Neurospine最新文献_第9页

Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration. 意外硬膜切开修补术的全内窥镜技术实用指南：外科视频演示。

IF 3.8 2区医学

Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2449054.527

Warayos Trathitephun, Jackapol Kamolpak, Siravich Suvithayasiri

{"title":"Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration.","authors":"Warayos Trathitephun, Jackapol Kamolpak, Siravich Suvithayasiri","doi":"10.14245/ns.2449054.527","DOIUrl":"https://doi.org/10.14245/ns.2449054.527","url":null,"abstract":"This surgical video demonstrates the full-endoscopic repair of an incidental durotomy, offering practical guidance and insights into the technique. Incidental dural tears occur in up to 1% of lumbar endoscopic surgeries, with risk factors including interlaminar approaches, stenosis decompression, and power drill usage. Although many dural tears are managed with sealant or gel foam, no standard exists for when surgical repair is necessary. Complications such as cerebrospinal fluid leakage, radiculopathy, and neurological deficits can arise, prompting the need for effective repair techniques. A 50-year-old man presented with bilateral leg claudication due to lumbar stenosis (L4-S1). Full-endoscopic decompression was performed, during which an incidental 10-mm dural tear occurred at L5-S1. The nerve root was repositioned into the dural sac, and the tear was repaired using a 6-0 prolene suture with a knot pusher under endoscopic guidance. Gelfoam was applied to aid compression, and irrigation pressure was reduced to prevent increased intracranial pressure. The patient was mobilized after 48 hours and experienced significant symptom improvement without neurological deficits. We propose that dural tears should be repaired when possible to prevent complications. Surgeon experience, tear size, and location are critical factors. This case demonstrates a simple, effective endoscopic repair method, though further studies are needed to establish its long-term efficacy.","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"21 4","pages":"1102-1105"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

First-in-Human Trial of Photodynamic Therapy for Spinal Cord Malignant Astrocytoma: Study Protocol. 光动力疗法治疗脊髓恶性星形细胞瘤的首次人体试验：研究方案。

IF 3.8 2区医学

Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2449272.636

Toshiki Endo, Yoshiharu Takahashi, Taketo Nishizawa, Tatsuya Sasaki, Aya Sato, Shinjiro Fukami, Satoshi Miyata, Jiro Akimoto

{"title":"First-in-Human Trial of Photodynamic Therapy for Spinal Cord Malignant Astrocytoma: Study Protocol.","authors":"Toshiki Endo, Yoshiharu Takahashi, Taketo Nishizawa, Tatsuya Sasaki, Aya Sato, Shinjiro Fukami, Satoshi Miyata, Jiro Akimoto","doi":"10.14245/ns.2449272.636","DOIUrl":"https://doi.org/10.14245/ns.2449272.636","url":null,"abstract":"Our extensive basic research on photodynamic therapy (PDT) application in models of intracranial malignant astrocytoma led to its clinical application for intracranial malignant astrocytoma in Japan. Having considered the safety and effectiveness of this pathology, we initiate a first-in-human clinical study of PDT for spinal cord malignant astrocytoma. This study has an open-label, single-arm design. The initial follow-up period is 12 months, at the end of which we will quantify survival after PDT for spinal cord malignant astrocytoma as primary objective. The secondary objective is to quantify the overall progression-free survival of treated patients and the percentage of patients surviving 6 months after PDT without recurrence. Twenty patients suffering from spinal cord malignant astrocytoma will be recruited. In particular, 10 of those should be newly diagnosed World Health Organization grade 4. After obtaining consent, each patient will receive a single intravenous injection of talaporfin sodium (40 mg/m2) 1 day before tumor resection. One day after completing tumor removal, the residual lesion and/or resection cavity will be irradiated using a 664-nm semiconductor laser with a radiation power density of 150 mW/cm2 and a radiation energy density of 27 J/cm2. The procedure will be performed 22-26 hours after talaporfin sodium administration. This study protocol has been reviewed and approved by the Certified Committee in the Japanese Ministry of Health, Labor, and Welfare University Hospital Medical Information Network Clinical Trials Registry (Japan Registry of Clinical Trials number, jRCT2021220040).","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"21 4","pages":"1276-1282"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

C7-T1 Full-Endoscopic Posterior Foraminotomy and Sequestrectomy Using Navigation. C7-T1全内窥镜下椎间孔切开术和导航固定式切开术。

IF 3.8 2区医学

Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2449002.501

Soubach Saravanan, Jean Yves Fournier, Alexandre Simonin

{"title":"C7-T1 Full-Endoscopic Posterior Foraminotomy and Sequestrectomy Using Navigation.","authors":"Soubach Saravanan, Jean Yves Fournier, Alexandre Simonin","doi":"10.14245/ns.2449002.501","DOIUrl":"10.14245/ns.2449002.501","url":null,"abstract":"The main objective of this case and video is to demonstrate the surgical technique of navigated full-endoscopic decompression and sequestrectomy at the C7-T1 level to alleviate C8 nerve root compression and manage cervicobrachialgia. Cervicobrachialgia resulting from C7-T1 disc herniation is a quite rare yet painful condition that can significantly impair motor function in the upper limb. Traditionally, open surgeries can be invasive, with prolonged recovery times and/or fusion of the level with adjacent segment disease. Posterior full-endoscopic approach offers a minimally invasive alternative that allows for quicker recovery, less postoperative pain, and improved outcomes. By preserving motion, it also prevents adjacent segment disease. A 72-year-old female presented with sudden-onset cervicobrachial pain radiating to the ulnar side of the right arm, coupled with paresthesia and weakness of the flexors/interosseous muscles (Medical Research Council=M3). Magnetic resonance imaging confirmed a large right-sided C7-T1 disc herniation compressing the C8 nerve root. A full-endoscopic C7-T1 posterior foraminotomy and sequestrectomy was performed with navigation. The patient experienced immediate relief from pain and improved motor function in the right hand postoperatively. Posterior full-endoscopic foraminotomy and sequestrectomy of the C7-T1 disc herniation is effective for treating cervicobrachialgia due to C8 nerve compression. The minimally invasive approach demonstrated in this video highlights the technique and stresses the advantage of navigation in the lower cervical spine.","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"21 4","pages":"1168-1171"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Commentary on "Full-Endoscopic Resection of a Lumbar Intradural Tumor (Schwannoma): Video Case Report and Description of the Surgical Technique". “全内镜切除腰椎硬膜内肿瘤（神经鞘瘤）：视频病例报告及手术技术描述”评论。

IF 3.8 2区医学

Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2449382.691

Yong Ahn

引用次数: 0

A Commentary on "Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration". “全内窥镜技术在意外硬膜切开修补术中的实用指导：一个外科视频演示”评论。

IF 3.8 2区医学

Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2449374.687

David Del Curto

引用次数: 0

Hybrid Endoscopic Thoracic Discectomy Using Robotic Arm and Navigation for Highly Migrated Calcified Disc Herniation. 机械臂与导航的混合内镜下胸椎椎间盘切除术治疗高度移位的钙化椎间盘突出症。

IF 3.8 2区医学

Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2449024.512

Yi-Hao Liang, Rohit Akshay Kavishwar, Maria Pedraza, Dimas Rahman Setiawan, Jae-Hwan Kim, Jin-Sung Kim

{"title":"Hybrid Endoscopic Thoracic Discectomy Using Robotic Arm and Navigation for Highly Migrated Calcified Disc Herniation.","authors":"Yi-Hao Liang, Rohit Akshay Kavishwar, Maria Pedraza, Dimas Rahman Setiawan, Jae-Hwan Kim, Jin-Sung Kim","doi":"10.14245/ns.2449024.512","DOIUrl":"10.14245/ns.2449024.512","url":null,"abstract":"This video provides a step-by-step guide for performing the hybrid endoscopic thoracic discectomy using navigation and robotic arm for addressing high migrated calcified disc herniation. With the development of techniques, endoscopic spine surgery has emerged as a reliable treatment for thoracic myelopathy. This approach offers high-resolution, off-axis visualization of the surgical field. The field is poised to advance further as endoscopic instruments are refined, becoming less invasive and more precise through the integration of navigation and robot-assisted systems. A 62-year-old woman presented to us with chief complaints of both legs weakness. She had difficulty standing and walking after squatted due to weakness in her legs and her Oswestry Disability Index score was 66. On examination her both side knee extension and ankle dorsiflexion were grade 4 without dysesthesia. The imaging examination confirmed the diagnosis of thoracic myelopathy caused by a highly migrated calcified disc herniation at T5-6 level. The patient underwent an endoscopic thoracic discectomy using robotic arm and navigation for addressing highly migrated calcified disc herniation, resulting in an excellent outcome. The continuous development of navigation and robotic systems in endoscopic thoracic surgery enhanced accuracy in surgical incisions and instrument placement, as well as improved efficiency in locating pathology and achieving precise decompression. Endoscopic thoracic discectomy combines full-endoscopy and unilateral biportal endoscopic (UBE) techniques to leverage the benefits of both approaches, including the cross-viewing of full-endoscopy cannula and the use of larger Kerrison rongeurs under UBE.","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"21 4","pages":"1126-1130"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic Contralateral Transaxillary Discectomy for Recurrent Disc Herniation. 内镜对侧经腋窝椎间盘切除术治疗复发性椎间盘突出症。

IF 3.8 2区医学

Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2449020.510

Sohrab Gollogly, James Yue, Facundo Van Isseldyk, Jin-Sung Kim, Mazda Farshad

{"title":"Endoscopic Contralateral Transaxillary Discectomy for Recurrent Disc Herniation.","authors":"Sohrab Gollogly, James Yue, Facundo Van Isseldyk, Jin-Sung Kim, Mazda Farshad","doi":"10.14245/ns.2449020.510","DOIUrl":"10.14245/ns.2449020.510","url":null,"abstract":"This video aims to describe an endoscopic surgical approach for accessing difficult to reach pathology such as disc herniations after previous surgery. The relatively small size of endoscopic instruments facilitates significant freedom of movement inside the spinal canal. The authors have experience with interlaminar approaches for contralateral pathology such as disc herniations, recurrent disc herniations, spinal stenosis, and facet cysts. The advantages of starting from the opposite side of the canal in a revision situation include the ability to establish a clear plane between the dura and the borders of the canal and visualize the disc from a different angle than the index operation. Contralateral approaches to residual or recurrent herniations can be performed with an \"over the top\" technique, navigating dorsal to the thecal sac to reach the far side of the canal. In the associated video we demonstrate a novel technique, a contralateral transaxillary endoscopic approach to a recurrent disc herniation at the L5-S1 level in a young male collegiate wrestler. In our experience, we have found this particular approach to be useful in patients with an early take off of the S1 nerve root which creates a large axillary window. In several instances this technique has allowed us to inspect the area of the reherniation from both the axilla and over the top of the thecal sac. This particular patient has a large recurrence 2 years after an open microscopic hemilaminotomy and discectomy. In this instance, an approach was chosen that navigates dorsal to the S1 nerve root and ventral to the thecal sac, starting on the opposite side of the spinal canal from the herniation. This approach is described as a contralateral interlaminar transaxillary discectomy.","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"21 4","pages":"1154-1159"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transforaminal Endoscopic Lumbar Foraminotomy for Iatrogenic Foraminal Stenosis Following Vertebroplasty. 椎体成形术后经椎间孔内窥镜腰椎椎间孔切开术治疗医源性椎间孔狭窄。

IF 3.8 2区医学

Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2449052.526

Yong Ahn, Do-Yeon Rhee

{"title":"Transforaminal Endoscopic Lumbar Foraminotomy for Iatrogenic Foraminal Stenosis Following Vertebroplasty.","authors":"Yong Ahn, Do-Yeon Rhee","doi":"10.14245/ns.2449052.526","DOIUrl":"https://doi.org/10.14245/ns.2449052.526","url":null,"abstract":"We present a case of iatrogenic lumbar foraminal stenosis caused by bone-cement leakage during vertebroplasty, successfully managed using transforaminal endoscopic lumbar foraminotomy (TELF). Vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures (VCFs); however, complications such as bone-cement leakage can lead to vascular or neurological issues, including lumbar radiculopathy. TELF is a minimally invasive surgical option for addressing various forms of lumbar foraminal stenosis. An 82-year-old female patient presented to Gachon University Gil Medical Center with severe right inguinal pain radiating to the anterior thigh and knee. Six months prior, she had undergone vertebroplasty at the L3 level for an osteoporotic VCF at another hospital. Following the procedure, she developed radicular leg pain with a diminished knee jerk reflex, which progressively worsened despite extensive conservative treatment. Magnetic resonance imaging and computed tomography revealed right-sided L3-4 foraminal stenosis caused by bone-cement leakage from the prior vertebroplasty. TELF was performed under local anesthesia to decompress the affected area. Bone-cement fragments, along with hypertrophic bone and ligaments, were successfully removed, achieving sufficient decompression of the exiting nerve root. The patient experienced immediate postoperative pain relief. This case represents the first documented instance of endoscopic decompression for iatrogenic foraminal stenosis following vertebroplasty. TELF, performed safely under local anesthesia, demonstrates its effectiveness as a minimally invasive solution for this rare complication.","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"21 4","pages":"1137-1140"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

National Trends in Lumbar Degenerative Spondylolisthesis With Stenosis Treated With Fusion Versus Decompression. 腰椎退行性椎体滑脱伴狭窄行融合与减压治疗的全国趋势。

IF 3.8 2区医学

Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2448624.312

Jacob R Ball, Matthew C Gallo, Kareem Kebaish, Nicole Hang, Andy Ton, Fergui Hernandez, Marc Abdou, William J Karakash, Jeffrey C Wang, Raymond J Hah, Ram K Alluri

{"title":"National Trends in Lumbar Degenerative Spondylolisthesis With Stenosis Treated With Fusion Versus Decompression.","authors":"Jacob R Ball, Matthew C Gallo, Kareem Kebaish, Nicole Hang, Andy Ton, Fergui Hernandez, Marc Abdou, William J Karakash, Jeffrey C Wang, Raymond J Hah, Ram K Alluri","doi":"10.14245/ns.2448624.312","DOIUrl":"https://doi.org/10.14245/ns.2448624.312","url":null,"abstract":"Objective: The purpose of this study is to describe utilization, demographics, complications, and revisions for patients with degenerative spondylolisthesis (DS) with stenosis undergoing decompression or decompression with fusion in the United States.Methods: A national insurance database was used to identify patients who underwent either decompression and fusion or decompression alone for management of DS from 2010-2022. Utilization trends, demographics, and complications for each procedure were compared.Results: A total of 162,878 patients were identified, of which 78,043 patients underwent combined single-level lumbar decompression and fusion and 84,835 underwent single-level lumbar decompression alone. Between 2010-2021, lumbar decompression and fusion became the predominant surgical intervention for DS in 2016 and continued to account for more than half of all procedures during the remainder of the study period. Factors such as age, sex, comorbidities, geographic region, and physician specialty training were associated with procedure choice. Decompression with fusion was associated with a lower risk of revision surgery up to 5 years postoperatively and an overall lower incidence of 30-day complications.Conclusion: Decompression with fusion has become the most common treatment for lumbar DS over the past decade despite a lack of compelling evidence supporting its use compared to decompression alone. A variety of patient and surgeon-specific factors is associated with procedure choice. After accounting for cofounders, we identified treatment-specific complications that may be valuable when counseling patients.","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"21 4","pages":"1068-1077"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New Insights Into Risk Factors for Proximal Junctional Failure in Adult Spinal Deformity Surgery - A Commentary on "Proximal Junctional Failure Development Despite Achieving Ideal Sagittal Correction According to Age-Adjusted Alignment Target in Patients With Adult Spinal Deformity: Risk Factor Analysis of 196 Cases Undergoing Low Thoracic to Pelvic Fusion". 成人脊柱畸形手术中近端连接功能衰竭危险因素的新认识——对“成人脊柱畸形患者在达到理想矢状面矫正后仍发生近端连接功能衰竭：196例低胸骨盆融合手术的危险因素分析”的评论。

IF 3.8 2区医学

Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2449350.675

Masayuki Miyagi, Gen Inoue, Masashi Takaso

引用次数: 0