Journal of neurosurgery
-
Journal of neurosurgery · Oct 2003
Multicenter Study Clinical TrialClinical and radiological evaluation of the Codman semiconstrained load-sharing anterior cervical plate: prospective multicenter trial and independent blinded evaluation of outcome.
Semiconstrained load-sharing implants for spinal fixation accommodate change in the screw-plate interface as bone grafts shrink. The authors evaluated the clinical and radiological outcome in patients after placement of the Codman anterior cervical plate (ACP) system, which allows change in the screw-plate angle. ⋯ Based on an independent blinded evaluation, the Codman ACP provides effective fixation with load sharing and is effective in achieving fusion with a 94% success rate. Direct comparison with rigidly locked devices is required to establish definitively the optimal method for anterior cervical fixation.
-
Journal of neurosurgery · Sep 2003
Multicenter Study Comparative StudySurvival following surgery and prognostic factors for recently diagnosed malignant glioma: data from the Glioma Outcomes Project.
The Glioma Outcomes Project represents a contemporary analysis of the management of malignant (Grade III and Grade IV/GBM) gliomas in North America. This observational database was used to evaluate the influence of resection, as opposed to biopsy, on patient outcome as measured by the length of survival. Attempts were made to reduce the impact of selection bias by repeating the data analysis after omitting patients with major negative prognostic factors. ⋯ These data provide Class II evidence to support tumor grade, patient's age, and patient's functional status as prognostic factors for survival in individuals with recently diagnosed malignant gliomas. Resection (compared with biopsy) is also a strong prognostic factor; however, no quantitative attempt was made to assess the true extent of the resection.
-
Journal of neurosurgery · Aug 2003
Multicenter Study Clinical TrialPeroneal intraneural ganglia: the importance of the articular branch. Clinical series.
The peroneal nerve is the most common site of intraneural ganglia. The neurological deficit associated with these cysts is often severe and the operation to eradicate them is difficult The aims of this multicenter study were to collate the authors' experience with a relatively rare lesion and to improve clinical outcomes by better understanding its controversial pathogenesis. ⋯ The clinical presentation, electrical studies, imaging characteristics, and operative observations regarding peroneal intraneural ganglia are predictable. Treatment must address the underlying pathoanatomy and should include decompression of the cyst and ligation of the articular branch of the nerve. To avoid extraneural recurrence, resection of the superior tibiofibular joint may also be necessary, but indications for this additional procedure need to be defined. These recommendations are based on the authors' belief that intraneural peroneal ganglia arise from the superior tibiofibular joint and are connected to it by the articular branch.
-
Journal of neurosurgery · Apr 2003
Randomized Controlled Trial Multicenter Study Clinical TrialEfficacy of antimicrobial-impregnated external ventricular drain catheters: a prospective, randomized, controlled trial.
Catheter-related infection of the cerebrospinal fluid (CSF) pathways is a potentially life-threatening complication of external ventricular drainage. A major source of infection is bacterial contamination along the external ventricular drain (EVD) catheter track. The authors examined the efficacy of EVD catheters impregnated with minocycline and rifampin in preventing these catheter-related infections. ⋯ The use of EVD catheters impregnated with minocycline and rifampin can significantly reduce the risk of catheter-related infections.
-
Journal of neurosurgery · Feb 2003
Randomized Controlled Trial Multicenter Study Clinical TrialLack of benefit of endoscopic ventriculoperitoneal shunt insertion: a multicenter randomized trial.
Endoscopically assisted ventricular catheter placement has been reported to reduce shunt failure in uncontrolled series. The authors investigated the efficacy of this procedure in a prospective multicenter randomized trial. ⋯ Endoscopic insertion of the initial VP shunt in children suffering from hydrocephalus did not reduce the incidence of shunt failure.