Publications by authors named "Colum P Nolan"

Purpose: Acute traumatic central cord syndrome (ATCCS) accounts for up to 70% of incomplete spinal cord injuries, and modern improvements in surgical and anaesthetic techniques have given surgeons more treatment options for the ATCCS patient. We present a literature review of ATCCS, with the aim of elucidating the best treatment option for the varying ATCCS patient characteristics and profiles. We aim to synthesise the available literature into a simple-to-use format to aid in the decision-making process.

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Lumbar spinal decompression surgery is commonly performed to relieve radicular symptoms to good effect. The formation of post-operative spinal subdural hygroma, or spinal subdural extra-arachnoid hygromas (SSEH) following incidental intra-operative durotomies, have been described in previous literatures. We report a case of a 63 years old lady who had initially underwent an uneventful posterior lumbar decompression for lower limb radiculopathy, without intraoperative durotomy, with development of concurrent SSEH and spinal subarachnoid hygroma (SSSH) during the early post-operative period with cauda equina compression.

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Intracranial haemorrhage (ICH) is a rare but devastating complication post spinal surgery. We present three cases of post spine surgery ICH that were associated with high drain outputs postoperatively. The first patient underwent C1-C6 instrumented fusion and C4-C6 decompression.

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Article Synopsis
  • The systematic review aimed to identify the best characteristics for adults with spondylolysis or grade-I spondylolisthesis who are suitable for pars repair, and to assess the safety and effectiveness of the repair techniques used in this population.
  • The review analyzed 5,813 articles, narrowing down to 47 relevant studies involving 590 adults, primarily young males presenting with persistent low back pain and a high incidence of bilateral lysis defects.
  • Most participants had no disc degeneration, with the majority diagnosed with spondylolysis and treated predominantly through the Buck's repair technique, which demonstrated a positive outcome in the majority of cases.
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Instrumentation during metastatic spine tumor surgery (MSTS) provides stability to the spinal column in patients with pathologic fracture or iatrogenic instability produced while undergoing extensive decompression. Titanium is the current implant material of choice in MSTS. However, it hinders radiotherapy planning and generates artifacts, with magnetic resonance imaging and computed tomography scans used for postoperative evaluation of tumor recurrence and/or complications.

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Study Design: Retrospective review.

Objective: The aim of this study was to develop a surgical invasiveness index for metastatic spine tumor surgery (MSTS) that can serve as a standardized tool in predicting intraoperative blood loss and surgical duration; for the purpose of ascertaining resource requirements and aiding in patient education.

Summary Of Background Data: Magnitude of surgery is important in the metastatic spine disease (MSD) population since these patients have a continuing postoperative oncological process; a consideration that must be taken into account to maintain or improve quality of life.

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Background: Gastrointestinal stromal tumors (GISTs) very rarely metastasize to the vertebrae. Tyrosine kinase inhibitors (TKIs) confer favorable long-term survival and durable disease control for metastatic disease. Here, we reviewed a case and the literature to determine the various management options, and neurological outcomes for these patients.

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Study Design: Retrospective review.

Purpose: To determine the accuracy of thoracolumbar pedicle screw insertion with the routine use of three-dimensional (3D) intraoperative imaging and navigation over a large series of screws in an Asian population.

Overview Of Literature: The use of 3D intraoperative imaging and navigation in spinal surgery is aimed at improving the accuracy of pedicle screw insertion.

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Study Design: Retrospective cohort study.

Objective: We intend to evaluate the accuracy and safety of cervical pedicle screw (CPS) insertion under O-arm-based 3-dimensional (3D) navigation guidance.

Methods: This is a retrospective study of patients who underwent CPS insertion under intraoperative O-arm-based 3D navigation during the years 2009 to 2018.

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Background: Juxtafacet cysts, synovial and ganglion cysts, emanate from the facet joints. Patients with these cysts are typically asymptomatic but may rarely present with radiculopathy and/or myelopathy.

Case Description: A 72-year-old female presented with a 1-month history of progressive lower extremity weakness (left more than right), numbness, and urinary incontinence.

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Surgery for ossification of the ligamentum flavum (OLF) comes with a relatively high risk of dural tear. We report a 50-year-old woman, who presented with symptomatic spinal stenosis from OLF at T11-T12 and lower lumbar spondylosis for which a single stage posterior decompression and instrumented fusion of both sites was done. Removal of the OLF resulted in a small dural tear with intact arachanoid which was covered using a fibrin sealant.

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Study Design: A retrospective study of radiographic parameters of patients who underwent lumbar spinal pedicle screw insertion.

Purpose: The optimal length of pedicle screws is often determined by the lateral radiograph during minimally invasive surgery (MIS). Compared with open techniques, measuring the precise length of screws or assessing the cortical breach is challenging.

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Background: Orthopedic residents in our institute have the opportunity to participate in navigation-assisted spine surgery during their residency training. This paves the way for a new dimension of learning spine surgery, which the previous generation was not exposed to. To study this in detail, we conducted a cross-sectional descriptive survey among our residents to analyse their perception, understanding, and competency regarding pedicle screw application using spinal navigation.

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Meningiomas are usually low-grade, solitary lesions that rarely metastasize. In this group of central nervous system tumours, the higher grade subtypes are notorious for resistance to conventional chemo-radiation therapies. Recent studies have shown efficacy in the use of bevacizumab in patients with recurrent and, or progressive anaplastic meningioma.

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Cerebral vasospasm and delayed cerebral ischemia remain common complications of aneurysmal subarachnoid hemorrhage (SAH), and yet therapies for cerebral vasospasm are limited. Despite a large number of clinical trials, only calcium antagonists have strong evidence supporting their effectiveness. The purpose of this work was to perform a systematic review of the literature on the treatment of cerebral vasospasm.

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The authors tested the null hypothesis that published literature with a high level of evidence does not support the assertion that subarachnoid hemorrhage (SAH) causes cerebral vasospasm, which in turn causes cerebral infarction and poor outcome after aneurysmal SAH. The medical literature on SAH was searched in MEDLINE. The author's personal files of all published literature on SAH were reviewed.

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