Archivos de la categoría Revistas

Spine: January 2015

The Spine Journal

January 2015 Volume 15, Issue 1, p1-212, e1-e8
is Free

Spine Free Articles

Correlation of Cord Signal Change With Physical Examination Findings in Patients With Cervical Myelopathy

Despite the numerous studies examining the relationship of cord signal changes CSC with outcomes of both surgical and nonsurgical treatment of cervical spondylotic myelopathy CSM, there have not been any studies examining specifically the relationship of physical examination findings with CSC.

CSC visualized on MRI correlates poorly with the upper extremity reflex examination in patients with cervical myelopathy. Of the pathological reflexes, Hoffman sign has the strongest association with CSC, but still was only positive in 67% of cases. More sensitive clinical measures need to be developed to more accurately associate CSC detected on MRI to the clinical severity of cervical spondylotic myelopathy. 1)

1) Nemani VM, Kim HJ, Piyaskulkaew C, Nguyen JT, Riew KD. Correlation of cord signal change with physical examination findings in patients with cervical myelopathy. Spine (Phila Pa 1976). 2015 Jan 1;40(1):6-10. doi: 10.1097/BRS.0000000000000659. PubMed PMID: 25341986.

 

Psychometric Properties of the Modified Japanese Orthopaedic Association Scale in Patients With Cervical Spondylotic Myelopathy

The modified Japanese Orthopaedic Association scale (mJOA) demonstrates both convergent and divergent validity and is responsive to change. These results validate existing studies and justify the use of this tool in further research efforts. Kopjar et al. hope this study will promote the global standardization of assessment tools and encourage clinicians to use the mJOA, alongside other ancillary measures, to evaluate functional status in patients with cervical spondylotic myelopathy (CSM). 1).

1) Kopjar B, Tetreault L, Kalsi-Ryan S, Fehlings M. Psychometric properties of the modified Japanese orthopaedic association scale in patients with cervical spondylotic myelopathy. Spine (Phila Pa 1976). 2015 Jan 1;40(1):E23-8. doi:10.1097/BRS.0000000000000648. PubMed PMID: 25341993.

Journal of Neurosurgery January 2015

Free Articles

Journal of Neurosurgery

Improved preservation of function during acoustic neuroma surgery

Outcomes after vestibular schwannoma surgery can be improved by avoiding irreversible injury, such as crush and thermal injury, and by maximizing the recuperation period after reversible injury, such as traction injury, through use of the extended recuperation treatment strategy.

Journal of Neurosurgery: Spine

Two-level total disc replacement with Mobi-C cervical artificial disc versus anterior discectomy and fusion: a prospective, randomized, controlled multicenter clinical trial with 4-year follow-up results

The data from this investigational device exemption (IDE )study through 48 months signify a number of clinically relevant benefits for total disc replacement (TDR) over anterior cervical discectomy and fusion (ACDF). Patients experienced improved clinical outcomes with TDR—including improvement in pain and function outcomes and superiority in overall primary endpoint success.
Additionally, incidences of adjacent-segment degeneration
and subsequent surgeries were reduced with TDR.
We expect that future studies and also longer-term followup
of this patient cohort may continue to establish 2-level
cervical TDR as a superior surgical option for symptomatic
degenerative disc disease.

Journal of Neurosurgery: Pediatrics

The supracerebellar-transtentorial approach to posteromedial temporal lesions in children with refractory epilepsy

Microsurgical treatment of arteriovenous malformations in pediatric patients: the Boston Children’s Hospital experience

Neurosurgical Focus

Introduction: A focus on low-grade glioma

Functional preoperative and intraoperative mapping and monitoring: increasing safety and efficacy in glioma surgery

Introduction of a standardized multimodality image protocol for navigation-guided surgery of suspected low-grade gliomas

Resection of cerebral gangliogliomas causing drug-resistant epilepsy: short- and long-term outcomes using intraoperative MRI and neuronavigation

Survival and low-grade glioma: the emergence of genetic information

Journal of Neurosurgery: Pediatrics Noviembre

Cover Image

FEATURED ARTICLE

Avoiding early complications and reoperation during occipitocervical fusion in pediatric patients

Occipitocervical fusion for pediatric occipitocervical  instability has a high rate of success in a wide variety of challenging circumstances; however, identifying potential risk factors can help to target variables that should be the focus of improvement.

Pediatric patients in the cohort of Mazur et al., with postoperative wound infections requiring surgical debridement had higher surgical failure rates after occipitocervical fusion. Those with skeletal dysplasia and congenital spinal anomaly were more likely to require reoperation for hardware failure. Better understanding of the mode of surgical failure may enable surgeons to develop strategies to decrease the need for reoperation in pediatric patients with OC instability 1).

1) Mazur MD, Sivakumar W, Riva-Cambrin J, Jones J, Brockmeyer DL. Avoiding early complications and reoperation during occipitocervical fusion in pediatric patients. J Neurosurg Pediatr. 2014 Aug 29:1-11. [Epub ahead of print] PubMed PMID: 25171720.

 

Journal of Neurosurgery: Spine November 2014

FEATURED ARTICLE

Adverse events in emergency oncological spine surgery: a prospective analysis

Cover ImageEmergency oncological spine surgery are generally palliative to reduce pain and improve patients neurology and health-related quality of life. In individuals with limited life expectancy, adverse events (AEs) can have catastrophic implications; therefore, an accurate AE incidence must be considered in the surgical decision-making process.

Dea et al., carried out a Prospective cohort study in a quaternary care referral center that included consecutive patients admitted between January 1, 2009, and December 31, 2012. Inclusion criteria were all patients undergoing emergency surgery for metastatic spine disease. AE data were reported and collected with the Spine AdVerse Events Severity System, version 2 [SAVES V2] forms) at weekly dedicated morbidity and mortality rounds attended by attending surgeons, residents, fellows, and nursing staff.

A total of 101 patients (50 males, 51 females) met the inclusion criteria and had complete data. Seventysix patients (76.2%) had at least 1 AE, and 11 patients (10.9%) died during their admission. Intraoperative surgical AEs were observed in 32% of patients (9.9% incidental durotomy, 16.8% blood loss > 2 L). Transient neurological deterioration occurred in 6 patients (5.9%). Infectious complications in this patient population were significant (surgical site 6%, other 50.5%). Delirium complicated the postoperative period in 20.8% of cases.

When evaluated in a rigorous prospective manner, metastatic spine surgery is associated with a higher morbidity rate than previously reported. This AE incidence must be considered by the patient, oncologist, and surgeon to determine appropriate management and preventative strategies to reduce AEs in this fragile patient population.

Dea N, Versteeg A, Fisher C, Kelly A, Hartig D, Boyd M, Paquette S, Kwon BK, Dvorak M, Street J. Adverse events in emergency oncological spine surgery: a prospective analysis. J Neurosurg Spine. 2014 Aug 22:1-6. [Epub ahead of print] PubMed PMID: 25147976.