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Article ; Online: Case Series of Tubular Retractor Assisted Minimally Invasive Extraforaminal L5/S1 Microdiskectomy.

Antony, Joyce / Ngoc Le, Dianne Hong / Yang, Liqun

2022 Volume 165, Page(s) e563–e570

Abstract: Background: We present the largest series of tubular assisted minimally invasive extraforaminal L5/S1 microdiskectomy and describe the operative nuances. An extraforaminal L5/S1 disk herniation poses a surgical challenge as a result of limited access ... ...

Abstract	Background: We present the largest series of tubular assisted minimally invasive extraforaminal L5/S1 microdiskectomy and describe the operative nuances. An extraforaminal L5/S1 disk herniation poses a surgical challenge as a result of limited access from a high iliac crest, the sacral ala, and the large transverse process of L5 necessitating oblique working angles. Methods: This is a case series of 28 consecutive patients who underwent tubular retractor-assisted minimally invasive extraforaminal L5/S1 microdiskectomy between 2017 and 2020 for L5 radiculopathy. Preoperative variables include demographics (age, gender); imaging characteristics (presence of spondylolisthesis, grade and presence of dynamic instability); and patient-reported measures of pain and function. Postoperatively, any complications, pain, and function were documented at 1-day, 3-month, and 12-months follow-up. Statistical analysis involved descriptive analysis of measured variables. Results: Patients (13 females and 15 males) had a median age of 62 years (range: 32-92). One patient demonstrated grade I spondylolisthesis with no dynamic instability. Twenty-six patients (93%) achieved complete pain resolution during the follow-up period. Two patients had persistent or recurrent radicular pain, 1 of whom resolved completely with a redo tubular retractor-assisted minimally invasive microdiskectomy. No other complications were noted during the postoperative follow-up. Conclusions: Tubular retractor-assisted minimally invasive extraforaminal L5/S1 microdiskectomy is an effective approach. Good surgical outcomes are achieved while avoiding the complications associated with more invasive options such as open surgery or fusion.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Diskectomy ; Female ; Humans ; Intervertebral Disc Displacement/diagnostic imaging ; Intervertebral Disc Displacement/surgery ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Pain/surgery ; Spondylolisthesis/diagnostic imaging ; Spondylolisthesis/surgery ; Treatment Outcome
Language	English
Publishing date	2022-06-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2022.06.102
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Article: Intraoperative MRI in trans-sphenoidal surgery using frameless stereotaxis.

Stanton, Mitchell / Antony, Joyce / Withers, Teresa

Surgical neurology international

2021 Volume 12, Page(s) 179

Abstract: Background: Intraoperative magnetic resonance imaging (iMRI) has been used for pituitary surgery for approximately 20 years. The introduction of frameless stereotaxis allows efficient navigation for both the ENT and neurosurgeon. This allows flexibility ...

Abstract	Background: Intraoperative magnetic resonance imaging (iMRI) has been used for pituitary surgery for approximately 20 years. The introduction of frameless stereotaxis allows efficient navigation for both the ENT and neurosurgeon. This allows flexibility in placement of the patients head to facilitate resection, efficient use of theater time and improves the safety profile of the operation. This is the first study to describe and investigate the use of frameless stereotaxis in conjunction with iMRI. Methods: Consecutive patients who underwent iMRI guided trans-sphenoidal debulking using frameless stereotaxis over a 3-year period, from January 2016 to June 2019, were included in this case series and reviewed retrospectively. The use of AxiEM (Medtronic, USA) tracker facilitated frameless stereotaxis in conjunction with iMRI for trans-sphenoidal debulking of sellar lesions based on the "twin-operating" model. Results: The cohort of 47 patients had a mean age of 55 years with a slight female predilection. The average lesion size measured 20 mm (3-46 mm) in maximal diameter with objective evidence of visual deterioration being the most common indication to consider surgery. The use of iMRI identified two patients with suboptimal decompression facilitating further resection in the same anesthetic and one hemorrhagic complication requiring evacuation and hemostasis to reduce postoperative morbidity. Conclusion: This study describes the procedural nuances in the use of frameless stereotaxis for iMRI in transsphenoidal surgery to further reduce morbidity and improve outcomes, as well as improving theater utilization and reducing cost.
Language	English
Publishing date	2021-04-19
Publishing country	United States
Document type	Journal Article
ISSN	2229-5097
ISSN	2229-5097
DOI	10.25259/SNI_842_2020
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Article ; Online: Case Report of an Anterior Thoracic Myelomeningocele: A Multidisciplinary Approach to Surgical Management.

Antony, Joyce / Neriamparambil, Anna Jolly / Ma, Norman

World neurosurgery

2020 Volume 143, Page(s) 202–208

Abstract: Background: Cervicothoracic myelomeningocele (MMC) is a rare entity with only 2 reported cases in the literature of anterior thoracic MMC.: Case description: We report a third case in a 3-year-old boy. MMC was diagnosed during antenatal screening and ...

Abstract	Background: Cervicothoracic myelomeningocele (MMC) is a rare entity with only 2 reported cases in the literature of anterior thoracic MMC. Case description: We report a third case in a 3-year-old boy. MMC was diagnosed during antenatal screening and later warranted surgical intervention. Despite being asymptomatic, radiologic surveillance demonstrated worsening syringomyelia, tonsillar descent, and cord signal change concerning for myelomalacia. Preoperative management involved respiratory assessment for pulmonary compromise, general pediatric consultation, gait analysis by physiotherapy, and serial imaging by radiology. Surgical management involved an anterior thoracotomy approach by cardiothoracic surgeons, repair of the MMC by neurosurgeons, and bone graft to ameliorate the bony defect in the vertebral body by orthopaedic surgeons. Postoperative care involved 4 days in the intensive care unit and 14 days on the pediatric neurosurgical ward. At 3-year follow-up, there was radiologic improvement of syringomyelia, tonsillar descent, and kyphoscoliosis with no neurological or pulmonary complications. Conclusions: This case highlights the unique multidisciplinary surgical management of the rare entity of anterior thoracic MMC without scoliosis correction for radiologic progression.
MeSH term(s)	Bone Transplantation ; Child, Preschool ; Combined Modality Therapy ; Humans ; Magnetic Resonance Imaging ; Male ; Meningomyelocele/diagnostic imaging ; Meningomyelocele/surgery ; Neurosurgical Procedures/methods ; Perioperative Care ; Scoliosis/complications ; Scoliosis/diagnostic imaging ; Scoliosis/surgery ; Spinal Diseases/diagnostic imaging ; Spinal Diseases/surgery ; Syringomyelia/complications ; Syringomyelia/diagnostic imaging ; Syringomyelia/surgery ; Thoracotomy ; Treatment Outcome ; Ultrasonography
Language	English
Publishing date	2020-07-29
Publishing country	United States
Document type	Case Reports
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.07.124
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Article ; Online: An Australian Response to the COVID-19 Pandemic and Its Implications on the Practice of Neurosurgery.

Antony, Joyce / James, William Thomas / Neriamparambil, Anna Jolly / Barot, Dwarkesh Dharmendra / Withers, Teresa

World neurosurgery

2020 Volume 139, Page(s) e864–e871

Abstract: Objective: This study was designed to assess the impact of public health policy in Australia in response to the coronavirus disease identified in 2019 (COVID-19) pandemic on the delivery of neurosurgical services. Being essential services, we postulated ...

Abstract	Objective: This study was designed to assess the impact of public health policy in Australia in response to the coronavirus disease identified in 2019 (COVID-19) pandemic on the delivery of neurosurgical services. Being essential services, we postulated that there would not be a decrease in elective and emergency neurosurgical presentations and surgeries. Methods: This is a prospective, observational, epidemiologic study in strict adherence to the "STROBE" (Strengthening The Reporting of OBservational studies in Epidemiology) guidelines. It is a cross-sectional, multicentric study involving 5 tertiary neurosurgical centers to capture all public neurosurgical admissions in Queensland during the past 3 months (February-April, 2020) of significant public health policy changes to combat COVID-19. Results: An analysis of the 1298 admissions for the Queensland population of 5.07 million Australians demonstrated a decrease in the number of elective and emergency admissions. The decline in elective admissions, particularly degenerative spine, benign neoplasms, and vascular pathologies, was a direct response of government strategy to curb activity to urgent surgical interventions only. Moreover, a trend toward fewer emergency admissions was also noted, partly explained by less trauma and also a decline in vascular pathologies including subarachnoid hemorrhage. Conclusions: In comparison with Europe and North America, this study demonstrates the impact of proactive public health measures in Australia that successfully flattened the COVID-19 curve while facilitating ongoing care of acutely unwell neurosurgical patients.
MeSH term(s)	Aged ; Aged, 80 and over ; Australia ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/surgery ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Neurosurgical Procedures/methods ; Neurosurgical Procedures/standards ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/surgery ; Prospective Studies ; SARS-CoV-2 ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2020-05-22
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.05.136
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Article ; Online: Influence of sagittal plane component alignment on kinematics after total knee arthroplasty.

Antony, Joyce / Tetsworth, Kevin / Hohmann, Erik

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA

2017 Volume 25, Issue 6, Page(s) 1686–1691

Abstract: Purpose: Knee kinematics is pivotal to patient satisfaction and functional ability after total knee arthroplasty (TKA). The aim of this study is to examine the influence of sagittal plane component alignment as defined by femoral component angle (FCA), ... ...

Abstract	Purpose: Knee kinematics is pivotal to patient satisfaction and functional ability after total knee arthroplasty (TKA). The aim of this study is to examine the influence of sagittal plane component alignment as defined by femoral component angle (FCA), tibial slope (TS) and posterior condylar offset (PCO) on knee kinematics as defined by maximum extension angle (MEA), maximum flexion angle (MFA) and range of motion (ROM) after TKA. Methods: This is a prospective, cross-sectional study of 105 osteoarthritic knees that underwent primary cruciate retaining TKA using a single implant design at a single tertiary institution. The sagittal plane component alignment was measured on weight-bearing true lateral radiographs taken day one post-operation and knee kinematics measured using a goniometer 1 year after TKA by the primary investigator. Results: Although the MFA was influenced by gender (P = 0.04); age, gender and pre-operative kinematics did not otherwise influence post-operative knee kinematics. The prediction model for MFA was statistically significant (P = 0.03) and accounted for 8.4 % of the variance. FCA (r = 0.3, P = 0.01) and PCO (r = 0.2, P = 0.05) demonstrated a statistically significant correlation with MFA. However, the prediction models for ROM and MEA did not achieve statistical significance. FCA (r = 0.2, P = 0.02) demonstrated a statistically significant correlation with ROM. Conclusion: The most important findings of this study are that the FCA demonstrates weak positive correlation with MFA and ROM and that PCO demonstrates weak positive correlation with MFA. However, TS does not contribute significantly to knee kinematics after TKA. This is clinically relevant as orthopaedic surgeons can increase the PCO in cruciate retaining TKA and the FCA within therapeutic limits to improve knee kinematics. Level of evidence: II.
Language	English
Publishing date	2017-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1159064-6
ISSN	1433-7347 ; 0942-2056
ISSN (online)	1433-7347
ISSN	0942-2056
DOI	10.1007/s00167-016-4098-x
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Article: Native and agricultural forests at risk to a changing climate in the Northern Plains

Joyce, LindaA / Bentrup, Gary / Cheng, AntonyS / Derner, Justin / Kolb, Peter / Schoeneberger, Michele

Climatic change. 2018 Jan., v. 146, no. 1-2

2018

Abstract: Native and agricultural forests in the Northern Plains provide ecosystem services that benefit human society—diversified agricultural systems, forest-based products, and rural vitality. The impacts of recent trends in temperature and disturbances are ... ...

Abstract	Native and agricultural forests in the Northern Plains provide ecosystem services that benefit human society—diversified agricultural systems, forest-based products, and rural vitality. The impacts of recent trends in temperature and disturbances are impairing the delivery of these services. Climate change projections identify future stressors of greater impact, placing at risk crops, soils, livestock, biodiversity, and agricultural and forest-based livelihoods. While these native and agricultural forests are also a viable option for providing mitigation and adaptation services to the Northern Plains, they themselves must be managed in terms of climate change risks. Because agricultural forests are planted systems, the primary approaches for reducing risks are through design, plant selection and management. For native forests, management, natural disturbances, and collaboration of multiple ownerships will be needed to address key risks.
Keywords	biodiversity ; climate change ; crops ; ecosystem services ; forests ; humans ; livelihood ; livestock ; risk ; soil ; temperature
Language	English
Dates of publication	2018-01
Size	p. 59-74.
Publishing place	Springer Netherlands
Document type	Article
ZDB-ID	751086-x
ISSN	0165-0009
ISSN	0165-0009
DOI	10.1007/s10584-017-2070-5
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: An Australian Response to the COVID-19 Pandemic and Its Implications on the Practice of Neurosurgery

Antony, Joyce / James, William Thomas / Neriamparambil, Anna Jolly / Barot, Dwarkesh Dharmendra / Withers, Teresa

World Neurosurgery

2020 Volume 139, Page(s) e864–e871

Keywords	Surgery ; Clinical Neurology ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.05.136
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Article ; Online: A Randomized, Double-blind, Placebo-controlled Proof-of-Concept Trial to Evaluate the Efficacy and Safety of Non-racemic Amisulpride (SEP-4199) for the Treatment of Bipolar I Depression.

Loebel, Antony / Koblan, Kenneth S / Tsai, Joyce / Deng, Ling / Fava, Maurizio / Kent, Justine / Hopkins, Seth C

Journal of affective disorders

2021 Volume 296, Page(s) 549–558

Abstract: Background: Non-racemic amisulpride (SEP-4199) is an 85:15 ratio of aramisulpride:esamisulpride with a 5-HT7 and D2 receptor binding profile optimized for the treatment of bipolar depression. The aim of this study was to evaluate the efficacy and safety ...

Abstract	Background: Non-racemic amisulpride (SEP-4199) is an 85:15 ratio of aramisulpride:esamisulpride with a 5-HT7 and D2 receptor binding profile optimized for the treatment of bipolar depression. The aim of this study was to evaluate the efficacy and safety of SEP-4199 for the treatment of bipolar depression. Methods: Patients meeting DSM-5 criteria for bipolar I depression were randomized to 6 weeks of double-blind, placebo-controlled treatment with SEP-4199 200 mg/d or 400 mg/d. The primary endpoint was change in the Montgomery-Asberg Depression Rating Scale (MADRS) at Week 6. The primary efficacy analysis population consisted of patients in Europe and US (n = 289); the secondary efficacy analysis population (ITT; n = 337) included patients in Japan. Results: Endpoint improvement in MADRS total score was observed on both the primary analysis for SEP-4199 200 mg/d (P = 0.054; effect size [ES], 0.31) and 400 mg/d (P = 0.054; ES, 0.29), and on the secondary (full ITT) analysis for SEP-4199 200 mg/d (P = 0.016; ES, 0.34) and 400 mg/d (P = 0.024; ES, 0.31). Study completion rates were 81% on SEP-4199 200 mg/d, 88% on 400 mg/d, and 86% on placebo. SEP-4199 had low rates of individual adverse events (<8%) and minimal effects on weight and lipids; median increases in prolactin were +83.6 μg/L on 200 mg/d, +95.2 μg/L on 400 mg/d compared with 0.0 μg/L on placebo. Limitations: The study excluded patients with bipolar II depression and serious psychiatric or medical comorbidity. Conclusion: Study results provide preliminary proof of concept, needing confirmation in subsequent randomized trials, for the efficacy of non-racemic amisulpride in bipolar depression.
MeSH term(s)	Amisulpride ; Bipolar Disorder/drug therapy ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Double-Blind Method ; Humans ; Treatment Outcome
Chemical Substances	Amisulpride (8110R61I4U)
Language	English
Publishing date	2021-10-03
Publishing country	Netherlands
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2021.09.109
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Article ; Online: Pachymeningeal enhancement-a comprehensive review of literature.

Antony, Joyce / Hacking, Craig / Jeffree, Rosalind L

Neurosurgical review

2015 Volume 38, Issue 4, Page(s) 649–659

Abstract: Pachymeningeal enhancement, synonymous with dural enhancement, is a radiological feature best appreciated on a contrast-enhanced magnetic resonance imaging (MRI). The vasculature of the dura mater is permeable, facilitating avid uptake of contrast agent ... ...

Abstract	Pachymeningeal enhancement, synonymous with dural enhancement, is a radiological feature best appreciated on a contrast-enhanced magnetic resonance imaging (MRI). The vasculature of the dura mater is permeable, facilitating avid uptake of contrast agent and subsequent enhancement. Thin, discontinuous enhancement can be normal, seen in half the normal population. In patients complaining of postural headaches worse on sitting, gadolinium-enhanced MRI findings of diffuse pachymeningeal enhancement is highly suggestive of benign intracranial hypotension. In these cases, the process of pachymeningeal enhancement is explained by the Monro-Kellie doctrine as compensatory volume changes by vasocongestion and interstitial oedema of the dura mater due to decreased cerebrospinal fluid (CSF) pressure. Focal and diffuse pachymeningeal enhancement can also be attributed to infectious or inflammatory, neoplastic and iatrogenic aetiologies. Correction of the underlying pathology often results in spontaneous resolution of the pachymeningeal enhancement. There have also been reports of pachymeningeal enhancement associated with cerebral venous sinus thrombosis, temporal arteritis, baroreceptor reflex failure syndrome and arteriovenous fistulae.
MeSH term(s)	Brain Diseases/pathology ; Cerebrospinal Fluid Pressure ; Cerebrovascular Circulation ; Dura Mater/blood supply ; Dura Mater/pathology ; Dura Mater/surgery ; Humans ; Intracranial Hypotension ; Magnetic Resonance Imaging/methods ; Meninges/blood supply ; Meninges/pathology ; Meninges/surgery ; Neurosurgical Procedures
Language	English
Publishing date	2015-10
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	6907-3
ISSN	1437-2320 ; 0344-5607
ISSN (online)	1437-2320
ISSN	0344-5607
DOI	10.1007/s10143-015-0646-y
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Article: An Australian Response to the COVID-19 Pandemic and Its Implications on the Practice of Neurosurgery

Antony, Joyce / James, William Thomas / Neriamparambil, Anna Jolly / Barot, Dwarkesh Dharmendra / Withers, Teresa

World neurosurgery (Online)

Abstract: OBJECTIVE: This study was designed to assess the impact of public health policy in Australia in response to the coronavirus disease identified in 2019 (COVID-19) pandemic on the delivery of neurosurgical services. Being essential services, we postulated ... ...

Abstract	OBJECTIVE: This study was designed to assess the impact of public health policy in Australia in response to the coronavirus disease identified in 2019 (COVID-19) pandemic on the delivery of neurosurgical services. Being essential services, we postulated that there would not be a decrease in elective and emergency neurosurgical presentations and surgeries. METHODS: This is a prospective, observational, epidemiologic study in strict adherence to the "STROBE" (Strengthening The Reporting of OBservational studies in Epidemiology) guidelines. It is a cross-sectional, multicentric study involving 5 tertiary neurosurgical centers to capture all public neurosurgical admissions in Queensland during the past 3 months (February-April, 2020) of significant public health policy changes to combat COVID-19. RESULTS: An analysis of the 1298 admissions for the Queensland population of 5.07 million Australians demonstrated a decrease in the number of elective and emergency admissions. The decline in elective admissions, particularly degenerative spine, benign neoplasms, and vascular pathologies, was a direct response of government strategy to curb activity to urgent surgical interventions only. Moreover, a trend toward fewer emergency admissions was also noted, partly explained by less trauma and also a decline in vascular pathologies including subarachnoid hemorrhage. CONCLUSIONS: In comparison with Europe and North America, this study demonstrates the impact of proactive public health measures in Australia that successfully flattened the COVID-19 curve while facilitating ongoing care of acutely unwell neurosurgical patients.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32450310
Database	COVID19

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