Pub Date : 2016-02-01DOI: 10.1097/WNQ.0000000000000132
S. Mukherjee, J. Yeh, H. Ellamushi
Introduction:There is a dearth of comparative outcome data on vertebroplasty for the treatment of vertebral compression fractures (VCF) according to vertebral level, number of levels, and etiology. The aim of this study was to investigate improvement of pain and function following vertebroplasty for a heterogenous cohort of patients with medically refractory VCF. Materials and Methods:A prospective observational study was conducted on a cohort of consecutive patients undergoing vertebroplasty following at least 4 weeks of failed medical management, between April 2007 and March 2012 at a single Neurosurgical center. Pain Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI) scores, analgesic usage, and complications were recorded preoperatively and at 1 day, 1 week, 1 month, 6 months, and 1 year postoperatively. Intraoperative vertebral body biopsy was performed routinely. Results:202 levels were augmented in 147 patients. The most common levels augmented were T12 (17%), L1 (18%), and L4 (10%). Significant reductions in pain VAS and ODI scores were evident at day 1 and sustained at up to 1 year postoperatively (P<0.001). They were not dependent on the level of fracture (T3-10, T11-L2, L3-S1) (P>0.05), number of levels treated (single level, 2 levels, >2 levels) (P>0.05), or etiology of VCF (P>0.05). At 1 year postoperatively, 79% (113/142) had no or reduced analgesic usage. The complication rate was 6% (9/147). There were 5 mortalities, none of which were directly related to surgery. Conclusions:Vertebroplasty for medically refractory VCF may offer sustained improvement in pain and function. The procedure is associated with low morbidity and mortality.
{"title":"Pain and Functional Outcomes Following Vertebroplasty for Vertebral Compression Fractures: A Tertiary Center Experience","authors":"S. Mukherjee, J. Yeh, H. Ellamushi","doi":"10.1097/WNQ.0000000000000132","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000132","url":null,"abstract":"Introduction:There is a dearth of comparative outcome data on vertebroplasty for the treatment of vertebral compression fractures (VCF) according to vertebral level, number of levels, and etiology. The aim of this study was to investigate improvement of pain and function following vertebroplasty for a heterogenous cohort of patients with medically refractory VCF. Materials and Methods:A prospective observational study was conducted on a cohort of consecutive patients undergoing vertebroplasty following at least 4 weeks of failed medical management, between April 2007 and March 2012 at a single Neurosurgical center. Pain Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI) scores, analgesic usage, and complications were recorded preoperatively and at 1 day, 1 week, 1 month, 6 months, and 1 year postoperatively. Intraoperative vertebral body biopsy was performed routinely. Results:202 levels were augmented in 147 patients. The most common levels augmented were T12 (17%), L1 (18%), and L4 (10%). Significant reductions in pain VAS and ODI scores were evident at day 1 and sustained at up to 1 year postoperatively (P<0.001). They were not dependent on the level of fracture (T3-10, T11-L2, L3-S1) (P>0.05), number of levels treated (single level, 2 levels, >2 levels) (P>0.05), or etiology of VCF (P>0.05). At 1 year postoperatively, 79% (113/142) had no or reduced analgesic usage. The complication rate was 6% (9/147). There were 5 mortalities, none of which were directly related to surgery. Conclusions:Vertebroplasty for medically refractory VCF may offer sustained improvement in pain and function. The procedure is associated with low morbidity and mortality.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"47–52"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61882778","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}
Pub Date : 2016-02-01DOI: 10.1097/WNQ.0000000000000128
Vedat Uruç, R. Özden, Aydıner Kalacı, Seyit K. Başarslan, H. Bayaroğullari
Thoracic outlet syndrome (TOS) is defined as the signs and symptoms caused by compression of brachial plexus and subclavian vessels in the cervicoaxillary region. Cervical ribs are very rare causes of TOS. Most of them are asymptomatic and incidentally diagnosed during routine chest x-ray. We presented here 4 cases of unusual cervical ribs articulating with hypertrophied scalene tubercle with different clinical presentations including: TOS, palpable mass at the supraclavicular region, and asymptomatic. TOS was treated surgically with good results. In conclusion, complete cervical costa, articulating with hypertrophied scalene tubercle is a very rare cause of TOS. Scalenotomy and complete resection of the cervical rib is a good choice for treatment. In addition, the cervical ribs should be considered in the differential diagnosis of the palpable masses seen at the supraclavicular regions. Plain radiographs are enough for diagnosis; however, 3-dimensional computerized tomography provides many advantages in preoperative surgical planning and demonstrating the articulating structure of the cervical ribs in a detailed manner.
{"title":"Four Cases of Unusual Complete Cervical Ribs Articulating With the Hypertrophied Scalene Tubercle With Different Clinical Presentations","authors":"Vedat Uruç, R. Özden, Aydıner Kalacı, Seyit K. Başarslan, H. Bayaroğullari","doi":"10.1097/WNQ.0000000000000128","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000128","url":null,"abstract":"Thoracic outlet syndrome (TOS) is defined as the signs and symptoms caused by compression of brachial plexus and subclavian vessels in the cervicoaxillary region. Cervical ribs are very rare causes of TOS. Most of them are asymptomatic and incidentally diagnosed during routine chest x-ray. We presented here 4 cases of unusual cervical ribs articulating with hypertrophied scalene tubercle with different clinical presentations including: TOS, palpable mass at the supraclavicular region, and asymptomatic. TOS was treated surgically with good results. In conclusion, complete cervical costa, articulating with hypertrophied scalene tubercle is a very rare cause of TOS. Scalenotomy and complete resection of the cervical rib is a good choice for treatment. In addition, the cervical ribs should be considered in the differential diagnosis of the palpable masses seen at the supraclavicular regions. Plain radiographs are enough for diagnosis; however, 3-dimensional computerized tomography provides many advantages in preoperative surgical planning and demonstrating the articulating structure of the cervical ribs in a detailed manner.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"75-79"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61882816","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}
Pub Date : 2016-02-01DOI: 10.1097/WNQ.0000000000000126
A. Zaater, Alaa Azzazi, Sameh A. Sakr, Ahmed M. Elsayed
Study Design:A prospective study assessing the outcomes of repeat surgery for recurrent lumbar disc herniation. Objectives:To evaluate the results of repeat surgery for recurrent disc herniation, and compare the results of disc excision with and without posterolateral fusion. Methods:The study included 39 patients who underwent disc excision with or without posterolateral fusion, with an average follow-up of 66.7 months (range, 24-116 months). Clinical symptoms were assessed based on the Japanese Orthopedic Association Back Scores. Medical and surgical data were examined and analyzed, including pain-free interval, intraoperative blood loss, length of surgery, and postoperative hospital stay. Results:Clinical outcome was excellent or good in 84.6% of patients, including 83.3% of patients undergoing a discectomy alone, and 84.6% of patients with posterolateral fusion. The recovery rate was 84.4%, and the difference between the fusion and nonfusion groups was insignificant (P=0.725). The difference in the postoperative back pain score was also insignificant (P=0.821). These two groups were not different in terms of age, pain-free interval, and follow-up duration. Intraoperative blood loss, length of surgery, and length of hospitalization were significantly less in patients undergoing discectomy alone than in patients with fusion. Conclusions:Repeat surgery for recurrent sciatica is effective in cases of true recurrent disc herniation. Disc excision alone is recommended for managing recurrent disc herniation.
{"title":"Recurrent Lumbar Disk Herniation With or Without Posterolateral Fusion","authors":"A. Zaater, Alaa Azzazi, Sameh A. Sakr, Ahmed M. Elsayed","doi":"10.1097/WNQ.0000000000000126","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000126","url":null,"abstract":"Study Design:A prospective study assessing the outcomes of repeat surgery for recurrent lumbar disc herniation. Objectives:To evaluate the results of repeat surgery for recurrent disc herniation, and compare the results of disc excision with and without posterolateral fusion. Methods:The study included 39 patients who underwent disc excision with or without posterolateral fusion, with an average follow-up of 66.7 months (range, 24-116 months). Clinical symptoms were assessed based on the Japanese Orthopedic Association Back Scores. Medical and surgical data were examined and analyzed, including pain-free interval, intraoperative blood loss, length of surgery, and postoperative hospital stay. Results:Clinical outcome was excellent or good in 84.6% of patients, including 83.3% of patients undergoing a discectomy alone, and 84.6% of patients with posterolateral fusion. The recovery rate was 84.4%, and the difference between the fusion and nonfusion groups was insignificant (P=0.725). The difference in the postoperative back pain score was also insignificant (P=0.821). These two groups were not different in terms of age, pain-free interval, and follow-up duration. Intraoperative blood loss, length of surgery, and length of hospitalization were significantly less in patients undergoing discectomy alone than in patients with fusion. Conclusions:Repeat surgery for recurrent sciatica is effective in cases of true recurrent disc herniation. Disc excision alone is recommended for managing recurrent disc herniation.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"42–46"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61883149","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}
Pub Date : 2016-02-01DOI: 10.1097/WNQ.0000000000000196
Tao Yang, Li Zhang, Ying Zhang, Wenyuan Liu, Xuezhong Wei, Zequan Hua
Aim:To evaluate the temperature change (one of the key weather factors) is relevant to Bell’s palsy (BP) occurrence and what kind of role does temperature change play in causing BP, via BP occurrence comparison of 2 capital cities. Materials and Methods:The epidemiological study of BP was conducted between the capital city of Liaoning Province, Shenyang (population: about 7.5 million in 2007 and 2008, climate type: temperate continental monsoon climate) and the capital city of Shanxi Province, Xi’an (population: about 6.5million in 2007 and 2008, climate type: warm sub-humid continental monsoon climate) in Table 1. Result:There were statistically significantly different in BP’s incidence rate between 2 kinds of jobs in 2 different capital cities (P<0.05), in BP’s incidence rate among 4 different seasons even in 2 different capital cities (P<0.05), in BP’s disease extent in 2different capital cities (P<0.05), in disease inducement between 2 different capital cities (P<0.05), and between 4 kinds of BP’s prognosis in 2 different capital cities (P<0.05). Conclusions:There was statistically significant correlation between weather change/character and the actual incidence of BP. The real factors that triggered the incidence of BP should be invested in further study.
{"title":"An Investigation of Weather Factors Effect on Bell’s Palsy by Comparison With 2 Capital Cities in China","authors":"Tao Yang, Li Zhang, Ying Zhang, Wenyuan Liu, Xuezhong Wei, Zequan Hua","doi":"10.1097/WNQ.0000000000000196","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000196","url":null,"abstract":"Aim:To evaluate the temperature change (one of the key weather factors) is relevant to Bell’s palsy (BP) occurrence and what kind of role does temperature change play in causing BP, via BP occurrence comparison of 2 capital cities. Materials and Methods:The epidemiological study of BP was conducted between the capital city of Liaoning Province, Shenyang (population: about 7.5 million in 2007 and 2008, climate type: temperate continental monsoon climate) and the capital city of Shanxi Province, Xi’an (population: about 6.5million in 2007 and 2008, climate type: warm sub-humid continental monsoon climate) in Table 1. Result:There were statistically significantly different in BP’s incidence rate between 2 kinds of jobs in 2 different capital cities (P<0.05), in BP’s incidence rate among 4 different seasons even in 2 different capital cities (P<0.05), in BP’s disease extent in 2different capital cities (P<0.05), in disease inducement between 2 different capital cities (P<0.05), and between 4 kinds of BP’s prognosis in 2 different capital cities (P<0.05). Conclusions:There was statistically significant correlation between weather change/character and the actual incidence of BP. The real factors that triggered the incidence of BP should be invested in further study.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"8–13"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886878","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}
Pub Date : 2016-02-01DOI: 10.1097/WNQ.0000000000000049
Xie Yuebing, X. Anqi, Wang Xiang, Y. Chao, C. Jing
The central nervous system germinoma, as a malignant tumor, mainly occurs in the pineal gland region or hypothalamic area, and tends to involve adolescents. Germinoma occurring in the basal ganglia is very easy to be mistaken as other pathologic tumors because of its relative occurrence and atypical imaging performance. Here we report the case of a young man suffering from an atypical germinoma and discuss its differential diagnosis in imaging.
{"title":"A Germinoma Involving Basal Ganglia: Case Report","authors":"Xie Yuebing, X. Anqi, Wang Xiang, Y. Chao, C. Jing","doi":"10.1097/WNQ.0000000000000049","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000049","url":null,"abstract":"The central nervous system germinoma, as a malignant tumor, mainly occurs in the pineal gland region or hypothalamic area, and tends to involve adolescents. Germinoma occurring in the basal ganglia is very easy to be mistaken as other pathologic tumors because of its relative occurrence and atypical imaging performance. Here we report the case of a young man suffering from an atypical germinoma and discuss its differential diagnosis in imaging.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"61–63"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61879635","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}
Pub Date : 2016-02-01DOI: 10.1097/WNQ.0000000000000119
A. Kamgarpour, E. Moradi, Alireza Showraki, N. Derakhshan, M. Jamali
Chiari type 0 malformation (CM-0), first introduced in 1998, is a new subtype of Chiari malformation with no signs of tonsillar ectopia. We present a case of CM-0 with multiple cafe au lait spots. This case presentation could indicate the possibility of an unrecognized correlation in the pathogenesis of CM-0 and formation of cafe au lait spots (isolated or as features of Legius syndrome/neurofibromatosis type 1).
{"title":"Chiari 0 Malformation With Multiple Café Au Lait Spots: A Case Report","authors":"A. Kamgarpour, E. Moradi, Alireza Showraki, N. Derakhshan, M. Jamali","doi":"10.1097/WNQ.0000000000000119","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000119","url":null,"abstract":"Chiari type 0 malformation (CM-0), first introduced in 1998, is a new subtype of Chiari malformation with no signs of tonsillar ectopia. We present a case of CM-0 with multiple cafe au lait spots. This case presentation could indicate the possibility of an unrecognized correlation in the pathogenesis of CM-0 and formation of cafe au lait spots (isolated or as features of Legius syndrome/neurofibromatosis type 1).","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"69-70"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61882686","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}
Pub Date : 2016-02-01DOI: 10.1097/WNQ.0000000000000127
H. Yamakawa, N. Tamakawa, H. Watarai, T. Tanigawara
Subarachnoid hemorrhage located in the supracerebellar cistern is an unusual complication of supratentorial neurosurgery. To the best of our knowledge, only 5 case reports have described the occurrence of this rare hemorrhage after burr hole surgery/drainage for the treatment of chronic subdural hematoma. We present the case of a patient with this rare postoperative complication of subarachnoid hemorrhage located in the supracerebellar cistern immediately after the burr hole evacuation of chronic subdural hematoma without continuous subdural drainage. A possible underlying mechanism is also discussed. Although the complication may be associated with significant morbidity and mortality, most cases follow a benign clinical course as observed in our case.
{"title":"Supracerebellar Subarachnoid Hemorrhage After Evacuation of Supratentorial Chronic Subdural Hematoma","authors":"H. Yamakawa, N. Tamakawa, H. Watarai, T. Tanigawara","doi":"10.1097/WNQ.0000000000000127","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000127","url":null,"abstract":"Subarachnoid hemorrhage located in the supracerebellar cistern is an unusual complication of supratentorial neurosurgery. To the best of our knowledge, only 5 case reports have described the occurrence of this rare hemorrhage after burr hole surgery/drainage for the treatment of chronic subdural hematoma. We present the case of a patient with this rare postoperative complication of subarachnoid hemorrhage located in the supracerebellar cistern immediately after the burr hole evacuation of chronic subdural hematoma without continuous subdural drainage. A possible underlying mechanism is also discussed. Although the complication may be associated with significant morbidity and mortality, most cases follow a benign clinical course as observed in our case.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"71-74"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61882763","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}
Pub Date : 2016-02-01DOI: 10.1097/WNQ.0000000000000131
N. Mitsukawa, Takashi Hayashi, K. Satoh
Saethre-Chotzen syndrome is extremely rare in Japan. We experienced a familial case of Saethre-Chotzen syndrome in 4 individuals of 3 generations. In all 4 individuals, a mutation in the TWIST gene was observed by a gene test. Some of these patients underwent surgical correction of brachycephaly and blepharoptosis with good results.
{"title":"A Familial Case of Saethre-Chotzen Syndrome in Japan","authors":"N. Mitsukawa, Takashi Hayashi, K. Satoh","doi":"10.1097/WNQ.0000000000000131","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000131","url":null,"abstract":"Saethre-Chotzen syndrome is extremely rare in Japan. We experienced a familial case of Saethre-Chotzen syndrome in 4 individuals of 3 generations. In all 4 individuals, a mutation in the TWIST gene was observed by a gene test. Some of these patients underwent surgical correction of brachycephaly and blepharoptosis with good results.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"99-102"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61883169","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}
Pub Date : 2016-02-01DOI: 10.1097/WNQ.0000000000000144
Si-qing Huang, Shuhui Gong, Jia-gang Liu
The aim of this paper is to present a 13-year-old patient with bilateral lower limb paralysis and bladder incontinence rapidly progressive within a week. Spine magnetic resonance imaging (MRI) showed a giant epidural mass extending from C6 to T6 and involving soft tissue paraspinally. A surgical procedure was performed, and postoperative histopathologic examinations proved that the mass was B-cell lymphoblastic lymphoma. Preoperative symptoms were not relieved because of some complications, which occurred postoperative. Decreased blood platelets caused a serious coagulation function disorder and discontinuity hyperpyrexia postoperatively. The patient had a poor prognosis and died 1 month postoperatively. When B-cell lymphoma has a serious neurological deficit with bone morrow involvement, surgical treatment should be considered cautiously.
{"title":"Rapidly Neurological Deficit Preoperative and Surgery-related Complications Occurred Postoperatively Caused by an Epidural Mass of B-Cell Lymphoblastic Lymphoma (Case Report)","authors":"Si-qing Huang, Shuhui Gong, Jia-gang Liu","doi":"10.1097/WNQ.0000000000000144","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000144","url":null,"abstract":"The aim of this paper is to present a 13-year-old patient with bilateral lower limb paralysis and bladder incontinence rapidly progressive within a week. Spine magnetic resonance imaging (MRI) showed a giant epidural mass extending from C6 to T6 and involving soft tissue paraspinally. A surgical procedure was performed, and postoperative histopathologic examinations proved that the mass was B-cell lymphoblastic lymphoma. Preoperative symptoms were not relieved because of some complications, which occurred postoperative. Decreased blood platelets caused a serious coagulation function disorder and discontinuity hyperpyrexia postoperatively. The patient had a poor prognosis and died 1 month postoperatively. When B-cell lymphoma has a serious neurological deficit with bone morrow involvement, surgical treatment should be considered cautiously.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"95–98"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61883577","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}
Pub Date : 2016-02-01DOI: 10.1097/WNQ.0000000000000197
S. Fariborz, Mohammad Gharedaghi, A. Khosravi, M. Samini
Introduction:There are 3 ways for the treatment of patients for spondylolisthesis grade 1 in lumbosacral region associating with lumbar disk herniation or lumbar stenosis: pedicular screw fixation method alone; pedicular screw with insertion of trans lumbar interbody fusion (TLIF), or with posterior lumbar interbody fusion (PLIF). Interestingly, all methods have associated with satisfactory results. However, which method is superior for the treatment of such patients still has remained controversial. Materials and Methods:Patients with clinical signs and symptoms of disk herniation or lumbar canal stenosis and also spondylolysthesis grade 1 were selected, who had randomly undergone pedicle screw and posterior fusion surgery, pedicle screw and TLIF surgery, pedicle screw and PLIF surgery, or without instrumentation and fusion, in neurosurgery section in Mashhad, from 2009 to 2011. Afterwards, clinical symptoms, radiologic study results, amount of fusion in terms of Brantigan and Stefee indices, and functional improvement by Oswestry Disability Index were recorded after 6 and 12 months from surgery, respectively. Results:Of 120 patients who were analyzed in 4 treatment groups, age and sex distribution was matched. Also, L4-L5 involvement was more common in 3 groups with a normal distribution. Statistically, Oswestry Disability Index had a significant reduction after operation, and no significant differences were observed among the 3 study groups. These groups showed no significant variation in degree of fusion and Brantigan and Stefee index, but in the group which had been undergone surgery without instrumentation and fusion, the difference was significant. Conclusions:After a 12-month follow-up, the 3 procedures of TLIF, PLIF, and posterior fusion pedicle screw did not show any difference in functional improvement of the patients, degree of fusion, and complications significantly, whereas all of them had a significant preference rather than the fourth group, in which no instrumentation and fusion was applied.
{"title":"Comparison of Results of 4 Methods of Surgery in Grade 1 Lumbosacral Spondylolisthesis","authors":"S. Fariborz, Mohammad Gharedaghi, A. Khosravi, M. Samini","doi":"10.1097/WNQ.0000000000000197","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000197","url":null,"abstract":"Introduction:There are 3 ways for the treatment of patients for spondylolisthesis grade 1 in lumbosacral region associating with lumbar disk herniation or lumbar stenosis: pedicular screw fixation method alone; pedicular screw with insertion of trans lumbar interbody fusion (TLIF), or with posterior lumbar interbody fusion (PLIF). Interestingly, all methods have associated with satisfactory results. However, which method is superior for the treatment of such patients still has remained controversial. Materials and Methods:Patients with clinical signs and symptoms of disk herniation or lumbar canal stenosis and also spondylolysthesis grade 1 were selected, who had randomly undergone pedicle screw and posterior fusion surgery, pedicle screw and TLIF surgery, pedicle screw and PLIF surgery, or without instrumentation and fusion, in neurosurgery section in Mashhad, from 2009 to 2011. Afterwards, clinical symptoms, radiologic study results, amount of fusion in terms of Brantigan and Stefee indices, and functional improvement by Oswestry Disability Index were recorded after 6 and 12 months from surgery, respectively. Results:Of 120 patients who were analyzed in 4 treatment groups, age and sex distribution was matched. Also, L4-L5 involvement was more common in 3 groups with a normal distribution. Statistically, Oswestry Disability Index had a significant reduction after operation, and no significant differences were observed among the 3 study groups. These groups showed no significant variation in degree of fusion and Brantigan and Stefee index, but in the group which had been undergone surgery without instrumentation and fusion, the difference was significant. Conclusions:After a 12-month follow-up, the 3 procedures of TLIF, PLIF, and posterior fusion pedicle screw did not show any difference in functional improvement of the patients, degree of fusion, and complications significantly, whereas all of them had a significant preference rather than the fourth group, in which no instrumentation and fusion was applied.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"14–18"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61887071","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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