Abstract:
BACKGROUND:The benefits of surgery for symptomatic spinal metastases have been demonstrated, largely based on series of patients undergoing debulking and instrumentation operations. However, as cancer treatments improve and overall survival lengths increase, the incidence of recurrent spinal cord compression after debulking may increase. The aim of the current paper is to document the postoperative evolution of neurological function, pain, and quality of life following debulking and instrumentation in the Global Spine Tumor Study Group (GSTSG) database. METHODS:The GSTSG database is a prospective multicenter data repository of consecutive patients that underwent surgery for a symptomatic spinal metastasis. For the present analysis, patients were selected from the database that underwent decompressive debulking surgery with instrumentation. Preoperative tumor type, Tomita and Tokuhashi scores, EQ-5D, Frankel, Karnofsky, and postoperative complications, survival, EQ-5D, Frankel, Karnofsky, and pain numeric rating scores (NRS) at 3, 6, 12, and 24 months were analyzed. RESULTS:A total of 914 patients underwent decompressive debulking surgery with instrumentation and had documented follow-up until death or until 2 years post surgery. Median preoperative Karnofsky performance index was 70. A total of 656 patients (71.8%) had visceral metastases and 490 (53.6%) had extraspinal bone metastases. Tomita scores were evenly distributed above (49.1%) and below or equal to 5 (50.9%), and Tokuhashi scores almost evenly distributed below or equal to 8 (46.3%) and above 8 (53.7%). Overall, 12-month survival after surgery was 56.3%. The surgery resulted in EQ-5D health status improvement and NRS pain reduction that was maintained throughout follow-up. Frankel scores improved at first follow-up in 25.0% of patients, but by 12 months neurological deterioration was observed in 18.8%. CONCLUSION:We found that palliative debulking and instrumentation surgeries were performed throughout all Tomita and Tokuhashi categories. These surgeries reduced pain scores and improved quality of life up to 2 years after surgery. After initial improvement, a proportion of patients experienced neurological deterioration by 1 year, but the majority of patients remained stable.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Depreitere B,Ricciardi F,Arts M,Balabaud L,Bunger C,Buchowski JM,Chung CK,Coppes MH,Fehlings MG,Kawahara N,Martin-Benlloch JA,Massicotte EM,Mazel C,Meyer B,Oner FC,Peul W,Quraishi N,Tokuhashi Y,Tomita K,Verlaan JJ,doi
10.1007/s00701-019-04197-5subject
Has Abstractpub_date
2020-04-01 00:00:00pages
943-950issue
4eissn
0001-6268issn
0942-0940pii
10.1007/s00701-019-04197-5journal_volume
162pub_type
杂志文章,多中心研究abstract::In a period of 13 years 978 cases of severe head injuries were operated on in our clinic. An analysis of the medical reports includes injuries of the superficial dural sinus (39 cases = 4%): among these injuries of the anterior and central part of the superior sagittal sinus (66 per cent), injuries of the transverse s...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01541788
更新日期:1992-01-01 00:00:00
abstract::A 35-year-old female presented with partial complex seizures. Computed tomography (CT) showed a slightly high density mass over the right frontal convexity, with heterogeneous contrast enhancement. T1-weighted magnetic resonance (MR) imaging showed the tumour as a hypo-intense lesion, with faint reticular enhancement ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050493
更新日期:1999-01-01 00:00:00
abstract::An experience with surgical management of 30 giant pituitary tumours is analysed in this report. The clinical features, anatomical spread and relationship of these tumours with the cavernous sinus and other parasellar and basal forebrain structures is analysed. The problem encountered in the surgical treatment are rev...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01412306
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:The asymmetry of tonsillar ectopia, syringomyelia, and clinical manifestations, and their correlations in adult Chiari I malformation (CIM) are seldom discussed. METHODS:Clinical and imaging data of 104 consecutive adult patients with CIM and syringomyelia were retrospectively reviewed. A method was devised...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2000-5
更新日期:2014-04-01 00:00:00
abstract::Between 1984 and 1991 86 patients with single cerebral metastases underwent linear accelerator radiosurgery using the atraumatic and reproducible Greitz-Bergström head-fixation device. Routine one-month follow-up documented disappearance of the tumour in 16 patients, with resolution of the oedema and ventricular shift...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01809265
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Distal anterior cerebral artery (DACA) aneurysms represent 2-9 % of intracranial aneurysms. They are often more amenable to surgical rather than endovascular treatment due to the size of parent vessels. METHOD:We illustrate surgical approaches for DACA aneurysms arising from different segments of the anteri...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1855-1
更新日期:2013-11-01 00:00:00
abstract::We present a rare fatal complication of an occipital condylar fracture. The patient was initially neurologically intact, but showed secondary clinical deterioration. Imaging revealed extensive extra-axial hemorrhage at the craniocervical junction and an acute obstructive hydrocephalus. MR imaging demonstrated a T2 hyp...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3165-5
更新日期:2017-06-01 00:00:00
abstract::An experimental technique for producing delayed cerebral vasospasm in a rabbit model is described. The basilar artery is punctured via the transclival route and angiographic verification is illustrated. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406370
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Major artery aneurysms may be found incidentally while evaluating moyamoya disease (MMD). The purpose of this study was to delineate the prevalence and characteristics of these uncommon aneurysms with a brief mention of their management and outcomes. METHODS:We conducted a retrospective review of 249 adult ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-0948-y
更新日期:2011-06-01 00:00:00
abstract::We performed cordectomy, a surgical technique that is infrequently used at present, for a patient with post-traumatic syringomyelia (following complete paraplegia of both lower limbs due to dislocation fracture of the 9th thoracic vertebra), yielding a favourable result. We recommend cordectomy as a surgical technique...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1421-9
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The scientific activity of neurosurgeons and neurosurgery residents as measured by bibliometric parameters is of increased interest. While data about academic output for neurosurgeons in the USA, the UK, and Canada have been published, no similar results for German neurosurgical residents exist. Within this ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-04011-2
更新日期:2019-10-01 00:00:00
abstract:PURPOSE:Complete yet safe resection close to motor areas in medically intractable epilepsy requires functional information. New deficit may occur despite preservation of motor cortex, e.g., through vascular compromise. Here, we explore for the first time the feasibility, safety, and the clinical value of continuous mot...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0675-9
更新日期:2010-08-01 00:00:00
abstract::Twenty-three patients with atypical forms of spinal tuberculosis treated between 1975 and 1985, are described. All presented with signs and symptoms of compression of the spinal cord or cauda equina, ranging from paraesthesiae and increasing weakness of extremities to paraplegia and loss of sphincter control. None of ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400511
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:The BrainIT group works collaboratively on developing standards for collection and analyses of data from brain-injured patients and to facilitate a more efficient infrastructure for assessing new health care technology with the primary objective of improving patient care. European Community (EC) funding supp...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,多中心研究
doi:10.1007/s00701-010-0719-1
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Microendoscopic discectomy (MED) is emerging as a minimally invasive alternative to conventional microsurgical discectomy (MSD). EASYGO! is a new system for spinal endoscopy that claims smooth transition from MSD to MED, with a reduced learning curve period. The aims of this study were to describe the compli...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-012-1321-5
更新日期:2012-06-01 00:00:00
abstract::Patients with multiple intracranial aneurysms present a great challenge to neurosurgical practice. The presence of one or more additional aneurysms, whether recognized or unrecognized, along with the source of the haemorrhage profoundly changes the outcome. It also alters the timing and strategy of surgery. In this st...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01456314
更新日期:1986-01-01 00:00:00
abstract::Myelocystoceles are rare lesions. Rarer still are thoracic myelocystoceles. Two patients with thoracic myelocystoceles are being reported. The first patient presented with swelling in the thoracic region with paraplegia and incontinence. MR with MR myelography revealed the malformation to be a thoracic myelocystocele....
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-006-0734-4
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:The arcade of Struthers has been described as possible cause of compression of the ulnar nerve but several authors and our own experience have doubt cast on its existence. We, therefore, performed an anatomical study to determine whether or not the arcade of Struthers exists. METHODS:Ten arms from fresh fro...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-003-0006-5
更新日期:2003-04-01 00:00:00
abstract::The objective of this study is to investigate the effect at the season of the time of surgery on the survival of brain tumor patients. The population studied consisted of 101 patients (39 males and 62 females), gathered from a geographically large area in northern Finland (from 64 degrees N to 70 degrees N), aged betw...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0438-7
更新日期:2009-11-01 00:00:00
abstract::Using magnetic resonance imaging with planes of section tangential to the left or right perietal convexity, we studied the sulcus pattern of the parietal lobes in 50 healthy subjects. The postcentral sulcus and the intraparietal sulcus were easily identified. As a characteristic landmark, and corresponding to postmort...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411428
更新日期:1995-01-01 00:00:00
abstract::In the arteriovenous malformations of the posterior fossa the arterial feeders and the dural venous sinuses can be identified in anatomical terminology. The arterialised veins which do not conform to adult anatomical descriptions represent the persistent embryonic veins of the metencephalic and myelencephalic segments...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406021
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:We developed a new simple therapeutic method for the treatment of chronic subdural hematoma (CSDH) without irrigation and drainage. This method is characterized by replacement of the hematoma with oxygen. METHODS:Seventy patients (seventy-eight sides) with CSDH were treated with this method from May 1994 to...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0689-x
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVES:Juxtafacet cysts (JFCs) of the subaxial cervical spine are rare causes of neurological deficits. Their imaging characteristics, relationship to segmental instability, and potential for inducing acute symptomatic deterioration have only been described in a few case reports and small case series. The objective...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-012-1549-0
更新日期:2013-02-01 00:00:00
abstract:INTRODUCTION:Navigated transcranial magnetic stimulation (nTMS) is increasingly used for preoperative mapping of motor function, and clinical evidence for its benefit for brain tumor patients is accumulating. In respect to language mapping with repetitive nTMS, literature reports have yielded variable results, and it i...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-017-3187-z
更新日期:2017-07-01 00:00:00
abstract::The findings of computerized tomography and clinical features were studied in 19 patients with traumatic intraventricular haemorrhage. Blood was found in various portion of the ventricles. Main sites of the blood was as follows: around the foramen of Monro, 6 patients; in the body and occipital horn of the lateral ven...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01404144
更新日期:1987-01-01 00:00:00
abstract:OBJECT:In the past, the accuracy of surface matching has been shown to be disappointing. We aimed to determine whether this had improved over the years by assessing application accuracy of current navigation systems, using either surface matching or point-pair matching. METHODS:Eleven patients, scheduled for intracran...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03867-8
更新日期:2019-05-01 00:00:00
abstract::Intracranial meningiomas are characteristically benign tumours with a tendency to recur following surgical resection. Our group is investigating the pathogenesis of meningioma recurrence. In our initial studies we identified two cases of dural "tails" associated with intracranial meningiomas. Gadolinium-enhanced magne...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401115
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:Distal middle cerebral artery (dMCA) aneurysms are very rare with a reported frequency of 2-6%. Typically, patients with ruptured distal MCA aneurysms have poor clinical outcomes because often there is both a subarachnoid haemorrhage (SAH) and an intracerebral haematoma (ICH). The goals of this study were to ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1061-5
更新日期:2007-01-01 00:00:00
abstract::The intracranial fracture of aneurysm clips due to stress corrosion failure is an increasingly common long term postoperative complication. To study the susceptibility of different clips to this process, we evaluated seven aneurysm clips (Mayfield, Yasargil, Vari-Angle McFadden, Scoville, Heifetz, and Pivot) in vitro....
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406875
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:Several studies have investigated the relation between intraoperative abnormal muscle response (AMR) findings and postoperative results in patients undergoing microvascular decompression (MVD) for hemifacial spasm (HFS). However, there is some debate over the reliability of AMR as an indicator of postoperati...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0571-x
更新日期:2005-09-01 00:00:00