{"title":"Power: how to get it and how to use it for the future","authors":"James I. Ausman MD, PhD (Editor)","doi":"10.1016/j.wneu.2009.09.014","DOIUrl":"10.1016/j.wneu.2009.09.014","url":null,"abstract":"","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Page 563"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.wneu.2009.09.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28655692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Surgical NeurologyPub Date : 2009-12-01DOI: 10.1016/j.surneu.2009.04.019
Michael T. Selch MD , Kevin Lin MD , Nzhde Agazaryan PhD , Steve Tenn PhD , Alessandra Gorgulho MD , John J. DeMarco PhD , Antonio A.F. DeSalles MD, PhD
{"title":"Initial clinical experience with image-guided linear accelerator-based spinal radiosurgery for treatment of benign nerve sheath tumors","authors":"Michael T. Selch MD , Kevin Lin MD , Nzhde Agazaryan PhD , Steve Tenn PhD , Alessandra Gorgulho MD , John J. DeMarco PhD , Antonio A.F. DeSalles MD, PhD","doi":"10.1016/j.surneu.2009.04.019","DOIUrl":"10.1016/j.surneu.2009.04.019","url":null,"abstract":"<div><h3>Background</h3><p>Stereotactic radiosurgery has proven a safe and effective treatment of cranial nerve sheath tumors. A similar approach should be successful for histologically identical spinal nerve sheath tumors.</p></div><div><h3>Methods</h3><p>The preliminary results of linear accelerator–based spinal radiosurgery were retrospectively reviewed for a group of 25 nerve sheath tumors. Tumor location was cervical 11, lumbar 10, and thoracic 4. Thirteen tumors caused sensory disturbance, 12 pain, and 9 weakness. Tumor size varied from 0.9 to 4.1 cm (median, 2.1 cm). Radiosurgery was performed with a 60-MV linear accelerator equipped with a micro-multileaf collimator. Median peripheral dose and prescription isodose were 12 Gy and 90%, respectively. Image guidance involved optical tracking of infrared reflectors, fusion of amorphous silicon radiographs with dynamically reconstructed digital radiographs, and automatic patient positioning. Follow-up varied from 12 to 58 months (median, 18).</p></div><div><h3>Results</h3><p>There have been no local failures. Tumor size remained stable in 18 cases, and 7 (28%) demonstrated more than 2 mm reduction in tumor size. Of 34 neurologic symptoms, 4 improved. There has been no clinical or imaging evidence for spinal cord injury. One patient had transient increase in pain and one transient increase in numbness.</p></div><div><h3>Conclusions</h3><p>Results of this limited experience indicate linear accelerator–based spinal radiosurgery is feasible for treatment of benign nerve sheath tumors. Further follow-up is necessary, but our results imply spinal radiosurgery may represent a therapeutic alternative to surgery for nerve sheath tumors. Symptom resolution may require a prescribed dose of more than 12 Gy.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 668-674"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.04.019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28386016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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