbar Degenerative Flat Back?

Abstract:

OBJECTIVE:To determine the optimal proximal fusion level after long instrumented fusion to the sacrum for lumbar degenerative flat back. METHODS:Data from 70 patients with lumbar degenerative flat back were reviewed retrospectively. Three groups were designated according to the upper instrumented vertebrae (UIV): group 1 (UIV = T10 or above), group 2 (UIV = T11-12), and group 3 (UIV = L1 or below). Pre- and postoperative pelvic parameters, degree of correction, and prevalence of proximal junctional kyphosis (PJK) and its risk factors were evaluated. RESULTS:The prevalence of PJK was 27.1% (average 35.5 months of follow-up). Preoperative pelvic incidence (PI) and sacral slope (SS) in group 1 were higher in the PJK group than in the non-PJK group (P = 0.03 and P = 0.001, respectively). Preoperative thoracolumbar (TL) in group 3 was higher in the PJK group than in the non-PJK group (P = 0.01). Postoperative pelvic tilt (PT) was lower (<20°) in the non-PJK group than in the PJK group (P = 0.025 in group 3). Postoperative TL in group 3 was lower than in the non-PJK group (P = 0.024). CONCLUSIONS:If the PI is ≥50°, TL kyphosis is ≥5°, and SS is ≥20°, the UIV should be raised above T10 up to the midthoracic level. If the PI is ≥50°, SS is ≤20°, and thoracic kyphosis (TK) is normal despite TL kyphosis, the UIV should be at T10. Even if the PI is ≥50°, TK is normal, and there is no TL kyphosis, the UIV should be set at L1 or below. Regardless of the UIV, the postoperative PT should be ≤20°.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Choi JH,Jang JS,Kim HS,Jang IT

doi

10.1016/j.wneu.2017.03.051

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

827-835

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(17)30374-1

journal_volume

106

pub_type

杂志文章
  • Microsurgical Outcome of Cerebellar Arteriovenous Malformations: Single-Center Experience.

    abstract:OBJECTIVE:We aimed to describe our single-center experience in treating cerebellar arteriovenous malformations (AVMs) with microsurgical resection. METHODS:During a 16-year period, 181 patients with cerebellar AVMs were surgically treated at the Department of Neurosurgery in Beijing Tiantan Hospital. Patient functiona...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2016.08.059

    authors: Tong X,Wu J,Lin F,Cao Y,Zhao Y,Wang S,Zhao J

    更新日期:2016-11-01 00:00:00

  • Planning and Executing the Neurosurgery Boot Camp: The Bolivia Experience.

    abstract:BACKGROUND:The neurosurgical boot camp has been fully incorporated into U.S. postgraduate education. This is the first implementation of the neurosurgical boot in a developing country. To advance neurosurgical education, we developed a similar boot camp program, in collaboration with Bolivian neurosurgeons, to determin...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2017.05.046

    authors: Ament JD,Kim T,Gold-Markel J,Germano IM,Dempsey R,Weaver JP,DiPatri AJ Jr,Andrews RJ,Sanchez M,Hinojosa J,Moser RP,Glick R

    更新日期:2017-08-01 00:00:00

  • Short Report on a Rare Presentation of Temporal Arachnoid Cyst and Lessons Learned.

    abstract:BACKGROUND:Stiff neck or nuchal rigidity is a significant clinical sign of neurologic disease. It is commonly associated with meningitis, subarachnoid hemorrhage, and posterior fossa tumors. It may also occur as a result of tonsillar impaction following pressure in the infratentorial compartment from an expanding poste...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2019.02.230

    authors: Onyia CU,Akinniranye O,Olaitan A,Agoha C

    更新日期:2019-06-01 00:00:00

  • An All-Anterior Approach for Quadruple Nerve Transfer for Upper Trunk Brachial Plexus Injuries.

    abstract:BACKGROUND:The most commonly performed nerve transfers in upper trunk (UT) or partial brachial plexus injuries (BPIs) include the spinal accessory nerve to suprascapular nerve, Oberlin, and, lately, radial nerve (RN) (branch to triceps) to axillary nerve (AN) transfers. Routinely, the former 3 procedures are performed ...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2018.08.139

    authors: Prasad GL

    更新日期:2018-12-01 00:00:00

  • Oxygen Embolism and Pneumocephalus After Hydrogen Peroxide Application During Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery: A Case Report and Literature Review.

    abstract:BACKGROUND:Hydrogen peroxide (H2O2) solution is commonly used to irrigate wounds because of its hemostatic and antiseptic properties. Previous studies suggest that H2O2 can result in toxicity to keratinocytes and fibroblasts, but complications after H2O2 application, including oxygen embolism, which is one of the most ...

    journal_title:World neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.wneu.2020.03.035

    authors: Zou P,Yang JS,Wang XF,Wei JM,Guo H,Zhang B,Zhang F,Chu L,Hao DJ,Zhao YT

    更新日期:2020-06-01 00:00:00

  • The Role of Low-Cost Microsurgical Training Models and Experience with Exercises Based on a Bovine Heart.

    abstract:BACKGROUND:Microscopic training is essential for development of neurosurgical skills. A range of models is reported in the literature for this purpose, including live animals, exvivo, and synthetic material. Among the factors involved in selection and development of a training station, cost is a decisive one. METHODS:...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2019.06.089

    authors: Olijnyk LD,Patel K,Brandão MR,de Morais ANL,de Carvalho RF,Severino AG,Mayor D,da Silva CE,Stefani MA

    更新日期:2019-10-01 00:00:00

  • When a Meningioma Isn't: Endoscopic Endonasal Orbital Decompression and Biopsy of Skull Base Rosai-Dorfman Disease Treated Previously with Empiric Radiation Therapy.

    abstract:BACKGROUND:Rosai-Dorfman disease (RDD) is a rare, benign histiocytosis disorder with only approximately 100 reported central nervous system cases in the literature. Even less common is skull base involvement of RDD, with about 41 reported cases. Radiographically, RDD can appear similar to a meningioma; the true diagnos...

    journal_title:World neurosurgery

    pub_type:

    doi:10.1016/j.wneu.2019.12.032

    authors: Shah V,Mohyeldin A,London NR,Fritz J,Prevedello DM,Carrau RL,Hardesty DA

    更新日期:2020-03-01 00:00:00

  • Solitary Cysticercal Cyst Inside the Blake's Pouch Remnant of Mega Cisterna Magna with Associated Aqueductal Stenosis: Clinical and Management Implications.

    abstract:BACKGROUND:Intraventricular and subarachnoid forms represent the relatively complex, albeit uncommon, manifestations of central nervous system involvement by cysticercal cysts. Cysticercal encystation inside the Blake's pouch remnant of mega cisterna magna (MCM) remains an extremely rare clinical scenario that, to the ...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2017.04.067

    authors: Das KK,Gosal JS,Singh S,Mehrotra A,Jaiswal A,Jaiswal S,Kumar R

    更新日期:2017-06-01 00:00:00

  • Severe Intradural Lumbar Disc Herniation with Cranially Oriented Free Fragment Migration.

    abstract:BACKGROUND:Intrathecal disc herniation is a rare but serious condition that has the potential to generate devastating neurologic deficits. We present a case of a 56-year-old man who developed cauda equina syndrome after several episodes of severe Valsalva maneuver. CASE DESCRIPTION:The patient was found to have develo...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2016.06.024

    authors: Tempel Z,Zhu X,McDowell MM,Agarwal N,Monaco EA 3rd

    更新日期:2016-08-01 00:00:00

  • Prevalence of Unruptured Intracranial Aneurysms Coexisting with Pituitary Adenomas.

    abstract:OBJECTIVE:The objective of this study was to evaluate the association between asymptomatic unruptured intracranial aneurysms (IAs) and pituitary adenomas (PAs) in Chinese people. METHODS:In total, 434 patients with newly diagnosed PA and 252 control subjects from the general population who underwent brain computed tom...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2019.02.084

    authors: Hu J,Lin Z,Zhang Y,Zheng X,Ran Q,Zhang D,Wu J,Li S,Yang H

    更新日期:2019-06-01 00:00:00

  • Alarming Internal Carotid Artery Aneurysm Eroding the Sphenoid Sinus.

    abstract::In rare instances, extradural internal carotid artery aneurysms can present with massive epistaxis, which is often a fatal event. We present the case of a young female with an aneurysm eroding through the sphenoid sinus and whose timely diagnosis resulted in treatment of the aneurysm with coil embolization and satisfa...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2017.09.006

    authors: Brasiliense LBC,Dumont TM

    更新日期:2017-12-01 00:00:00

  • Brain-Machine Interfaces: The Role of the Neurosurgeon.

    abstract::Neurotechnology is set to expand rapidly in the coming years as technological innovations in hardware and software are translated to the clinical setting. Given our unique access to patients with neurologic disorders, expertise with which to guide appropriate treatments, and technical skills to implant brain-machine i...

    journal_title:World neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.wneu.2020.11.028

    authors: Chari A,Budhdeo S,Sparks R,Barone DG,Marcus HJ,Pereira EAC,Tisdall MM

    更新日期:2020-11-13 00:00:00

  • Case-Control Study of Patients at Risk of Medical Complications after Elective Craniotomy.

    abstract:OBJECTIVE:Medical complications severely impair recovery of neurosurgical patients after craniotomy. The purpose of this study was to identify patients at risk of peri- and postoperative medical complications. Therefore, we present a large population of patients with different medical complications after elective crani...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2016.03.087

    authors: Anthofer J,Wester M,Zeman F,Brawanski A,Schebesch KM

    更新日期:2016-07-01 00:00:00

  • Impact of Symptomatic Metastatic Spinal Cord Compression on Survival of Patients with Non-Small-Cell Lung Cancer.

    abstract:OBJECTIVES:Non-small-cell lung cancer (NSCLC) is one of the most common primary tumor sites among patients with metastatic spinal cord compression (MSCC). This disorder is related to neurologic dysfunction and can reduce the quality of life, but the association between MSCC and death is unclear. The aim of this study w...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2017.09.079

    authors: da Silva GT,Bergmann A,Thuler LCS

    更新日期:2017-12-01 00:00:00

  • Results of Percutaneous Balloon Compression in Trigeminal Pain Syndromes.

    abstract:OBJECTIVE:To investigate initial pain relief and subsequent recurrence after percutaneous balloon compression (PBC) and describe its association with the nature of trigeminal pain, previous procedures, or other clinical factors. METHODS:A total of 222 patients with medically refractory trigeminal pain treated with PBC...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2018.03.111

    authors: Grewal SS,Kerezoudis P,Garcia O,Quinones-Hinojosa A,Reimer R,Wharen RE

    更新日期:2018-06-01 00:00:00

  • Implementation of Intraoperative Computed Tomography for Deep Brain Stimulation: Pitfalls and Optimization of Workflow, Accuracy, and Radiation Exposure.

    abstract:OBJECTIVE:Deep brain stimulation (DBS) is an effective treatment for movement disorders. Stereotactic electrode placement can be guided by intraoperative imaging, which also allows for immediate intraoperative quality control. This article is about implementation and refining a workflow applying intraoperative computed...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2018.12.079

    authors: Carl B,Bopp M,Gjorgjevski M,Oehrn C,Timmermann L,Nimsky C

    更新日期:2018-12-27 00:00:00

  • Muscle Weakness-Related Spinal Instability Is the Cause of Cervical Spinal Degeneration and Spinal Stabilization Is the Treatment: An Experience with 215 Cases Surgically Treated over 7 Years.

    abstract:BACKGROUND:The rationale of only fixation without any kind of bone, ligament, disc, or osteophyte decompression as a treatment for single- or multiple-level cervical spinal degeneration was analyzed. The concept was based on the understanding that muscle weakness-related spinal instability is the cause of spinal degene...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2020.03.104

    authors: Goel A,Dandpat S,Shah A,Rai S,Vutha R

    更新日期:2020-08-01 00:00:00

  • Minimally Invasive Decompression and Intracorporeal Bone Grafting Combined with Temporary Percutaneous Short-Segment Pedicle Screw Fixation for Treatment of Thoracolumbar Burst Fracture with Neurological Deficits.

    abstract:OBJECTIVE:We evaluated the clinical and radiographic outcomes of patients with thoracolumbar burst fractures and neurological deficits treated with minimally invasive decompression and intracorporeal bone grafting combined with percutaneous short-segment stabilization. METHODS:Patients with thoracolumbar burst fractur...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2019.11.123

    authors: Chen L,Liu H,Hong Y,Yang Y,Hu L

    更新日期:2020-03-01 00:00:00

  • Local Anesthesia for Endovascular Treatment of Unruptured Intracranial Aneurysms: Feasibility, Safety, and Periprocedural Complications.

    abstract:OBJECTIVE:The aim of the study is to report the feasibility, safety, and outcomes associated with endovascular treatment (EVT) of unruptured intracranial aneurysms (UIAs) under local anesthesia. METHODS:Between March 2011 and December 2016, 184 consecutive patients with 198 UIAs were treated with coil embolization und...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2017.05.077

    authors: Song J,Yang NR,Lee CY

    更新日期:2017-08-01 00:00:00

  • Risk of Aneurysm Residual Regrowth, Recurrence, and de Novo Aneurysm Formation After Microsurgical Clip Occlusion Based on Follow-up with Catheter Angiography.

    abstract:INTRODUCTION:Established guidelines for radiologic surveillance after microsurgical treatment of intracranial aneurysms are lacking in the literature because of small sample sizes, poor definitions, and heterogeneous use of imaging modalities. We aimed to propose clinically meaningful definitions for postoperative aneu...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2017.06.110

    authors: Burkhardt JK,Chua MHJ,Weiss M,Do ASS,Winkler EA,Lawton MT

    更新日期:2017-10-01 00:00:00

  • Risk Factors and Independent Predictors of 30-Day Readmission for Altered Mental Status After Elective Spine Surgery for Spine Deformity: A Single-Institutional Study of 1090 Patients.

    abstract:BACKGROUND:Altered mental status (AMS) has been associated with inferior surgical outcomes. The factors leading to AMS after spine surgery are unknown. The aim of this study is to determine the risk factors and independent predictors of 30-day readmission for AMS in patients with spine deformity after undergoing electi...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2017.02.001

    authors: Elsamadicy AA,Adogwa O,Reddy GB,Sergesketter A,Warwick H,Jones T,Cheng J,Bagley CA,Karikari IO

    更新日期:2017-05-01 00:00:00

  • Effect of Fetal Posterior Circulation on Efficacy of Flow Diversion for Treatment of Posterior Communicating Artery Aneurysms: A Multi-Institutional Study.

    abstract:BACKGROUND:Flow diversion (FD) has emerged as an effective treatment modality for aneurysms of the posterior communicating artery (PCOM). Whether or not a fetal posterior circulation (FPC) affects PCOM aneurysm occlusion rates after FD remains undetermined. METHODS:We performed a retrospective cohort study in which tr...

    journal_title:World neurosurgery

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.wneu.2019.04.112

    authors: Rinaldo L,Brinjikji W,Cloft H,Lanzino G,Gonzalez LF,Kan P,Castilla LR

    更新日期:2019-07-01 00:00:00

  • Growth of Primary and Remnant Vestibular Schwannomas: A Three-Year Follow-Up Study.

    abstract:OBJECTIVE:Vestibular schwannomas (VSs) are benign, slowly growing tumors. The management strategy, however, remains unclear for both primary VS and remnant VS after subtotal or partial resection. In this study, we analyzed the radiographical tumor growth to elucidate factors possibly predicting growth or regrowth of th...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2015.02.005

    authors: Tomita Y,Tosaka M,Aihara M,Horiguchi K,Yoshimoto Y

    更新日期:2015-06-01 00:00:00

  • Worldwide Access to Stereotactic Radiosurgery.

    abstract::Stereotactic radiosurgery is a safe and effective technology that can address a variety of neurosurgical conditions, but in many parts of the world, access remains an issue. Although the technology is increasingly available in the United States, Canada, Europe, and parts of Asia, poor access to central nervous system ...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2019.04.031

    authors: Pannullo SC,Julie DAR,Chidambaram S,Balogun OD,Formenti SC,Apuzzo MLJ,Knisely JPS

    更新日期:2019-10-01 00:00:00

  • Reduction of Slippage Influences Surgical Outcomes of Grade II and III Lumbar Isthmic Spondylolisthesis.

    abstract:OBJECTIVE:To explore influence of reduction of slippage on radiologic parameters, clinical outcomes, and perioperative complications in treatment of grade II/III lumbar isthmic spondylolisthesis. METHODS:We divided 156 patients with grade II/III spondylolisthesis into 2 groups with preoperative balanced or unbalanced ...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2018.08.217

    authors: Shi L,Chen Y,Miao J,Shi J,Chen D

    更新日期:2018-12-01 00:00:00

  • Endoscopic Modified Transseptal Transsphenoidal Approach for Maximal Preservation of Sinonasal Quality of Life and Olfaction.

    abstract:OBJECTIVE:Patients experience significant postoperative sinonasal symptoms for the first few months after endoscopic transnasal transsphenoidal approach (ETN-TSA) surgery. We modified this technique by bypassing the nasal mucosa and approaching through the septum bilaterally. In this study, we analyze whether these tec...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2015.12.050

    authors: Hong SD,Nam DH,Kong DS,Kim HY,Chung SK,Dhong HJ

    更新日期:2016-03-01 00:00:00

  • In-Hospital Complications After Surgery in Elderly Patients with Asymptomatic or Minor Symptom Meningiomas: A Nationwide Registry Study.

    abstract:BACKGROUND:Asymptomatic or minor symptom meningiomas (AMSMs) in the elderly are incidental findings, with no consensus reached on the optimal management strategy. In the present study, we aimed to determine the surgical risk factors for elderly patients with AMSMs using a nationwide registry database in Japan. METHODS...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2021.01.001

    authors: Ikawa F,Isobe N,Michihata N,Oya S,Ohata K,Saito K,Yoshida K,Fushimi K,Yasunaga H,Tominaga T,Kurisu K

    更新日期:2021-01-11 00:00:00

  • A Frameless Stereotactic Implantation Technique for Depth Electrodes in Refractory Epilepsy Using Intraoperative Magnetic Resonance Imaging.

    abstract:OBJECTIVE:Various complex techniques for depth electrode insertion in refractory epilepsy using preoperative imaging have been investigated. We evaluated a simple, accurate, cost-effective, and timesaving method using intraoperative magnetic resonance imaging (MRI). METHODS:A neuronavigation-guided insertion tube atta...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2016.06.114

    authors: Roessler K,Sommer B,Merkel A,Rampp S,Gollwitzer S,Hamer HM,Buchfelder M

    更新日期:2016-10-01 00:00:00

  • Herpes Simplex Type 2 Encephalitis After Craniotomy: Case Report and Literature Review.

    abstract:BACKGROUND:Herpes simplex encephalitis (HSE) after neurosurgical procedures is extremely uncommon, and the few published case reports mainly described herpes simplex virus type 1 (HSV-1) as being culpable. We present a rare case of HSV-2 encephalitis after craniotomy and describe its pathophysiology and optimal managem...

    journal_title:World neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.wneu.2015.11.101

    authors: Berger A,Shahar T,Margalit N

    更新日期:2016-04-01 00:00:00

  • Preoperative Cytoreduction of Clival Giant Cell Tumor: An Effective Replication of the Systemic Modality in the Skull Base.

    abstract:BACKGROUND:Giant cell tumors (GCTs) are benign tumors with a predilection for the epimetaphyseal region of the long bones. GCTs involving the skull base are rare, and only a few available cases have been reported. Surgical gross total resection is the recommended method of treatment for GCTs. In the case of skull base ...

    journal_title:World neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.wneu.2018.07.207

    authors: Sekar A,Rudrappa S,Gopal S,Ghosal N,Gupta V,Ts L

    更新日期:2018-11-01 00:00:00