Abstract:
BACKGROUND CONTEXT:Transforaminal epidural steroid injection (TFESI) is recognised as a treatment for symptomatic lumbar disc herniation, whilst surgical decompression is generally thought to be the most effective treatment option for lumbar spinal stenosis. There is little available literature examining the effect of TFESI on symptomatic lumbar spinal stenosis. PURPOSE:To evaluate the use of TFESI as an alternative to surgery in patients with symptomatic stenosis. STUDY DESIGN/SETTING:An observational study which took place between May 2010 and July 2013. All patients were seen by the Extended Scope Physiotherapist (ESP) injection service. PATIENT SAMPLE:A total of 68 consecutive patients were included. Thirty-one were male and 37 were female. The average age was 75 years. OUTCOME MEASURES:The primary outcome measure was the avoidance of decompressive surgery. METHODS:Patients with radicular leg pain were seen by an ESP in an Outpatient setting. Concordant clinical examination and magnetic resonance imaging were required for diagnosis. Peri-radicular bupivacaine hydrochloride 0.25% (3 ml) and triamcinolone (40 mg) were then injected. Outcome measures were recorded at 6 weeks, 1 year and 2 years. RESULTS:Of 68 patients with spinal stenosis, 22 (32%) had opted for surgery at two year follow-up. Thirty (44%) patients were satisfied with non-surgical management at 2 years, required no further treatment, and were discharged. Of the remaining 24%, nine patients were referred for further injection, four declined surgery but were referred to the Pain Relief Clinic, two still had a similar level of pain but declined surgery and one had died. CONCLUSIONS:Our study reports a considerably lower percentage patients opting for surgery than previously demonstrated by the available literature. TFESI is a reasonable treatment for lumbar spinal stenosis and can result in long-term relief from symptoms in a high proportion of patients.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Davis N,Hourigan P,Clarke Adoi
10.1080/02688697.2016.1206188subject
Has Abstractpub_date
2017-04-01 00:00:00pages
205-208issue
2eissn
0268-8697issn
1360-046Xjournal_volume
31pub_type
杂志文章abstract:BACKGROUND:Maintenance of on-call referrals databases is on the rise in neurosurgical units across the UK and helps provide data to estimate workload. We hypothesize that these databases underestimate the workload and propose the use of the number of telephone calls to the on-call registrar as an easily obtainable and ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2012.743966
更新日期:2013-06-01 00:00:00
abstract:INTRODUCTION:There is a high rate of IDH1/2 mutations in low grade gliomas and in high grade gliomas deriving from them. IDH analysis of gliomas is a novel method of classification and an independent prognostic marker. We compared antibody and sequencing methods for the detection of IDH mutations. METHOD:88 samples fr...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2013.771139
更新日期:2013-08-01 00:00:00
abstract::Laser angioplasty is used to vaporize atheroma in limb arteries. The present investigation was undertaken to determine the nature, size and quantity of particulate matter generated, and the appearance of the intima of a carotid artery model after laser treatment. Particulate matter was not significantly increased foll...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699108998443
更新日期:1991-01-01 00:00:00
abstract::We report a case of cervical spine, tracheal and oesophageal trauma from a go-karting injury caused by the patient's scarf catching in the vehicle's wheel. We discuss the significance of the pre-hospital and operative management of this potentially life-threatening injury by a multi-specialty surgical team. The import...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2010.544788
更新日期:2011-04-01 00:00:00
abstract::Elevation of a depressed skull fracture (DSF) overlying a venous sinus is generally avoided due to risk of sinus injury. Rarely, the sinus may be compressed by the fractured segment, causing intracranial hypertension (IH) or encephalopathy and can only be diagnosed with cerebral angiography or MR imaging techniques. T...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1429566
更新日期:2020-04-01 00:00:00
abstract::Intracranial tuberculoma represents the most common mass lesion in neurotuberculosis. We report an unusual case of tuberculoma with haemorrhage presenting clinically as a cerebellar haemorrhage. Cranial CT scan revealed a peripherally enhancing cerebellar mass with haemorrhage and obstructive hydrocephalus, requiring ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690802439110
更新日期:2009-04-01 00:00:00
abstract::A retrospective study of the surgical management of 41 cerebellopontine angle (CPA) meningiomas was performed. All patients were treated by a single surgeon (TTK) over a 25 year period (1967-1992). There were 13 males, 28 females with a median age of 53.5 years. The median follow-up after surgery was 9 years (range 2-...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699650040539
更新日期:1996-02-01 00:00:00
abstract::Confusion frequently occurs in patients with gliomas for a number of reasons. One cause is a superimposed intracerebral infection. The case of a 73-year-old man who deteriorated after debulking of a high-grade glioma is described. However, he was successfully treated for Listeria monocytogenes (L. monocytogenes) diagn...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2010.535927
更新日期:2011-06-01 00:00:00
abstract:INTRODUCTION:Surgical-site infection (SSI) is associated with significant morbidity and mortality. Public Health England or PHE has published guidance on its surveillance, which is now mandatory in some specialities. We review how appropriate their programme is for monitoring SSI in cranial neurosurgery [CN]. METHOD:S...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2015.1071321
更新日期:2016-01-01 00:00:00
abstract::In March 2015, the Supreme Court's landmark ruling on the common law case of Montgomery vs Lanarkshire Health Board established the doctrine of informed patient consent, setting the legal standards that doctors should abide by. In this review, our primary aim has been to establish whether, despite the well-publicised ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1519111
更新日期:2018-12-01 00:00:00
abstract::A series of 31 patients harbouring 33 glomus tumours of the skull base were treated by a posterolateral combined otoneurosurgical approach. Seventy-four percent of tumours were totally exercised. Only one case required a 2-staged procedure. Three patients were given postoperative radiotherapy. Twenty-eight patients ha...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698909001022
更新日期:1989-01-01 00:00:00
abstract::We have studied 139 cases of intracranial germ cell tumours up to the beginning of 1993, 63.3% of which showed monotypic histological patterns and 36.7% were shown to be mixed tumours. All these cases underwent surgery followed by radiation and/or chemotherapy. All cases of choriocarcinoma died within 2 years. Cases o...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.1080/02688699550041395
更新日期:1995-01-01 00:00:00
abstract:AIM:Cervical Spondylotic Myelopathy (CSM) is a disabling condition arising from arthritic compression and consequent injury of the cervical spinal cord. Stratification of CSM severity has been useful to inform clinical practice and research analysis. In the UK the Myelopathy Disability Index (MDI) is a popular assessme...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1839741
更新日期:2020-11-10 00:00:00
abstract::The clinical course of 21 patients who underwent syringopleural shunting for syringomyelia is summarised. All the patients were continuing to deteriorate at the time of the operation. Objective improvement was seen in nine patients following the procedure but three subsequently deteriorated. Contralateral syrinx sympt...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698709034342
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Nerve and muscle biopsy are common procedures often performed by junior surgical trainees. This educational review article describes the operative details of performing biopsies of muscle and nerve. Indications, pre-operative investigations and complication rates are described to aid in proper patient select...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688697.2013.793288
更新日期:2013-12-01 00:00:00
abstract::Background: Posterior fossa decompression both with and without duraplasty are accepted treatments for symptomatic adult patients with Chiari Malformations Type 1 (CM-1). There is still debate of the superiority of one technique over the other. The purpose of this study was to determine the clinical and craniometrical...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2019.1617407
更新日期:2019-10-01 00:00:00
abstract::Microdialysis enables the chemistry of extracellular fluid in body tissues to be measured. Extracellular proteases such as the cysteine protease, cathepsin S (CatS), are thought to facilitate astrocytoma invasion. Microdialysates obtained from human brain tumours in vivo were subjected to cathepsin S activity and ELIS...
journal_title:British journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1080/02688690701248190
更新日期:2007-04-01 00:00:00
abstract::Among 344 patients with posterior fossa tumours treated from 1979 to 1986 a ventriculoperitoneal, or, less commonly, a ventriculatrial shunt was inserted in 164 cases pre-operatively. Haematoma following the insertion of a shunt was found to be an important cause of deterioration. While the occurrence of cerebrospinal...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699008992760
更新日期:1990-01-01 00:00:00
abstract::We describe a patient who within 2 months of undergoing radio-chemotherapy for glioblastoma developed an Epstein-Barr virus-positive primary diffuse large B-cell CNS lymphoma. To our knowledge, this is the first such case reported in the literature showing that new tumefactions following aggressive treatment for gliob...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2013.829554
更新日期:2014-04-01 00:00:00
abstract::The aim of this study was to evaluate guidance techniques and patient outcomes of ultrasound-guided neuronavigation of deep-seated intracerebral cavernous hemangiomas (CAs). Thirty-five patients with deep-seated intracerebral CAs with sizes ranging between 7 and 45 mm were operated upon only with ultrasound-guidance. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690120097714
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVES:The lumbar infusion test is an invasive technique for quantifying cerebrospinal dynamics in patients with hydrocephalus. However, some patients have difficulty tolerating the duration of this procedure. Therefore, we investigated the limits of shortening the test by examining the reliability of cerebrospinal...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2011.591848
更新日期:2012-02-01 00:00:00
abstract::Non-traumatic 'spontaneous' CSF fistulae are uncommon. The clinical features of 23 patients treated for non-traumatic CSF fistulae are presented. Twenty of these patients had normal CSF pressure and six developed meningitis. Surgical repair of these fistulae is recommended in order to reduce the risk of meningitis. Fo...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699109005187
更新日期:1991-01-01 00:00:00
abstract::Cortical venous thrombosis can present with non-specific findings including headaches and seizures. Subsequent cortical infarction has a variety of radiological appearances. The authors describe the diagnostic challenge of a case of cortical venous thrombosis presenting with focal motor seizures where imaging showed a...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2012.709552
更新日期:2013-02-01 00:00:00
abstract::Background: Indications and clinical outcomes of percutaneous endoscopic thoracic discectomy(PETD) in treating thoracic disc herniation is rarely reported and still controversial. We reported an unsatisfied recovery of thoracic disc herniation with PETD, treated by a second posterior thoracic laminectomy and Ponte ost...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1751069
更新日期:2020-04-11 00:00:00
abstract::Side-effects of iohexol myelography were compared after pre-treatment with oral dexamethasone (n = 42) or placebo (n = 44) in a prospective, randomized, double blind, controlled clinical trial. Although myelogram side-effects were commoner in the placebo group, the differences generally did not reach statistical signi...
journal_title:British journal of neurosurgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1080/02688699650040151
更新日期:1996-06-01 00:00:00
abstract::Cavernous angiomas affecting the optic pathway are rare. This report describes the case of a 12-year-old girl who presented with a 10-month history of right-sided blurred vision caused by a cavernous angioma affecting the right side of the optic chiasm. The computed tomography (CT) scan demonstrated a hyperdense image...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688697.2012.685820
更新日期:2012-12-01 00:00:00
abstract::We describe the operative technique and our preliminary experience with use of the Renishaw neuromate(®) stereotactic robot to implant depth electrodes for investigation of focal epilepsy in the UK. Conventional electrocorticography involving a craniotomy and implantation of grids of electrodes directly onto the brain...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2013.798859
更新日期:2013-10-01 00:00:00
abstract::The transnasal approach is the most utilized approach to the sellar region. This study was conducted to identify an anatomical landmark on the lateral surface of the head that corresponds to the midpoint of the sellar floor at the level of sphenoidal rostrum. This point, lined up with the nostril, simulates the surgic...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
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更新日期:2009-06-01 00:00:00
abstract::True posterior communicating artery (PCoA) aneurysm is an aneurysm that originates from the PCoA, and large or giant true PCoA aneurysms are rare. We report a case of a large true PCoA aneurysm successfully clipped after anterior clinoidectomy and discuss the diagnostic pitfalls associated with this rare clinical enti...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688697.2013.771727
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Glioblastoma multiforme (GBM) is the most aggressive type of primary brain tumor. It is a rapidly progressive, highly recurrent, fatal intracranial neoplasm, and the demand for novel treatment is urgent. Valproic acid (VPA) is a potential anticancer agent that belongs to a class of histone deacetylase (HDAC)...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2011.638996
更新日期:2012-06-01 00:00:00