Journal of neurosurgery
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The authors report the case of a patient with amyloidoma of the thoracic spine. A 34-year-old man presented with a 2-month history of upper-back pain, bilateral lower-extremity weakness, and numbness below the nipple. A computerized tomography study revealed an extradural mass with destruction of the T-2 lamina and pedicle. ⋯ Histological examination showed typical amyloid masses that demonstrated apple-green double refraction on examination of the Congo red-stained section under polarized light. Amyloidomas are rare benign lesions that, unlike other forms of amyloidosis, have an excellent prognosis. A cure is possible with complete resection of the mass.
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Journal of neurosurgery · Apr 2001
Long-lasting analgesic effect of radiofrequency treatment of the lumbosacral dorsal root ganglion.
The authors conducted a study to establish the benefit of radiofrequency (RF) treatment of the lumbosacral dorsal root ganglion (DRG) as a therapy to reduce symptomatic pain in patients with chronic spinal pain radiating to the leg. ⋯ The use of RF in the treatment of DRG appears to be a useful and safe therapy in patients with chronic spinal pain that radiates to the leg. The initial success rate is approximately 60%. It seems to lead to a time-limited effect on the target structure, and the mean duration of pain reduction is approximately 3.7 years. The mechanism of action remains unclear.
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Journal of neurosurgery · Apr 2001
Evaluation of the neuroprotective effects of sodium channel blockers after spinal cord injury: improved behavioral and neuroanatomical recovery with riluzole.
Persistent activation of voltage-sensitive Na+ channels is associated with cellular toxicity and may contribute to the degeneration of neural tissue following traumatic brain and spinal cord injury (SCI). Pharmacological blockade of these channels can attenuate secondary pathophysiology and reduce functional deficits acutely. ⋯ Systemic Na+ channel blockers, in particular riluzole, can confer significant neuroprotection after in vivo SCI and result in behavioral recovery and sparing of both gray and white matter.
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Journal of neurosurgery · Apr 2001
Can airway complications following multilevel anterior cervical surgery be avoided?
The authors conducted a study to determine how to avoid emergency postoperative reintubation and its associated morbidity in patients who have undergone multilevel anterior-posterior cervical spine surgery. ⋯ Emergency reintubation following anterior-posterior cervical surgery and fusion can be avoided by maintaining intubation overnight and subsequently having an anesthesiologist remove the tube after healing is fiberoptically confirmed. Familiarity with major risk factors contributing to airway compromise, combined with this protocol, should minimize the significant morbidity associated with reintubation following multilevel anterior-posterior cervical fusion.