Cervical spondylotic myelopathy treated with corpectomy: technique and results in 44 patients.

Abstract:

:Forty-four patients with cervical spondylotic myelopathy who underwent a ventral surgical approach were evaluated with respect to the results of surgery. The neurological status of the patients was categorized according to the modified Japanese Orthopedic Association scale (0-18). Three patients had a functional score of 8, one patient 9, five patients 10, five patients 11, seven patients 12, seven patients 13, seven patients 14, and nine patients had a functional score of 15, preoperatively. Twenty-three patients underwent a one-level corpectomy, 15 patients a two-level corpectomy, and six patients underwent a three-level corpectomy. Forty-one (93.1%) of the 44 patients underwent ventral cervical plate fixation. Complications among the 44 patients included graft- and instrumentation-related complications in seven cases, iliac crest donor-site infection in three cases, and respiratory complications in three cases. The follow-up periods ranged between 7 and 60 months (mean 42.3 months). Overall, the fusion rate was 97.72%. Three patients showed no functional change (6.8%), two patients were worse (4.5%), and 39 patients (88.6%) showed functional improvement in their score between +1 and +6 points (mean 2.16 points). There was no statistically significant difference in the functional improvement score in patients younger or older than 60 years old. The mean improvement in the functional score was found to be +2.857 +/- 1.352, +2.400 +/- 1.454, and +0.5000 +/- 1.871 following one-level corpectomy, two-level, and three-level corpectomies, respectively. There were statistically significant differences in the neurological improvement observed between patients with one-level corpectomy and three-level corpectomy (p < 0.01), as well as between those with two-level and three-level corpectomy (p < 0.05). There was no statistically significant difference in the neurological outcome between patients with one-level and two-level corpectomy (p > 0.05). The results of this study demonstrate a high rate of solid bone fusion and a high rate of functional (neurological) improvement. Five patients underwent reoperation, predominantly for instrumentation failure. The use of instrumentation dictates careful consideration of the risk/benefit ratio associated with its use in each case.

journal_name

Neurosurg Focus

journal_title

Neurosurgical focus

authors

Naderi S,Alberstone CD,Rupp FW,Benzel EC,Baldwin NG

doi

10.3171/foc.1996.1.6.6

subject

Has Abstract

pub_date

1996-12-15 00:00:00

pages

e5; discussion 1 p following e5

issue

6

issn

1092-0684

pii

010605

journal_volume

1

pub_type

杂志文章
  • Contralateral C-7 transfer: is direct repair really superior to grafting?

    abstract::It is not uncommon for a severe traumatic brachial plexus injury to involve all 5 roots, resulting in a flail upper limb. In such cases, surgical reconstruction is often palliative, providing only rudimentary function. Nerve transfers are the mainstay of reconstructive strategies due to the predominance of root avulsi...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2017.4.FOCUS1794

    authors: Bhatia A,Doshi P,Koul A,Shah V,Brown JM,Salama M

    更新日期:2017-07-01 00:00:00

  • J. Lawrence Pool, M.D.: a pioneer in vascular neurosurgery.

    abstract::The authors detail the life and career of Dr. J. Lawrence Pool, as well as his significant contributions to the field of cerebrovascular neurosurgery. The discipline of cerebrovascular neurosurgery is a young and dynamic field, which underwent rapid and substantial growth during the middle of the twentieth century. As...

    journal_title:Neurosurgical focus

    pub_type: 传,历史文章,杂志文章

    doi:

    authors: Zacharia BE,Mocco J,Komotar RJ,Solomon RA,Quest DO

    更新日期:2006-06-15 00:00:00

  • Clinical characteristics and outcomes of null-cell versus silent gonadotroph adenomas in a series of 1166 pituitary adenomas from a single institution.

    abstract:OBJECTIVE:Nonfunctioning pituitary adenomas present without biochemical or clinical signs of hormone excess and are the second most common type of pituitary adenomas. The 2017 WHO classification scheme of pituitary adenomas differentiates null-cell adenomas (NCAs) and silent gonadotroph adenomas (SGAs). The present stu...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2020.3.FOCUS20114

    authors: Haddad AF,Young JS,Oh T,Pereira MP,Joshi RS,Pereira KM,Osorio RC,Donohue KC,Peeran Z,Sudhir S,Jain S,Beniwal A,Chopra AS,Sandhu NS,Theodosopoulos PV,Kunwar S,El-Sayed IH,Gurrola J,Blevins LS,Aghi MK

    更新日期:2020-06-01 00:00:00

  • The far-lateral approach for foramen magnum meningiomas.

    abstract::Foramen magnum meningiomas (FMMs) are slow growing, most often intradural and extramedullary tumors that pose significant challenges to the skull base neurosurgeon. The indolent clinical course of FMMs and their insidious onset of symptoms are important factors that contribute to delayed diagnosis and relative large s...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2013.10.FOCUS13332

    authors: Flores BC,Boudreaux BP,Klinger DR,Mickey BE,Barnett SL

    更新日期:2013-12-01 00:00:00

  • Staged-volume radiosurgery for large arteriovenous malformations: a review.

    abstract::Stereotactic radiosurgery is an effective management strategy for properly selected patients with arteriovenous malformations (AVMs). However, the risk of postradiosurgical radiation-related injury is higher in patients with large AVMs. Multistaged volumetric management of large AVMs was undertaken to limit the radiat...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2014.6.FOCUS14217

    authors: AlKhalili K,Chalouhi N,Tjoumakaris S,Rosenwasser R,Jabbour P

    更新日期:2014-09-01 00:00:00

  • Genetics of choroid plexus tumors.

    abstract::Choroid plexus tumors consist of papillomas and carcinomas. A variety of germline and somatic genetic changes have been demonstrated for each of these subtypes. In this paper, the authors summarize the current knowledge of the genetic bases of these tumors. ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2006.20.1.11

    authors: Kamaly-Asl ID,Shams N,Taylor MD

    更新日期:2006-01-15 00:00:00

  • Comparison of minimally invasive transspinous and open approaches for thoracolumbar intradural-extramedullary spinal tumors.

    abstract::OBJECT Spinal tumor resection has historically been performed via open approaches, although minimally invasive approaches have recently been found to be effective in small cohort series. The authors compare surgical characteristics and clinical outcomes of surgery in patients undergoing mini-open and open approaches f...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2015.5.FOCUS15187

    authors: Raygor KP,Than KD,Chou D,Mummaneni PV

    更新日期:2015-08-01 00:00:00

  • High flow EC-IC bypass for a giant left MCA aneurysm.

    abstract::Giant cerebral aneurysms may be treated through a variety of options, including aneurysm trapping with concurrent bypass. This video describes the case of a large, recurrent, left middle cerebral artery aneurysm that was treated using a high flow, radial artery bypass graft, from the external carotid artery to the lef...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2015.V1.FOCUS14548

    authors: Arias EJ,Zipfel GJ

    更新日期:2015-01-01 00:00:00

  • Endovascular strategies for carotid cavernous and intracerebral dural arteriovenous fistulas.

    abstract::Interventional neuroradiology is a less invasive modality than open neurosurgery for the treatment of a wide range of neurovascular disorders. Refinements in technique and improvements in the design of microcatheters, guide wires, and embolic materials have yielded superior clinical outcomes and provided an impetus to...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2003.15.4.7

    authors: Ng PP,Higashida RT,Cullen S,Malek R,Halbach VV,Dowd CF

    更新日期:2003-10-15 00:00:00

  • Hemodynamic instability after carotid artery angioplasty and stent placement: a review of the literature.

    abstract::In this review of the literature the goal was to determine the frequency and relevance of hemodynamic instability after carotid artery (CA) angioplasty and stent placement. Hemodynamic instability after CA angioplasty and stent placement is a well-recognized phenomenon that occurs in 29 to 51% of patients undergoing t...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2005.18.1.7

    authors: Gupta R,Horowitz M,Jovin TG

    更新日期:2005-01-15 00:00:00

  • Dr. Otto "Tiger" Freer: inventor and innovator.

    abstract::Every neurosurgeon develops his or her own standard approach to common intracranial pathologies in terms of the order in which different stages are performed and which instruments are used to perform individual tasks. The majority of the basic steps in performing a craniotomy are learned through repetition and practic...

    journal_title:Neurosurgical focus

    pub_type: 传,历史文章,杂志文章

    doi:10.3171/2012.6.FOCUS12137

    authors: Chittiboina P,Connor DE Jr,Nanda A

    更新日期:2012-08-01 00:00:00

  • An improved reservoir for the flushing test to diagnose shunt insufficiency.

    abstract::OBJECTIVE Reservoirs integrated into hydrocephalus shunts are commonly used for the removal of CSF and for intra-ventricular pressure measurement. Pumping with the reservoir to diagnose shunt sufficiency is still a matter of controversy. The authors describe an improved flushing device and its characteristic features ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2016.6.FOCUS15540

    authors: Schlosser HG,Crawack HJ,Miethke C,Knitter T,Zeiner A,Sprung C

    更新日期:2016-09-01 00:00:00

  • Harvey Cushing's experience with cranial deformity.

    abstract::Surgery for cranial deformity was associated with significant surgical morbidity during the early part of the 20th century. For this reason, Harvey Cushing was initially not in favor of surgical treatment of craniosynostosis. Later in his career, Cushing began to operate on these children, although it never became a m...

    journal_title:Neurosurgical focus

    pub_type: 传,历史文章,杂志文章

    doi:10.3171/2010.9.FOCUS10191

    authors: Maher CO,Buchman SR,O'Hara E,Cohen-Gadol AA

    更新日期:2010-12-01 00:00:00

  • A new trend in operative technique for intracerebral hemorrhage: a comparative study of stereotactic endoscopic removal and stereotactic catheter drainage.

    abstract::The development of less invasive methods to evacuate intracerebral hematomas (ICHs) has improved outcome in patients with traumatic brain injury. Eighteen patients with ICHs underwent surgery via one of two methods: stereotactic endoscopic removal (SER) or stereotactic catheter drainage (SCD). The outcome results were...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1996.1.4.2

    authors: Kim MH,Song JH,Kim SH,Park DB,Shin KM

    更新日期:1996-10-15 00:00:00

  • Continuous monitoring of cerebrovascular pressure reactivity in patients with head injury.

    abstract:OBJECT:Cerebrovascular pressure reactivity is the ability of cerebral vessels to respond to changes in transmural pressure. A cerebrovascular pressure reactivity index (PRx) can be determined as the moving correlation coefficient between mean intracranial pressure (ICP) and mean arterial blood pressure. METHODS:The au...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/FOC.2008.25.10.E2

    authors: Zweifel C,Lavinio A,Steiner LA,Radolovich D,Smielewski P,Timofeev I,Hiler M,Balestreri M,Kirkpatrick PJ,Pickard JD,Hutchinson P,Czosnyka M

    更新日期:2008-10-01 00:00:00

  • Intraoperative MRI-based elastic fusion for anatomically accurate tractography of the corticospinal tract: correlation with intraoperative neuromonitoring and clinical status.

    abstract:OBJECTIVE:Tractography is a useful technique that is standardly applied to visualize subcortical pathways. However, brain shift hampers tractography use during the course of surgery. While intraoperative MRI (ioMRI) has been shown to be beneficial for use in oncology, intraoperative tractography can rarely be performed...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2020.10.FOCUS20774

    authors: Ille S,Schroeder A,Wagner A,Negwer C,Kreiser K,Meyer B,Krieg SM

    更新日期:2021-01-01 00:00:00

  • An historical context of modern principles in the management of intracranial injury from projectiles.

    abstract::The contemporary management of projectile head injuries owes much to the lessons neurosurgeons have distilled from their experiences in war. Through early investigation and an increasingly detailed account of wartime clinical experience, neurosurgeons--including the field's early giants--began to gain a greater unders...

    journal_title:Neurosurgical focus

    pub_type: 历史文章,杂志文章

    doi:10.3171/2010.2.FOCUS1038

    authors: Agarwalla PK,Dunn GP,Laws ER

    更新日期:2010-05-01 00:00:00

  • Curative Onyx embolization of tentorial dural arteriovenous fistulas.

    abstract:OBJECT:The authors conducted a study to review their experience with tentorial dural arteriovenous fistulas (DAVFs) treated with transarterial endovascular embolization in which Onyx was used. METHODS:The authors reviewed prospectively collected data in 9 patients with tentorial DAVFs treated with Onyx embolization be...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2011.12.FOCUS11323

    authors: Puffer RC,Daniels DJ,Kallmes DF,Cloft HJ,Lanzino G

    更新日期:2012-05-01 00:00:00

  • "Picture-in-picture" endoscopic images in the microscope.

    abstract::The authors describe a new piece of equipment that enables simultaneous monitoring of the endoscopic image and unilateral microscopic image; that is, "picture-in-picture" images for endoscope-assisted microsurgery. The system is simple and purely optical, consisting of light-weight semi-rigid fibers and a special adap...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1999.6.4.13

    authors: Seki Y,Umezu H,Usui M,Tsumanuma T,Nakatate K

    更新日期:1999-04-15 00:00:00

  • Tethered spinal cord following repair of myelomeningocele.

    abstract:OBJECT:The goal of this paper is to elucidate the clinical presentation of tethered cord syndrome (TCS) following repair of a myelomeningocele. METHODS:Approximately 10 to 30% of children will develop TCS following repair of a myelomeningocele. Because essentially all children with repaired myelomeningocele will have ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2004.16.2.8

    authors: Hudgins RJ,Gilreath CL

    更新日期:2004-02-15 00:00:00

  • Tractography and the connectome in neurosurgical treatment of gliomas: the premise, the progress, and the potential.

    abstract::The ability of diffusion tensor MRI to detect the preferential diffusion of water in cerebral white matter tracts enables neurosurgeons to noninvasively visualize the relationship of lesions to functional neural pathways. Although viewed as a research tool in its infancy, diffusion tractography has evolved into a neur...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2019.11.FOCUS19785

    authors: Henderson F,Abdullah KG,Verma R,Brem S

    更新日期:2020-02-01 00:00:00

  • Pediatric sports-related traumatic brain injury in United States trauma centers.

    abstract::OBJECTIVE Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2016.1.FOCUS15612

    authors: Yue JK,Winkler EA,Burke JF,Chan AK,Dhall SS,Berger MS,Manley GT,Tarapore PE

    更新日期:2016-04-01 00:00:00

  • A stepwise illustration of the retrosigmoid approach for resection of a cerebellopontine meningioma.

    abstract::The retrosigmoid approach is a work-horse approach to the cerebellopontine angle (CPA), providing access from the foremen magnum to the tentorium. Indications for this approach are variable such as resection of meningiomas, acoustic neuromas and epidermoid tumors, treatment of vascular lesions of vertebrobasilar syste...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2014.V1.FOCUS13445

    authors: Cıkla U,Kujoth GC,Başkaya MK

    更新日期:2014-01-01 00:00:00

  • Transcirculation Pipeline embolization device deployment: a rescue technique.

    abstract::The Pipeline embolization device (PED) has become a very important tool in the treatment of nonruptured cerebral aneurysms. However, a patient's difficult anatomy or vascular stenosis may affect the device delivery. The purpose of this article was to describe an alternate technique for PED deployment when ipsilateral ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2017.2.FOCUS16485

    authors: Valle-Giler EP,Atallah E,Tjoumakaris S,Rosenwasser RH,Jabbour P

    更新日期:2017-06-01 00:00:00

  • Endoscopic microscopic transpedicular thoracic discectomy. Technical note.

    abstract::In an effort to make thoracic discectomy simple and less invasive while using direct visualization, a 70 degrees -angled lens endoscope has been adopted to visualize the ventral aspect of the spinal cord dura mater during microsurgical thoracic discectomy via a transpedicular approach. The patient is positioned in a 6...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1998.4.2.8

    authors: Jho HD

    更新日期:1998-02-15 00:00:00

  • Endovascular management of cerebral vasospasm.

    abstract::Cerebral vasospasm remains a feared complication from subarachnoid hemorrhage. Vasospasm typically occurs from three to fourteen days post-aneurysm rupture, with peak risk on Day 7. Up to 50% of patients with angiographic vasospasm will subsequently develop delayed cerebral ischemia; 15-20% of this subset will develop...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2014.V2.FOCUS14172

    authors: Kelman C,Reavey-Cantwell J

    更新日期:2014-07-01 00:00:00

  • Diagnostic approach to Cushing disease.

    abstract::In Cushing disease, a pituitary corticotroph neoplasm causes secondary adrenal hypercortisolism. This condition has known morbidity and mortality, underscoring the need for an efficient and accurate diagnostic approach. An 11 p.m. salivary cortisol level is a modern, simple initial screening tool for the diagnosis of ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2007.23.3.2

    authors: Gross BA,Mindea SA,Pick AJ,Chandler JP,Batjer HH

    更新日期:2007-01-01 00:00:00

  • Iatrogenic spondylodiscitis. Case report and review of literature.

    abstract::Iatrogenic intervertebral disc space infection is encountered following microsurgical discectomy, percutaneous laser disc decompression, automated percutaneous lumbar nucleotomy operations, and discography. The purpose of this paper is to present a case report and review the literature on the uncommon origins of pyoge...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:

    authors: Taşdemiroğlu E,Sengöz A,Bagatur E

    更新日期:2004-06-15 00:00:00

  • Effect of intraarterial papaverine and/or angioplasty on the cerebral veins in patients with vasospasm after subarachnoid hemorrhage due to ruptured intracranial aneurysms.

    abstract:OBJECT:The goal in this study was to determine if there was a change in intracranial venous diameters after endovascular treatment of carotid distribution vasospasm caused by subarachnoid hemorrhage. METHODS:The venous diameters were measured in all patients who received intraarterial papaverine and/or balloon angiopl...

    journal_title:Neurosurgical focus

    pub_type: 临床试验,杂志文章

    doi:10.3171/foc.2006.21.3.16

    authors: Elsayed AA,Moran CJ,Cross DT 3rd,Derdeyn CP,Pilgram TK,Milburn JM,Dacey RG Jr,Diringer MN Jr

    更新日期:2006-09-15 00:00:00

  • The role of radiosurgery for hemangiopericytomas.

    abstract:OBJECT:Hemangiopericytomas represent a small subset of meningeal tumors. Despite their relatively uncommon nature, they are aggressive tumors known for recurrence. Resection is the standard treatment in most, although regrowth and metastases are common even after resection. The authors evaluate the role of stereotactic...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.2003.14.5.15

    authors: Chang SD,Sakamoto GT

    更新日期:2003-05-15 00:00:00