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  • Journal of Neurosurgery Publishing Group (JNSPG)  (6)
  • Unknown  (6)
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  • Journal of Neurosurgery Publishing Group (JNSPG)  (6)
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  • Unknown  (6)
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  • 1
    Online Resource
    Online Resource
    Effectiveness of deformity-correction surgery for primary degenerative sagittal imbalance: a meta-analysis
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2017
    In:  Journal of Neurosurgery: Spine Vol. 27, No. 5 ( 2017-11), p. 540-551
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 27, No. 5 ( 2017-11), p. 540-551
    Abstract: As life expectancy continues to increase, primary degenerative sagittal imbalance (PDSI) is diagnosed in an increasing number of elderly people. Although corrective surgery for this sagittal deformity is becoming more popular, the effectiveness of the procedure remains unclear. The authors aimed to collate the available evidence on the effectiveness and complications of deformity-correction surgery in patients with PDSI. METHODS The authors carried out a meta-analysis of clinical studies regarding deformity correction in patients with PDSI. The studies were identified through searches of the PubMed, Embase, Web of Science, and Cochrane databases. Surgery outcomes were evaluated and overall treatment effectiveness was assessed in terms of the minimum clinically important difference (MCID) in Oswestry Disability Index (ODI) values and pain levels according to visual analog scale (VAS) scores and in terms of restoration of spinopelvic parameters to within a normal range. Data are expressed as mean differences with 95% CIs. RESULTS Ten studies comprising 327 patients were included. The VAS and ODI values improved after deformity-correction surgery. The smallest treatment effect exceeded the MCID for VAS values (4.15 [95% CI 3.48–4.82]) but not for ODI values (18.11 [95% CI 10.99–25.23] ). At the final follow-up visit, the mean lumbar lordosis angle (−38.60° [95% CI −44.19° to −33.01°]), thoracic kyphosis angle (31.10° [95% CI 24.67°–37.53°] ), C-7 sagittal vertical axis (65.00 mm [95% CI 35.27–94.72 mm]), and pelvic tilt angle (30.82° [95% CI 24.41°–37.23°] ) remained outside their normal ranges. Meta-regression analyses revealed a significant effect of ODI change in relation to lumbar lordosis change (p = 0.004). After a mean of 2 years after deformity correction, the mean lumbar lordosis angle and C-7 sagittal vertical axis decreased by 5.82° and 38.91 mm, respectively, and the mean thoracic kyphosis angle increased by 4.7°. The incidences of proximal junctional kyphosis and pseudarthrosis were 23.7% and 12.8%, respectively. CONCLUSIONS Deformity correction substantially relieves back pain for about 2 years in adult patients with PDSI. Sufficient surgical restoration of lumbar lordosis can lead to substantial improvement in patient disability and reduced decompensation. Deformity correction represents a viable therapeutic option for patients with PDSI, but further technical advancements are necessary to achieve sufficient lumbar lordosis and reduce complication rates.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2017.3.SPINE161134
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2017
    Location Call Number Limitation Availability
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Direct visualization of deep brain stimulation targets in Parkinson disease with the use of 7-tesla magnetic resonance imaging : Clinical article
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2010
    In:  Journal of Neurosurgery Vol. 113, No. 3 ( 2010-09), p. 639-647
    Details
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 113, No. 3 ( 2010-09), p. 639-647
    Abstract: A challenge associated with deep brain stimulation (DBS) in treating advanced Parkinson disease (PD) is the direct visualization of brain nuclei, which often involves indirect approximations of stereotactic targets. In the present study, the authors compared T2*-weighted images obtained using 7-T MR imaging with those obtained using 1.5- and 3-T MR imaging to ascertain whether 7-T imaging enables better visualization of targets for DBS in PD. Methods The authors compared 1.5-, 3-, and 7-T MR images obtained in 11 healthy volunteers and 1 patient with PD. Results With 7-T imaging, distinct images of the brain were obtained, including the subthalamic nucleus (STN) and internal globus pallidus (GPi). Compared with the 1.5- and 3-T MR images of the STN and GPi, the 7-T MR images showed marked improvements in spatial resolution, tissue contrast, and signal-to-noise ratio. Conclusions Data in this study reveal the superiority of 7-T MR imaging for visualizing structures targeted for DBS in the management of PD. This finding suggests that by enabling the direct visualization of neural structures of interest, 7-T MR imaging could be a valuable aid in neurosurgical procedures.
    Type of Medium: Online Resource
    ISSN: 0022-3085 , 1933-0693
    URL: Article
    DOI: 10.3171/2010.3.JNS091385
    RVK:
    XA 10000
    RVK:
    XA 55270
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2010
    detail.hit.zdb_id: 2026156-1
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  • 3
    Online Resource
    Online Resource
    Delayed facial palsy after microvascular decompression for hemifacial spasm: friend or foe?
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2018
    In:  Journal of Neurosurgery Vol. 129, No. 2 ( 2018-08), p. 299-307
    Details
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 129, No. 2 ( 2018-08), p. 299-307
    Abstract: The authors investigated the incidence, clinical course, and predisposing factors associated with delayed facial palsy (DFP) following microvascular decompression (MVD). METHODS The authors reviewed the records of 310 patients (311 cases) who were followed after MVD for hemifacial spasm (HFS). Of these patients, 45 (14.5%) developed DFP after MVD. The clinical characteristics and predisposing factors of the patients with HFS were investigated to identify prognostic factors that predicted the development of DFP after MVD. Log-rank tests were used to compare times to symptom disappearance, and a logistic regression analysis was performed to compare clinical characteristics between patients who developed DFP and those who did not. RESULTS HFS was completely resolved immediately after MVD in 158 cases (50.8%), and HFS eventually disappeared in 289 (92.9%) of the cases. Of the 45 patients with DFP, 17 were men and 28 were women. DFP occurred between postoperative Days 1 and 44 (mean 9.67 days). Finally, 44 patients (97.8%) completely recovered. The average time to recovery was 3.9 months (range 1–24 months). Patients who had experienced an immediate disappearance of HFS experienced a significantly higher occurrence of DFP than those who did not (odds ratio 0.383, 95% confidence interval 0.183–0.802; p = 0.011). In addition, preoperative botulinum neurotoxin injections negatively influenced the occurrence of DFP (p = 0.016). CONCLUSIONS In this study, the incidence rate of DFP was slightly higher than previously reported values. Moreover, DFP can occur even when spasms disappear immediately after MVD, but the patients with DFP can fully recover within weeks.
    Type of Medium: Online Resource
    ISSN: 0022-3085 , 1933-0693
    URL: Article
    DOI: 10.3171/2017.3.JNS162869
    RVK:
    XA 10000
    RVK:
    XA 55270
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2018
    detail.hit.zdb_id: 2026156-1
    Location Call Number Limitation Availability
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    Online Resource
  • 4
    Online Resource
    Online Resource
    Congenital scoliosis treated with posterior vertebral column resection in patients younger than 18 years: longer than 10-year follow-up
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2016
    In:  Journal of Neurosurgery: Spine Vol. 25, No. 2 ( 2016-08), p. 225-233
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 25, No. 2 ( 2016-08), p. 225-233
    Abstract: There have been no reports on the long-term radiographic outcomes of posterior vertebral column resection (PVCR) in patients with congenital scoliosis. The purpose of this study was to evaluate the surgical outcomes and complications after PVCR and its long-term effects on correcting this deformity in children with congenital scoliosis. METHODS The authors retrospectively analyzed the medical records of 45 patients with congenital scoliosis who were younger than 18 years at the time of surgery and who underwent PVCR and fusion with pedicle screw fixation (PSF). The mean age of the patients at the time of surgery was 11.3 years (range 2.4–18.0 years), and the mean length of follow-up was 12.8 years (range 10.1–18.2 years). RESULTS The mean Cobb angle of the main curve was 46.5° before PVCR, 13.7° immediately after PVCR, and 17.6° at the last follow-up. For the compensatory cranial curve, PVCR corrected the preoperative Cobb angle of 21.2° to 9.1° postoperatively and maintained it at 10.9° at the last follow-up. For the compensatory caudal curve, the preoperative Cobb angle of 23.8° improved to 7.7° postoperatively and was 9.8° at the last follow-up. The authors noted 22 complications, and the overall incidence of complications was 48.9%. CONCLUSIONS Posterior vertebral column resection is an effective procedure for managing congenital scoliosis in patients younger than 18 years. Use of PVCR and fusion with PSF for congenital scoliosis achieved rigid fixation and satisfactory deformity correction that was maintained over the long term. However, the authors note that PVCR is a technically demanding procedure and entails risks for major complications and excessive blood loss.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2015.11.SPINE151099
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2016
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  • 5
    Online Resource
    Online Resource
    Predictors of neurologic outcome after surgery for cervical ossification of the posterior longitudinal ligament differ based on myelopathy severity: a multicenter study
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2021
    In:  Journal of Neurosurgery: Spine Vol. 34, No. 5 ( 2021-05), p. 749-758
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 34, No. 5 ( 2021-05), p. 749-758
    Abstract: The purpose of this retrospective multicenter study was to compare prognostic factors for neurological recovery in patients undergoing surgery for cervical ossification of the posterior longitudinal ligament (OPLL) based on their presenting mild, moderate, or severe myelopathy. METHODS The study included 372 consecutive patients with OPLL who underwent surgery for cervical myelopathy between 2006 and 2016 in East Asian countries with a high OPLL prevalence. Baseline and postoperative clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) myelopathy score and recovery ratio. Radiographic assessment included occupying ratio, cervical range of motion, and sagittal alignment parameters. Patient myelopathy was classified as mild, moderate, or severe based on the preoperative JOA score. Linear and multivariate regression analyses were performed to identify patient and surgical factors associated with neurological recovery stratified by baseline myelopathy severity. RESULTS The mean follow-up period was 45.4 months (range 25–140 months). The mean preoperative and postoperative JOA scores and recovery ratios for the total cohort were 11.7 ± 3.0, 14.5 ± 2.7, and 55.2% ± 39.3%, respectively. In patients with mild myelopathy, only age and diabetes correlated with recovery. In patients with moderate to severe myelopathy, older age and preoperative increased signal intensity on T2-weighted imaging were significantly correlated with a lower likelihood of recovery, while female sex and anterior decompression with fusion (ADF) were associated with better recovery. CONCLUSIONS Various patient and surgical factors are correlated with likelihood of neurological recovery after surgical treatment for cervical OPLL, depending on the severity of presenting myelopathy. Older age, male sex, intramedullary high signal intensity, and posterior decompression are associated with less myelopathy improvement in patients with worse baseline function. Therefore, myelopathy-specific preoperative counseling regarding prognosis for postoperative long-term neurological improvement should include consideration of these individual and surgical factors.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2020.8.SPINE20504
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2021
    Location Call Number Limitation Availability
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  • 6
    Online Resource
    Online Resource
    Surgical treatment for delayed pyogenic spondylitis after percutaneous vertebroplasty and kyphoplasty : Report of 4 cases
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2008
    In:  Journal of Neurosurgery: Spine Vol. 9, No. 3 ( 2008-09), p. 265-272
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 9, No. 3 ( 2008-09), p. 265-272
    Abstract: Only 6 cases of pyogenic spondylitis following vertebroplasty or kyphoplasty have been reported, and their causes remained unclear. The authors report on 4 cases of delayed pyogenic spondylitis (DPS) following vertebroplasty or ky-phoplasty for osteoporotic compression fractures and metastatic disease. Four patients presented with DPS after vertebroplasty or kyphoplasty and underwent surgical treatment. Clinical history, laboratory examination, and MR imaging confirmed the diagnosis of DPS. Anterior debridement, reconstruction, and posterior instrumented fusion were performed. The mean interval for the delayed occurrence of pyogenic spondylitis after surgery was 12.3 months. The infections were primarily bacterial in origin, but most patients also suffered diverse medical comorbidities. Despite successful treatment of the infections, comorbidity was and is a factor that compromises good results. Medical comorbidities associated with compromised immunity may increase susceptibility to DPS after vertebroplasty or kyphoplasty. In cases of incapacitating back pain after a pain-free period following either of these surgeries, evaluation of the erythrocyte sedimentation rate and C-reactive protein level and examination of contrast-enhanced MR imaging studies are essential to rule out delayed vertebral infection. Surgical treatment requires cement removal and anterior reconstruction with or without additional posterior instrumented fusion.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/SPI/2008/9/9/265
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2008
    Location Call Number Limitation Availability
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