Abstract:
OBJECT:Primary and metastatic neoplasms of the lumbosacral junction frequently pose a complex problem for the surgical management and stabilization of the spine because of the anatomical and biomechanical factors of this transition zone between spine and pelvis. The authors have used a modification of the Galveston technique, originally described by Allen and Ferguson in the treatment of scoliosis, to achieve rigid spinal-pelvic fixation in patients with lumbosacral neoplasms. The authors retrospectively reviewed their experience, with particular attention to method, pain relief, and neurological status. METHODS:From July 1994 through December 1998, 13 patients at the authors' institution have required spinal-pelvic fixation secondary to instability caused by primary (eight cases) or metastatic (five cases) neoplasms. Previous treatment included spinal surgery in 10 (77%), radiation therapy in seven (54%), and/or chemotherapy in six (46%). Following tumor resection, fixation was achieved by intraoperative placement of contoured titanium rods bilaterally into the ilium. These rods were attached to the lumbar spine with pedicle screws and subsequently crosslinked. Arthrodesis was performed. In the follow-up period of 3 to 50 months (average 20 months), nine (69%) of 13 patients were still alive. There were no cases of surgery-related death. Seven weeks postoperatively instrumentation failure occurred in one patient and was corrected by performing double L-rod spinal-pelvic fixation. Two patients experienced neurological dysfunction (ankle weakness and neurogenic bladder) that was thought to be related to tumor resection rather than the fixation procedure. Neurological status improved in four patients and remained unchanged in seven patients. Ambulatory status improved in 62% (eight patients), remained unchanged in 23% (three patients), and worsened in 15% (two patients). Spinal pain, as measured by a visual analog pain scale and determined by medication consumption was significantly reduced in 85% (11 cases). CONCLUSIONS:In selected patients with primary or metastatic lumbosacral tumors, resection followed by modified Galveston L-rod spinal-pelvic fixation is an effective means of achieving stabilization that can provide significant pain relief and preserve ambulatory capacity.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Jackson RJ,Gokaslan ZLdoi
10.3171/spi.2000.92.1.0061subject
Has Abstractpub_date
2000-01-01 00:00:00pages
61-70issue
1 Suppleissn
0022-3085issn
1933-0693journal_volume
92pub_type
杂志文章abstract::Optochiasmal arachnoiditis has been reported following treatment of ruptured intracranial aneurysms, particularly arising from the anterior communicating artery. It has been suggested that the accompanying loss of vision is due to a muslin-induced optic neuropathy. This paper considers five cases of this condition; th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.75.3.0393
更新日期:1991-09-01 00:00:00
abstract::OBJECTIVE Maximum extent of resection (EOR) for lower-grade and high-grade gliomas can increase survival rates of patients. However, these infiltrative gliomas are often observed near or within eloquent regions of the brain. Awake surgery is of known benefit for the treatment of gliomas associated with eloquent region...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.9.JNS16152
更新日期:2017-10-01 00:00:00
abstract::In this paper, the authors describe the history of neurosurgery at St. Michael's Hospital, University of Toronto. St. Michael's has long been regarded as one of the top teaching and research hospitals in Canada. A detailed literature review of published and unpublished works was performed to formulate a succinct but i...
journal_title:Journal of neurosurgery
pub_type: 历史文章,杂志文章
doi:10.3171/2016.9.JNS161119
更新日期:2017-12-01 00:00:00
abstract::Leukotrienes derive from arachidonic acid metabolism via the lipoxygenase pathway and modulate several cellular events. In the central nervous system, leukotrienes are mainly synthesized in the gray matter and in vascular tissues. Their production is enhanced in ischemic conditions and in experimental subarachnoid hem...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.4.0488
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:Hemifacial spasm (HFS) is characterized by involuntary tonic and/or clonic contractions of facial nerve muscles. Fully endoscopic microvascular decompression (E-MVD) for HFS has not been widely adopted. This paper aims to illustrate the safety and efficacy of the fully endoscopic technique for HFS treatment. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.4.JNS172631
更新日期:2018-10-05 00:00:00
abstract:OBJECTIVE:Keyhole approaches, namely the minipterional approach (MPTa) and the supraorbital approach (SOa), are alternatives to the standard pterional approach to treat lesions located in the anterior and middle cranial fossae. Despite their increasing popularity and acceptance, the indications and limitations of these...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.12.JNS193196
更新日期:2020-03-13 00:00:00
abstract::Two unusual cases of neurocutaneous melanosis are presented. Both patients had congenital giant hairy nevi and both developed hydrocephalus, seizures, and myelopathy. The first patient displayed multicentric cerebral and spinal cord melanosis, as opposed to the more commonly described basilar leptomeningeal involvemen...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.4.0782
更新日期:1984-10-01 00:00:00
abstract:OBJECT:The use of intercostal nerves (ICNs) for the neurotization of the musculocutaneous nerve (MCN) in adult patients with traumatic brachial plexus palsy has been well described. However, its use for brachial plexus palsy in infants has rarely been reported. The authors surgically created 31 ICN-MCN communications f...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2001.94.3.0386
更新日期:2001-03-01 00:00:00
abstract::Needle biopsy of the brain utilizing computerized tomography (CT) scan data is an accepted diagnostic technique that has been performed both with and without the aid of stereotaxic frames. Experience with both techniques has resulted in a specific procedure for CT-guided free-hand biopsy which is performed in the CT s...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.3.0341
更新日期:1987-09-01 00:00:00
abstract:OBJECT:Seizures frequently accompany moderate to severe traumatic brain injury. Phenytoin and carbamazepine are effective in preventing early, but not late, posttraumatic seizures. In this study the authors compare the safety and effectiveness of valproate with those of short-term phenytoin for prevention of seizures f...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.3171/jns.1999.91.4.0593
更新日期:1999-10-01 00:00:00
abstract::The incidence of extracranial internal carotid artery (ICA) abnormalities, namely kinks, coils, and stenoses, was evaluated in a consecutive unselected series of 76 cases of single supratentorial saccular aneurysms submitted to bilateral carotid angiography. These patients were compared with a control group of 120 pat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.5.0693
更新日期:1981-11-01 00:00:00
abstract:OBJECT:Obtaining brain biopsy specimens is often the diagnostic test of last resort for patients with unexplained neurological conditions, particularly those with a rapidly deteriorating neurological course. The goals of this analysis were to determine the diagnostic sensitivity of brain biopsy specimens in these types...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2007.106.1.72
更新日期:2007-01-01 00:00:00
abstract::Experience indicates that stand-alone cages may lack the necessary stability to secure highly unstable motion segments at the lumbosacral junction. The authors have designed a special carbon fiber composite interbody cage that allows additional screw placement in anterior lumbar interbody fusion procedures performed a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.98.2.0222
更新日期:2003-03-01 00:00:00
abstract::Five cases of diastematomyelia are described and illustrated. These and a further 60 cases from the literature are analyzed. The data corroborate the opinion that early diagnosis and treatment result in a better prognosis. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.51.3.0355
更新日期:1979-09-01 00:00:00
abstract:OBJECT:Little attention has been given to the functional challenges of the insular approach to the resection of gliomas, despite the potential damage of essential neural networks that underlie the insula. The object of this study is to analyze the subcortical anatomy of the insular region when infiltrated by gliomas, a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.11.JNS141992
更新日期:2015-10-01 00:00:00
abstract::A 2- to 15-year follow-up study is presented of a series of 35 consecutive patients treated for ruptured aneurysms of the middle cerebral artery by reinforcement with gauze wrapping. Only one patient suffered early recurrent hemorrhage in the postoperative period, and none had a late hemorrhage. The procedure carried ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.6.0828
更新日期:1977-12-01 00:00:00
abstract::The authors present angiographic demonstration of bilateral, congenital, total absence of the internal carotid arteries in a patient with subarachnoid hemorrhage. Angiography demonstrated complete absence of both internal carotid arteries. The intracranial blood supply had been provided by communication between a hype...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.42.4.0478
更新日期:1975-04-01 00:00:00
abstract:OBJECT:Recent evidence has indicated that the efficacy of the epidural blood patch (EBP) in the treatment of spontaneous CSF hypovolemia (SCH) is still limited. Therefore, further improvement of the EBP technique is an important clinical challenge. The authors describe a series of cases of SCH treated with fluoroscopic...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.1.JNS101326
更新日期:2011-06-01 00:00:00
abstract::OBJECTIVEThe goal of this article is to review the history of surgery for low- and high-grade gliomas located within the insula with particular focus on microsurgical technique, anatomical considerations, survival, and postoperative morbidity.METHODSThe authors reviewed the literature for published reports focused on ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2018.10.JNS181519
更新日期:2019-01-01 00:00:00
abstract::Intrathecal ossification causing progressive myelopathy or radiculopathy does not occur frequently. The majority of the reported lesions have been in the thoracic spine and seldom in the sacral canal. This report presents the occurrence of disabling low backache and sciatica from intradural periradicular ossification ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.1.0132
更新日期:1978-07-01 00:00:00
abstract:OBJECT:The authors report a simple method for bilateral open-door cervical expansive laminoplasty in which hydroxyapatite (HA) spacers are secured by titanium screws. A biomechanical study was also conducted to confirm the strength of the screw fixation. METHODS:A unilateral posterior approach was used to allow preser...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.96.1.0022
更新日期:2002-01-01 00:00:00
abstract:OBJECT:Although craniopharyngiomas are benign intracranial tumors, their high recurrence rates and intimate associations with surrounding neurovascular structures make gross tumor resection challenging. Stereotactic radiosurgery has been introduced as a valuable adjuvant therapy for recurrent or residual craniopharyngi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.8.GKS141411
更新日期:2014-12-01 00:00:00
abstract:OBJECT:The authors conducted a biomechanical study to evaluate pedicle screw pullout strength in osteoporotic cadaveric spines. Nonaugmented hemivertebrae were compared with pressurized polymethylmethacrylate (PMMA)-augmented hemivertebrae. METHODS:Six formalin-fixed cadaveric thoracolumbar spines at least two standar...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.96.3.0309
更新日期:2002-04-01 00:00:00
abstract:OBJECT:Obsessive-compulsive disorder (OCD) is a common and disabling psychiatric illness, and in a significant proportion of patients with OCD the disease is refractory to conventional pharmacotherapy and psychotherapy. For more than half a century, patients with severe, treatment-resistant OCD have been treated with s...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.11.JNS12389
更新日期:2013-03-01 00:00:00
abstract::The magnetic resonance longitudinal relaxation time (T1) and transverse relaxation time (T2) of the water proton of the periventricular white and cortical gray matter were measured for 17 control patients and 21 patients with suspected normal-pressure hydrocephalus (NPH). Of the latter group, 14 showed good response t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.6.0864
更新日期:1990-12-01 00:00:00
abstract::The authors report the case of a newborn presenting at birth with macrocephaly and a large pineal region hemorrhagic cyst without neurological deficit. No neurosurgical intervention was performed, and subsequent imaging studies demonstrated complete involution of the cyst. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2006.104.4.275
更新日期:2006-04-01 00:00:00
abstract:OBJECT:Aneurysmal subarachnoid hemorrhage rarely occurs in young adults. The aim of this work was to clarify the clinical characteristics of ruptured aneurysms in young adults in the third and fourth decades of life and to compare these two age groups. METHODS:The authors retrospectively investigated 2493 patients who...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.99.2.0276
更新日期:2003-08-01 00:00:00
abstract::Tophaceous pseudogout is one of the rarest forms of crystal deposition disease, typically presenting as a destructive and invasive mass involving the temporomandibular joint or the infratemporal fossa region in the absence of any other articular manifestations. Previous cases have been assumed to be caused by calcium ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.1.0148
更新日期:1999-01-01 00:00:00
abstract:OBJECT:Intracranial hemorrhage associated with cerebral hyperperfusion syndrome (CHS) following carotid endarterectomy (CEA) or carotid artery stenting (CAS) is a rare but potentially devastating complication. In the present study the authors evaluated 4494 patients with carotid artery stenosis who had undergone CEA or...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/12/1130
更新日期:2007-12-01 00:00:00
abstract::Head trauma, intracerebral hematoma formation, and hemorrhagic cerebral infarction cause extravasation of the intravascular contents, red blood cell (RBC) hemolysis, hemosiderin deposition within the neuropil, and an increased incidence of epilepsy. Reports conflict regarding the efficacy of the administration of prop...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.3.0467
更新日期:1984-03-01 00:00:00