Abstract:
BACKGROUND AND OBJECTIVE:En bloc resections aim at surgically removing a tumor in a single, intact piece. Approach must be planned for the complete removal of the tumor without violation of its margins. The shared knowledge of the morbidity, mortality, risk assessment for local disease recurrence, complications, and death, related to spine tumors excised en bloc could improve the treating physician's apprehension of the diseases and decision making process before, during, and after surgical treatment. The purpose of this study was to review and report the experience gained during 25 years in one of the world's biggest spine oncologic centers. METHODS:A retrospective study of prospective collected data of 1681 patients affected by spine tumors, of whom 220 had en bloc resections performed. RESULTS:Most tumors were primary-165 cases (43 benign and 122 malignant); metastases occurred in 55 patients. A total of 60 patients died from the disease and 33 local recurrences were recorded. A total of 153 complications were observed in 100 of 216 patients (46.2%); 64 of these patients (30%) suffered 1 complication, whereas the rest had 2 or more. All complications were categorized according to temporal distribution and severity. These were further divided into 7 groups according to the type of complication. There were 105 major and 48 minor complications. Seven patients (4.6%) died as a result of complications. There were 33 local recurrences (15.28%) recorded. Contaminated cases, surgical margins of the resected tumor-intralesional, marginal, and malignant tumors-were statistically significant independent risk factors for local recurrence of the tumor. Contamination, local recurrence, neoadjuvant radiotherapy, number of levels resected, and metastatic tumors compared with primary malignant tumor were shown to be independent risk factors for a patient's death. CONCLUSIONS:Treatment of spinal aggressive benign and malignant bone tumors with en bloc resection is beneficial in terms of better local control and prognosis, although it is a highly demanding and risky procedure. Margins are the key point of this procedure, thus a careful preoperative oncologic and surgical staging is necessary to define the optimal surgical approach. The adverse event profile of these surgeries is high. Therefore, it should be performed by experienced and multidisciplinary teams in specialized high volume centers.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Boriani S,Gasbarrini A,Bandiera S,Ghermandi R,Lador Rdoi
10.1016/j.wneu.2016.10.086subject
Has Abstractpub_date
2017-02-01 00:00:00pages
217-229eissn
1878-8750issn
1878-8769pii
S1878-8750(16)31075-0journal_volume
98pub_type
杂志文章abstract:BACKGROUND:Fenestration of the basilar artery is a segmental duplication of the vessel due to nonfusion of the embryonal arteries and is the second most common vascular disjunction. Here, we present a single case example demonstrating the utility of the temporary bridging device Comaneci as a new option in the endovasc...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.047
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:Prognostic factors of favorable and unfavorable clinical outcome after aneurysmal subarachnoid hemorrhage (SAH) are still not completely known. We retrospectively analyzed the aneurysm location as a factor for patients' outcome after aneurysmal SAH. METHODS:We retrospectively selected patients from our prosp...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.04.086
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:Immediate postoperative and early clinical outcome of treatment of spinal kyphoscoliosis (SKS) associated with Chiari formation (CF) and syringomyelia (SM) and treated by atlantoaxial fixation is described. METHODS:During the period April 2016 to March 2018, 11 patients with SKS as a major presenting symptom...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.01.212
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:We previously reported inpatient and 30-day postoperative patient-reported outcomes (PROs) of a controlled, noncrossover pilot study using preoperative mindfulness-based stress reduction (MBSR) training for lumbar spine surgery. Our goal here was to assess 3-month and 12-month postoperative PROs of preoperat...
journal_title:World neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.wneu.2020.03.186
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The laterocavernous sinus system is best defined as the entire territory served by the laterocavernous and the superior petrosal sinuses (SPS). METHODS:The laterocavernous sinus is a small but important venous structure located between the two dural layers forming the lateral wall of the cavernous sinus and...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2010.09.016
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:An isolated, unilateral fracture of the C1 lateral mass is a rare condition that has been only minimally described in the literature. Historically, these fractures have predominantly been managed conservatively with either external immobilization or traction. CASE DESCRIPTION:We review the literature and pr...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.206
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Major depressive disorder is a common and disabling illness and is the leading cause of disability worldwide. Despite aggressive medical, behavioral, and electroconvulsive therapies, a significant number of patients remain refractory to treatment. Deep brain stimulation (DBS) has proven efficacy in neurobeha...
journal_title:World neurosurgery
pub_type: 历史文章,杂志文章,评审
doi:10.1016/j.wneu.2012.10.068
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Recent changes in surgical training environments may have limited opportunities for trainees to gain proficiency in skill. Complex skills such as neurosurgery require extended periods of training. Methods to enhance surgical training are required to overcome duty-hour restrictions, to ensure the acquisition ...
journal_title:World neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.wneu.2017.08.123
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Central nervous system abscesses frequently can be seen in the immunocompromised population and most commonly consist of intracranial collections in the adult patient. Spinal intradural abscesses are less commonly encountered, and there are even fewer numbers in the pediatric population with a concordant abs...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.02.243
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To report the comprehensive long-term functional and quality of life outcomes after craniectomy (CE) and craniotomy (CO) in individuals with traumatic brain injury (TBI). METHODS:Information on all individuals with TBI who had undergone CE or CO were extracted from the TBI Model Systems database from 2002 to...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.07.124
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:For adult patients undergoing surgical decompression for Chiari malformation type I (CM-I), the patient-level factors that influence extended length of stay (LOS) are relatively unknown. The aim of this study was to investigate the impact of patient-baseline comorbidities, demographics, and postoperative comp...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.02.158
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Anterior cervical diskectomy and fusion with plate-screw construct has been gradually applied for multilevel cervical spondylotic myelopathy in recent years. However, long cervical plate was associated with complications including breakage or loosening of plate and screws, trachea-esophageal injury, neurovas...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2017.05.045
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Injury of the ureter is a potentially devastating complication most often reported in gynecologic, colorectal, or vascular pelvic surgery or endoscopic procedures for ureteric diseases. We report a rare case of ureteral rupture occurring as a complication of percutaneous pedicle screw placement. CASE DESCRI...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.11.175
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the association between obesity and outcomes after microdiscectomy for lumbar disc herniation. METHODS:The primary outcome measure was change in Oswestry Disability Index (ODI) at 1 year after surgery. Obesity was defined as body mass index (BMI) ≥30. Prospective data were retrieved from the Norw...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2017.11.156
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:Idiopathic normal pressure hydrocephalus (iNPH) may present, besides the classic triad of symptoms, with extrapyramidal parkinsonianlike movement disorders. We present a randomized prospective study comparing adjustable ventriculoperitoneal (VP) shunt insertion plus dopamine oral therapy (group A) versus VP s...
journal_title:World neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.wneu.2016.03.004
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Lack of risk stratification among patients with varying severities of compound head injury has resulted in too-inconsistent and conflicting results to support any management strategy over another. The purpose of this study was to validate a new clinico-radiological grading scheme with implications on outcome...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.05.058
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:After subarachnoid hemorrhage (SAH), headache management is often difficult owing to the need to use multiple analgesic drugs. Fentanyl is an opioid we can use after surgery, and it can decrease pain post SAH. The aim of this study was to investigate the effectiveness and safety of fentanyl for management of...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.10.062
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Tumor recurrence or incomplete resection in nonfunctioning pituitary adenomas (NFPAs) is relatively common. However, predictive factors of tumor recurrence in NFPAs are not well established. We evaluated possible factors related to tumor recurrence in a large cohort of NFPAs at a single pituitary neurosurger...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.043
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Social media plays an increasingly important role in dissemination of knowledge and raising awareness of selected topics among the general public and the academic community. OBJECTIVE:To investigate the relationship between social media metrics and academic indices of neurosurgical programs and journals. M...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.01.087
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Arteriovenous malformations (AVMs) represent a complex pathologic entity in terms of their associated angioarchitecture and blood flow dynamics. METHODS:Using existing imaging data, we generated a patient's giant AVM to scale. RESULTS:A series of 3-dimensional (3D) models were generated and blood flow dyna...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.03.095
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To describe a successful one-step intraoperative reduction of atlantoaxial rotatory subluxation (AARS) using neuromuscular blockade and intraoperative traction. METHODS:While the patient was undergoing continuous somatosensory evoked potential monitoring, crown halo traction was applied under general anesthe...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2012.11.040
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Primary central nervous system lymphoma (PCNSL) is an aggressive lymphoma confined to the CNS. Although the pathogenesis of PCNSL in immunocompetent individuals remains unclear, there have been several case studies demonstrating the "sentinel" inflammatory lesions months before the manifestation of PCNSL. Ho...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2015.11.099
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Previous studies have implicated traumatic brain injury (TBI) as a risk factor for Parkinson disease (PD). However, the incidence risk of new-onset TBI among patients with PD is not well established. This study investigated the contribution of PD to new-onset TBI associations. METHODS:The study selected 607...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.027
更新日期:2018-05-01 00:00:00
abstract::The global incidence of spinal cord injury (SCI) is 15-40 cases per million people, with the socioeconomic and healthcare costs amounting to nearly $10 billion per annum in the USA alone. Despite substantial advances in medical care and surgical technology, many patients with SCI still experience significant long-term...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2013.08.004
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:Glioblastoma multiforme (GBM) is an aggressive primary brain tumor with dismal survival. This study aims to examine the prognostic value of primary tumor sites and race on survival outcomes. METHODS:Patient data obtained from the Scott and White Hospital Brain Tumor Registry (1976-2013) were stratified accor...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.104
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To describe longitudinal image changes in supratentorial hemispheric meningiomas based on magnetic resonance imaging after preoperative embolization using calibrated microspheres. METHODS:A total of 14 patients with symptomatic supratentorial meningiomas were included in a prospective, mono-centric, mono-arm...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.078
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Olfactory neuroblastoma (ON) is a highly aggressive and locally recurrent neoplasm. Distant systemic metastases are not uncommon, but remote leptomeningeal dissemination is extremely rare. CASE DESCRIPTION:We report 2 cases of ON previously treated with endoscopic endonasal radical surgical resection and ra...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2019.11.042
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Previous studies have suggested that interleukin (IL)-17A is a key factor that contributes to intervertebral disc degeneration (IDD), whereas autophagy has been shown to be a protective mechanism in IDD. However, the relationship between IL-17A and autophagy in IDD remains to be fully elucidated. This study ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.07.117
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:In children, decompressive craniectomy is commonly performed in cases of increased intracranial pressure that is not medically managed. Currently, it is standard practice to perform cranioplasty after decompressive craniectomy, although optimal timing for the procedure remains controversial. To date, few stu...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.085
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:Neuronavigation procedures demand high precision and accuracy. Despite this need, there are still few studies analyzing errors in such procedures. The aim of this study was to use a custom-built cranial phantom to measure target position and orientation errors in different phases of a simulated neuronavigatio...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.052
更新日期:2019-06-01 00:00:00