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Neurosurgery Clinics of North America

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https://read.qxmd.com/read/31078240/preface
#1
EDITORIAL
Zoher Ghogawala
No abstract text is available yet for this article.
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078239/artificial-intelligence-for-the-treatment-of-lumbar-spondylolisthesis
#2
REVIEW
Zoher Ghogawala, Melissa Dunbar, Irfan Essa
Multiple registries are currently collecting patient-specific data on lumbar spondylolisthesis including outcomes data. The collection of imaging diagnostics data along with comparative outcomes data following decompression versus decompression and fusion treatments for degenerative spondylolisthesis represents an enormous opportunity for modern machine-learning analytics research.
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078238/future-studies-and-directions-for-the-optimization-of-outcomes-for-lumbar-spondylolisthesis
#3
REVIEW
Luis M Tumialán
Randomized prospective studies show clear benefits for operative versus nonoperative management of symptomatic lumbar spondylolisthesis, but there is no universally accepted surgical treatment. This article presents options for surgical management of lumbar spondylolisthesis, reviews the clinical trials delineating the role and type of surgical intervention, and explores the directions of future investigations. The next decade will add further clarity to the surgical management of spondylolisthesis, not by randomized prospective trials, but by surgical registries...
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078237/cost-effectiveness-for-surgical-treatment-of-degenerative-spondylolisthesis
#4
REVIEW
Kristen E Jones, David W Polly
Surgery for degenerative lumbar spondylolisthesis is significantly more cost-effective than nonsurgical management in patients who have failed to improve with a 6-week trial of nonsurgical management. Decompression plus fusion becomes more cost-effective compared with decompression alone at 2 years following surgery. Further study is needed to evaluate the most cost-effective fusion approach and augmentation strategy.
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078236/summary-of-guidelines-for-the-treatment-of-lumbar-spondylolisthesis
#5
REVIEW
Andrew K Chan, Viraj Sharma, Leslie C Robinson, Praveen V Mummaneni
Degenerative lumbar spondylolisthesis is a common cause of low back pain, affecting about 11.5% of the United States population. Patients with symptomatic lumbar spondylolisthesis may first be treated with conservative management strategies including, but not limited to, non-narcotic and narcotic pain medications, epidural steroid injections, transforaminal injections, and physical therapy. For well-selected patients who fail conservative management strategies, surgical management is appropriate. This article summarizes the guidelines for the treatment of lumbar spondylolisthesis...
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078235/surgical-treatment-of-lumbar-spondylolisthesis-in-the-elderly
#6
REVIEW
Vikram Chakravarthy, Arpan Patel, William Kemp, Michael Steinmetz
By 2060, population projections estimate the number of individuals older than 65 will double. Prevalence of degenerative spondylolisthesis is reported as 4.1%-11.1% within the general population. Given the growing older population, the need for evidence-based guidance is essential. Regarding benefit derived from decompression alone versus decompression plus fusion for degenerative spondylolisthesis, the consensus is that all patients do not require a fusion; however, clarity around clearly identifying this cohort is lacking...
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078234/surgical-versus-nonsurgical-treatment-of-lumbar-spondylolisthesis
#7
REVIEW
Michael Karsy, Erica F Bisson
Degenerative spine disease with low back pain affects ∼80% of the U.S. population, and spinal stenosis and degenerative spondylolisthesis affect ∼20% of the population. Nonoperative and operative interventions have both been studied extensively to better our understanding of how these strategies enable us to improve outcomes in patients with degenerative lumbar spondylolisthesis. This review aims to compare nonoperative and operative strategies and describe the use of incremental cost-effectiveness ratios to assess treatment options in this patient population...
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078233/rethinking-surgical-treatment-of-lumbar-spondylolisthesis-anatomic-considerations
#8
REVIEW
Akihito Minamide, Munehito Yoshida, Hiroshi Yamada, Andrew K Simpson
The goal was to develop a classification of degenerative spondylolisthesis (DS) and concurrent lumbar spinal stenosis (LSS) based on pathologic stage and determine how these subtypes of DS affect outcomes for minimally invasive decompression. Patients who underwent microendoscopic laminotomy for single-level LSS with DS were included. Degenerative spondylolisthesis pathologic staging was defined as early, advanced, or end stage, based on percent slippage (10% slippage), degree of dynamic instability (3 mm), and disc height...
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078232/lateral-approaches-for-the-surgical-treatment-of-lumbar-spondylolisthesis
#9
REVIEW
Jason E McGowan, Adam S Kanter
Spondylolisthesis is a common cause of lower back pain in people of all ages. When nonsurgical management is unsuccessful in treatment for lumbar spondylolisthesis, surgical treatment algorithms can be used. This article focuses on lateral lumbar interbody fusion (LLIF). It represents a minimally invasive approach that affords surgeons an increased ability to restore disc height, indirectly decompress the neural elements, and affect global spinal alignment. As the role for circumferential minimally invasive spine surgery continues to expand, the use of LLIF in the setting of spondylolisthesis-and other pathologies-will continue to represent a robust fusion option...
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078231/minimally-invasive-approaches-for-surgical-treatment-of-lumbar-spondylolisthesis
#10
REVIEW
Ibrahim Hussain, Sertac Kirnaz, Gibran Wibawa, Christoph Wipplinger, Roger Härtl
The unilateral laminotomy for bilateral decompression initially was described in the late 1990s and has evolved in conjunction with minimally invasive surgical instrumentation. This technique has been shown to significantly improve bilateral symptoms regardless of the side of approach. It also can be used for multilevel decompressions using the slalom technique with alternating lateralizing sites of access. The over-the-top technique involving a unilateral approach for bilateral decompression helps preserve the posterior tension band and can accomplish the operative goals with better clinical outcomes than traditional open approaches...
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078230/degenerative-lumbar-spondylolisthesis-definition-natural-history-conservative-management-and-surgical-treatment
#11
REVIEW
Mohamad Bydon, Mohammed Ali Alvi, Anshit Goyal
Degenerative lumbar spondylolisthesis is one of the most common causes of low back pain and is defined as displacement of one vertebra over subjacent vertebra, associated with degenerative changes, without an associated disruption or defect in the vertebral ring. Undersetanding natural history of degenerative spondylolisthesis is important to tailor an individualized management plan for each patient. A trial of conservative therapy may be considered for patients with low-grade spondylolisthesis presenting with radiculopathy and/or pseudoclaudication...
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078229/high-grade-lumbar-spondylolisthesis
#12
REVIEW
Aaron W Beck, Andrew K Simpson
Most high-grade spondylolistheses are resultant from isthmic spondylolisthesis, as complete discontinuity of the pars is typically necessary to allow for this degree of anterior vertebral translation, although can occur less commonly in other scenarios. Higher-grade slips can affect the global sagittal balance of the patient and often result in altered gait patterns and compensatory posturing. Management usually entails surgical decompression and fusion with instrumentation. The addition of anterior column support carries many advantages, including greater surface area for fusion, dynamic compression load sharing at the lumbosacral junction, and a powerful adjunct for deformity correction...
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/31078228/isthmic-lumbar-spondylolisthesis
#13
REVIEW
Amandeep Bhalla, Christopher M Bono
Lumbar isthmic spondylolisthesis is the anterior translation of one lumbar vertebra relative to the next caudal segment as a result of an abnormality in the pars interarticularis. Although it is most often an asymptomatic radiographic finding, symptomatic patients may present with low back and/or radicular leg pain. In the setting of persistent symptoms, despite nonoperative treatment, surgery can be considered. Successful arthrodesis and neurologic decompression, when necessary, are the chief goals of surgical treatment, which has demonstrated reasonable long-term outcomes...
July 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/30898279/neuromodulation-successful-treatments-future-opportunity-and-challenges
#14
EDITORIAL
Wendell Lake, Ashwini Sharan, Chengyuan Wu
No abstract text is available yet for this article.
April 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/30898278/brain-computer-interfaces-in-quadriplegic-patients
#15
REVIEW
Morgan B Lee, Daniel R Kramer, Terrance Peng, Michael F Barbaro, Charles Y Liu, Spencer Kellis, Brian Lee
Brain-computer interfaces (BCI) are implantable devices that interface directly with the nervous system. BCI for quadriplegic patients restore function by reading motor intent from the brain and use the signal to control physical, virtual, and native prosthetic effectors. Future closed-loop motor BCI will incorporate sensory feedback to provide patients with an effective and intuitive experience. Development of widely available BCI for patients with neurologic injury will depend on the successes of today's clinical BCI...
April 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/30898277/evolving-techniques-and-indications-in-peripheral-nerve-stimulation-for-pain
#16
REVIEW
Garrett P Banks, Christopher J Winfree
Peripheral nerve stimulation is the direct electrical stimulation of named nerves outside the central neuraxis to alleviate pain in the distribution of the targeted peripheral nerve. These treatments have shown efficacy in treating a variety of neuropathic, musculoskeletal, and visceral refractory pain pathologies; although not first line, these therapies are an important part of the treatment repertoire for chronic pain. With careful patient selection and judicious choice of stimulation technique, excellent results can be achieved for a variety of pain etiologies and distributions...
April 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/30898276/nerve-stimulation-for-pain
#17
REVIEW
Mark Corriveau, Wendell Lake, Amgad Hanna
Nerve stimulation is a reversible technique that is used successfully for the treatment of traumatic neuropathic pain, complex regional pain syndrome, and craniofacial neuropathic pain. Nerve field stimulation targets painful regions rather than a single nerve and has expanded indications, including axial low back pain. Appropriate patient education and motivation are crucial prior to surgery. Ongoing research is necessary to provide high-level evidence for the use of nerve stimulation. Most electrodes are primarily designed for spinal cord stimulation, hence the need to develop nerve electrodes dedicated for nerve stimulation...
April 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/30898275/deep-brain-stimulation-for-depression-an-emerging-indication
#18
REVIEW
Megan M Filkowski, Sameer A Sheth
Depression is a heterogenous disorder, with roughly 30% of patients deemed resistant to conventional treatments. In these cases, neurosurgical interventions such as lesion procedures or deep brain stimulation offer possible therapeutic options. Here, we review neurosurgical interventions for treatment-resistant depression, focusing on the recent advancements and future directions of deep brain stimulation.
April 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/30898274/responsive-neurostimulation-for-the-treatment-of-epilepsy
#19
REVIEW
Caio M Matias, Ashwini Sharan, Chengyuan Wu
There are a significant number of patients with epilepsy who are drug-resistant and for whom resective procedures are not an option. For these patients, neuromodulation may be an option, including closed-loop stimulation, such as responsive neurostimulation (RNS). The RNS System is a programmable and responsive device that consists of leads, a pulse generator, and an external programmer. An algorithm detects specific patterns of epileptogenic activity and triggers focal stimulation to interrupt a seizure. RNS is an effective and safe adjunctive therapy that in addition to seizure frequency reduction may have other applications, such as drug-response evaluation and long-term electrocorticography recording...
April 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/30898273/vagus-nerve-stimulation-for-the-treatment-of-epilepsy
#20
REVIEW
Hernán F J González, Aaron Yengo-Kahn, Dario J Englot
Vagus nerve stimulation (VNS) was the first neuromodulation device approved for treatment of epilepsy. In more than 20 years of study, VNS has consistently demonstrated efficacy in treating epilepsy. After 2 years, approximately 50% of patients experience at least 50% reduced seizure frequency. Adverse events with VNS treatment are rare and include surgical adverse events (including infection, vocal cord paresis, and so forth) and stimulation side effects (hoarseness, voice change, and cough). Future developments in VNS, including closed-loop and noninvasive stimulation, may reduce side effects or increase efficacy of VNS...
April 2019: Neurosurgery Clinics of North America
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