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  1. Article ; Online: The Addition of Radiofrequency Tumor Ablation to Kyphoplasty May Reduce the Rate of Local Recurrence in Spinal Metastases Secondary to Breast Cancer.

    Ragheb, Andrew / Vanood, Aimen / Fahim, Daniel K

    World neurosurgery

    2022  Volume 161, Page(s) e500–e507

    Abstract: Background: Approximately 10% of all cancer patients develop spinal metastases. When a symptomatic compression fracture occurs without associated deformity or neurologic deficit, it can be treated with kyphoplasty with or without radiofrequency ablation ...

    Abstract Background: Approximately 10% of all cancer patients develop spinal metastases. When a symptomatic compression fracture occurs without associated deformity or neurologic deficit, it can be treated with kyphoplasty with or without radiofrequency ablation (RFA). Treatment with kyphoplasty is well established but does not address the underlying oncologic disease.
    Methods: Retrospective medical chart analysis of breast cancer patients (n = 23) with metastatic spinal fractures (n = 50 vertebral levels) who underwent RFA and kyphoplasty was undertaken. Key variables of interest included: fracture location, pain levels, and local recurrence. Local recurrence data were compared to published rates of recurrence in breast cancer-related metastatic spinal fractures treated with vertebroplasty or kyphoplasty alone. Data were analyzed using χ
    Results: The mean preoperative pain level for this cohort was 6.9 on a 10-point visual analogue scale. Significant reductions in pain levels were observed postoperatively, at discharge (3.5; P < 0.05), at 1-month follow-up (2.8; P < 0.05), at 3-month follow-up (1.1; P < 0.05), and at 6-month follow-up (0.7 P < 0.05). Compared with published data of breast cancer patients with metastatic spinal fractures treated with vertebroplasty or kyphoplasty alone, the addition of RFA resulted in reduced local tumor recurrence (2% vs. 14%; P < 0.05). Average length of follow-up was 39 months.
    Conclusions: The results suggest that the addition of RFA to kyphoplasty may reduce local tumor recurrence while providing similar pain relief benefits. The extrapolation of this added benefit to metastases from other primary cancers should be examined in future studies.
    MeSH term(s) Breast Neoplasms/surgery ; Female ; Fractures, Compression/surgery ; Humans ; Kyphoplasty ; Neoplasm Recurrence, Local ; Pain ; Radiofrequency Ablation ; Retrospective Studies ; Spinal Fractures/surgery ; Spinal Neoplasms/surgery
    Language English
    Publishing date 2022-02-17
    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.2022.02.052
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  2. Article ; Online: Long-Term Reoperation Rates After Open versus Minimally Invasive Spine Surgery for Degenerative Lumbar Disease: Five Year Follow-Up of 2130 Patients.

    Ramanathan, Siddharth / Rapp, Aaron / Perez-Cruet, Mick / Fahim, Daniel K

    World neurosurgery

    2022  Volume 171, Page(s) e126–e136

    Abstract: Background: Minimally Invasive Spine Surgery (MISS) is a growing alternative to Open Spine Surgery (OSS). The preservation of musculature and minimization of iatrogenic injury is hypothesized to decrease the need for reoperation by preserving normal ... ...

    Abstract Background: Minimally Invasive Spine Surgery (MISS) is a growing alternative to Open Spine Surgery (OSS). The preservation of musculature and minimization of iatrogenic injury is hypothesized to decrease the need for reoperation by preserving normal anatomy. Our objective is to compare the relative long-term reoperation rates after MISS and OSS for the treatment of degenerative disease of the lumbar spine.
    Methods: This retrospective analysis compares the long-term reoperation rates after MISS and OSS. Eligible patients were adults with a primary lumbar intervention carried out between 5/1/2004 and 1/31/2014 to allow for at least 5 years of follow up. Patients without sufficient descriptive metrics or follow-up data were excluded. The primary outcome was the rate of lumbar spine reoperation.
    Results: A total of 2130 patients met the inclusion criteria-1895 underwent OSS and 235 underwent MISS. On average and across all surgery types (decompression and decompression with fusion), 28% of OSS patients required reoperation during the minimum 5-year follow up period while only 14% of MISS patients required reoperation (P = 0.001). The MISS group was statistically identical to the OSS group in all categories except that the MISS group was on average 1.8 years older (62.25 vs. 60.45, P = 0.039) and had a higher incidence of diabetes (26% vs. 17%, P = 0.000), but had a lower average body mass index than the OSS group (28.35 vs. 29.60, P = 0.002).
    Conclusions: In the setting of degenerative lumbar spine disease, MISS has the potential to reduce the long-term need for reoperation when compared with OSS.
    MeSH term(s) Adult ; Humans ; Retrospective Studies ; Reoperation ; Follow-Up Studies ; Lumbar Vertebrae/surgery ; Second-Look Surgery ; Minimally Invasive Surgical Procedures ; Treatment Outcome ; Spinal Fusion
    Language English
    Publishing date 2022-11-25
    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.2022.11.100
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  3. Article ; Online: Stand-Alone Balloon Kyphoplasty for Treatment of Traumatic Burst Fracture in Pediatric Patient.

    Thomas, Alison M / Fahim, Daniel K

    World neurosurgery

    2019  Volume 125, Page(s) 475–480

    Abstract: Background: Kyphoplasty is commonly employed in the treatment of compression fractures in the elderly and is increasingly used in the treatment of adult trauma along with concomitant instrumentation. Although kyphoplasty with instrumentation has been ... ...

    Abstract Background: Kyphoplasty is commonly employed in the treatment of compression fractures in the elderly and is increasingly used in the treatment of adult trauma along with concomitant instrumentation. Although kyphoplasty with instrumentation has been reported in pediatric patients, concerns regarding retardation of spinal growth and iatrogenic spinal deformity have been raised. The utilization of kyphoplasty without instrumentation has yet to be reported in the case of pediatric patients.
    Case description: A 13-year-old male presented to the emergency department with a traumatic L2 burst fracture with 50% loss of height, which continued to cause severe pain after a trial of bracing. He was subsequently treated with a kyphoplasty without instrumentation. He experienced a rapid and excellent recovery and resumed all previous activity.
    Conclusions: Kyphoplasty alone without instrumentation is a less invasive means to treat these patients and also prevents iatrogenic deformity or retardation of growth in the pediatric spine.
    MeSH term(s) Adolescent ; Fractures, Compression/diagnostic imaging ; Fractures, Compression/surgery ; Humans ; Kyphoplasty/methods ; Lumbar Vertebrae/diagnostic imaging ; Male ; Spinal Fractures/diagnostic imaging ; Spinal Fractures/surgery ; Tomography, X-Ray Computed
    Language English
    Publishing date 2019-02-08
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2019.01.184
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  4. Article ; Online: Safety and efficacy of balloon kyphoplasty at 4 or more levels in a single anesthetic session.

    Wang, Alan C / Fahim, Daniel K

    Journal of neurosurgery. Spine

    2018  Volume 28, Issue 4, Page(s) 372–378

    Abstract: OBJECTIVE In this case series, the authors evaluated the safety of balloon kyphoplasty at 4 or more vertebral levels in a single anesthetic session. The current standard is that no more than 3 levels should be cemented at one time because of a perceived ... ...

    Abstract OBJECTIVE In this case series, the authors evaluated the safety of balloon kyphoplasty at 4 or more vertebral levels in a single anesthetic session. The current standard is that no more than 3 levels should be cemented at one time because of a perceived risk of increased complications. METHODS A retrospective chart review was performed for 19 consecutive patients who underwent ≥ 4-level balloon kyphoplasty between July 1, 2011, and December 31, 2015. Outcomes documented included kyphoplasty-associated complications and incidences of subsequent vertebral fracture. RESULTS Nineteen patients aged 22 to 95 years (mean 66.1 years, median 66 years; 53% male, 47% female) had 4 or more vertebrae cemented during the same procedure (mean 4.6 levels [62 thoracic, 29 lumbar]). No postoperative anesthetic complication, infection, extensive blood loss, symptomatic cement leakage, pneumothorax, or new-onset anemia was observed. Five patients experienced new compression fracture within a mean of 278 days postoperatively. One patient with metastatic cancer suffered bilateral pulmonary embolism 19 days after surgery, but no evidence of cement in the pulmonary vasculature was found. CONCLUSIONS In this case series, kyphoplasty performed on 4 or more vertebral levels was not found to increase risk to patient safety, and it might decrease unnecessary risks associated with multiple operations. Also, morbidity associated with leaving some fractures untreated because of an unfounded fear of increased risk of complications might be decreased by treating 4 or more levels in the same anesthetic session.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Anesthetics ; Female ; Fractures, Compression/surgery ; Humans ; Kyphoplasty/adverse effects ; Kyphoplasty/methods ; Lumbar Vertebrae/surgery ; Male ; Middle Aged ; Osteoporotic Fractures/surgery ; Retrospective Studies ; Spinal Fractures/surgery ; Thoracic Vertebrae/surgery ; Treatment Outcome ; Vertebroplasty/adverse effects ; Vertebroplasty/methods ; Young Adult
    Chemical Substances Anesthetics
    Language English
    Publishing date 2018-01-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2158643-3
    ISSN 1547-5646 ; 1547-5654
    ISSN (online) 1547-5646
    ISSN 1547-5654
    DOI 10.3171/2017.8.SPINE17358
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    Uk I Zs.135 -Spine-: Show issues Location:
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  5. Article: Anatomical Variations of the Recurrent Laryngeal Nerve and Implications for Injury Prevention during Surgical Procedures of the Neck.

    Thomas, Alison M / Fahim, Daniel K / Gemechu, Jickssa M

    Diagnostics (Basel, Switzerland)

    2020  Volume 10, Issue 9

    Abstract: Accurate knowledge of anatomical variations of the recurrent laryngeal nerve (RLN) provides information to prevent inadvertent intraoperative injury and ultimately guide best clinical and surgical practices. The present study aims to assess the potential ...

    Abstract Accurate knowledge of anatomical variations of the recurrent laryngeal nerve (RLN) provides information to prevent inadvertent intraoperative injury and ultimately guide best clinical and surgical practices. The present study aims to assess the potential anatomical variability of RLN pertaining to its course, branching pattern, and relationship to the inferior thyroid artery, which makes it vulnerable during surgical procedures of the neck. Fifty-five formalin-fixed cadavers were carefully dissected and examined, with the course of the RLN carefully evaluated and documented bilaterally. Our findings indicate that extra-laryngeal branches coming off the RLN on both the right and left side innervate the esophagus, trachea, and mainly intrinsic laryngeal muscles. On the right side, 89.1% of the cadavers demonstrated 2-5 extra-laryngeal branches. On the left, 74.6% of the cadavers demonstrated 2-3 extra-laryngeal branches. In relation to the inferior thyroid artery (ITA), 67.9% of right RLNs were located anteriorly, while 32.1% were located posteriorly. On the other hand, 32.1% of left RLNs were anterior to the ITA, while 67.9% were related posteriorly. On both sides, 3-5% of RLN crossed in between the branches of the ITA. Anatomical consideration of the variations in the course, branching pattern, and relationship of the RLNs is essential to minimize complications associated with surgical procedures of the neck, especially thyroidectomy and anterior cervical discectomy and fusion (ACDF) surgery. The information gained in this study emphasizes the need to preferentially utilize left-sided approaches for ACDF surgery whenever possible.
    Language English
    Publishing date 2020-09-04
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics10090670
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  6. Article ; Online: Malignant primary tumors of scalp with cranial extension: multidisciplinary surgical strategies and outcomes.

    Huntoon, Kristin M / Mayer, Rory R / Fahim, Daniel K / Kumar, Saloni / Adelman, David M / McCutcheon, Ian E

    Journal of neurosurgery

    2023  Volume 140, Issue 4, Page(s) 979–986

    Abstract: Objective: Malignant cancers arising in the scalp may exhibit calvarial invasion, dural extension, and rarely cerebral involvement. Typically, such lesions require a multidisciplinary approach involving both neurosurgery and plastic surgery for optimal ... ...

    Abstract Objective: Malignant cancers arising in the scalp may exhibit calvarial invasion, dural extension, and rarely cerebral involvement. Typically, such lesions require a multidisciplinary approach involving both neurosurgery and plastic surgery for optimal resection and reconstruction. The authors present a retrospective analysis of patients with scalp malignancies who underwent resection and reconstruction.
    Methods: Patients presenting with scalp malignancies (1993-2021, n = 84) who required neurosurgical assistance for tumor resection were prospectively entered into a database. These data were retrospectively reviewed for this case series. The extent of neurosurgical resection was classified into four levels of involvement: scalp (level I), calvarial (level II), dural (level III), or intraparenchymal (level IV). Complications and evidence of local, locoregional, or regional recurrence were documented.
    Results: Patients underwent level I (n = 2), level II (n = 61), level III (n = 13), and level IV (n = 8) resections. Pathologies consisted of primarily squamous cell carcinoma (n = 50, 59.5%), basal cell carcinoma (n = 11, 13.1%), and melanoma (n = 9, 10.7%), with infrequent lesions including sarcoma, atypical fibroxanthoma, and malignant fibrous histiocytoma. For cases requiring a cranioplasty, 92.2% were done using titanium mesh and 7.8% with methylmethacrylate. At a mean follow-up of 35.5 ± 45.9 months, the overall survival was 48.8% (n = 41) and recurrence-free survival was 31.0% (n = 43). Scalp-based reconstruction involving plastic surgery was performed in 75 (89.3%) patients. The most commonly used free flap was a latissimus dorsi muscle flap (n = 46, 61.3%). One or more postoperative complications occurred in 21.4% of all patients, the most common being wound dehiscence or delayed wound healing in 13% (n = 11).
    Conclusions: A multidisciplinary approach with aggressive neurosurgical resection is associated with good outcomes in patients with primary malignant scalp tumors, despite invasive disease on presentation. This analysis suggests that aggressive resection (level II and higher) is effective at reducing locoregional recurrence and is not associated with a higher risk of complications relative to resection without craniectomy. As most patients require scalp reconstruction to close the postresection defect, usually with vascularized free tissue transfer, involving a plastic surgeon in the surgical planning and execution is essential.
    MeSH term(s) Humans ; Retrospective Studies ; Scalp/surgery ; Neoplasm Recurrence, Local/surgery ; Neoplasm Recurrence, Local/pathology ; Plastic Surgery Procedures ; Free Tissue Flaps/surgery ; Postoperative Complications/surgery
    Language English
    Publishing date 2023-09-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3089-2
    ISSN 1933-0693 ; 0022-3085
    ISSN (online) 1933-0693
    ISSN 0022-3085
    DOI 10.3171/2023.7.JNS23974
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  7. Article ; Online: Industry-Sponsored Research Payments in Neurosurgery-Analysis of the Open Payments Database From 2014 to 2018.

    Vanood, Aimen / Sharrak, Aryana / Karabon, Patrick / Fahim, Daniel K

    Neurosurgery

    2020  Volume 88, Issue 3, Page(s) E250–E258

    Abstract: Background: The Open Payments Database (OPD) started in 2013 to combat financial conflicts of interest between physicians and medical industry.: Objective: To evaluate the first 5 yr of the OPD regarding industry-sponsored research funding (ISRF) in ... ...

    Abstract Background: The Open Payments Database (OPD) started in 2013 to combat financial conflicts of interest between physicians and medical industry.
    Objective: To evaluate the first 5 yr of the OPD regarding industry-sponsored research funding (ISRF) in neurosurgery.
    Methods: The Open Payments Research Payments dataset was examined from 2014 to 2018 for payments where the clinical primary investigator identified their specialty as neurosurgery.
    Results: Between 2014 and 2018, a $106.77 million in ISRF was made to 731 neurosurgeons. Fewer than 11% of neurosurgeons received ISRF yearly. The average received $140 000 in total but the median received $30,000. This was because the highest paid neurosurgeon received $3.56 million. A greater proportion ISRF was made to neurosurgeons affiliated with teaching institutions when compared to other specialties (26.74% vs 20.89%, P = .0021). The proportion of the total value of ISRF distributed to neurosurgery declined from 0.43% of payments to all specialties in 2014 to 0.37% in 2018 (P < .001), but no steady decline was observed from year to year.
    Conclusion: ISRF to neurosurgeons comprises a small percentage of research payments made to medical research by industry sponsors. Although a greater percentage of payments are made to neurosurgeons in teaching institutions compared to other specialties, the majority is given to neurosurgeons not affiliated with a teaching institution. A significant percentage of ISRF is given to a small percentage of neurosurgeons. There may be opportunities for more neurosurgeons to engage in industry-sponsored research to advance our field as long as full and complete disclosures can always be made.
    MeSH term(s) Biomedical Research/economics ; Biomedical Research/trends ; Databases, Factual/trends ; Disclosure/trends ; Drug Industry/economics ; Drug Industry/trends ; Humans ; Neurosurgeons/economics ; Neurosurgeons/trends ; Neurosurgery/economics ; Neurosurgery/trends ; Salaries and Fringe Benefits/economics ; Salaries and Fringe Benefits/trends ; United States
    Language English
    Publishing date 2020-11-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1093/neuros/nyaa506
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    Zs.MO 539: Show issues

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  8. Article ; Online: Cervical Spine and Craniocervical Junction Reconstruction with a Vascularized Fibula Free Flap.

    Goldman, Joshua J / Huynh, Kristine A / Elfallal, Wissam / Chaiyasate, Kongkrit / Fahim, Daniel K

    World neurosurgery

    2020  Volume 144, Page(s) 34–38

    Abstract: Background: Long-term stabilization of the cervical spine after extensive multilevel tumor resection is difficult to achieve. The current standard approach of instrumentation combined with allograft or nonvascularized autograft is limited in settings of ...

    Abstract Background: Long-term stabilization of the cervical spine after extensive multilevel tumor resection is difficult to achieve. The current standard approach of instrumentation combined with allograft or nonvascularized autograft is limited in settings of increased risk of nonunion or delayed union (i.e., prior radiation therapy or poorly vascularized wound beds).
    Case description: We report the first time to our knowledge that a vascularized fibular free flap has been used to reconstruct the cervical column across 5 vertebral levels, from the craniocervical junction to the lower cervical spine. We describe a transoral approach to the area and compare this method with other reconstructive options.
    Conclusions: Vascularized bone grafting is a viable alternative to achieve lasting stability because of hastened fusion time, limited reliance on osseous remodeling, and incorporation into the axial skeleton with strut strength.
    MeSH term(s) Adult ; Bone Transplantation/methods ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery ; Fibula/blood supply ; Fibula/transplantation ; Foreign-Body Migration/diagnostic imaging ; Foreign-Body Migration/surgery ; Free Tissue Flaps/blood supply ; Free Tissue Flaps/transplantation ; Humans ; Male ; Reconstructive Surgical Procedures/methods ; Skull/diagnostic imaging ; Skull/surgery ; Transplantation, Autologous/methods
    Language English
    Publishing date 2020-08-11
    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.2020.08.057
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  9. Article ; Online: Prognostic Factors and Survival Outcome in Patients with Chordoma in the United States: A Population-Based Analysis.

    Lee, Ivan J / Lee, Robert J / Fahim, Daniel K

    World neurosurgery

    2017  Volume 104, Page(s) 346–355

    Abstract: Objective: To evaluate prognostic factors of patients with chordoma through a population-based analysis.: Methods: Surveillance, Epidemiology, and End Results (SEER) database was queried for patients with chordoma from 1973 to 2013. Kaplan-Meier ... ...

    Abstract Objective: To evaluate prognostic factors of patients with chordoma through a population-based analysis.
    Methods: Surveillance, Epidemiology, and End Results (SEER) database was queried for patients with chordoma from 1973 to 2013. Kaplan-Meier univariate analysis and Cox regression multivariate analysis were performed to examine prognostic factors in overall survival (OS) and disease-specific survival (DSS).
    Results: One thousand five hundred ninety-eight patients with chordoma are identified. Kaplan-Meier analysis showed that OS and DSS were 61% and 71% at 5 years and 41% and 57% at 10 years. Multivariate Cox regression analysis demonstrated that independent predictors of OS and DSS are age at diagnosis (hazard ratio [HR]= 2.80 [95% confidence interval {CI}, 2.12-3.70], P < 0.001; HR = 1.60 [95% CI, 1.18-2.16], P = 0.002), surgical treatment (HR = 0.62 [95% CI, 0.52-0.73], P < 0.001; HR = 0.64 [95% CI, 0.52-0.79], P < 0.001), radiation therapy (HR = 1.23 [95% CI, 1.07-1.42], P = 0.004; HR = 1.29 [95% CI, 1.09-1.54], P = 0.004), tumor size (HR = 1.53 [95% CI, 1.32-1.78], P < 0.001; HR = 1.62 [95% CI, 1.35-1.94], P < 0.001) and distant metastasis (HR = 3.40 [95% CI, 2.45-4.71], P < 0.001; HR = 3.77 [95% CI, 2.61-5.45], P < 0.001).
    Conclusion: We report the largest study to date to evaluate prognostic factors of patients with chordoma. Multivariate analysis demonstrated that older age, greater tumor size, and distant metastasis were correlated with decreased survival, whereas surgical resection was correlated with increased survival. Patients receiving radiation therapy also showed decreased survival, likely an indication of the patients' advanced stage of disease, making them poor surgical candidates.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Chordoma/mortality ; Chordoma/surgery ; Cohort Studies ; Disease Progression ; Female ; Humans ; Infant ; Infant, Newborn ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Postoperative Complications/mortality ; Prognosis ; Proportional Hazards Models ; SEER Program ; Skull Base Neoplasms/mortality ; Skull Base Neoplasms/surgery ; Skull Neoplasms/mortality ; Skull Neoplasms/surgery ; Spinal Neoplasms/mortality ; Spinal Neoplasms/surgery ; Statistics as Topic ; Treatment Outcome ; Tumor Burden ; United States ; Young Adult
    Language English
    Publishing date 2017-08
    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.2017.04.118
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  10. Article ; Online: Definitive single-stage posterior surgical correction of complete traumatic spondyloptosis at the thoracolumbar junction.

    Sandquist, Lee / Paris, Alexander / Fahim, Daniel K

    Journal of neurosurgery. Spine

    2015  Volume 22, Issue 6, Page(s) 653–657

    Abstract: Complete dislocation at the thoracolumbar junction is a rare occurrence, with only 4 previously reported cases in 3 separate series. Surgical procedures in the reported cases of spondyloptosis at the thoracolumbar junction have been described using ... ...

    Abstract Complete dislocation at the thoracolumbar junction is a rare occurrence, with only 4 previously reported cases in 3 separate series. Surgical procedures in the reported cases of spondyloptosis at the thoracolumbar junction have been described using instrumentation, reduction, decompression, and stabilization techniques. In this report the authors' patient presented with spondyloptosis at the thoracolumbar junction, resulting in a T-11 American Spinal Injury Association Grade A injury. The authors corrected the patient's thoracolumbar spondyloptosis with surgical reconstruction without the use of leveraged instrumented reduction. They describe a single-stage, posterior-only spinal realignment, reconstruction, and stabilization. Within months of beginning postoperative therapy, the patient enrolled and attended courses at a local college and regained personal independence by learning to drive a motor vehicle with a hand control. Two-year radiographic and clinical follow-up confirms solid fusion across the reconstruction.
    MeSH term(s) Decompression, Surgical/methods ; Humans ; Joint Dislocations/surgery ; Lumbar Vertebrae/surgery ; Male ; Reconstructive Surgical Procedures ; Spinal Fractures/surgery ; Spinal Fusion/methods ; Spondylolisthesis/diagnosis ; Spondylolisthesis/surgery ; Thoracic Vertebrae/surgery ; Treatment Outcome ; Young Adult
    Keywords covid19
    Language English
    Publishing date 2015-06
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2158643-3
    ISSN 1547-5646 ; 1547-5654
    ISSN (online) 1547-5646
    ISSN 1547-5654
    DOI 10.3171/2014.10.SPINE14165
    Database MEDical Literature Analysis and Retrieval System OnLINE

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