Abstract:
OBJECT:Historically, destructive procedures for cancer pain were the main line of treatment therapy. However, the use of high-dose opioids has essentially replaced such procedures. Recognition of the limits of medical therapy to treat cancer pain effectively is growing, while conversely, in regions with limited access to pain medications, the importance of destructive surgical techniques is increasing. A critical evaluation of the evidence for destructive techniques is warranted, and the authors review current evidence underlying these procedures. METHODS:A US National Library of Medicine PubMed search for "ablation," "DREZ," "dorsal root entry zone," "cingulotomy," "cordotomy," "ganglionectomy," "mesencephalotomy," "myelotomy," "neurotomy," "neurectomy," "rhizotomy," "sympathectomy," "thalamotomy," "tractotomy," and "pain" was undertaken. The search was then limited to human studies, English-language literature, cancer pain, and reports with more than 1 patient. RESULTS:One hundred twenty papers were identified and reviewed based on the selection criteria described. According to the Canadian and US task forces, classification of clinical research literature only "sympathectomy" was supported by Class I or II studies, with 2 Class I papers and 1 Class II paper identified for cancer pain. All other procedures were supported by Class III studies of variable quality. Cordotomy in particular was the most extensively studied and reviewed procedure. Given the large number of patients studied, consistent results, multiplicity of reports and, even though evidence quality for individual studies was relatively low, cumulative evidence suggests that cordotomy may play an important role in the treatment of cancer pain. CONCLUSIONS:Destructive procedures for cancer pain may play more than a historic role in the management of cancer pain. Cumulative evidence from even the poorest quality studies suggests that some procedures, such as cordotomy, should be included in the armamentarium available to the neurosurgeon today. To renew appropriate interest in these procedures, evidence and studies that meets today's evidence-based research criteria are warranted.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Raslan AM,Cetas JS,McCartney S,Burchiel KJdoi
10.3171/2010.6.JNS10119subject
Has Abstractpub_date
2011-01-01 00:00:00pages
155-70issue
1eissn
0022-3085issn
1933-0693journal_volume
114pub_type
杂志文章,评审abstract::Methyl-2-cyanoacrylate was used to mechanically immobilize the coronal suture unilaterally in a series of New Zealand white rabbits at varying ages. The animals were separated into groups; some were sacrificed at 30 day and some at 60 days postoperatively. Amalgam markers were placed in the parietal and frontal bones ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.6.0794
更新日期:1980-12-01 00:00:00
abstract::OBJECTIVECerebral cavernous malformations (CCMs) are frequently diagnosed vascular malformations of the brain. Although most CCMs are asymptomatic, some can be responsible for intracerebral hemorrhage or seizures. In selected cases, microsurgical resection is the preferred treatment option. Treatment with the unselect...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.12.JNS172404
更新日期:2018-06-15 00:00:00
abstract::Five patients with typical cervical myeloradiculopathy caused by focal cervical spinal stenosis are presented. Dorsal intrusions into the spinal canal by hypertrophied apophyseal joints and thickened laminae resulted in cord and nerve root compression. Minor spondylotic changes were present in the floor of the spinal ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.3.0387
更新日期:1978-09-01 00:00:00
abstract:OBJECT:The authors conducted a study to examine the detailed anatomy of the denticulate ligaments and to assess their classic role in spinal cord stability within the spinal canal. METHODS:Detailed observation of the denticulate ligaments in 12 adult cadavers was performed. Stress was applied in all major planes to di...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2001.94.2.0271
更新日期:2001-04-01 00:00:00
abstract:OBJECT:The primary goals of this study were: 1) to examine the influence of disease and treatment on headache in patients with sporadic vestibular schwannoma (VS); and 2) to identify clinical predictors of long-term headache disability. METHODS:This was a cross-sectional observational study with international multicen...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.3171/2014.12.JNS142109
更新日期:2015-11-01 00:00:00
abstract::A simple method is presented for localizing the anatomical site of vertex lesions seen on a computerized tomography (CT) brain scan, using the patient's plain lateral skull film. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.1.0071
更新日期:1978-07-01 00:00:00
abstract::In this report, the authors demonstrated that idiopathic pituitary hyperplasia (PH) can cause complete bitemporal hemianopia and amenorrhea, even in the setting of mild anatomical compression of the optic chiasm and normal pituitary function. Furthermore, complete resolution of symptoms can be achieved with surgical d...
journal_title:Journal of neurosurgery
pub_type:
doi:10.3171/2020.5.JNS20448
更新日期:2020-08-14 00:00:00
abstract:OBJECT:Oligometastatic brain metastases may be treated with stereotactic radiosurgery (SRS) alone, but no consensus exists as to when SRS alone would be appropriate. A survey was conducted at 2 radiosurgery meetings to determine which factors SRS practitioners emphasize in recommending SRS alone, and what physician cha...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.8.GKS10999
更新日期:2010-12-01 00:00:00
abstract:OBJECT:Vasospasm is a leading cause of morbidity and death following aneurysmal subarachnoid hemorrhage (SAH). It is important to predict which patients are at risk for vasospasm so that interventions can be made. There are several potential risk factors for vasospasm, one of which is age. However, the effect of age on...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.9.JNS081670
更新日期:2010-06-01 00:00:00
abstract::Failure to obliterate intracranial aneurysms completely during initial surgery still occurs in spite of recent technical advances. Of the 115 reoperations reported in this series, 89% of the aneurysms were obliterated, and 84% of the patients had a satisfactory outcome. Twelve patients had poor results, three (2.6%) o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.5.0848
更新日期:1984-11-01 00:00:00
abstract::A patient with a giant traumatic aneurysm of the right internal carotid artery presented with recurrent massive epistaxis 30 years after a head injury. During an episode of acute hemorrhage, this patient was effectively treated with occlusion of the internal carotid artery circulation by a detachable inflatable balloo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.68.1.0142
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:Craniopharyngiomas are rare and benign tumors of the sellar and/or parasellar region. Primary treatment involves resection followed by adjuvant radiotherapy. While the grade of resection was frequently analyzed following surgery, the neurological outcome and especially neuropsychological deficits and quality ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.10.JNS181557
更新日期:2019-04-19 00:00:00
abstract:OBJECT:Neuronal injury remains a leading cause of morbidity in both neonates and adults with injuries induced by intracranial hemorrhage, ischemia-reperfusion, and excitotoxicity. To date, a number of neuroprotective strategies have been evaluated, but they have shown little benefit. Poloxamer 188 (P-188), a membrane-a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.1.36
更新日期:2007-01-01 00:00:00
abstract::The authors retrospectively reviewed the surgical outcomes in 10 cases of symptomatic intradural extramedullary spinal metastases of nonneurogenic origin because the collective experience in treating this rare manifestation of systemic cancer is limited. Pain and weakness were the presenting complaints in 70% of the p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1996.85.2.0225
更新日期:1996-08-01 00:00:00
abstract:OBJECT:Proper screening, management, and follow-up of Grade 1 and 2 blunt carotid artery injuries (BCIs) remains controversial. These low-grade BCIs were analyzed to define their natural history and establish a rational management plan based on lesion progression and cerebral infarction. METHODS:A retrospective review...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.1.JNS14642
更新日期:2015-05-01 00:00:00
abstract:OBJECT:Scar formation in the carotid sheath is often identified during carotid endarterectomy (CEA) in patients with previous cardiac surgery, and dissection of the carotid sheath and exposure of the carotid arteries in such patients are difficult. The purpose of the present study was to investigate factors related to ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.4.JNS091819
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:The authors conducted a pilot study on hybrid fluorescein-guided surgery for pituitary adenoma resection and herein describe the feasibility and safety of this technique. METHODS:In this pilot study, the authors included all consecutive patients presenting with pituitary adenomas, functioning and nonfunction...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.1.JNS181512
更新日期:2019-04-05 00:00:00
abstract::A retrospective series of 12,478 patients with breast cancer included 2467 patients with spinal metastases. Local treatment was not necessary in 688 patients. Neurological dificit did not develop in 1735 patients who underwent radiotherapy. Forty-four patients developed myelopathy due to spinal cord compression as dem...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.5.0653
更新日期:1977-11-01 00:00:00
abstract:OBJECT:Motor vehicle accidents (MVAs) are a leading cause of death and disability in young people. Given that a major cause of death from MVAs is traumatic brain injury, and neurosurgeons hold special expertise in this area relative to other members of a trauma team, the authors hypothesized that neurosurgeon populatio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.6.JNS111281
更新日期:2012-09-01 00:00:00
abstract::To evaluate microcirculatory disturbance and cerebral edema associated with subarachnoid hemorrhage (SAH), both stereological morphometry on the intraparenchymal capillary network and microgravimetry were performed on a rabbit SAH model. Autologous arterial blood (5 ml) was injected into the cisterna magna, and the an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.3.0410
更新日期:1990-09-01 00:00:00
abstract::Rapid growth and diffuse brain infiltration are hallmarks of malignant gliomas. The underlying molecular pathomechanisms of these tumors, however, remain to be determined. The authors present a novel glioma invasion model that allows researchers to monitor consecutively tumor cell proliferation and migration in an org...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.102.4.0738
更新日期:2005-04-01 00:00:00
abstract::The intracranial vertebral artery and its branches are a common site of aneurysms in the posterior fossa. Ninety-four aneurysms in 86 patients were analyzed for their clinical manifestation, diagnosis, and treatment. There were three distinct varieties of aneurysm in this group: 56 (60%) saccular aneurysms, 26 (28%) d...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.3.0345
更新日期:1988-09-01 00:00:00
abstract::OBJECTIVE The molecular mechanisms behind cerebral aneurysm formation and rupture remain poorly understood. In the past decade, microRNAs (miRNAs) have been shown to be key regulators in a host of biological processes. They are noncoding RNA molecules, approximately 21 nucleotides long, that posttranscriptionally inhi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.11.JNS151841
更新日期:2016-12-01 00:00:00
abstract:OBJECT:Infiltrative tumor resection is based on regional (macroscopic) imaging identification of tumorous tissue and the attempt to delineate invasive tumor margins in macroscopically normal-appearing tissue, while preserving normal brain tissue. The authors tested miniaturized confocal fiberoptic endomicroscopy by usi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.8.JNS11559
更新日期:2011-12-01 00:00:00
abstract::The purpose of this report was to review the results of stereotactic radiosurgery in the management of patients with residual neurocytomas after initial resection or biopsy procedures. Four patients underwent stereotactic radiosurgery for histologically proven neurocytoma. Clinical and imaging studies were performed t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.5.0879
更新日期:2001-11-01 00:00:00
abstract::To evaluate the biology of thyrotropin (TSH)-producing pituitary adenomas, the authors reviewed the charts of 19 patients who underwent transsphenoidal surgery within a 15-year period at the University of California, San Francisco (UCSF). Between 1989 and 1991, the period during which immunostaining techniques were us...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.4.0521
更新日期:1993-10-01 00:00:00
abstract:OBJECT:Subarachnoid hemorrhage (SAH) from ruptured posterior inferior cerebellar artery (PICA) aneurysms is uncommon, and long-term outcome data for patients who have suffered such hemorrhages is lacking. This study investigated in-hospital and long-term clinical data from a prospective cohort of patients with SAH from...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.10.JNS141079
更新日期:2015-08-01 00:00:00
abstract::Two patients are reported in whom the presence of triventricular hydrocephalus and aqueductal obstruction or stenosis due to multiple expanding lacunae in the mesencephalothalamic region possibly corresponds to abnormally dilated perivascular spaces. Placement of a ventriculoperitoneal cerebrospinal fluid (CSF) shunt ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.91.4.0669
更新日期:1999-10-01 00:00:00
abstract::The hydrogen clearance method was used to measure total and focal cerebral blood flow (CBF) in the monkey before and for 5 hours after a simulated subarachnoid hemorrhage (SAH). Some monkeys also received 0.2 to 1.0 mg/kg phentolamine intracisternally 3 hours after SAH. Results show that SAH did not change cerebrovasc...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.44.3.0353
更新日期:1976-03-01 00:00:00
abstract::The authors describe three patients with expanding hemorrhagic mass lesions who presented 13 to 18 years after undergoing Silastic duraplasty. In all patients, results of bacteriological cultures of the masses obtained intraoperatively were positive, revealing low-virulence bacteria. Two of the patients were treated w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.3.0559
更新日期:1999-03-01 00:00:00