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  1. Article ; Online: Spinal nerve root stimulation.

    Haque, Raqeeb / Winfree, Christopher J

    Neurosurgical focus

    2006  Volume 21, Issue 6, Page(s) E4

    Abstract: Spinal nerve root stimulation is a recently developed form of neuromodulation used for the treatment of chronic pain conditions. Unlike spinal cord stimulation, in which electrical impulses are directed at the dorsal columns, spinal nerve root ... ...

    Abstract Spinal nerve root stimulation is a recently developed form of neuromodulation used for the treatment of chronic pain conditions. Unlike spinal cord stimulation, in which electrical impulses are directed at the dorsal columns, spinal nerve root stimulation guides electrical current directly to one or more nerve roots. There are a variety of techniques by which this can be accomplished, yet no consistent terminology to describe these variations exists. In this review, the authors group the various techniques according to anatomical approach, define each category, describe and illustrate each of the techniques, review the available reports on their uses, and discuss the advantages and disadvantages of each one.
    MeSH term(s) Analgesia/instrumentation ; Analgesia/methods ; Contraindications ; Electric Stimulation Therapy/instrumentation ; Electric Stimulation Therapy/methods ; Electrodes, Implanted ; Ganglia, Spinal/physiopathology ; Humans ; Low Back Pain/therapy ; Pelvic Pain/therapy ; Spinal Canal ; Spinal Nerve Roots/physiopathology ; Spinothalamic Tracts/physiopathology ; Urination Disorders/therapy
    Language English
    Publishing date 2006-12-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2026589-X
    ISSN 1092-0684 ; 1092-0684
    ISSN (online) 1092-0684
    ISSN 1092-0684
    DOI 10.3171/foc.2006.21.6.7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Spontaneous thrombosis of a giant fusiform aneurysm following extracranial-intracranial bypass surgery.

    Haque, Raqeeb / Kellner, Christopher / Solomon, Robert A

    Journal of neurosurgery

    2009  Volume 110, Issue 3, Page(s) 469–474

    Abstract: The authors describe the cases of 2 patients who underwent extracranial-intracranial bypass surgery for a giant fusiform aneurysm but in whom further surgery was then not necessary because the aneurysm spontaneously thrombosed. The authors hypothesize ... ...

    Abstract The authors describe the cases of 2 patients who underwent extracranial-intracranial bypass surgery for a giant fusiform aneurysm but in whom further surgery was then not necessary because the aneurysm spontaneously thrombosed. The authors hypothesize that this thrombosis was caused by alterations in aneurysm's hemodynamics, leading to a decreased rate of blood flow in the aneurysm. In the older of the 2 cases, more than 10 years after surgery the patient has not required further surgical intervention. Spontaneous thrombosis of a giant fusiform aneurysm is a rare occurrence during extracranial-intracranial bypass, and although continual monitoring is recommended, these patients can remain stable long term.
    MeSH term(s) Adult ; Cerebral Revascularization ; Female ; Humans ; Intracranial Aneurysm/physiopathology ; Intracranial Aneurysm/surgery ; Intracranial Thrombosis/etiology ; Postoperative Complications
    Language English
    Publishing date 2009-03
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 3089-2
    ISSN 1933-0693 ; 0022-3085
    ISSN (online) 1933-0693
    ISSN 0022-3085
    DOI 10.3171/2007.12.17653
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  3. Article: Cavernous malformations of the brainstem.

    Haque, Raqeeb / Kellner, Christopher P / Solomon, Robert A

    Clinical neurosurgery

    2008  Volume 55, Page(s) 88–96

    MeSH term(s) Adult ; Brain Stem/pathology ; Brain Stem/surgery ; Brain Stem Neoplasms/diagnosis ; Brain Stem Neoplasms/surgery ; Cerebral Hemorrhage/diagnosis ; Cerebral Hemorrhage/surgery ; Craniotomy ; Female ; Hemangioma, Cavernous, Central Nervous System/diagnosis ; Hemangioma, Cavernous, Central Nervous System/surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Neurologic Examination ; Postoperative Complications/diagnosis ; Pregnancy ; Pregnancy Complications, Neoplastic/diagnosis ; Pregnancy Complications, Neoplastic/surgery ; Prognosis ; Remission, Spontaneous
    Language English
    Publishing date 2008
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 127548-3
    ISSN 0069-4827
    ISSN 0069-4827
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  4. Article ; Online: Complications, outcomes, and need for fusion after minimally invasive posterior cervical foraminotomy and microdiscectomy.

    Skovrlj, Branko / Gologorsky, Yakov / Haque, Raqeeb / Fessler, Richard G / Qureshi, Sheeraz A

    The spine journal : official journal of the North American Spine Society

    2014  Volume 14, Issue 10, Page(s) 2405–2411

    Abstract: Background context: Posterior cervical foraminotomy (PCF) with or without microdiscectomy (posterior cervical discectomy [PCD]) is a frequently used surgical technique for cervical radiculopathy secondary to foraminal stenosis or a laterally located ... ...

    Abstract Background context: Posterior cervical foraminotomy (PCF) with or without microdiscectomy (posterior cervical discectomy [PCD]) is a frequently used surgical technique for cervical radiculopathy secondary to foraminal stenosis or a laterally located herniated disc. Currently, these procedures are being performed with increasing frequency using advanced minimally invasive techniques. Although the safety and efficacy of minimally invasive PCF/PCD (MI-PCF/PCD) have been established, reports on long-term outcome and need for secondary surgical intervention at the index or adjacent level are lacking.
    Purpose: To determine the rates of complications, long-term outcomes, and need for secondary surgical intervention at the index or adjacent level after MI-PCF and microdiscectomy.
    Study design: Retrospective analysis of a prospective cohort.
    Patient sample: Seventy patients treated with MI-PCF and/or MI-PCD for cervical radiculopathy.
    Outcome measures: Visual Analog Scale for neck/arm (VASN/A) pain and Neck Disability Index (NDI).
    Methods: Ninety-seven patients underwent MI-PCF with or without MI-PCD between 2002 and 2011. Adequate prospective follow-up was available for 70 patients (95 cervical levels). The primary outcome assessed was need for secondary surgical intervention at the index or adjacent level. The secondary outcomes assessed included complications and improvements in NDI and VASN/A scores. All complications were reviewed. Mixed-model analyses of variance with random subject effects and autoregressive first-order correlation structures were used to test for differences among NDI, VASA, and VASN measurements made over time while accounting for the correlation among repeated observations within a patient. All statistical hypothesis tests were conducted at the 5% level of significance.
    Results: Patients were followed for a mean of 32.1 months. Of 70 patients operated, there were 3 (4.3%) complications (1 cerebrospinal fluid leak, 1 postoperative wound hematoma, and 1 radiculitis), none of which required a secondary operative intervention. Five patients required an anterior cervical discectomy and fusion (eight total levels fused) on average 44.4 months after the index surgery. Of those, five (5.3%) were at the index level and three (2.1%) were at adjacent levels. Neck Disability Index scores improved significantly (p<.0001) immediately postoperatively and continued to decrease gradually with time. Visual Analog Scale for neck/arm scores improved significantly (p<.0001) from baseline immediately postoperatively but tended to plateau with time.
    Conclusions: Minimally invasive PCF with or without MI-PCD is an excellent alternative for cervical radiculopathy secondary to foraminal stenosis or a laterally located herniated disc. There is a low rate (1.1% per index level per year) of future index site fusion and a very low rate (0.9% per adjacent level per year) of adjacent-level disease requiring surgery.
    MeSH term(s) Adult ; Cervical Vertebrae/surgery ; Cohort Studies ; Disability Evaluation ; Diskectomy/adverse effects ; Diskectomy/methods ; Female ; Follow-Up Studies ; Foraminotomy/adverse effects ; Foraminotomy/methods ; Humans ; Incidence ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/adverse effects ; Minimally Invasive Surgical Procedures/methods ; Pain Measurement ; Postoperative Complications ; Prospective Studies ; Radiculopathy/surgery ; Reoperation ; Retrospective Studies ; Spinal Fusion/statistics & numerical data ; Treatment Outcome
    Language English
    Publishing date 2014-10-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2037072-6
    ISSN 1878-1632 ; 1529-9430
    ISSN (online) 1878-1632
    ISSN 1529-9430
    DOI 10.1016/j.spinee.2014.01.048
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  5. Article ; Online: "Push-Through" Rod Passage Technique for the Improvement of Lumbar Lordosis and Sagittal Balance in Minimally Invasive Adult Degenerative Scoliosis Surgery.

    Haque, Raqeeb M / Uddin, Omar M / Ahmed, Yousef / El Ahmadieh, Tarek Y / Hashmi, Sohaib Z / Shah, Amir / Fessler, Richard G

    Clinical spine surgery

    2016  Volume 29, Issue 8, Page(s) 323–330

    Abstract: Of background data: Traditional open surgical techniques for correction of adult degenerative scoliosis (ADS) are often associated with increased blood loss, postoperative pain, and complications. Minimally invasive (MIS) techniques have been utilized ... ...

    Abstract Of background data: Traditional open surgical techniques for correction of adult degenerative scoliosis (ADS) are often associated with increased blood loss, postoperative pain, and complications. Minimally invasive (MIS) techniques have been utilized to address these issues; however, concerns regarding improving certain alignment parameters have been raised.
    Objective: A new "push-through" technique for MIS correction of ADS has been developed wherein a rod is bent before its placement into the screw heads and then contoured further to yield improved correction of radiographic parameters.
    Methods and study design: Preoperative and postoperative radiographic measurements of 3 patients who underwent MIS correction of scoliosis using the "push-through" technique were compared with 22 prior patients who had received traditional MIS correction. All patients received staged correction of scoliosis. The first stage involved insertion of lateral lumbar interbodies. Standing x-rays were then evaluated for overall global balance. The second stage involved appropriate MIS facetectomies, facet fusions, posterior transforaminal interbodies at lower lumbar segments, and finally the placement of rods.TECHNIQUE OVERVIEW:: (1) A long rod composed of titanium is bent with a mild lordosis and passed through the extensions of the screw heads cephalad to caudad. (2) The rod is passed fully through the incision so it extrudes from the caudal end of the construct. At this point, further lordosis is bent into the rods. (3) The rod is then pulled back into the appropriate position. (4) The unnecessary cephalad rod is then cut to appropriate length with a circular saw. (5) Rod reducers are then sequentially lowered and tightened to achieve the desired correction.
    Results: Mean age for all patients was 66.02 years. Preoperative coronal Cobb, sagittal vertical axis (SVA), and pelvic incidence (PI) were similar in all patients, whereas lumbar lordosis (LL) was smaller (15.27 vs. 29.85 degrees, P=0.00389) and pelvic tilt (PT) was larger (37.00 vs. 27.00 degrees, P=0.00011) in "push-through" patients. Postoperatively, "pushthrough" patients experienced greater correction of LL (21.93 vs. 3.70 degrees, P=0.00001), PI-LL (-18.57 vs. -0.26 degrees, P=0.00471), PT (-7.67 vs. -0.40 degrees, P=0.00341), SVA (-40.67 mm vs. 0.95 mm, P=0.05846), and coronal Cobb (-20.23 vs. -18.76 degrees, P=0.75).
    Conclusions: This new method of contouring a rod enables improved LL. This technique is easy to perform and can be a valuable tool in treating ADS using MIS techniques.
    MeSH term(s) Aged ; Bone Screws ; Cohort Studies ; Disability Evaluation ; Female ; Humans ; Lordosis/surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Radiography ; Scoliosis/surgery ; Spinal Fusion/instrumentation ; Spinal Fusion/methods ; Tomography, X-Ray Computed ; Treatment Outcome
    Language English
    Publishing date 2016
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2849646-2
    ISSN 2380-0194 ; 2380-0186
    ISSN (online) 2380-0194
    ISSN 2380-0186
    DOI 10.1097/BSD.0000000000000094
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  6. Article: Primary dural repair in minimally invasive spine surgery.

    Haque, Raqeeb M / Hashmi, Sohaib Z / Ahmed, Yousef / Uddin, Omar / Ogden, Alfred T / Fessler, Richard

    Case reports in medicine

    2013  Volume 2013, Page(s) 876351

    Abstract: We describe an effective surgical technique in primary repair of the spinal dura during minimally invasive spine surgery (MISS). Objective. Minimally invasive spine surgery includes the treatment of intradural lesions, and proper closure of the dura is ... ...

    Abstract We describe an effective surgical technique in primary repair of the spinal dura during minimally invasive spine surgery (MISS). Objective. Minimally invasive spine surgery includes the treatment of intradural lesions, and proper closure of the dura is necessary. However, primary dural closure can be difficult due to the restricted space of MIS retractors and the availability of appropriate surgical instrumentation. Methods. We describe the use of a needle already used in the pediatric neurosurgical arena that can facilitate easier and safer closure of spinal dura through MISS retractors in two illustrative intradural cases. Results and Discussion. The primary dural closure technique is described and patient demographics are included. The instruments specifically used for the intradural closure through MIS retractor systems include (1) 4-0 Surgilon braided nylon (Covidien, Dublin, Ireland) with a CV-20 taper 1/2 circle, 10 mm diameter needle; (2) Scanlan (Saint Paul, MN, USA) dura closure set. Conclusion. Successful primary dural repair can be performed on primary and incidental durotomies during minimally invasive spinal surgery. We describe the novel use of a 10 mm diameter needle to help surgeons safely and efficiently close the dura with more ease than previously described.
    Keywords covid19
    Language English
    Publishing date 2013-05-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2502642-2
    ISSN 1687-9635 ; 1687-9627
    ISSN (online) 1687-9635
    ISSN 1687-9627
    DOI 10.1155/2013/876351
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  7. Article: Transforaminal nerve root stimulation: a technical report.

    Haque, Raqeeb / Winfree, Christopher J

    Neuromodulation : journal of the International Neuromodulation Society

    2003  Volume 12, Issue 3, Page(s) 254–257

    Abstract: Objectives. This technical report provides a detailed description of a method of transforaminal nerve root stimulation useful in the treatment of chronic pain conditions. Material and Methods. We describe a patient who presented with a medically ... ...

    Abstract Objectives. This technical report provides a detailed description of a method of transforaminal nerve root stimulation useful in the treatment of chronic pain conditions. Material and Methods. We describe a patient who presented with a medically refractory peripheral neuropathy and suffered from bilateral foot pain. We utilized transforaminal nerve root stimulation to provide robust stimulation paresthesias to the painful areas. Implementing progressively angled stylets, we were able to successfully navigate the stimulators into the intervertebral foramenae with a retrograde approach. Results. The patient experienced appropriate pain relief after the stimulation and did not have any complications related to the procedure. Conclusions. We describe a method of transforaminal nerve root stimulation that can be easily implemented by providers using the standard tools available to them. Transforaminal nerve root stimulation may be appropriate for patients in whom more traditional approaches such as spinal cord stimulation or peripheral nerve stimulation are suboptimal.
    Language English
    Publishing date 2003-06-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1500372-3
    ISSN 1094-7159
    ISSN 1094-7159
    DOI 10.1111/j.1525-1403.2009.00224.x
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  8. Article ; Online: Minimally invasive thoracic corpectomy: 3-dimensional operative video of a posterolateral approach to decompression and anterior column reconstruction.

    Smith, Zachary A / Wong, Albert P / El Ahmadieh, Tarek Y / Aoun, Salah G / Haque, Raqeeb / Bendok, Bernard B / Fessler, Richard G

    Neurosurgery

    2013  Volume 73, Issue 2 Suppl Operative, Page(s) ons141

    MeSH term(s) Breast Neoplasms/pathology ; Decompression, Surgical ; Female ; Humans ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Reconstructive Surgical Procedures ; Spinal Neoplasms/secondary ; Spinal Neoplasms/surgery ; Thoracic Vertebrae/surgery ; Video Recording
    Language English
    Publishing date 2013-12
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1227/01.neu.0000431467.97462.e1
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  9. Article ; Online: Cost minimization in treatment of adult degenerative scoliosis.

    Uddin, Omar M / Haque, Raqeeb / Sugrue, Patrick A / Ahmed, Yousef M / El Ahmadieh, Tarek Y / Press, Joel M / Koski, Tyler / Fessler, Richard G

    Journal of neurosurgery. Spine

    2015  Volume 23, Issue 6, Page(s) 798–806

    Abstract: Object: Back pain is an increasing concern for the aging population. This study aims to evaluate if minimally invasive surgery presents cost-minimization benefits compared with open surgery in treating adult degenerative scoliosis.: Methods: Seventy- ... ...

    Abstract Object: Back pain is an increasing concern for the aging population. This study aims to evaluate if minimally invasive surgery presents cost-minimization benefits compared with open surgery in treating adult degenerative scoliosis.
    Methods: Seventy-one patients with adult degenerative scoliosis received 2-stage, multilevel surgical correction through either a minimally invasive spine surgery (MIS) approach with posterior instrumentation (n = 38) or an open midline (Open) approach (n = 33). Costs were derived from hospital and rehabilitation charges. Length of stay, blood loss, and radiographic outcomes were obtained from electronic medical records. Functional outcomes were measured with Oswestry Disability Index (ODI) and visual analog scale (VAS) surveys.
    Results: Patients in both cohorts were similar in age (Age(MIS) = 65.68 yrs, Age(Open) = 63.58 yrs, p = 0.28). The mean follow-up was 18.16 months and 21.82 months for the MIS and Open cohorts, respectively (p = 0.34). MIS and Open cohorts had an average of 4.37 and 7.61 levels of fusion, respectively (p < 0.01). Total inpatient charges were lower for the MIS cohort ($269,807 vs $391,889, p < 0.01), and outpatient rehabilitation charges were similar ($41,072 vs $49,272, p = 0.48). MIS patients experienced reduced length of hospital stay (7.03 days vs 14.88 days, p < 0.01) and estimated blood loss (EBL) (EBL(MIS) = 470.26 ml, EBL(Open)= 2872.73 ml, p < 0.01). Baseline ODI scores were lower in the MIS cohort (40.03 vs 48.04, p = 0.03), and the cohorts experienced similar 1-year improvement (ΔODI(MIS) = -15.98, ΔODI(Open) = -21.96, p = 0.25). Baseline VAS scores were similar (VAS(MIS) = 6.56, VAS(Open)= 7.10, p = 0.32), but MIS patients experienced less reduction after 1 year (ΔVAS(MIS) = -3.36, ΔVAS(Open) = -4.73, p = 0.04). Preoperative sagittal vertical axis (SVA) were comparable (preoperative SVA(MIS) = 63.47 mm, preoperative SVA(Open) = 71.3 mm, p = 0.60), but MIS patients had larger postoperative SVA (postoperative SVA(MIS) = 51.17 mm, postoperative SVA(Open) = 28.17 mm, p = 0.03).
    Conclusions: Minimally invasive surgery demonstrated reduced costs, blood loss, and hospital stays, whereas open surgery exhibited greater improvement in VAS scores, deformity correction, and sagittal balance. Additional studies with more patients and longer follow-up will determine if MIS provides cost-minimization opportunities for treatment of adult degenerative scoliosis.
    MeSH term(s) Adult ; Aged ; Cost-Benefit Analysis ; Female ; Health Care Costs ; Humans ; Intervertebral Disc Degeneration/complications ; Intervertebral Disc Degeneration/economics ; Intervertebral Disc Degeneration/surgery ; Length of Stay/economics ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/economics ; Retrospective Studies ; Scoliosis/economics ; Scoliosis/etiology ; Scoliosis/surgery ; Treatment Outcome
    Language English
    Publishing date 2015-12
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 2158643-3
    ISSN 1547-5646 ; 1547-5654
    ISSN (online) 1547-5646
    ISSN 1547-5654
    DOI 10.3171/2015.3.SPINE14560
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  10. Article ; Online: Alterations in systemic complement component 3a and 5a levels in patients with cerebral arteriovenous malformations.

    Haque, Raqeeb / Hwang, Brian Y / Appelboom, Geoffrey / Piazza, Matthew A / Guo, Kuanghua / Connolly, E Sander

    Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

    2011  Volume 18, Issue 9, Page(s) 1235–1239

    Abstract: The role of the complement cascade in the pathophysiology of cerebral arteriovenous malformation (AVM) is largely undefined. Complement subcomponents, C3a and C5a, are potent anaphylatoxins and key mediators of immuno-inflammatory response. Complement ... ...

    Abstract The role of the complement cascade in the pathophysiology of cerebral arteriovenous malformation (AVM) is largely undefined. Complement subcomponents, C3a and C5a, are potent anaphylatoxins and key mediators of immuno-inflammatory response. Complement activation may contribute to the pro-inflammatory state observed in AVM. Thus, we sought to determine the systemic levels of C3a and C5a and their response to treatments in patients with AVM. Blood samples of 18 patients undergoing treatment for unruptured AVM, and from 30 healthy control participants, were obtained at four times: (i) pre-treatment, (ii) 24-hours post-embolization, (iii) 24-hours post-resection, and at 1-month follow-up. Plasma concentrations of C3a and C5a were measured using enzyme-linked immunosorbent assay. The pre-treatment mean plasma C3a level was significantly higher in patients with AVM (1817±168 ng/mL) compared to controls (1126±151 ng/mL). The mean C3a level decreased 24-hours after embolization (1482±170 ng/mL) and remained at statistically similar levels 24-hours after resection (1511±149 ng/mL) and at 1-month follow-up (1535±133 ng/mL). Mean C3a levels at the three time points were higher than control levels.The baseline mean plasma C5a level was significantly elevated in patients with AVM (13.1±2.2 ng/mL) compared to controls (3.9±1.5 ng/mL).Mean C5a level decreasedpost-embolization (8.2±2.3 ng/mL) and remained at similar levels post-resection (8.5±3.0 ng/mL) and at 1-month follow-up (7.7±2.9 ng/mL). Mean C5a levels at the three time points were significantly higher than the control levels. We conclude that systemic C3a and C5a levels in patients with AVM are elevated at baseline, decrease significantly after embolization, and remain at the new baseline levels after surgery and 1-month follow-up.
    MeSH term(s) Adult ; Aged ; Chi-Square Distribution ; Complement C3a/metabolism ; Complement C5a/metabolism ; Female ; Humans ; Intracranial Arteriovenous Malformations/blood ; Male ; Middle Aged ; Retrospective Studies
    Chemical Substances Complement C3a (80295-42-7) ; Complement C5a (80295-54-1)
    Language English
    Publishing date 2011-09
    Publishing country Scotland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1193674-5
    ISSN 1532-2653 ; 0967-5868
    ISSN (online) 1532-2653
    ISSN 0967-5868
    DOI 10.1016/j.jocn.2011.02.015
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