Publications by authors named "Finn Ghent"

8 Publications

  • Page 1 of 1

Calcifying pseudoneoplasm of the neuraxis: A rare case involving the oculomotor nerve.

Surg Neurol Int 2020 15;11:249. Epub 2020 Aug 15.

Department of Neurosurgery, St George Public Hospital, Gray Street, Australia.

Background: Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare entity which can occur at intracranial and spinal locations. Clinical presentation is due to local mass effect rather than tissue infiltration. Lesions causing significant symptoms or are showing radiological progression require surgical resection. Maximal surgical resection is considered curative for this non-neoplastic entity with only two cases of recurrence reported in the literature. Cranial nerve involvement is extremely rare and the presenting neurological deficit is unlikely to improve even with surgical intervention.

Case Description: We describe a case of CAPNON at the right posterior clinoid process with involvement of the right oculomotor nerve in a 38-year-old male. Computed tomography demonstrated an amorphous mass which had intermediate to low T1 and T2 signal on magnetic resonance imaging. The oculomotor nerve was compressed with sign of atrophy. The patient underwent maximal surgical debulking for progressive symptoms of worsening pain and ophthalmoplegia. Postoperatively, the patient's symptoms were stable but did not improve.

Conclusion: Preoperative diagnosis of CAPNON is difficult due to its rarity and nonspecific clinical and radiological findings. Surgical resection is considered in cases with worsening symptoms, progression on serial imaging, or uncertain diagnosis. Relatively inaccessible lesions with little or no clinical symptoms can be observed.
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http://dx.doi.org/10.25259/SNI_386_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468187PMC
August 2020

Assessment and Post-Intervention Recovery After Surgery for Lumbar Disk Herniation Based on Objective Gait Metrics from Wearable Devices Using the Gait Posture Index.

World Neurosurg 2020 Oct 22;142:e111-e116. Epub 2020 Jun 22.

NeuroSpine Surgery Research Group (NSURG), Sydney, Australia; NeurospineClinic, Prince of Wales Private Hospital, Randwick, Australia; Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.

Objective: Surgery for lumbar disk herniation (LDH) presents an option for patients when conservative measures fail. The objective of this clinical study is to investigate a novel, objective outcome measure in patients undergoing lumbar microdiscectomy.

Methods: Twenty-four patients were evaluated pre- and postoperatively using the Oswestry Disability Index (ODI), and a novel objective scoring tool, the Gait Posture index (GPi). The score is calculated from 4 key physical health metrics: daily step count, walking speed, step length, and walking posture. The GPi ranges from 0 (nonambulant) to 100 (excellent walking performance). Wearable accelerometers and observational recordings were used to evaluate the components of the GPi. The GPi was calculated and compared with the ODI, pre- and postintervention. The study was designed as a proof of concept and confirmation of validity for use of the GPi in LDH.

Results: At follow-up (average 66 ± 36 days), 23 of 24 patients had an improvement in their GPi after surgery. The average GPi of the cohort improved from 59.33 ± 16.06 to 85.75 ± 9.22 with P < 0.001, with significant changes in all 4 components. The average preoperative ODI was 54.54 ± 20.70, improving to 16.33 ± 14.095 with P < 0.001. The Pearson correlation coefficient was r = 0.56, indicating a correlation between change in ODI and change in GPi.

Conclusions: The GPi score is a new, objective descriptor of mobility in spinal surgery which can be used to augment traditional subjective outcome scoring surveys such as the ODI. Significant changes are seen in the GPi and its constituent metrics in patients undergoing surgery for LDH.
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http://dx.doi.org/10.1016/j.wneu.2020.06.104DOI Listing
October 2020

Intracranial Ewing Sarcoma - A case report.

Surg Neurol Int 2020 30;11:134. Epub 2020 May 30.

Department of Neurosurgery, St. George Public Hospital, Kogarah, New South Wales, Australia.

Background: Intracranial Ewing's sarcoma (ES) is a rare entity with <15 cases reported in the literature. It belongs to a family of round-cell neuroectodermally derived tumors bearing many similarities to peripheral primitive neuroectodermal tumor (pPNET). There is currently no established treatment protocol. Reported cases are treated with either surgery alone or surgery with adjuvant chemotherapy and radiation.

Case Description: We describe a case of intracranial left frontal ES in a 19-year-old patient who presented with change in behavior. Diagnosis was unclear based on radiological findings on MRI and CT alone. MRI brain with contrast demonstrated a large extra-axial ovoid heterogeneously enhancing left frontal convexity mass. The patient underwent gross total resection with adjuvant chemotherapy and radiation. No local or systemic recurrence was found at 12 months postoperatively.

Conclusion: Intracranial ES/pPNET is rare tumor with nonspecific clinical presentation and radiological findings. They are locally invasive. Surgery with adjuvant chemoradiation is the mainstay treatment. Distinction of pPNET and cPNET is important for therapeutic and prognostic purposes.
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http://dx.doi.org/10.25259/SNI_178_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294174PMC
May 2020

Corrigendum to "Stand-alone anterior lumbar interbody fusion for treatment of degenerative spondylolisthesis" [J Clin Neurosci 22(10) (2015) 1619-1624].

J Clin Neurosci 2019 Feb;60:176

Neuro Spine Clinic, Prince of Wales Private Hospital, Suite 7a, Level 7, Barker Street, Randwick, NSW 2031, Australia; Prince of Wales Hospital, Randwick, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia.

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http://dx.doi.org/10.1016/j.jocn.2018.12.038DOI Listing
February 2019

Stand-alone anterior lumbar interbody fusion for treatment of degenerative spondylolisthesis.

J Clin Neurosci 2015 Oct 3;22(10):1619-24. Epub 2015 Jul 3.

Neuro Spine Clinic, Prince of Wales Private Hospital, Suite 7a, Level 7, Barker Street, Randwick, NSW 2031, Australia; Prince of Wales Hospital, Randwick, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia.

We sought to evaluate the clinical and radiologic efficacy of stand-alone anterior lumbar interbody fusion (ALIF) for low grade degenerative spondylolisthesis, the favoured surgical management approach at our institution. The optimal approach for surgical management of spondylolisthesis remains contentious. We performed a prospective analysis of all consecutive patients with low grade lumbar spondylolisthesis who underwent ALIF between 2009 and 2013 by a single surgeon (n=27). The mean age was 64.9 years with a male to female ratio of 14:13. There were 32 levels operated and the average preoperative spondylolisthesis was 14.8%, which reduced to 6.4% postoperatively and 9.4% at the latest follow-up (p=0001). Postoperative disc height was increased to 175% of preoperative values and was statistically significant (p<0.001) and remained improved with an overall change of 139% at the latest follow-up. The radiological fusion rate was 91%. The 12-Item Short Form Health Survey (SF-12) mental and physical component summary improved from 31.7 to 43.0 (p=0.007) and from 35.4 to 51.7 (p=0.0026), respectively. The mean visual analogue scale pain score improved from 7.6 to 2.2 (p<0.001), and the mean Oswestry disability index improved from 56.9 to 17.8% (p<0.0001). The overall clinical success rate was 93%. The posterior disc height correlated with spondylolisthesis reduction (p=0.04) and the only clinical factor affecting reduction was body mass index (p=0.04). The present study provides encouraging short term results for stand-alone ALIF as a procedure for low grade lumbar degenerative spondylolisthesis. Future studies should include adequately powered, prospective, multicentre registry studies with long term follow-up to allow a better assessment of the relative benefits and risks.
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http://dx.doi.org/10.1016/j.jocn.2015.03.034DOI Listing
October 2015

Haemorrhagic lumbar juxtafacet cyst with ligamentum flavum involvement.

Case Rep Orthop 2014 14;2014:126067. Epub 2014 Dec 14.

Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, Sydney, NSW 2031, Australia.

Juxtafacet cysts are an uncommon cause of radiculopathy. They occur most frequently in the lumbar region, and their distribution across the spine correlates with mobility. Haemorrhagic complications are rare and may occur in the absence of any provocation, although there is some association with anticoagulation and trauma. We present a case of acute radiculopathy due to an L5/S1 juxtafacet cyst with unprovoked haemorrhage which was found to extend into ligamentum flavum. The patient underwent uncomplicated microscope assisted decompression with excellent results. The demographics, presentation, aetiology, and management of juxtafacet cysts are discussed.
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http://dx.doi.org/10.1155/2014/126067DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279113PMC
January 2015

A contrast-enhancing lumbar ligamentum flavum haematoma.

BMJ Case Rep 2014 Mar 18;2014. Epub 2014 Mar 18.

Department of Neurosurgery, Prince of Wales Hospital, Sydney, New South Wales, Australia.

We present a case of lower back pain with lumbar nerve compromise due to a ligamentum flavum haematoma which was successfully treated surgically. A 62-year-old man was evaluated for lower back pain with associated leg pain and early signs of cauda equina syndrome. MRI of the lumbar spine demonstrated a contrast-enhancing mass adjacent to the lamina of L3 which was causing severe canal stenosis. Surgical excision of the lesion was recommended. The patient underwent an L3 laminectomy with excision of the epidural lesion. Histopathology showed it to be a haematoma of the ligamentum flavum with no untoward features. The patient recovered without complication.
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http://dx.doi.org/10.1136/bcr-2013-202521DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962851PMC
March 2014

Impending paradoxical embolism: have we lost the clot?

Clin Respir J 2014 Oct 20;8(4):460-2. Epub 2014 Jan 20.

Department of Cardiothoracic Surgery, Prince of Wales Hospital, Sydney, Australia.

Impending paradoxical embolism is a rare diagnosis that requires urgent treatment. We present a case where surgical thromboembolectomy was undertaken. The thrombus vanished from view on transesophageal ultrasound and was presumed to have undergone embolisation while bypass was established. Unexpectedly, it was found tangled in the superior vena cava cannula apertures.
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http://dx.doi.org/10.1111/crj.12093DOI Listing
October 2014