Abstract:
OBJECT:Growth factors such as bone morphogenetic protein-2 (BMP-2) have been proven to promote spine fusion and to overcome the disadvantages of an autologous bone graft. The optimum method to deliver such growth factors remains a matter of discussion. The purpose of this study was to determine the safety and efficacy of a new poly(D,L-lactide) (PDLLA) carrier system for BMP-2 and to compare this carrier system with a collagen sponge carrier in a sheep cervical spine interbody fusion model. METHODS:Thirty-two sheep underwent C3-4 discectomy and fusion: Group 1, titanium cage (eight animals); Group 2, titanium cage coated with a PDLLA carrier (eight animals); Group 3, titanium cage coated with a PDLLA carrier including BMP-2 (150 microg) (eight animals); and Group 4, titanium cage combined with a collagen sponge carrier including BMP-2 (150 microg) (eight animals). Blood samples, body weight, and temperature were assessed. Radiographs were obtained pre- and postoperatively and after 1, 2, 4, 8, and 12 weeks. At the same time points, disc space height, intervertebral angle, and lordosis angle were measured. After the sheep were killed 12 weeks postoperatively, flexion-extension radiography was performed to evaluate fusion sites. Quantitative computerized tomography scans were obtained to assess bone mineral density (BMD), bone mineral content (BMC), and bone callus volume (BCV). Biomechanical testing was performed in flexion, extension, axial rotation, and lateral bending. Stiffness, range of motion, neutral, and elastic zone were determined. Histomorphological and -morphometrical analyses were performed, and polychrome sequential labeling was used to determine the timeframe of new bone formation. There were no differences among the groups concerning blood counts, body weight, and temperature. Compared with the noncoated cages, all PDLLA-coated cages showed significantly higher values for BMD of the callus, as well as slightly higher values for BMC, BCV, and the bone volume/total volume ratio. In comparison with the cage-alone group, the BMP-2 groups showed significantly higher values for BMD and biomechanical stiffness. Histomorphological, -morphometrical, and polychrome sequential labeling analyses demonstrated greater progression of callus formation in the BMP-2 groups than in any other group. Compared with BMP-2 delivered using a collagen sponge carrier, BMP-2 application with a PDLLA carrier resulted in a higher BCV and a greater progression of interbody callus formation in the histomorphometrical analysis. CONCLUSIONS:The use of cervical spine interbody fusion cages coated with PDLLA as a delivery system for growth factors was effective. In this 12-week follow-up study, the PDLLA coating showed no adverse effects. The slight but not significant positive effect of the PDLLA carrier on interbody fusion might be a result of the degradation process of the biodegradable carrier. Compared with collagen sponge delivery of BMP-2, the PDLLA-coated interbody cages significantly increased the results of interbody bone matrix formation. In this new combination (implant + PDLLA + growth factor) the cage represents a "real fusion" cage, because it not only serves as a mechanical device for spinal fixation but also as a local drug delivery system.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Kandziora F,Bail H,Schmidmaier G,Schollmeier G,Scholz M,Knispel C,Hiller T,Pflugmacher R,Mittlmeier T,Raschke M,Haas NPdoi
10.3171/spi.2002.97.1.0040subject
Has Abstractpub_date
2002-07-01 00:00:00pages
40-8issue
1 Suppleissn
0022-3085issn
1933-0693journal_volume
97pub_type
杂志文章abstract::The authors describe a newly recognized complication of lumboperitoneal (LP) shunt placement, namely, intracranial hypotension from leakage of cerebrospinal fluid (CSF) through a defect in the lumbar dura created by the shunt catheter. They report on a 47-year-old obese woman with idiopathic intracranial hypertension ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/07/0173
更新日期:2007-07-01 00:00:00
abstract:OBJECT:Cavernomas in the occipital lobe are relatively rare. Because of the proximity to the visual cortex and incoming subcortical tracts, microsurgical removal of occipital cavernomas may be associated with a risk of visual field defects. The goal of the study was to analyze long-term outcome after operative treatmen...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.5.JNS112102
更新日期:2012-08-01 00:00:00
abstract::This report describes 60 dural specimens from patients with pituitary adenomas treated by transsphenoidal microsurgery, and attempts to define more precisely the clinical and pathological correlation of microscopic dural invasion. Analysis of the adenomas was based on four characteristics; size, surgical invasiveness ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.3.0402
更新日期:1986-03-01 00:00:00
abstract:OBJECT:Complete avulsion traumatic brachial plexus injuries (BPIs) can be treated using nerve and musculoskeletal reconstruction procedures. However, these interventions are most viable within certain timeframes, and even then they cannot restore all lost function. Little is known about how patients make decisions rega...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.2.JNS132686
更新日期:2015-06-01 00:00:00
abstract::Plateau waves, characterized by acute transient rises of the intracranial pressure (ICP), are accompanied by a marked decrease of the cerebral perfusion pressure. Patients with plateau waves, however, often show no clinical symptoms of ischemia of the brain stem, such as vasopressor response or impairment of conscious...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.4.0556
更新日期:1985-10-01 00:00:00
abstract::Fifty-nine cases of vertebral hemangioma were seen at the Mayo Clinic between 1980 and 1990. Vertebral hemangiomas were discovered incidentally in 35 patients, while pain was the presenting complaint in 13 patients. Five patients presented directly with progressive neurological deficit requiring surgery, and six patie...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.1.0036
更新日期:1993-01-01 00:00:00
abstract:OBJECT:The authors investigated whether HydroCoils decreased coil compaction and aneurysm recanalization in a canine model of a large, wide-necked, high-flow bifurcation aneurysm. METHODS:Eleven experimental aneurysms were created. Two aneurysms were untreated (Group 1); three were treated with standard platinum coils...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.6.0996
更新日期:2004-12-01 00:00:00
abstract:OBJECT:The authors discuss the indications for and timing of a diagnostic neurosurgical procedure in children with diabetes insipidus (DI) and a thickened pituitary stalk (TPS) on magnetic resonance (MR) imaging. METHODS:Seven children with a TPS who presented with DI eventually underwent surgery for diagnostic purpos...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2005.103.2.0142
更新日期:2005-08-01 00:00:00
abstract::Tuberculosis continues to be a major public health concern, especially in developing countries. Many types of neurotuberculosis have been described, but there is only one previously reported case of subdural empyema caused by tuberculous bacilli. A 1-year-old boy who had been treated for pulmonary tuberculosis was ref...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.94.6.0988
更新日期:2001-06-01 00:00:00
abstract::Electrocortical stimulation mapping (ESM) is the clinical standard for localizing critical sensorimotor and language functions, but other functions can be assessed with this technique as well. The authors describe an 8-year-old girl with a left frontal desmoplastic gangliocytoma and medically intractable epilepsy who ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2007.106.6.501
更新日期:2007-06-01 00:00:00
abstract::Bilateral intracerebral hydatid cysts developed in a 14-year-old patient after an infarct of presumed embolic origin in the left frontotemporoparietal region. The average rate of growth of these cysts was about 5 cm per year. This suggests that the growth rate is far from uniform and indeed, particularly in young pati...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.5.0781
更新日期:1985-05-01 00:00:00
abstract::The case of General Leonard Wood is notable both for its contribution to the field of neurosurgery and its historical significance. As one of Harvey Cushing's first successful brain tumor operations in 1910, Wood's surgery was part of the case series that culminated in Cushing's monograph Meningioma. This case was imp...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/2011.7.JNS102067
更新日期:2011-12-01 00:00:00
abstract::There are few reports of anterior communicating artery aneurysms causing visual symptoms, and penetration of the optic chiasm by such aneurysms has not been reported. A 40-year-old man presented with the abrupt onset of left homonymous hemianopsia, right visual acuity disturbance (finger counting), and slight headache...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1997.87.2.0324
更新日期:1997-08-01 00:00:00
abstract::Fourteen cases of primary intracranial germ-cell tumors are presented. Histologically, there were eight germinomas, three teratomas, and three germ-cell tumors of more than one histological type. Immunohistochemical studies revealed alpha-fetoprotein in yolk-sac tumor components in two cases and beta human choriogonad...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.6.0826
更新日期:1985-06-01 00:00:00
abstract::Increasing evidence suggests that disturbances in the modulatory influence of the vasoactive peptide, calcitonin gene-related peptide (CGRP), contribute to the pathogenesis of cerebral vasospasm after subarachnoid hemorrhage (SAH). However, only limited success has been achieved in trials attempting to ameliorate vaso...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.1.0091
更新日期:1995-01-01 00:00:00
abstract::OBJECTIVETumors involving Meckel's cave remain extremely challenging because of the surrounding complex neurovascular structures and deep-seated location. The authors investigated a new minimal-access technique using the endoscopic transorbital approach (eTOA) through the superior eyelid crease to Meckel's cave and mi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.6.JNS181099
更新日期:2018-11-01 00:00:00
abstract::The variability of reflex responses during selective dorsal rhizotomy was studied in eight children between the ages of 3 and 7 years. For a given dorsal root or rootlet, the electrical reflex threshold and response varied considerably when observed over several minutes. Changes in electrode pressure, mechanical disse...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.3.0346
更新日期:1993-09-01 00:00:00
abstract::The mechanisms that give rise to ischemic brain damage have not been definitively determined, but considerable evidence exists that three major factors are involved: increases in the intercellular cytosolic calcium concentration (Ca++i), acidosis, and production of free radicals. A nonphysiological rise in Ca++i due t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1992.77.3.0337
更新日期:1992-09-01 00:00:00
abstract::The mortality rate has recently been reduced to only a small percentage of patients selected for early aneurysm surgery. Despite recovery without neurological deficits, however, a diffuse encephalopathy may remain, with emotional and psychological sequelae that will interfere with rehabilitation and social reintegrati...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.5.0673
更新日期:1985-05-01 00:00:00
abstract::The ability of a single large intravenous dose of the sodium succinate esters of the glucocorticoids methylprednisolone, prednisolone, or hydrocortisone to enhance early neurological recovery after moderate to severe blunt head injury was examined in male CF-1 mice. Unanesthetized mice were restrained and subjected to...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.62.6.0882
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVE:Direct brain compression and secondary injury due to increased intracranial pressure are believed to be the pathognomic causes of a grave outcome in acute subdural hemorrhage (aSDH). However, ischemic damage from aSDH has received limited attention. The authors hypothesized that cerebral microcirculation is a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.5.JNS162579
更新日期:2018-10-01 00:00:00
abstract::A case is described in which incorrect preliminary programming of a computerized tomography (CT) machine caused transposition of the left- and right-side indicators in a CT scan, which led to craniotomy on the normal side. The possible mechanism for this is incorrect pre-scan programming of the CT scanner with respect...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.2.0291
更新日期:1987-08-01 00:00:00
abstract:OBJECTIVE:The present study was designed to explore the association between facility type (academic center [AC] vs non-AC), facility volume (high-volume facility [HVF] vs low-volume facility [LVF]), and outcomes of glioblastoma (GBM) treatment. METHODS:Based on the National Cancer Database (NCDB), GBM patients were ca...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.10.JNS182247
更新日期:2019-02-15 00:00:00
abstract:OBJECT:It is assumed that the observed increase in brain tumor incidence may at least partially be explained by increased use of MRI. However, to date no direct estimate of this effect is available. The authors undertook this registry-based study to examine whether regional frequencies of cerebral MRI use correlate to ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.12.JNS131312
更新日期:2014-04-01 00:00:00
abstract::The authors describe their minimally invasive technique for performing a superficial temporal artery (STA) to middle cerebral artery (MCA) bypass, which relies on an enlarged bur hole (2-2.5 cm) rather than the standard craniotomy. They perform this procedure in a minimally invasive fashion, using CT angiography for i...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/109/9/0553
更新日期:2008-09-01 00:00:00
abstract::The authors report a series of 34 meningiomas of the sphenoid ridge. Eight tumors were totally removed uneventfully: two from the middle sphenoid ridge and six from the pterion or Sylvian point. Five tumors were not operated on because of their extensions or the patient's age. Twenty-one tumors raised serious surgical...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.5.0587
更新日期:1980-11-01 00:00:00
abstract:OBJECTIVE:Although intravenous indocyanine green (ICG) videoangiography has been reported to be useful when applied to cerebral arteriovenous malformation (AVM) surgery, the ICG that remains after the procedure makes it difficult to understand the anatomy, to evaluate nidus blood flow changes, and to repeat ICG videoan...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2020.3.JNS20319
更新日期:2020-05-22 00:00:00
abstract:OBJECT:Disturbance in anorectal function is a major factor restricting the activities of daily living in patients with spinal cord disorders. To detect changes in anorectal motilities due to a tethered spinal cord, anorectal functions were evaluated using a saline enema test and fecoflowmetry before and after patients ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.98.3.0251
更新日期:2003-04-01 00:00:00
abstract:OBJECT:The differentiation of malignant lymphomas from gliomas or malignant gliomas by conventional MRI can be difficult. The authors studied Gd-enhanced MR images to obtain a differential diagnosis between malignant lymphomas and gliomas without central necrosis or cystic changes and investigated the diagnostic value ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.9.JNS14106
更新日期:2015-06-01 00:00:00
abstract::The authors describe an experimental model that allows dynamic studies of blood flow in the pituitary gland. Twenty-eight male Wistar rats were anesthetized and the pituitary gland was exposed using a parapharyngeal approach. Teflon-coated platinum wire electrodes were placed in the adenohypophysis near the midline an...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.1.0116
更新日期:1985-07-01 00:00:00