3,448 results match your criteria Neurosurgical Focus [Journal]


Outcomes of decompression and fusion for treatment of spinal infection

Neurosurg Focus 2019 Feb 15;46(1):E7. Epub 2019 Feb 15.

1Department of Neurosurgery, University of Louisville, Louisville, Kentucky.

Objective: Spine infection including vertebral osteomyelitis, discitis, paraspinal musculoskeletal infection, and spinal abscess refractory to medical management poses significant challenges to the treating physician. Surgical management is often required in patients suffering neurological deficits or spinal deformity with significant pain. To date, best practices have not been elucidated for the optimization of health outcomes and resource utilization in the setting of surgical intervention for spinal infection. Read More

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http://dx.doi.org/10.3171/2018.10.FOCUS18460DOI Listing
February 2019
2 Reads

Mini-pterional approach for clip ligation of ethmoidal dural arteriovenous fistula.

Neurosurg Focus 2019 Apr;46(Suppl_2):V9

1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Ethmoidal dural arteriovenous fistulas (DAVFs) have a near-universal association with cortical venous drainage and a malignant clinical course. Endovascular treatment options are often limited due to the high frequency of ophthalmic artery ethmoidal supply. A 64-year-old gentleman presented with syncope and was found to have a right ethmoidal DAVF. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18660DOI Listing
April 2019
1 Read

Left temporal craniotomy and direct microcatheterization of the middle meningeal artery for treatment of a complex temporal dural arteriovenous fistula.

Neurosurg Focus 2019 Apr;46(Suppl_2):V8

The preferred method for treating complex dural arteriovenous fistulae of the transverse and sigmoid sinuses is via endovascular, transarterial embolization using liquid embolysate. However, this treatment approach mandates access to distal dural feeding arteries that can be technically challenging by standard endovascular approaches. This video describes a left temporal craniotomy for direct stick microcatheterization of an endovascularly inaccessible distal posterior division of the middle meningeal artery for embolization of a complex left temporal dural arteriovenous fistula. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18650DOI Listing
April 2019
3 Reads
2.105 Impact Factor

Application of the selective indocyanine green videoangiography in microsurgical treatment of a craniocervical junction dural arteriovenous fistula.

Neurosurg Focus 2019 Apr;46(Suppl_2):V5

Craniocervical junction dural arteriovenous fistula (CCJDAVF) is a rare and unique type of intracranial DAVF with complex neurovascular anatomy, making it difficult to identify the arterialized vein during operation. The authors report the case of a 50-year-old male who presented with symptoms of venous hypertensive myelopathy. Angiography demonstrated a left CCJDAVF. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18681DOI Listing
April 2019
3 Reads

Trans-superior ophthalmic vein approach for treatment of carotid-cavernous fistula.

Neurosurg Focus 2019 Apr;46(Suppl_2):V4

1Department of Neurosurgery, Baylor College of Medicine, Houston, Texas; and.

The authors present a case of a patient with a Barrow Type B carotid-cavernous fistula (CCF) who presented with severe symptoms of eye redness, diplopia, and proptosis. Due to the tortuosity and size of her angular vein and the lack of good flow/access via the inferior petrosal sinus, she was treated with a transvenous approach via a large, dilated superior ophthalmic vein for coil embolization of the CCF. The patient had a full angiographic and symptomatic cure. Read More

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http://dx.doi.org/10.3171/2019.4.FocusVid.18496DOI Listing
April 2019
1 Read

Left anterior cranial fossa dural arteriovenous fistula ligation using a supra-orbital (eyebrow) craniotomy.

Neurosurg Focus 2019 Apr;46(Suppl_2):V3

A 67-year-old male presented to the hospital with a left anterior cranial fossa arteriovenous fistula connecting the anterior ethmoidal artery to the cavernous sinus and superior sagittal sinus. After failed embolization, the patient was taken for a supra-orbital (eyebrow) craniotomy for surgical dissection and clipping of the fistula. An intraoperative angiogram confirmed successful fistula ligation. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18682DOI Listing
April 2019
1 Read

Surgical treatment of previously embolized craniocervical junction dural arteriovenous fistula.

Neurosurg Focus 2019 Apr;46(Suppl_2):V2

Departments of1Neurologic Surgery and.

Craniocervical junction dural arteriovenous fistulas (dAVFs) are rare vascular lesions with a potentially dangerous natural history due to the onset of neurological deficit secondary to intracranial hemorrhage or myelopathy due to venous congestion. Despite advances in endovascular techniques, many dAVFs located in this area continue to require surgical treatment as embolization is often not feasible or safe. In this video, the authors illustrate a patient with a symptomatic craniocervical junction dAVF who had undergone attempted Onyx embolization at another institution. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18639DOI Listing
April 2019
1 Read

Bifrontal approach for clip ligation of bilateral ethmoidal dural arteriovenous fistulas: operative video.

Neurosurg Focus 2019 Apr;46(Suppl_2):V14

Venous interruption through surgical clip ligation is the gold standard treatment for ethmoidal dural arteriovenous fistula (e-dAVF). Their malignant natural history is attributable to the higher predilection for retrograde cortical venous drainage. This video illustrates an e-dAVF in a 70-year-old man with progressive tinnitus and headache. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18702DOI Listing

Endovascular management of complex superior sagittal sinus dural arteriovenous fistula.

Neurosurg Focus 2019 Apr;46(Suppl_2):V11

Superior sagittal sinus (SSS) dural arteriovenous fistulas (DAVFs) are rare and present unique challenges to treatment. Complex, often bilateral, arterial supply and involvement of large volumes of eloquent cortical venous drainage may necessitate multimodality therapy such as endovascular, microsurgical, and stereotactic radiosurgery techniques. The authors present a complex SSS DAVF associated with an occluded/severely stenotic SSS. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18687DOI Listing
April 2019
1 Read

Microsurgical treatment of tentorial dural fistulas causing thalamic venous hypertension: two illustrative sister cases.

Neurosurg Focus 2019 Apr;46(Suppl_2):V13

This video is a presentation of technical tenets for the microsurgical clipping of a tentorial dural arteriovenous fistula presenting with thalamic venous hypertension. These cases are easily misdiagnosed and often supplied by the tentorial artery of Davidoff and Schecter. The cases shown in the video uniquely illustrate a supracerebellar infratentorial approach to identify and clip an arterialized tentorial vein utilizing intraoperative Doppler and fluorescein, with navigation and an intraoperative cerebral angiogram in a hybrid neuroangiography operative suite. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18635DOI Listing
April 2019
2 Reads

Nuances of transarterial and transvenous embolization of a large tentorial arteriovenous fistula.

Neurosurg Focus 2019 Apr;46(Suppl_2):V12

Departments of1Neurosurgery and.

An 80-year-old female presented with a long history of severe pulsatile tinnitus, vertigo, and decreased hearing. She was found to have a large right-sided tentorial arteriovenous fistula (AVF) with enlarged deep draining veins, including the vein of Rosenthal. The patient underwent Onyx embolization of the fistula via a combined transarterial and transvenous approach resulting in complete obliteration of the fistula. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18674DOI Listing
April 2019
4 Reads

Right jugular foramen dural arteriovenous fistula Cognard IV.

Neurosurg Focus 2019 Apr;46(Suppl_2):V7

Posterior fossa dural arteriovenous fistulas (dAVFs) are rare vascular malformations. They carry a significant risk of hemorrhage if associated with cortical venous reflux. A 70-year-old man presented with right-sided medullary hemorrhage with pronounced Wallenberg syndrome. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18667DOI Listing
April 2019
1 Read

Far lateral approach for microsurgical ligation of C1 dural arteriovenous fistula: surgical anatomy and technical nuances.

Neurosurg Focus 2019 Apr;46(Suppl_2):V6

This video demonstrates the diagnosis and surgical ligation of a C1 dural arteriovenous fistula via a far lateral, transcondylar approach. The patient's dural arteriovenous fistula was identified by MRI signal changes in the spinal cord and a cerebrospinal angiogram demonstrating an abnormal hypertrophied early venous drainage pattern suggestive of a C1 vessel origin. Indocyanine green was used to verify surgical treatment of the fistula intraoperatively. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18697DOI Listing
April 2019
2 Reads

Staged transarterial endovascular embolization of a malignant dural arteriovenous fistula using Onyx and n-butyl cyanoacrylate.

Neurosurg Focus 2019 Apr;46(Suppl_2):V1

Dural arteriovenous fistulae (dAVFs) are vascular anomalies formed by abnormal connections between branches of dural arteries and dural veins or dural venous sinus(es). These pathologic shunts constitute 10%-15% of all intracranial arteriovenous malformations. The hallmark of malignant dAVFs is the presence of cortical venous drainage, a finding that increases the likelihood of nonhemorrhagic neurologic deficit, intracranial hemorrhage, and mortality if left unaddressed. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18676DOI Listing
April 2019
1 Read

Transarterial and transvenous approaches for embolization of tentorial dural arteriovenous fistula.

Neurosurg Focus 2019 Apr;46(Suppl_2):V10

Tentorial dural arteriovenous fistulas (DAVFs) are uncommon, complex fistulas located between the leaves of the tentorium cerebelli with a specific anatomic and clinical presentation characterized by high hemorrhagic risk. They have an extensive arterial supply and complex venous drainages, making them difficult to treat. There is recent literature favoring treatment through an endovascular transarterial route. Read More

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http://dx.doi.org/10.3171/2019.2.FocusVid.18690DOI Listing
April 2019
4 Reads

An enhanced recovery after surgery pathway: association with rapid discharge and minimal complications after anterior cervical spine surgery.

Neurosurg Focus 2019 Apr;46(4):E9

3Department of Orthopaedic Surgery, Hospital for Special Surgery; and.

OBJECTIVEEnhanced recovery after surgery (ERAS) pathways are associated with improved outcomes, lower morbidity and complications, and higher patient satisfaction in multiple surgical subspecialties. Despite these gains, there are few data to guide the application of ERAS concepts to spine surgery. The authors report the development and implementation of the first ERAS pathway for patients undergoing anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA). Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18643DOI Listing
April 2019
1 Read

Opioid-free anesthesia within an enhanced recovery after surgery pathway for minimally invasive lumbar spine surgery: a retrospective matched cohort study.

Neurosurg Focus 2019 Apr;46(4):E8

3Department of Orthopaedic Surgery, Hospital for Special Surgery; and.

OBJECTIVEEnhanced recovery after surgery (ERAS) and multimodal analgesia are established care models that minimize perioperative opioid consumption and promote positive outcomes after spine surgery. Opioid-free anesthesia (OFA) is an emerging technique that may achieve similar goals. The purpose of this study was to evaluate an OFA regimen within an ERAS pathway for lumbar decompressive surgery and to compare perioperative opioid requirements in a matched cohort of patients managed with traditional opioid-containing anesthesia (OCA). Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18645DOI Listing

Improving recovery after elective degenerative spine surgery: 5-year experience with an enhanced recovery after surgery (ERAS) protocol.

Neurosurg Focus 2019 Apr;46(4):E7

Departments of1Neurosurgery and.

OBJECTIVEEnhanced recovery after surgery (ERAS) has led to a paradigm shift in various surgical specialties. Its application can result in substantial benefits in perioperative healthcare utilization through preoperative physical and mental patient optimization and modulation of the recovery process. Still, ERAS remains relatively new to spine surgery. Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18646DOI Listing
April 2019
6 Reads

Benefits of Enhanced Recovery After Surgery for fusion in degenerative spine surgery: impact on outcome, length of stay, and patient satisfaction.

Neurosurg Focus 2019 Apr;46(4):E6

2Department of Neurosurgery, Spine Unit, Geneva University Hospitals, Geneva, Switzerland.

OBJECTIVEEnhanced Recovery After Surgery (ERAS) proposes a multimodal, evidence-based approach to perioperative care. Thanks to the improvement in care protocols and the fluidity of the patient pathway, the first goal of ERAS is the improvement of surgical outcomes and patient experience, with a final impact on a reduction in the hospital length of stay (LOS). The implementation of ERAS in spinal surgery is in the early stages. Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18669DOI Listing
April 2019
1 Read

Enhanced perioperative care and decreased cost and length of stay after elective major spinal surgery.

Neurosurg Focus 2019 Apr;46(4):E5

2Orthopaedics and Sports Medicine, and.

OBJECTIVEThe purpose of this study was to compare total cost and length of stay (LOS) between spine surgery patients enrolled in an enhanced perioperative care (EPOC) pathway and patients receiving traditional perioperative care (TRDC).METHODSAll spine surgery candidates were screened for inclusion in the EPOC pathway. This cohort was compared to a retrospective cohort of patients who received TRDC and a concurrent group of patients who met inclusion criteria but did not receive the EPOC (no pathway care [NOPC] group). Read More

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https://thejns.org/view/journals/neurosurg-focus/46/4/articl
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http://dx.doi.org/10.3171/2019.1.FOCUS18630DOI Listing
April 2019
6 Reads

Reductions in length of stay, narcotics use, and pain following implementation of an enhanced recovery after surgery program for 1- to 3-level lumbar fusion surgery.

Neurosurg Focus 2019 Apr;46(4):E4

Departments of1Neurological Surgery and.

OBJECTIVELumbar fusion is typically associated with high degrees of pain and immobility. The implementation of an enhanced recovery after surgery (ERAS) approach has been successful in speeding the recovery after other surgical procedures. In this paper, the authors examined the results of early implementation of ERAS for lumbar fusion. Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18692DOI Listing

Enhanced recovery after spine surgery: a systematic review.

Neurosurg Focus 2019 Apr;46(4):E3

OBJECTIVEEnhanced recovery after surgery (ERAS) is a multidimensional approach to improving the care of surgical patients using subspecialty- and procedure-specific evidence-based protocols. The literature provides evidence of the benefits of ERAS implementation, which include expedited functional recovery, decreased postoperative morbidity, reduced costs, and improved subjective patient experience. Although extensively examined in other surgical areas, ERAS principles have been applied to spine surgery only in recent years. Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18700DOI Listing
April 2019
1 Read

Clinical results of percutaneous biportal endoscopic lumbar interbody fusion with application of enhanced recovery after surgery.

Neurosurg Focus 2019 Apr;46(4):E18

OBJECTIVEThe aims of enhanced recovery after surgery (ERAS) are to improve surgical outcomes, shorten hospital stays, and reduce complications. The objective of this study was to introduce ERAS with biportal endoscopic transforaminal lumbar interbody fusion (TLIF) and to investigate the clinical results.METHODSPatients were divided into two groups based on the fusion procedures. Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18695DOI Listing

Rotational thromboelastometry-guided transfusion during lumbar pedicle subtraction osteotomy for adult spinal deformity: preliminary findings from a matched cohort study.

Neurosurg Focus 2019 Apr;46(4):E17

Departments of1Neurosurgery and.

OBJECTIVESignificant blood loss and coagulopathy are often encountered during adult spinal deformity (ASD) surgery, and the optimal intraoperative transfusion algorithm is debatable. Rotational thromboelastometry (ROTEM), a functional viscoelastometric method for real-time hemostasis testing, may allow early identification of coagulopathy and improve transfusion practices. The objective of this study was to investigate the effect of ROTEM-guided blood product management on perioperative blood loss and transfusion requirements in ASD patients undergoing correction with pedicle subtraction osteotomy (PSO). Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18572DOI Listing

A novel technique for awake, minimally invasive transforaminal lumbar interbody fusion: technical note.

Neurosurg Focus 2019 Apr;46(4):E16

Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is associated with improved patient-reported outcomes in well-selected patients. Recently, some neurosurgeons have aimed to further improve outcomes by utilizing multimodal methods to avoid the use of general anesthesia. Here, the authors report on the use of a novel awake technique for MI-TLIF in two patients. Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18510DOI Listing

Editorial. Reducing the burden of spine fusion.

Neurosurg Focus 2019 Apr;46(4):E15

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http://dx.doi.org/10.3171/2019.1.FOCUS1945DOI Listing
April 2019
1 Read

Endoscopic transforaminal lumbar interbody fusion without general anesthesia: operative and clinical outcomes in 100 consecutive patients with a minimum 1-year follow-up.

Neurosurg Focus 2019 Apr;46(4):E14

Departments of1Neurological Surgery and.

OBJECTIVEOpen spinal fusion surgery is often associated with significant blood loss, postoperative pain, and prolonged recovery times. Seeking to minimize surgical and perioperative morbidity, the authors adopted an endoscopic minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) technique performed without general anesthesia. In this report, they present data on the first 100 patients treated with this procedure. Read More

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http://dx.doi.org/10.3171/2018.12.FOCUS18701DOI Listing
April 2019
3 Reads

Characterizing the risk and outcome profiles of lumbar fusion procedures in patients with opioid use disorders: a step toward improving enhanced recovery protocols for a unique patient population.

Neurosurg Focus 2019 Apr;46(4):E12

OBJECTIVEThe authors set out to conduct the first national-level study assessing the risks and outcomes for different lumbar fusion procedures in patients with opioid use disorders (OUDs) to help guide the future development of targeted enhanced recovery after surgery (ERAS) protocols for this unique population.METHODSData for patients with or without OUDs who underwent an anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), or lateral transverse lumbar interbody fusion (LLIF) for lumbar disc degeneration (LDD) were collected from the 2013-2014 National (Nationwide) Inpatient Sample database. Multivariable logistic regression was implemented to analyze how OUD status impacted in-hospital complications, length of hospital stay, discharge disposition, and total charges by procedure type. Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18652DOI Listing

Development and implementation of a comprehensive spine surgery enhanced recovery after surgery protocol: the Cleveland Clinic experience.

Neurosurg Focus 2019 Apr;46(4):E11

Departments of1Neurosurgery and.

Enhanced recovery after surgery (ERAS) protocols have been shown to be effective at reducing perioperative morbidity and costs while improving outcomes. To date, spine surgery protocols have been limited in scope, focusing only on specific types of procedures or specific parts of the surgical episode. The authors describe the creation and implementation of one of the first comprehensive ERAS protocols for spine surgery. Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18696DOI Listing
April 2019
7 Reads

Does an enhanced recovery after surgery protocol change costs and outcomes of single-level lumbar microdiscectomy?

Neurosurg Focus 2019 Apr;46(4):E10

2Neurosurgery, Ümraniye Training and Research Hospital, Ümraniye, İstanbul, Turkey.

OBJECTIVEEnhanced recovery after surgery (ERAS) is a multimodal approach that aims to improve perioperative surgical outcomes. The aim of this study was to evaluate the benefits of ERAS in terms of cost-effectiveness and postoperative outcomes in single-level lumbar microdiscectomy.METHODSThis study was a single-center retrospective comparing costs and outcomes before and after implementation of the ERAS pathway. Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18665DOI Listing

Introduction. Enhanced recovery after surgery (ERAS) in spine.

Neurosurg Focus 2019 Apr;46(4):E1

4Department of Neurosurgery, University of Utah, Salt Lake City, Utah.

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http://dx.doi.org/10.3171/2019.1.FOCUS1957DOI Listing

Imaging characteristics of chronic spinal cord injury identified during screening for a cell transplantation clinical trial.

Neurosurg Focus 2019 Mar;46(3):E8

Departments of1Neurological Surgery.

OBJECTIVEIn cell transplantation trials for spinal cord injury (SCI), quantifiable imaging criteria that serve as inclusion criteria are important in trial design. The authors' institutional experience has demonstrated an overall high rate of screen failures. The authors examined the causes for trial exclusion in a phase I, open-lab clinical trial examining the role of autologous Schwann cell intramedullary transplantation. Read More

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http://dx.doi.org/10.3171/2018.12.FOCUS18593DOI Listing
March 2019
1 Read

The role of diffusion tensor imaging in the diagnosis, prognosis, and assessment of recovery and treatment of spinal cord injury: a systematic review.

Neurosurg Focus 2019 Mar;46(3):E7

2Division of Neurosurgery.

OBJECTIVEDiffusion tensor imaging (DTI) is an MRI tool that provides an objective, noninvasive, in vivo assessment of spinal cord injury (SCI). DTI is significantly better at visualizing microstructures than standard MRI sequences. In this imaging modality, the direction and amplitude of the diffusion of water molecules inside tissues is measured, and this diffusion can be measured using a variety of parameters. Read More

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http://dx.doi.org/10.3171/2019.1.FOCUS18591DOI Listing
March 2019
3 Reads

Spinal cord injury and the human microbiome: beyond the brain-gut axis.

Neurosurg Focus 2019 Mar;46(3):E11

1Department of Neurosurgery.

In addition to standard management for the treatment of the acute phase of spinal cord injury (SCI), implementation of novel neuroprotective interventions offers the potential for significant reductions in morbidity and long-term health costs. A better understanding of the systemic changes after SCI could provide insight into mechanisms that lead to secondary injury. An emerging area of research involves the complex interplay of the gut microbiome and the CNS, i. Read More

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http://dx.doi.org/10.3171/2018.12.FOCUS18206DOI Listing
March 2019
1 Read

Stem cell therapies for acute spinal cord injury in humans: a review.

Neurosurg Focus 2019 Mar;46(3):E10

Recent advances in stem cell biology present significant opportunities to advance clinical applications of stem cell-based therapies for spinal cord injury (SCI). In this review, the authors critically analyze the basic science and translational evidence that supports the use of various stem cell sources, including induced pluripotent stem cells, oligodendrocyte precursor cells, and mesenchymal stem cells. They subsequently explore recent advances in stem cell biology and discuss ongoing clinical translation efforts, including combinatorial strategies utilizing scaffolds, biogels, and growth factors to augment stem cell survival, function, and engraftment. Read More

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http://dx.doi.org/10.3171/2018.12.FOCUS18602DOI Listing
March 2019
3 Reads

Immunosuppressive mechanisms for stem cell transplant survival in spinal cord injury.

Neurosurg Focus 2019 Mar;46(3):E9

2Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California.

Spinal cord injury (SCI) has been associated with a dismal prognosis-recovery is not expected, and the most standard interventions have been temporizing measures that do little to mitigate the extent of damage. While advances in surgical and medical techniques have certainly improved this outlook, limitations in functional recovery continue to impede clinically significant improvements. These limitations are dependent on evolving immunological mechanisms that shape the cellular environment at the site of SCI. Read More

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http://dx.doi.org/10.3171/2018.12.FOCUS18589DOI Listing
March 2019
1 Read

Value of aggressive surgical and intensive care unit in elderly patients with traumatic spinal cord injury.

Neurosurg Focus 2019 Mar;46(3):E3

Departments of1Neurological Surgery.

OBJECTIVEThe elderly are a growing subpopulation within traumatic spinal cord injury (SCI) patients. Studies have reported high morbidity and mortality rates in elderly patients who undergo surgery for SCI. In this study, the authors compare the perioperative outcomes of surgically managed elderly SCI patients with those of a younger cohort and those reported in the literature. Read More

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http://dx.doi.org/10.3171/2018.12.FOCUS18555DOI Listing
March 2019
3 Reads

Efficacy of riluzole in the treatment of spinal cord injury: a systematic review of the literature.

Neurosurg Focus 2019 Mar;46(3):E6

OBJECTIVERiluzole is a glutamatergic modulator that has recently shown potential for neuroprotection after spinal cord injury (SCI). While the effects of riluzole are extensively documented in animal models of SCI, there remains heterogeneity in findings. Moreover, there is a paucity of data on the pharmacology of riluzole and its effects in humans. Read More

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https://thejns.org/view/journals/neurosurg-focus/46/3/articl
Publisher Site
http://dx.doi.org/10.3171/2019.1.FOCUS18596DOI Listing
March 2019
8 Reads

A case series of penetrating spinal trauma: comparisons to blunt trauma, surgical indications, and outcomes.

Neurosurg Focus 2019 Mar;46(3):E4

1Department of Neurosurgery and.

OBJECTIVEWhile blunt spinal trauma accounts for the majority of spine trauma, penetrating injuries affect a substantial number of patients. The goal of this study was to examine the epidemiology of penetrating spine injuries compared with blunt injuries and review the operative interventions and outcomes in the penetrating spine injury group.METHODSThe prospectively maintained trauma database was queried for spinal fractures from 2012 to 2018. Read More

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http://dx.doi.org/10.3171/2018.12.FOCUS18577DOI Listing
March 2019
4 Reads

Correlation of magnetic resonance diffusion tensor imaging parameters with American Spinal Injury Association score for prognostication and long-term outcomes.

Neurosurg Focus 2019 Mar;46(3):E2

OBJECTIVEConventional MRI is routinely used to demonstrate the anatomical site of spinal cord injury (SCI). However, quantitative and qualitative imaging parameters have limited use in predicting neurological outcomes. Currently, there are no reliable neuroimaging biomarkers to predict short- and long-term outcome after SCI. Read More

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http://dx.doi.org/10.3171/2018.12.FOCUS18595DOI Listing
March 2019
2 Reads

Introduction. Acute spinal cord injury.

Neurosurg Focus 2019 Mar;46(3):E1

1Department of Neurological Surgery, University of California, San Francisco, California.

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http://dx.doi.org/10.3171/2019.1.FOCUS1912DOI Listing
March 2019
1 Read

Superficial temporal artery-superior cerebellar artery bypass and trapping of a fusiform aneurysm using intradural anterior petrosectomy: technical case report and anatomical study.

Neurosurg Focus 2019 Feb;46(2):E9

1Department of Neurosurgery, Saitama Medical Center; and.

Aneurysms at the distal portion of the superior cerebellar artery (SCA) are very rare. Because of the deep location and a propensity for nonsaccular morphology, aneurysm trapping or endovascular occlusion of the parent artery are the usual treatment options, which are associated with varying risks of ischemic complications. The authors report on a 60-year-old woman who had a 3. Read More

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http://dx.doi.org/10.3171/2018.11.FOCUS18432DOI Listing
February 2019
1 Read

Carotid-vertebral artery bypass with saphenous vein graft for symptomatic vertebrobasilar insufficiency.

Neurosurg Focus 2019 Feb;46(2):E8

1Department of Neurosurgery, Peking University First Hospital; and.

OBJECTIVESymptomatic steno-occlusion of the proximal vertebral artery (VA) or subclavian artery (ScA) heralds a poor prognosis and high risk of stroke recurrence despite medical therapy, including antiplatelet or anticoagulant drugs. In some cases, the V2 segment of the cervical VA is patent and perfused via collateral vessels. The authors describe 7 patients who were successfully treated by external carotid artery (ECA)-saphenous vein (SV)-VA bypass. Read More

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http://dx.doi.org/10.3171/2018.11.FOCUS18360DOI Listing
February 2019
3 Reads

Feasibility and safety of intraoperative BOLD functional MRI cerebrovascular reactivity to evaluate extracranial-to-intracranial bypass efficacy.

Neurosurg Focus 2019 Feb;46(2):E7

1Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland.

Blood oxygenation level-dependent functional MRI cerebrovascular reactivity (BOLD-CVR) is a contemporary technique to assess brain tissue hemodynamic changes after extracranial- intracranial (EC-IC) bypass flow augmentation surgery. The authors conducted a preliminary study to investigate the feasibility and safety of intraoperative 3-T MRI BOLD-CVR after EC-IC bypass flow augmentation surgery. Five consecutive patients selected for EC-IC bypass revascularization underwent an intraoperative BOLD-CVR examination to assess early hemodynamic changes after revascularization and to confirm the safety of this technique. Read More

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http://dx.doi.org/10.3171/2018.11.FOCUS18502DOI Listing
February 2019
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Clinical factors influencing the development of extracranial-intracranial bypass graft for steno-occlusive cerebrovascular disease.

Neurosurg Focus 2019 Feb;46(2):E5

1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo; and.

OBJECTIVEEffectively retaining the patency of the extracranial-intracranial (ECIC) bypass is one of the most important factors in improving long-term results; however, the factors influencing bypass patency have not been discussed much. Therefore, the authors investigated factors influencing the development of the bypass graft.METHODSIn this retrospective study, the authors evaluated 49 consecutive hemispheres in 47 adult Japanese patients who had undergone ECIC bypass for chronic steno-occlusive cerebrovascular disease. Read More

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http://dx.doi.org/10.3171/2018.11.FOCUS18500DOI Listing
February 2019
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Extracranial-intracranial bypass approach to cerebral revascularization: a historical perspective.

Neurosurg Focus 2019 Feb;46(2):E2

1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and.

While the majority of cerebral revascularization advancements were made in the last century, it is worth noting the humble beginnings of vascular surgery throughout history to appreciate its progression and application to neurovascular pathology in the modern era. Nearly 5000 years of basic human inquiry into the vasculature and its role in neurological disease has resulted in the complex neurosurgical procedures used today to save and improve lives. This paper explores the story of the extracranial-intracranial approach to cerebral revascularization. Read More

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http://dx.doi.org/10.3171/2018.11.FOCUS18527DOI Listing
February 2019
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Cerebral revascularization after the Carotid Occlusion Surgery Study: what candidates remain, and can we do better?

Neurosurg Focus 2019 Feb;46(2):E3

Departments of1Neurosurgery and.

OBJECTIVECerebral revascularization for carotid occlusion was previously a mainstay procedure for the cerebrovascular neurosurgeon. However, the 1985 extracranial-intracranial bypass trial and subsequently the Carotid Occlusion Surgery Study (COSS) provided level 1 evidence via randomized controlled trials against bypass for symptomatic atherosclerotic carotid occlusion disease. However, in a small number of patients optimal medical therapy fails, and some patients with flow-limiting stenosis develop a perfusion-dependent neurological examination. Read More

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http://dx.doi.org/10.3171/2018.11.FOCUS18536DOI Listing
February 2019
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Internal maxillary artery bypass for the treatment of complex middle cerebral artery aneurysms.

Neurosurg Focus 2019 Feb;46(2):E10

1Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, China.

OBJECTIVEThe rapid innovation of the endovascular armamentarium results in a decreased number of indications for a classic surgical approach. However, a middle cerebral artery (MCA) aneurysm remains the best example of one for which results have favored microsurgery over endovascular intervention. In this study, the authors aimed to evaluate the experience and efficacy regarding surgical outcomes after applying internal maxillary artery (IMA) bypass for complex MCA aneurysms (CMCAAs). Read More

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http://dx.doi.org/10.3171/2018.11.FOCUS18457DOI Listing
February 2019
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