bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of life after different surgical procedures for the treatment of spinal metastases: results of a single-center prospective case series
Authors: de Ruiter Godard C. W. , Nogarede Claudine O. , Wolfs Jasper F. C. , Arts Mark P. 
Published: January 2017

OBJECTIVE
The performance of surgery for spinal metastases is rapidly increasing. Different surgical procedures, ranging from stabilization alone to stabilization combined with corpectomy, are thereby performed for various indications. Little is known about the impact of these different procedures on patient quality of life (QOL), but this factor is crucial when discussing the various therapeutic options with patients and their families. Thus, the authors of this study investigated the effect of various surgical procedures for spinal metastases on patient QOL.

METHODS
The authors prospectively followed a cohort of 113 patients with spinal metastases who were referred to their clinic for surgical evaluation between July 2012 and July 2014. Quality of life was assessed using the EQ-5D at intake and at 3, 6, 9, and 12 months after treatment.

RESULTS
Nineteen patients were treated conservatively, 41 underwent decompressive surgery with or without stabilization, 47 underwent a piecemeal corpectomy procedure with stabilization and expandable cage reconstruction, and 6 had a stabilization procedure without decompression. Among all surgical patients, the mean EQ-5D score was significantly increased from 0.44 pretreatment to 0.59 at 3 months after treatment (p < 0.001). Mean EQ-5D scores at 1 year after surgery further increased to 0.84 following decompression with stabilization, 0.74 after corpectomy with stabilization, and 0.94 after stabilization without decompression. Frankel scores also improved after surgery. There were no significant differences in improvements in EQ-5D scores and Frankel grades among the different surgical procedures. In addition, mortality and complication rates were similar.

CONCLUSIONS
Quality of life can improve significantly after various extensive and less extensive surgical procedures in patients with spinal metastases. The relatively invasive corpectomy procedure, as compared with alternative less invasive techniques, does not negatively affect outcome.
Stereotactic radiosurgery for intradural spine tumors using cone-beam CT image guidance
Authors: Monserrate Andrés , Zussman Benjamin , Ozpinar Alp , Niranjan Ajay , Flickinger John C. , Gerszten Peter C. 
Published: January 2017

OBJECTIVE
Cone-beam CT (CBCT) image guidance technology has been widely adopted for spine radiosurgery delivery. There is relatively little experience with spine radiosurgery for intradural tumors using CBCT image guidance. This study prospectively evaluated a series of intradural spine tumors treated with radiosurgery. Patient setup accuracy for spine radiosurgery delivery using CBCT image guidance for intradural spine tumors was determined.

METHODS
Eighty-two patients with intradural tumors were treated and prospectively evaluated. The positioning deviations of the spine radiosurgery treatments in patients were recorded. Radiosurgery was delivered using a linear accelerator with a beam modulator and CBCT image guidance combined with a robotic couch that allows positioning correction in 3 translational and 3 rotational directions. To measure patient movement, 3 quality assurance CBCTs were performed and recorded in 30 patients: before, halfway, and after the radiosurgery treatment. The positioning data and fused images of planning CT and CBCT from the treatments were analyzed to determine intrafraction patient movements. From each of 3 CBCTs, 3 translational and 3 rotational coordinates were obtained.

RESULTS
The radiosurgery procedure was successfully completed for all patients. Lesion locations included cervical (22), thoracic (17), lumbar (38), and sacral (5). Tumor histologies included schwannoma (27), neurofibromas (18), meningioma (16), hemangioblastoma (8), and ependymoma (5). The mean prescription dose was 17 Gy (range 12–27 Gy) delivered in 1–3 fractions. At the halfway point of the radiation, the translational variations and standard deviations were 0.4 ± 0.5, 0.5 ± 0.8, and 0.4 ± 0.5 mm in the lateral (x), longitudinal (y), and anteroposterior (z) directions, respectively. Similarly, the variations immediately after treatment were 0.5 ± 0.4, 0.5 ± 0.6, and 0.6 ± 0.5 mm along x, y, and z directions, respectively. The mean rotational angles were 0.3° ± 0.4°, 0.3° ± 0.4°, and 0.3° ± 0.4° along yaw, roll, and pitch, respectively, at the halfway point and 0.5° ± 0.5°, 0.4° ± 0.5°, and 0.2° ± 0.3° immediately after treatment.

CONCLUSIONS
Radiosurgery offers an alternative treatment option for intradural spine tumors in patients who may not be optimal candidates for open surgery. CBCT image guidance for patient setup for spine radiosurgery is accurate and successful in patients with intradural tumors.
CyberKnife stereotactic radiosurgery for the treatment of symptomatic vertebral hemangiomas: a single-institution experience
Authors: Zhang Michael , Chen Yi-Ren , Chang Steven D. , Veeravagu Anand 
Published: January 2017

OBJECTIVE
Symptomatic vertebral hemangiomas (SVHs) are a very rare pathology that can present with persistent pain or neurological deficits that warrant surgical intervention. Given the relative rarity and difficulty in assessment, the authors sought to present a dedicated series of SVHs treated using stereotactic radiosurgery (SRS) to provide insight into clinical decision making.

METHODS
A retrospective review of a single institution's experience with hypofractionated radiosurgery for SVH from 2004 to 2011 was conducted to determine the clinical and radiographic outcomes following SRS treatment. The authors report and analyze the treatment course of 5 patients with 7 lesions, 2 of which were treated primarily by SRS.

RESULTS
Of the 5 patients studied, 4 presented with a chief complaint of pain refractory to conservative measures. Three patients reported dysesthesias, and 2 reported upper-extremity weakness. Following radiosurgery, 4 of 5 patients exhibited improvement in their primary symptoms (3 for pain and 1 for weakness), achieving a clinical response after a mean period of 1 year. In 2 cases there was 20%–40% reduction in lesion size in the most responsive dimension as noted on images. All treatments were well tolerated.

CONCLUSIONS
SRS for SVH is a safe and feasible treatment strategy, comparable to prior radiotherapy studies, and in select cases may successfully confer delayed decompressive effects. Additional investigation will determine future patient selection and how conformal SRS treatment can best be administered.
Spinal stereotactic body radiotherapy following intralesional curettage with separation surgery for initial or salvage chordoma treatment
Authors: Lockney Dennis T. , Shub Timothy , Hopkins Benjamin , Lockney Natalie A. , Moussazadeh Nelson , Lis Eric , Yamada Yoshiya , Schmitt Adam M. , Higginson Daniel S. , Laufer Ilya , Bilsky Mark 
Published: January 2017

OBJECTIVE
Chordoma is a rare malignant tumor for which en bloc resection with wide margins is advocated as primary treatment. Unfortunately, due to anatomical constraints, en bloc resection to achieve wide or marginal margins is not feasible for many patients as the resulting morbidity would be prohibitive. The objective of this study was to evaluate the efficacy of intralesional curettage and separation surgery followed by spinal stereotactic body radiation therapy (SBRT) in patients with chordomas in the mobile spine.

METHODS
The authors performed a retrospective chart review of all patients with chordoma in the mobile spine treated from 2004 to 2016. Patients were identified from a prospectively collected database. Initially 22 patients were identified with mobile spine chordomas. With inclusion criteria of cytoreductive separation surgery followed closely by SBRT and a minimum of 6 months of follow-up imaging, 12 patients were included. Clinical and pathological characteristics of each patient were collected and data were analyzed. Patients were divided into two cohorts—those undergoing intralesional resection followed by SBRT as initial chordoma treatment at Memorial Sloan Kettering Cancer Center (MSKCC) (Cohort 1) and those undergoing salvage treatment following recurrence (Cohort 2). Treatment toxicities were classified according to the Common Terminology Criteria for Adverse Events version 4.03. Overall survival was analyzed using Kaplan-Meier analysis.

RESULTS
The 12 patients had a median post-SBRT follow-up time of 26 months. Cohort 1 had 5 patients with median post-SBRT follow-up time of 65.9 months and local control rate of 80% at last follow-up. Only one patient had disease progression, at 48.2 months following surgery and SBRT. Cohort 2 had 7 patients who had been treated at other institutions prior to undergoing both surgery and SBRT (salvage therapy) at MSKCC. The local control rate was 57.1% and the median follow-up duration was 10.7 months. One patient required repeat irradiation. Major surgery- and radiation-related complications occurred in 18% and 27% of patients, respectively. Epidural spinal cord compression scores were collected for each patient pre- and postoperatively.

CONCLUSIONS
The combination of surgery and SBRT provides excellent local control following intralesional curettage and separation surgery for chordomas in the mobile spine. Patients who underwent intralesional curettage and spinal SBRT as initial treatment had better disease control than those undergoing salvage therapy. High-dose radiotherapy may offer several biological benefits for tumor control.
Dynamic contrast-enhanced magnetic resonance imaging of osseous spine metastasis before and 1 hour after high-dose image-guided radiation therapy
Authors: Lis Eric , Saha Atin , Peck Kyung K. , Zatcky Joan , Zelefsky Michael J. , Yamada Yoshiya , Holodny Andrei I. , Bilsky Mark H. , Karimi Sasan 
Published: January 2017

OBJECTIVE
High-dose image-guided radiation therapy (HD IGRT) has been instrumental in mitigating some limitations of conventional RT. The recent emergence of dynamic contrast-enhanced (DCE) MRI to investigate tumor physiology can be used to verify the response of human tumors to HD IGRT. The purpose of this study was to evaluate the near-immediate effects of HD IGRT on spine metastases through the use of DCE MRI perfusion studies.

METHODS
Six patients with spine metastases from prostate, thyroid, and renal cell carcinoma who underwent HD IGRT were studied using DCE MRI prior to and 1 hour after HD IGRT. The DCE perfusion parameters plasma volume (Vp) and vascular permeability (Ktrans) were measured to assess the near-immediate and long-term tumor response. A Mann-Whitney U-test was performed to compare significant changes (at p ≤ 0.05) in perfusion parameters before and after RT.

RESULTS
The authors observed a precipitous drop in Vp within 1 hour of HD IGRT, with a mean decrease of 65.2%. A significant difference was found between Vp values for before and 1 hour after RT (p ≤ 0.05). No significant change was seen in Vp (p = 0.31) and Ktrans (p = 0.1) from 1 hour after RT to the first follow-up.

CONCLUSIONS
The data suggest that there is an immediate effect of HD IGRT on the vascularity of spine metastases, as demonstrated by a precipitous decrease in Vp. The DCE MRI studies can detect such changes within 1 hour after RT, and findings are concordant with existing animal models.
Two-level cervical arthroplasty using a “no-distraction” technique
Authors: Rajakumar Deshpande , Sharma Ankit , Hari Akshay , Konar Subhas , Krishna Murali 
Published: January 2017

Cervical arthroplasty is being recognized as an emerging alternative to anterior cervical fusion with comparable or superior outcomes. The authors describe the surgical nuances of 2-level cervical arthroplasty in a case of 2-level degenerative disease. In this surgical technique, conventional vertebral body distraction has been avoided to prevent facet distraction, which can be a cause of persistent postoperative neck pain. Good motion preservation was observed at the 1-year follow-up examination.The video can be found here: https://youtu.be/YTpRVRXuZZk.
Resection of uncovertebral joints and posterior longitudinal ligament for cervical disc arthroplasty
Authors: Tu Tsung-Hsi , Chang Chih-Chang , Wu Jau-Ching , Fay Li-Yu , Huang Wen-Cheng , Cheng Henrich 
Published: January 2017

The most commonly accepted indications for cervical disc arthroplasty (CDA) are 1- and 2-level cervical disc herniation or spondylosis causing radiculopathy or myelopathy that is refractory to medical management. Unlike anterior cervical discectomy and fusion (ACDF), which eliminates motion, CDA aims to restore the physiological range of motion of the indexed joint. Thus, the effect of indirect decompression gained by the insertion of a sufficiently large interbody graft and incorporation into arthrodesis after ACDF cannot be duplicated for CDA. For patients undergoing CDA, during extreme flexion/extension or rotation, the exiting nerve roots might be impinged by inadequately decompressed foraminal osteophytes. Therefore, the authors advocate generous decompression, including resection of the posterior longitudinal ligament (PLL) and bilateral uncovertebral joints (UVJs), even in the asymptomatic side. This video demonstrates full dural expansion and enlarged neuroforamen after removal of the PLL and UVJs. Venous hemorrhage encountered during foraminotomy can always be controlled by cottonoid packing or hemostatic agents. Also, the endplates of the surrounding vertebral bodies were meticulously prepared for parallel insertion of the ProDisc-C Nova (DePuy Synthes Spine) artificial disc. Please note that the ProDisc-C Nova is currently not available on the US market.The video can be found here: https://youtu.be/XUo34j6WFYs.
Surgical technique for revision surgery of cervical artificial disc replacements
Authors: Onken Julia , Meyer Bernhard , Vajkoczy Peter 
Published: January 2017

OBJECTIVECervical artificial disc replacement (C-ADR) is a widely used procedure with low risk at implantation. Few cases have been reported about the surgical techniques of C-ADR revision. The authors describe their surgical experience with the explantation of a Galileo C-ADR.METHODSRevision surgery was performed in a 58-year-old patient. Patient positioning and surgical opening techniques were performed as appropriate for anterior cervical decompression.RESULTSRevision surgery via the initial anterior approach was successful following an atraumatic removal of the implant. Fusion of the C5–6 segment was performed without complications.CONCLUSIONSIn general, the authors observed recurrent nerve palsy and malpositioning of the revised implant in C-ADR revision surgery. Problems with implant removal did not occur because the fusion rate was low due to the short time between initial surgery and C-ADR revision surgery.The video can be found here: https://youtu.be/32CUEDquinc.
Stepwise illustration of teeth-fixation semi-constrained cervical disc arthroplasty
Authors: Chang Chih-Chang , Wu Jau-Ching , Chang Peng-Yuan , Yeh Mei-Yin , Kuo Yi-Hsuan , Fay Li-Yu , Tu Tsung-Hsi , Huang Wen-Cheng , Cheng Henrich 
Published: January 2017

There are many kinds of artificial discs available for cervical disc arthroplasty (CDA), with various designs of fixation and articulation mechanisms. Each of these designs has different features and theoretically fits most optimally in selected types of patients. However, there has been insufficient literature to guide individualized selection among these CDA devices. Since CDA aims to restore the joint function rather than arthrodesis, tailor-made size, shape, and mechanical properties should be taken into account for each candidate's target disc. Despite several large-scale prospective randomized control trials that have demonstrated the effectiveness and durability of CDA for up to 8 years, none of them involved more than one kind of artificial disc. In this video the authors present detailed steps and technical aspects of the newly introduced ProDisc-C Vivo (DePuy Synthes Spine), which has the same ball-and-socket design for controlled, predictable motion as the ProDisc-C. The newly derived teeth fixation provides high primary stability and multilevel capability by avoidance of previous keel-related limitations and complications (e.g., split vertebral fracture). Please note that the ProDisc-C Vivo is currently not available on the US market.The authors present the case of a 53-year-old woman who had symptoms of both radiculopathy and myelopathy caused by a large, calcified disc herniation at C4–5. There was no improvement after 4 months of medical treatment and rehabilitation. A single-level CDA was successfully performed with the ProDisc-C Vivo, and her symptoms were completely ameliorated afterward. The follow-up images demonstrated preservation of motion at the indexed level.The video can be found here: https://youtu.be/4DSES1xgvQU.
Hybrid cervical disc arthroplasty
Authors: Tu Tsung-Hsi , Wu Jau-Ching , Cheng Henrich , Mummaneni Praveen V. 
Published: January 2017

For patients with multilevel cervical stenosis at nonadjacent segments, one of the traditional approaches has included a multilevel fusion of the abnormal segments as well as the intervening normal segment. In this video we demonstrate an alternative treatment plan with tailored use of a combination of anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) with an intervening skipped level.The authors present the case of a 72-year-old woman with myeloradiculopathy and a large disc herniation with facet joint degeneration at C3–4 and bulging disc at C5–6. After nonoperative treatment failed, she underwent a single-level ACDF at C3–4 and single-level arthroplasty at C5–6, which successfully relieved her symptoms. No intervention was performed at the normal intervening C4–5 segment. By using ACDF combined with arthroplasty, the authors have avoided a 3-level fusion for this patient and maintained the range of motion of 2 disc levels.The video can be found here: https://youtu.be/OrxcPUBvqLk.
M6-C artificial disc placement
Authors: Coric Domagoj , Parish John , Boltes Margaret O. 
Published: January 2017

There has been a steady evolution of cervical total disc replacement (TDR) devices over the last decade resulting in surgical technique that closely mimics anterior cervical discectomy and fusion as well as disc design that emphasizes quality of motion. The M6-C TDR device is a modern-generation artificial disc composed of titanium endplates with tri-keel fixation as well as a polyethylene weave with a polyurethane core. Although not yet approved by the FDA, M6-C has finished a pilot and pivotal US Investigational Device Exemption (IDE) study. The authors present the surgical technique for implantation of a 2-level M6-C cervical TDR device.The video can be found here: https://youtu.be/rFEAqINLRCo.
Intrahemispheric theta rhythm desynchronization impairs working memory
Authors: Alekseichuk Ivan , Pabel Stefanie Corinna , Antal Andrea , Paulus Walter 
Published: January 2017

Background: There is a growing interest in large-scale connectivity as one of the crucial factors in working memory. Correlative evidence has revealed the anatomical and electrophysiological players in the working memory network, but understanding of the effective role of their connectivity remains elusive. Objective: In this double-blind, placebo-controlled study we aimed to identify the causal role of theta phase connectivity in visual-spatial working memory. Methods: The frontoparietal network was over- or de-synchronized in the anterior-posterior direction by multi-electrode, 6 Hz transcranial alternating current stimulation (tACS). Results: A decrease in memory performance and increase in reaction time was caused by frontoparietal intrahemispheric desynchronization. According to the diffusion drift model, this originated in a lower signal-to-noise ratio, known as the drift rate index, in the memory system. The EEG analysis revealed a corresponding decrease in phase connectivity between prefrontal and parietal areas after tACS-driven desynchronization. The over-synchronization did not result in any changes in either the behavioral or electrophysiological levels in healthy participants. Conclusion: Taken together, we demonstrate the feasibility of manipulating multi-site large-scale networks in humans, and the disruptive effect of frontoparietal desynchronization on theta phase connectivity and visual-spatial working memory.
Effect of Hydromagnetic Mixed Convection Double Lid-Driven Square Cavity with Inside Elliptic Heated Block
Authors: Munshi M. J. H. , Alim M. A. 
Published: January 2017

Mixed convection heat transfer in a two-dimensional the effect of hydromagnetic mixed convection in a double lid driven square cavity with inside elliptic heated block is studied numerically. The left wall of the square cavity and inside the elliptic block was kept at Th while the right wall of the square cavity at a cold temperature Tc with Th > Tc. The lid is assumed to be upper wall moving in left to right and lower wall right to left directions respectively. The magnetic field of strength B is applied parallel to x- axis. Result is presented firstly for different Reynolds number (50 ? Re ? 150), Prandtl number Pr= 0.733 and presented for different Grashof number (103 ? Gr ? 106). The numerical results studied the effect of Reynolds number, Grashof number and buoyancy ratio on the local values. It is found that direction of lid and different elliptic heated block are more effective on heat and mass transfer on fluid flow with increasing magnetic field for all studied parameters.
Mid Latitude Sporadic E-layer Variability during Ascending Phase of Solar Cycle 24
Authors: Atulkar R. , Khan P. A. , Mansoori A. A. , Purohit P. K. 
Published: January 2017

The paper presents a comparative study of the ionospheric sporadic E layer parameters (fbEs, foEs, and hEs) retrieved from ground based ionosonde at mid latitude station Yamagawa, Japan (31.20 N, 130.370 E) during the ascending phase of 24th solar cycle i.e. during January 2012 to December 2014. The comparison between the E-region parameters has been carried out on a diurnal, seasonal, annual and day night basis. The diurnal maxima of foEs, fbEs, and hEs are generally higher during high solar activity. From the present study it is found that the highest values of fbEs are observed during the summer while the lowest values are observed during autumn at mid latitude. Similarly, the highest values of foEs are observed during the summer season while the lowest values are recorded in autumn season. However, the highest values of hEs are recorded during the spring and the lowest values are recorded in autumn. The variability of Es during the day and night time is also studied. The sporadic E can form and disappear in a short time during either the day or night. We have also studied the percentage occurrence of sporadic E. The occurrence of Es changes from year to year.