This site usescookies, tags, and tracking settings to store information that help give you the very best browsing experience. Dismiss this warning

Filter

Refine by Publication

Refine by Date
—

Refine by Access

By Author

  • Print
  • Save

Search Results

You are looking at1-10of62items for

  • Author or Editor: Khoi D. Thanx
  • Refine by Access: allx
Clear All Modify Search
Full access

Letter to the Editor: Tarlov cysts

Anne Louise Oaklander

InNeurosurgical Focus Volume 32 (2012): Issue 4 (Apr 2012)

Free access

Comparison of minimally invasive transspinous and open approaches for thoracolumbar intradural-extramedullary spinal tumors

Kunal P. Raygor, Khoi D. Than, Dean Chou, and Praveen V. Mummaneni

OBJECT

Spinal tumor resection has historically been performed via open approaches, although minimally invasive approaches have recently been found to be effective in small cohort series. The authors compare surgical characteristics and clinical outcomes of surgery in patients undergoing mini-open and open approaches for intradural-extramedullary tumor resection.

开云体育世界杯赔率

The authors retrospectively reviewed 65 consecutive intradural-extramedullary tumor resections performed at their institution from 2007 to 2014. Patients with cervical tumors or pathology demonstrating neurofibroma were excluded (n = 14). The nonparametric Mann-Whitney U-test and Pearson chi-square test were used to compare continuous and categorical variables, respectively. Statistical analyses were performed using SPSS, with significance set at p < 0.05.

RESULTS

Fifty-one thoracolumbar intradural-extramedullary tumor resections were included; 25 were performed via the minimally invasive transspinous approach. There were no statistically significant differences in age, sex, body mass index, preoperative American Spinal Injury Association (ASIA) score, preoperative symptom duration, American Society of Anesthesiologists (ASA) physical status class, tumor size, or tumor location. There was no statistically significant difference between groups with respect to the duration of the operation or extent of resection, but the mean estimated blood loss was significantly lower in the minimally invasive surgery (MIS) cohort (142 vs 320 ml, p < 0.05). In each group, the 2 most common tumor pathologies were schwannoma and meningioma. There were no statistically significant differences in length of hospitalization, ASIA score improvement, complication rate, or recurrence rate. The mean duration of follow-up was 2 years for the MIS group and 1.6 years for the open surgery group.

CONCLUSIONS

This is one of the largest comparisons of minimally invasive and open approaches to the resection of thoracolumbar intradural-extramedullary tumors. With well-matched cohorts, the minimally invasive transspinous approach appears to be as safe and effective as the open technique, with the advantage of significantly reduced intraoperative blood loss.

InNeurosurgical Focus Volume 39 (2015): Issue 2 (Aug 2015): Intradural Spinal Tumors

Full access

Minimally invasive deformity correction: surgical technique

Kevin S. Chen, Khoi D. Than, Frank LaMarca, and Paul Park

This video details a minimally invasive treatment of symptomatic adult kyphoscoliosis. Both anterior and posterior approaches are used to obtain sagittal and coronal balance. In addition, improved lumbar lordosis is achieved to closely match the patient's pelvic incidence. The key steps for the lateral transpsoas procedure are detailed in the first portion of the video and include positioning, fluoroscopic localization, exposure with tubular retractor placement, interbody preparation and grafting, and closure. The second portion of the video shows positioning, fluoroscopic positioning/guidance, exposure for percutaneous pedicle screw placement, rod insertion, and closure.

The video can be found here:http://youtu.be/cHkTMtSXZ8A.

InNeurosurgical Focus Volume 35 (2013): Issue v2supplement (Jul 2013): Video Atlas - Minimally Invasive Spine Surgery

Full access

Minimally invasive unilateral approach for bilateral decompression of spinal stenosis and modified transforaminal lumbar interbody fusion for degenerative spondylolisthesis

Kevin S. Chen, Khoi D. Than, Frank LaMarca, and Paul Park

This video describes a minimally invasive approach for treatment of symptomatic grade I spondylolisthesis and high-grade spinal stenosis. In this procedure, a unilateral approach for bilateral decompression is utilized in conjunction with a modified transforaminal lumbar interbody fusion and percutaneous pedicle screw fixation. The key steps in the procedure are outlined, and include positioning, fluoroscopic positioning/guidance, exposure with tubular retractor system, technique for ipsilateral and contra-lateral decompression, disc space preparation and interbody grafting, percutaneous pedicle screw and rod placement, and closure.

The video can be found here:http://youtu.be/QTymO4Cu4B0.

InNeurosurgical Focus Volume 35 (2013): Issue v2supplement (Jul 2013): Video Atlas - Minimally Invasive Spine Surgery

Full access

Pseudogout of the cervical and thoracic spine mimicking infection after lumbar fusion: case report

Kelly J. Bridges, Carli L. Bullis, Ajay Wanchu, and Khoi D. Than

Pseudogout is a form of acute calcium pyrophosphate deposition (CPPD) disease that typically afflicts the elderly. CPPD commonly involves larger joints, such as the knees, wrists, shoulders, and hips, and has been known to involve the spine.

The authors report the case of a 66-year-old woman with a recent history of lumbar laminectomy and fusion who presented 5 weeks postprocedure with a clinical and radiographic picture consistent with multilevel skip lesions involving the cervical and thoracic spine, thoracic discitis, and epidural abscess. Serial blood cultures and repeat biopsy samples were sterile. Subsequent wrist and ankle erythema, pain, and swelling led to synovial fluid analysis, and pseudogout was diagnosed. She was treated with an interleukin-1 inhibitor with immediate symptom relief.

To the authors’ knowledge, this is only the second report of spinal pseudogout presenting with a clinical and radiographic picture consistent with discitis and epidural abscess. This report is the first to report skip lesions of pseudogout occurring throughout the spine that are uniquely remote from a recent lumbar surgery.

In开云手机版app下载安装最新版脊柱神经外科杂志:卷2开云体育app官方网站下载入口7 (2017): Issue 2 (Aug 2017)

Free access

Letter to the Editor. PEEK interbody device and pseudarthrosis

Hardik Sardana, Roshan Sahu, and Shweta Kedia

InJournal of Neurosurgery: Spine Volume 31: Issue 4 (Oct 2019)

Full access

Impact of anesthesia on transcranial electric motor evoked potential monitoring during spine surgery: a review of the literature

Anthony C. Wang, Khoi D. Than, Arnold B. Etame, Frank La Marca, and Paul Park

Object

Transcranial motor evoked potential (TcMEP) monitoring is frequently used in complex spinal surgeries to prevent neurological injury. Anesthesia, however, can significantly affect the reliability of TcMEP monitoring. Understanding the impact of various anesthetic agents on neurophysiological monitoring is therefore essential.

开云体育世界杯赔率

地中海的国家图书馆文献检索icine database was conducted to identify articles pertaining to anesthesia and TcMEP monitoring during spine surgery. Twenty studies were selected and reviewed.

Results

Inhalational anesthetics and neuromuscular blockade have been shown to limit the ability of TcMEP monitoring to detect significant changes. Hypothermia can also negatively affect monitoring. Opioids, however, have little influence on TcMEPs. Total intravenous anesthesia regimens can minimize the need for inhalational anesthetics.

Conclusions

In general, selecting the appropriate anesthetic regimen with maintenance of a stable concentration of inhalational or intravenous anesthetics optimizes TcMEP monitoring.

InNeurosurgical Focus Volume 27: Issue 4 (Oct 2009): Intraoperative Neuromonitoring

Full access

Outcomes after surgery for cervical spine deformity: review of the literature

Arnold B. Etame, Anthony C. Wang, Khoi D. Than, Frank La Marca, and Paul Park

Object

Symptomatic cervical kyphosis can result from a variety of causes. Symptoms can include pain, neurological deficits, and functional limitation due to loss of horizontal gaze.

开云体育世界杯赔率

The authors review the long-term functional and radiographic outcomes following surgery for symptomatic cervical kyphosis by performing a PubMed database literature search.

Results

Fourteen retrospective studies involving a total of 399 patients were identified. Surgical intervention included ventral, dorsal, or circumferential approaches. Analysis of the degree of deformity correction and functional parameters demonstrated significant postsurgical improvement. Overall, patient satisfaction appeared high. Five studies reported mortality with rates ranging from 3.1 to 6.7%. Major medical complications after surgery were reported in 5 studies with rates ranging from 3.1 to 44.4%. The overall neurological complication rate was 13.5%.

Conclusions

Although complications are not insignificant, surgery appears to be an effective option when conservative measures fail to provide relief.

InNeurosurgical Focus Volume 28 (2010): Issue 3 (Mar 2010)

Restricted access

Dr. Ruth Jackson: the legacy of the first female spine surgeon

Ethan S. Srinivasan, Melissa M. Erickson, Christopher I. Shaffrey, and Khoi D. Than

露丝杰克逊博士出生于1902年,是第一个联邦应急管理局le spine surgeon on record. Her story of remarkable resilience and sacrifice is even more relevant given the stark gender disparities in orthopedic surgery and neurosurgery that remain today. Dr. Jackson entered the field during the Great Depression and overcame significant barriers at each step along the process. In 1937, she became the first woman to pass the American Board of Orthopedic Surgery examination and join the American Academy of Orthopedic Surgeons as a full member. Her work in the cervical spine led to a notable lecture record and the publication of several articles, as well as a book,The Cervical Syndrome, in which she discussed the anatomy, etiology, and treatment of cervical pathologies. Additionally, Dr. Jackson developed the Jackson CerviPillo, a neck support that is still in use today. She left a legacy that continues to resonate through the work of the Ruth Jackson Orthopedic Society, which supports women at all levels of practice and training. From the story of Dr. Jackson’s life, we can appreciate her single-minded determination that blazed a path for women in spine surgery, as well as consider the progress that remains to be made.

InJournal of Neurosurgery: Spine Volume 37: Issue 5 (Nov 2022)

Free access

Laminoplasty versus laminectomy with posterior spinal fusion for multilevel cervical spondylotic myelopathy: influence of cervical alignment on outcomes

Darryl Lau, Ethan A. Winkler, Khoi D. Than, Dean Chou, and Praveen V. Mummaneni

OBJECTIVE

Cervical curvature is an important factor when deciding between laminoplasty and laminectomy with posterior spinal fusion (LPSF) for cervical spondylotic myelopathy (CSM). This study compares outcomes following laminoplasty and LPSF in patients with matched postoperative cervical lordosis.

开云体育世界杯赔率

广告ults undergoing laminoplasty or LPSF for cervical CSM from 2011 to 2014 were identified. Matched cohorts were obtained by excluding LPSF patients with postoperative cervical Cobb angles outside the range of laminoplasty patients. Clinical outcomes and radiographic results were compared. A subgroup analysis of patients with and without preoperative pain was performed, and the effects of cervical curvature on pain outcomes were examined.

RESULTS

共有145名患者包括:101和erwent laminoplasty and 44 who underwent LPSF. Preoperative Nurick scale score, pain incidence, and visual analog scale (VAS) neck pain scores were similar between the two groups. Patients who underwent LPSF had significantly less preoperative cervical lordosis (5.8° vs 10.9°, p = 0.018). Preoperative and postoperative C2–7 sagittal vertical axis (SVA) and T-1 slope were similar between the two groups. Laminoplasty cases were associated with less blood loss (196.6 vs 325.0 ml, p < 0.001) and trended toward shorter hospital stays (3.5 vs 4.3 days, p = 0.054). The perioperative complication rate was 8.3%; there was no significant difference between the groups. LPSF was associated with a higher long-term complication rate (11.6% vs 2.2%, p = 0.036), with pseudarthrosis accounting for 3 of 5 complications in the LPSF group. Follow-up cervical Cobb angle was similar between the groups (8.8° vs 7.1°, p = 0.454). At final follow-up, LPSF had a significantly lower mean Nurick score (0.9 vs 1.4, p = 0.014). Among patients with preoperative neck pain, pain incidence (36.4% vs 31.3%, p = 0.629) and VAS neck pain (2.1 vs 1.8, p = 0.731) were similar between the groups. Similarly, in patients without preoperative pain, there was no significant difference in pain incidence (19.4% vs 18.2%, p = 0.926) and VAS neck pain (1.0 vs 1.1, p = 0.908). For laminoplasty, there was a significant trend for lower pain incidence (p = 0.010) and VAS neck pain (p = 0.004) with greater cervical lordosis, especially when greater than 20° (p = 0.011 and p = 0.018). Mean follow-up was 17.3 months.

CONCLUSIONS

For patients with CSM, LPSF was associated with slightly greater blood loss and a higher long-term complication rate, but offered greater neurological improvement than laminoplasty. In cohorts of matched follow-up cervical sagittal alignment, pain outcomes were similar between laminoplasty and LPSF patients. However, among laminoplasty patients, greater cervical lordosis was associated with better pain outcomes, especially for lordosis greater than 20°. Cervical curvature (lordosis) should be considered as an important factor in pain outcomes following posterior decompression for multilevel CSM.

In开云手机版app下载安装最新版脊柱神经外科杂志:卷2开云体育app官方网站下载入口7 (2017): Issue 5 (Nov 2017)

Baidu
map