Abstract:
OBJECT:The relatively stationary anatomy of the intracranial compartment has allowed the development of stereotactic radiosurgery as an effective treatment option for many intracranial lesions. Difficulty in accurately tracking extracranial targets has limited its development in the treatment of these lesions. The ability to track extracranial structures in real time with ultrasound images allows a system to upgrade and interface pretreatment volumetric images for extracranial applications. In this report the authors describe this technique as applied to the treatment of localized metastatic spinal disease. METHODS:The extracranial stereotactic system consists of an optically tracked ultrasonography unit that can be registered to a linear accelerator coordinate system. Stereotactic ultrasound images are acquired following patient positioning, based on a pretreatment computerized tomography (CT) simulation. The soft-tissue shifts between the virtual CT-based treatment plan and the actual treatment are determined. The degree of patient offset is tracked and used to correct the treatment plan. The ultrasonography-based stereotactic navigation system is accurate to within an approximate means of 1.5 mm based on testing with an absolute coordinate phantom. A radiosurgical treatment was delivered using the system for localization of a metastatic spinal lesion. Compared with the virtual CT simulation, the actual treatment plan isocenter was shifted 12.2 mm based on the stereotactic ultrasound image. The patient was treated using noncoplanar beams to a dose of 15.0 Gy to the 80% isodose shell in a single fraction. CONCLUSIONS:A system for high-precision radiosurgical treatment of metastatic spinal tumors has been developed, tested, and applied clinically. Optical tracking of the ultrasonography probe provides real-time tracking of the patient anatomy and allows computation of the target displacement prior to treatment delivery. The results reported here suggest the feasibility and safety of the technique.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Ryken TC,Meeks SL,Traynelis V,Haller J,Bouchet LG,Bova FJ,Pennington EC,Buatti JMdoi
10.3171/foc.2001.11.6.9subject
Has Abstractpub_date
2001-12-15 00:00:00pages
e8issue
6issn
1092-0684pii
110608journal_volume
11pub_type
杂志文章abstract::Cerebral venous sinus thrombosis (CVST) is characterized by formation of widespread thrombus within the cerebral venous sinus system. CVST can cause venous hypertension, venous infarcts, hemorrhage and seizures. It is managed in most cases with systemic anticoagulation through the use of heparin to resolve the thrombu...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.V2.FOCUS14186
更新日期:2014-07-01 00:00:00
abstract::Cysticercosis is the most common parasitic infection of the central nervous system. It infrequently affects the spine, but when it does, it can present with symptoms similar to other more common spinal diseases. The authors present a case of isolated intramedullary cysticercosis of the cervical spine and review the li...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.12.6.11
更新日期:2002-06-15 00:00:00
abstract:OBJECT:Multiple brain metastases are a common health problem, frequently found in patients with cancer. The prognosis, even after treatment with whole-brain radiation therapy (WBRT), is poor, with an average expected survival time of less than 6 months. Investigators at numerous centers have evaluated the role of stere...
journal_title:Neurosurgical focus
pub_type: 杂志文章,随机对照试验
doi:10.3171/foc.2000.9.2.5
更新日期:2000-08-15 00:00:00
abstract::Peritumoral cysts (those arising immediately adjacent to the tumor mass) are frequently associated with benign and malignant tumors of the brain and spinal cord (syringomyelia). The cystic component of central nervous system (CNS) tumors and associated peritumoral cysts are often the cause of clinical symptoms. Becaus...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.5.10
更新日期:2007-05-15 00:00:00
abstract::Current Procedural Terminology (CPT) standardizes medical procedure coding for billing and reimbursement. Since adoption of CPT coding as the basis for the Medicare Fee Schedule (MFS) in 1992, CPT coding policies and policy changes have been influenced not only by medical necessity and customary practice, but also inc...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.12.4.2
更新日期:2002-04-15 00:00:00
abstract::OBJECTIVE The aim of this study was to identify and discuss operative nuances utilizing image guidance in the surgical management of aggressive sacral tumors. METHODS The authors report on their single-institution, multi-surgeon, retrospective case series involving patients with pathology-proven aggressive sacral tumo...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2016.6.FOCUS16125
更新日期:2017-01-01 00:00:00
abstract::The clinical success of lumbar spinal fusion varies considerably, depending on techniques and indications. Although spinal fusion generally helps to eliminate certain types of pain, it may also decrease function by limiting patient mobility. Furthermore, spinal fusion may increase stresses on adjacent nonfused motion ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.1.1
更新日期:2007-01-15 00:00:00
abstract::Stereotactic radiosurgery (SRS) with the Gamma Knife and linear accelerator has revolutionized neurosurgery over the past 20 years. The most common indications for radiosurgery today are tumors and arteriovenous malformations of the brain. Functional indications such as treatment of movement disorders or intractable p...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC-07/12/E3
更新日期:2007-01-01 00:00:00
abstract::Spinal epidural lipomatosis is most commonly observed in patients receiving long-term exogenous steroid therapy, but can also be seen in patients with endogenous steroid overproduction, obesity, or idiopathic disease. With this condition, there is hypertrophy of the epidural adipose tissue, causing a narrowing of the ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2004-04-15 00:00:00
abstract:OBJECTIVE:In addition to the rising burden of surgical disease globally, infrastructure and human resources for health remain a great challenge for low- and middle-income countries, especially in Uganda. In this study, the authors aim to explore the trends of neurosurgical care at a regional referral hospital in Uganda...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.7.FOCUS18270
更新日期:2018-10-01 00:00:00
abstract::In this paper, the authors' aim is to provide an evidence-based review of primary and secondary ischemic stroke prevention guidelines covering most of the common risk factors and stroke etiologies for the practicing neurosurgeon. The key to stroke prevention is in the identification and treatment of the major risk fac...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.2.FOCUS1164
更新日期:2011-06-01 00:00:00
abstract:OBJECT:Intraneural ganglia are nonneoplastic mucinous cysts contained within the epineurium of peripheral nerves. Their pathogenesis has been controversial. Historically, the majority of authors have favored de novo formation (degenerative theory). Because of their rarity, intraneural ganglia affecting the upper limb h...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC.2009.26.2.E10
更新日期:2009-02-01 00:00:00
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
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:The microvascular anatomy of spinal perimedullary arteriovenous fistulas (AVFs) is more complicated than that of dural AVFs, and occlusion rates of AVF after open microsurgery or endovascular embolization are lower in patients with perimedullary AVFs (29%-70%) than they are in those with dural AVF (97%-98%). ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.12.FOCUS15574
更新日期:2016-03-01 00:00:00
abstract::This video demonstrates a surgical technique of resecting dorsum sellae meningioma using a combined interhemispheric translamina terminalis approach and pterional approach with clinoidectomy. The tumor, 5 cm in maximum diameter, originated from the dorsum sellae, compressed the third ventricle and the midbrain, and di...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.10.FocusVid.17302
更新日期:2017-10-01 00:00:00
abstract::Chiari malformation is a developmental disorder that is often associated with other abnormalities of the cerebrospinal axis. Despite widespread recognition of this association, there is relatively little information on the treatment of these coexisting disorders in the setting of cerebellar tonsillar ectopia. In an ef...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1999.6.6.5
更新日期:1999-06-15 00:00:00
abstract::With the aid of a computer model, this investigation describes the relationship between mean arterial pressure (MAP) reduction and its effect on total arteriovenous malformation (AVM) shunt flow, feeding artery velocities, and cerebral blood flow in hypotensive, structurally normal vascular beds adjacent to the AVM ni...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1997.2.6.6
更新日期:1997-06-15 00:00:00
abstract:OBJECT:The surgical treatment of tumors located near eloquent cortex carries a high risk of inducing worsening neurological deficits. Intraoperative electrocorticography techniques have been developed to help identify these areas at the time of surgery in an effort to minimize such risks. The optimal anesthetic techniq...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2003.15.1.8
更新日期:2003-07-15 00:00:00
abstract::Early neurosurgical procedures dealt mainly with treatment of head trauma, especially skull fractures. Since the early medical writings by Hippocrates, a great deal of respect was given to the dura mater, and many other surgeons warned against violating the dura. It was not until the 19th century that neurosurgeons st...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2014.2.FOCUS13564
更新日期:2014-04-01 00:00:00
abstract:OBJECT:An experimental study was performed to determine the biomechanical end-mounting configurations that replicate in vivo physiological motion of the cervical spine in a multiple-level human cadaveric model. The vertebral motion response for the modified testing protocol was compared to in vivo motion data and tradi...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:2004-09-15 00:00:00
abstract::OBJECTIVE Tectal gliomas constitute a rare and inhomogeneous group of lesions with an uncertain clinical course. Because these supposedly benign tumors are frequently followed up by observation over many years, the authors undertook this analysis of their own case series in an effort to demonstrate that the clinical c...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.3.FOCUS1850
更新日期:2018-06-01 00:00:00
abstract::Primary leiomyosarcoma of the central nervous system is rare and has been described both de novo and following temporally remote radiotherapy for a different unrelated malignancy. The authors report the case of a 42-year-old man in whom 60Co radiation treatment had been performed for an unknown primary mass in the bra...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.6.13
更新日期:2002-06-15 00:00:00
abstract::The authors describe a surgical technique for the correction of symptomatic degenerative lumbar scoliosis. Using a single, unilateral, interbody cage placed on the concave side of the coronal deformity, combined with a dorsal decompression and instrumented posterolateral fusion, this technique has resulted in excellen...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.12.FOCUS09281
更新日期:2010-03-01 00:00:00
abstract::Surgery of the mind has a rather checkered past. Though its history begins with the prehistoric trephination of skulls to allow "evil spirits" to escape, the early- to mid-20th century saw a surge in the popularity of psychosurgery. The 2 prevailing operations were topectomy and leukotomy for the treatment of certain ...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2017.6.FOCUS17259
更新日期:2017-09-01 00:00:00
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
更新日期:2015-08-01 00:00:00
abstract::Considerable financial and human resources have been directed toward the emerging field of comparative effectiveness research (CER) in the US. Fundamentally, the concept of CER is so logical as to be almost self-evident; namely, that research regarding therapeutic strategies should go beyond efficacy and examine objec...
journal_title:Neurosurgical focus
pub_type: 社论
doi:10.3171/2012.5.FOCUS12127
更新日期:2012-07-01 00:00:00
abstract::Drug addiction represents a significant public health concern that has high rates of relapse despite optimal medical therapy and rehabilitation support. New therapies are needed, and deep brain stimulation (DBS) may be an effective treatment. The past 15 years have seen numerous animal DBS studies for addiction to var...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.5.FOCUS18163
更新日期:2018-08-01 00:00:00
abstract::Lumbosacral interbody fusion may be indicated to treat degenerative disc disease at L5-S1, instability or spondylolisthesis at that level, and severe neural foraminal stenosis resulting from loss of disc space height. In addition, L5-S1 interbody fusion may provide anterior support to a long posterior fusion construct...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2014.2.FOCUS13467
更新日期:2014-05-01 00:00:00
abstract::Trepanation is the process by which a hole is drilled into the skull, exposing the intracranial contents for either medical or mystical purposes. It represents one of the oldest surgical procedures, and its practice was widespread in many ancient cultures and several parts of the world. Trepanation was used in ancient...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章,评审
doi:10.3171/foc.2007.23.1.11
更新日期:2007-01-01 00:00:00
abstract::OBJECTIVEPituitary adenomas occur in a heterogeneous patient population with diverse perioperative risk factors, endocrinopathies, and other tumor-related comorbidities. This heterogeneity makes predicting postoperative outcomes challenging when using traditional scoring systems. Modern machine learning algorithms can...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.8.FOCUS18268
更新日期:2018-11-01 00:00:00