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Pediatric Cervical Spine Injuries and SCIWORA: WFNS Spine Committee Recommendations
Nikolay Konovalov,Nikolay Peev,Mehmet Zileli,Salman Sharif,Stanislav Kaprovoy,Stanislav Timonin 대한척추신경외과학회 2020 Neurospine Vol.17 No.4
Cervical trauma in children have variations from the adults mainly due to anatomic differences. An optimal diagnostic and treatment strategy is critical, particularly when there is a lack of standardized protocols for the management of such cases. This review paper examines the diagnostic and treatment options of pediatric cervical trauma and Spinal Cord Injury Without Radiographic Abnormality (SCIWORA). A literature search for the last 10 years were conducted using key words. Case reports, experimental studies, papers other than English language were excluded. Up-to-date information on pediatric cervical trauma and SCIWORA were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of WFNS Spine Committee. The statements were voted and reached a consensus using Delphi method. This review reflects different aspects of contemporary pediatric cervical trauma decision-making and treatment, and SCIWORA. The mainstay of SCIWORA treatment is nonsurgical with immobilization, avoidance of risky activities. Prognosis generally depends on the initial neurological status and magnetic resonance imaging. Due to a significant discrepancy in the literature on diagnostic and management, future randomized controlled trials are needed to aid in generating standardized protocols.
Optochiasmatic cavernoma: Surgical treatment and outcomes
Anton Konovalov,Oleg Saripov,Vadim Gadzhiagaev,Oleg Titov,Nikolay Lasunin,Abzal Zhumabekov,Dmitry Fomichev,Eliava Shalva Salvovich,Pavel Kalinin,Bipin Chaurasia 대한뇌혈관외과학회 2023 Journal of Cerebrovascular and Endovascular Neuros Vol.25 No.4
Objective: Optochiasmatic cavernoma is an extremely rare cerebral lesion. They account for approximately 1% of all cavernomas of the central nervous system. Reports on this pathology are limited. Abrupt visual deterioration is a common symptom of the disease. Treatment strategy and visual outcomes after different treatment approaches remain a subject for discussion.Methods: Patients operated in a period 2005-2021 were analyzed in this study. All patients preoperatively underwent computed tomography (CT) scan, CT-angiography, and magnetic resonance imaging (MRI). Visual function of the patients was assessed pre-op, post-op and at the follow-up. Duration of visual dysfunction was noted as well. Surgical details were also extracted from medical notes. All patients were followed up, and control MRI was performed one month after operation. We assessed surgical series of optochiasmatic cavernomas published for last 10 years. Further comparative analysis with our data was performed.Results: Five patients were included into this study. There were four men and one woman. Mean age comprised 33.8 years (range 20-48 years). Most patients were admitted to our hospital due to visual disturbances (80%). Visual function improved in four patients. Visual function was unchanged in one patient, lacking visual disturbancies pre-op. Complication developed in one patient.Conclusions: Optochiasmatic cavernomas are encountered extremely rare. Despite the use of contemporary diagnostic options, differential diagnosis remains challenging. Full diagnostic work-up is mandatory. After the diagnosis is made, surgical treatment should be considered first. Total microsurgical or endoscopic transsphenoidal removal of the optochiasmatic cavernoma is a relatively safe and effective treatment method facilitating improvement of visual function.
Spinal cord stimulation in chronic pain: technical advances
Emil Isagulyan,Konstantin Slavin,Nikolay Konovalov,Eugeny Dorochov,Alexey Tomsky,Andrey Dekopov,Elizaveta Makashova,David Isagulyan,Pavel Genov 대한통증학회 2020 The Korean Journal of Pain Vol.33 No.2
Chronic severe pain results in a detrimental effect on the patient’s quality of life. Such patients have to take a large number of medications, including opioids, often without satisfactory effect, sometimes leading to medication abuse and the pain worsening. Spinal cord stimulation (SCS) is one of the most effective technologies that, unlike other interventional pain treatment methods, achieves long-term results in patients suffering from chronic neuropathic pain. The first described mode of SCS was a conventional tonic stimulation, but now the novel modalities (high-frequency and burst), techniques (dorsal root ganglia stimulations), and technical develop-ment (wireless and implantable pulse generator-free systems) of SCS are becom-ing more popular. The improvement of SCS systems, their miniaturization, and the appearance of new mechanisms for anchoring electrodes results in a significant reduction in the rate of complications and revision surgeries, and the appearance of new waves of stimulation allows not only to avoid the phenomenon of addiction, but also to improve the long-term results of chronic SCS. The purpose of this review is to describe the current condition of SCS and up-to-date technical advances.
Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations
Mehmet Zileli,Enrique Osorio-Fonseca,Nikolay Konovalov,Carlos Cardenas-Jalabe,Stanislav Kaprovoy,Sergey Mlyavykh,Artur Pogosyan 대한척추신경외과학회 2020 Neurospine Vol.17 No.4
Epidemiology, prevention, early management of cervical spine trauma and it's reduction are the objectives of this review paper. A PubMed and MEDLINE search between 2009 and 2019 were conducted using keywords. Case reports, experimental studies, papers other than English language and and unrelated studies were excluded. Up-to-date information on epidemiology of spine trauma, prevention, early emergency management, transportation, and closed reduction were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of World Federation of Neurosurgical Societies (WFNS) Spine Committee. The statements were voted and reached a positive or negative consensus using Delphi method. Global incidence of traumatic spinal injury is higher in low- and middle-income countries. The most frequent reasons are road traffic accidents and falls. The incidence from low falls in the elderly are increasing in high-income countries due to ageing populations. Prevention needs legislative, engineering, educational, and social efforts that need common efforts of all society. Emergency care of the trauma patient, transportation, and in-hospital acute management should be planned by implementing detailed protocols to prevent further damage to the spinal cord. This review summarizes the WFNS Spine Committee recommendations on epidemiology, prevention, and early management of cervical spine injuries.
Upper Cervical Spine Trauma: WFNS Spine Committee Recommendations
Oscar L. Alves,Leopoldina Pereira,김세훈,Andrey Grin,Nobuyuki Shimokawa,Nikolay Konovalov,Mehmet Zileli 대한척추신경외과학회 2020 Neurospine Vol.17 No.4
Craniovertebral junction (CVJ) trauma is a challenging clinical condition. Being a highly mobile functional unit at the junction of the skull and the vertebral column, traumatic events in this area may produce devastating neurological complications and death. Additionally, many of the CVJ traumatic injuries can be left undiagnosed or even raise difficult treatment dilemmas. We present a literature review in the format of recommendations on the diagnosis and management of different scenarios for upper cervical trauma and produce recommendations, which can be applicable to various areas of the globe.
Reply to Commentary on “History of Spinal Neurosurgery and Spine Societies”
Mehmet Zileli,Salman Sharif,Maurizio Fornari,Premenand Ramani,Fengzeng Jian,Richard Fessler,Se-Hoon Kim,Toshihiro Takami,Nobuyuki Shimokawa,Gilbert Dechambenoit,Mahmood Qureshi,Nikolay Konovalov,Marco 대한척추신경외과학회 2021 Neurospine Vol.18 No.1
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