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Radiosurgery to the spinal dorsal root ganglion induces fibrosis and inhibits satellite glial cell activation while preserving axonal neurotransmission

Ezequiel Goldschmidt, Wendy Fellows-Mayle, Rachel Wolfe, Ajay Niranjan, John C. Flickinger, L. Dade Lunsford, and Peter C. Gerszten

L ow - back pain and radiculopathy are the second most frequent disorders affecting the population in North America, preceded only by the common cold. 5 , 10 , 18 More than 10 million people in the United States are disabled because of incapacitating lumbar radiculopathies, for which treatment continues to be a challenge. 8 , 16 , 21 Radiosurgery has been utilized since the 1950s to treat refractory trigeminal neuralgia, with Lars Leksell being the first to target the trigeminal nerve using focused radiation. 2 , 12 , 23 Despite the success of radiosurgery to

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Transarticular screw fixation of C1–2 for the treatment of arthropathy-associated occipital neuralgia

Report of 2 cases

Peyman Pakzaban

syndromes of a vascular, neoplastic, and posttraumatic nature has been successfully treated with decompressive surgery. 3 , 4 , 17 , 22 It is reasonable to assume that the same pathophysiological mechanisms that mediate immediate postoperative improvement after microvascular decompression for trigeminal neuralgia also apply to decompressive surgery for occipital neuralgia. However, in the absence of decompression, improvement of occipital neuralgia with motion elimination alone requires further explanation. A possible pathophysiological mechanism for this improvement

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Anomalous vertebral artery—induced cervical cord compression causing severe nape pain

Case report

Kei Watanabe, Kazuhiro Hasegawa, and Kou Takano

dorsal vascular region compressing the spinal cord. Because spinal arteriovenous malformations or other vascular malformations have similar MR imaging characteristics, conventional angiography was performed to differentiate the VA anomaly from other vascular legions. Jannetta 3 first reported the technique for the treatment of trigeminal neuralgia; he placed a small piece of polyvinyl chloride sponge between the trigeminal nerve and the branch of superior cerebellar artery at the brainstem. Since Jannetta introduced this microvascular decompressive technique, it has

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Letter

Brainstem ischemia

Hernando Rafael

M , Perani D , Lenzi GL , : Chronic pain: a PET study of the central effects of percutaneous huge cervical cordotomy . Pain 46 : 9 – 12 , 1991 10.1016/0304-3959(91)90026-T 3 Fromm GH , Terrence CF , Maroon JC : Trigeminal neuralgia: current concept regarding etiology and pathogenesis . Arch Neurol 41 : 1204 – 1207 , 1984 10.1001/archneur.1984.04050220102026 4 García-Gomez I , Goldsmith HS , Angulo J , Prados A , López-Hervás Cuevas B , : Angiogenic capacity of human omental stem cells . Neurol Res 27 : 807 – 811

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Endoscopic transnasal decompression for management of basilar invagination in osteogenesis imperfecta

Technical note

Mitchell A. Hansen, Melville J. da Cruz, and Brian K. Owler

complications associated with surgery in this time. The patient no longer demonstrated any sign or symptom of BI. Discussion Osteogenesis imperfecta is frequently complicated by spine deformities. There are many reports of scoliosis, kyphosis, or both in patients with OI. The most serious complications of OI are caused by BI. Criteria for surgery in a young patient include symptoms such as unremitting cough and laughter headaches, trigeminal neuralgia, nystagmus, and critical long-tract signs. Problems with speech, swallowing, and hand function can be symptoms of

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Pathological effects and motor response threshold changes following radiofrequency application at various distances from the L-5 nerve root: an experimental study

Laboratory investigation

Joseph Maarrawi, Sandra Kobaiter-Maarrawi, Ismat Ghanem, Youssef Ali, Georges Aftimos, Nabil Okais, and Elie Samaha

trigeminal neuralgia, chronic low-back pain, postherpetic neuralgia, complex regional pain syndrome, 10 and osteoid osteoma in the pediatric and adult populations. 5 , 6 It has also been established that RF ablation is a well-validated and safe technique for the treatment of spinal osteoid osteomas, 1 , 3 , 17 even those very close to neurological structures (that is, the roots and spinal cord), 11 and has been recently demonstrated to be useful in producing epiphysiodesis in laboratory animals, with the projected goal of treating limb length discrepancies and angular

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“Fulfilling the chief of his duties as a physician”: Harvey Cushing, selective dorsal rhizotomy and elective spine surgery for quality of life

Historical vignette

Hormuzdiyar H. Dasenbrock, Courtney Pendleton, Matthew J. McGirt, Daniel M. Sciubba, Ziya L. Gokaslan, Alfredo Quiñones-Hinojosa, and Ali Bydon

operative route to the Gasserian ganglion for patients with trigeminal neuralgia; 23 , 41 likewise, he pioneered the subtemporal decompression to prevent debilitating symptoms from elevated intracranial pressure in patients with inoperable brain tumors. 17 , 20 , 22 In his paper “The Special Field of Neurological Surgery,” Cushing emphasized quality of life: “in affording a measure of relief to these distressing cases, one may fulfill the chief of his [or her] duties as a physician—to prolong life and at the same time alleviate suffering.” 24 In the same paper

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Retrospective analysis of peripheral nerve sheath tumors of the second cervical nerve root in 60 surgically treated patients

Atul Goel, Dattatraya Muzumdar, Trimurti Nadkarni, Ketan Desai, Nitin Dange, and Aadil Chagla

of trigeminal neuralgia . Arch Psychiatr Nervenkr 227 : 33 – 37 , 1979 4 Donner TR , Voorhies RM , Kline DG : Neural sheath tumors of major nerves . J Neurosurg 81 : 362 – 373 , 1994 5 Ducatman BS , Scheithaure BW , Piepgras DG , Reiman HM , Il-strup DM : Malignant peripheral nerve sheath tumors. A clinicopathologic study of 120 cases . Cancer 57 : 2006 – 2021 , 1986 6 Fields WS , Zulch KJ , Maslenikov V : High cervical neurinoma. Special neurologic and radiologic featues . Zentralbl Neurochir 33 : 99 – 102

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Three-dimensional constructive interference in steady-state magnetic resonance imaging in syringomyelia: advantages over conventional imaging

Florian Roser, Florian H. Ebner, Søren Danz, Felix Riether, Rainer Ritz, Klaus Dietz, Thomas Naegele, and Marcos S. Tatagiba

subtle arachnoid scarring in the subarachnoid space. To reveal subarachnoid pathology T2-weighted MR imaging is the method of choice, but the loss of signal due to CSF flow is an inherent problem, leading to a reduction in contrast within the subarachnoid space. The 3D CISS MR imaging sequence was first introduced in 1993 by Casselman et al. 6 Three-dimensional CISS imaging demonstrates enhanced contrast within the subarachnoid space 6 and is the sequence of choice in the preoperative diagnosis of trigeminal neuralgia, aqueductal stenosis, or brachial plexus lesions

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Efficacy and cost-effectiveness analysis of external beam and stereotactic body radiation therapy in the treatment of spine metastases: a matched-pair analysis

Clinical article

Marsha L. Haley, Peter C. Gerszten, Dwight E. Heron, Yue-Fang Chang, Dave S. Atteberry, and Steven A. Burton

Guideline Initiative: Stereotactic Radiosurgery for Patients With Intractable Typical Trigeminal Neuralgia Who Have Failed Medical Management. Radiosurgery Practice Guideline Report #1-03, Issued January 2009 Harrisburg, PA , International RadioSurgery Association , 2009 . ( http://www.irsa.org/TN%20Guideline-UpdatedJan2009.pdf ) [Accessed December 13, 2010] 13 Tong D , Gillick L , Hendrickson FR : The palliation of symptomatic osseous metastases: final results of the Study by the Radiation Therapy Oncology Group . Cancer 50 : 893 – 899 , 1982 10