Publications by authors named "Victor G El-Hajj"

Background And Objectives: Vertebral artery injury (VAI) because of traumatic subaxial cervical spine injury is a rare but potentially devastating condition as it could lead to stroke. The aim of this study was to examine the incidence, risk factors, outcomes, and radiographic predictors of VAI in patients surgically treated for subaxial cervical spine injuries at a tertiary care trauma center.

Methods: This is a retrospective population-based cohort study, including all patients surgically treated for traumatic subaxial cervical spine injuries at the study center between 2006 and 2018.

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Background/objectives: Spinal astrocytomas (SA) represent 30-40% of all intramedullary spinal cord tumors (IMSCTs) and present significant clinical challenges due to their aggressive behavior and potential for recurrence. We aimed to pool the evidence on SA and investigate predictors of regrowth or recurrence after surgical resection.

Methods: A systematic review and meta-analysis were conducted on peer-reviewed human studies from several databases covering the field of SA.

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Purpose: Spinal chordomas are aggressive tumors that rarely occur in the pediatric population. Demographics and post-treatment outcomes in this select group of patients is poorly studied. We hence aimed to analyze the clinical characteristics, demographics, and survival outcomes of pediatric patients with spinal chordomas, in contrast to the adult population.

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Objective: The precision of neuronavigation systems relies on the correct registration of the patient's position in space and aligning it with radiological 3D imaging data. Registration is usually performed by the acquisition of anatomical landmarks or surface matching based on facial features. Another possibility is automatic image registration using intraoperative imaging.

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Article Synopsis
  • Posterior fossa decompression is a surgical procedure for Chiari malformation type I that can lead to complications and persistent symptoms in up to 20% of patients, especially in pediatric cases where prediction tools are lacking.
  • A study of 71 pediatric patients with Chiari 1 found that motor deficits, surgical complications, and persistent hydrocephalus post-surgery were significant predictors of poor outcomes, while the presence of syringomyelia was associated with better outcomes.
  • The findings highlight the need to consider these factors when evaluating potential surgical risks and what to expect in postoperative recovery for children undergoing this procedure.
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Background And Objectives: Stroke remains a leading cause of morbidity and mortality worldwide. Socioeconomic disparities significantly affect the treatment and outcomes of cardiovascular and cerebrovascular diseases, including acute ischemic stroke. This study examines patients treated at Thomas Jefferson University Hospital, with ZIP code-based socioeconomic data predominantly representing areas in Pennsylvania and New Jersey, as the majority of patients originate from these regions.

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Introduction: Spinal low-grade gliomas (sLGGs) are a group of tumors that arise from glial cells in the spinal cord. Current evidence supporting the use of adjuvant radiotherapy for the management of sLGG is lacking. We hence aimed to compare overall survival rates in patients receiving surgery alone with those receiving surgery with adjuvant radiotherapy.

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Background: Dysphonia is one of the more common complications following anterior cervical discectomy and fusion (ACDF). ACDF is the gold standard for treating degenerative cervical spine disorders, and identifying high-risk patients is therefore crucial.

Purpose: This study aimed to evaluate different machine learning models to predict persistent dysphonia after ACDF.

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Introduction: The pipeline embolization device (PED) is commonly used for intracranial aneurysm treatment. While its effectiveness for certain types of aneurysms is well-established, its efficacy for saccular aneurysms remains controversial. We aimed to assess the long-term outcomes of PED treatment for unruptured intracranial saccular aneurysms.

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Article Synopsis
  • The text introduces a systematic review focused on spinal nerve sheath tumors, highlighting the lack of comprehensive literature on their epidemiology, characteristics, diagnosis, and treatment outcomes.
  • The review aims to gather and evaluate recent studies from databases like PubMed and Embase, filtering for specific keywords and excluding non-research articles, with data extraction covering various aspects like surgery and recurrence rates.
  • Ultimately, the review serves as a reference guide for diagnosing and treating spinal schwannomas, while also identifying gaps in existing research for future studies.
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This retrospective study analyzed prognostic factors for neurological improvement and ambulation in 194 adult patients (≥ 15 years) with traumatic cervical spinal cord injuries treated at the neurological SCI unit (SCIU) at the Karolinska University Hospital Stockholm, Sweden, between 2010 and 2020. The primary outcome was American spinal injury association impairment scale (AIS) improvement, with secondary focus on ambulation restoration. Results showed 41% experienced AIS improvement, with 51% regaining ambulation over a median follow-up of 3.

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Objective: To evaluate the short-term surgical outcomes and the reimbursement patterns, after treatment of type 2 odontoid fractures using the anterior or posterior approach.

Methods: The National Surgical Quality Improvement Program database was queried for surgically treated patients with type 2 odontoid fractures by the anterior or posterior approach between 2016 and 2020. Propensity score matching with the optimal approach was used to balance the cohorts.

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Objective: Chordomas are rare tumors that originate from undifferentiated remnants of the notochord. Currently, there are no established guidelines regarding the choice of adjuvant radiation modality for patients surgically treated for chordomas. Using a nationwide, multicenter database, the authors aimed to compare long-term survival outcomes associated with the use of proton or photon adjuvant therapy for the management of chordomas of skull base and spine.

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Article Synopsis
  • The study evaluates the effectiveness of two surgical methods, minimally invasive posterior cervical foraminotomy (MIS-PCF) and anterior transcorporeal approach (ATCA), for treating cervical radiculopathy.
  • A systematic review analyzed data from 40 studies and found that both techniques had similar complication and reoperation rates, along with comparable blood loss and operation time.
  • However, the ATCA technique resulted in a significantly greater reduction in neck pain, as measured by the visual analog scale (VAS), indicating it might be the better option for relieving symptoms.
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Purpose: Chordomas are rare malignant neoplasms primarily treated surgically. Disparities related to race and socioeconomic status, may affect patient outcomes. This study aims to identify prognostic factors for access to care and survival in patients with spinal chordomas.

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Background: Intraoperative MRI (iMRI) has emerged as a useful tool in glioma surgery to safely improve the extent of resection. However, iMRI requires a dedicated operating room (OR) with an integrated MRI scanner solely for this purpose. Due to physical or economical restraints, this may not be feasible in all centers.

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  • Anterior Cervical Corpectomy and Fusion (ACCF) may offer better decompression results than Anterior Cervical Discectomy and Fusion (ACDF), but ACCF comes with higher surgical risks; this study focuses on their safety in treating cervical spine injuries.
  • The study matched 60 patients who underwent either ACCF or ACDF for injuries affecting multiple disc spaces, finding that ACCF patients had more vertebral body injuries, while ACDF patients had more traumatic disc ruptures.
  • Both surgical methods showed similar rates of complications, revision surgeries, mortality, and long-term outcomes, suggesting that ACCF is a safe alternative for patients with significant anterior column injuries.
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Background: Traumatic subaxial cervical spine fractures are a significant public health concern due to their association with spinal cord injuries (SCI). Despite being mostly caused by low-energy trauma, these fractures significantly contribute to morbidity and mortality. Currently, research regarding early mortality based on the choice of treatment following these fractures is limited.

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Objective: Neurosurgery is one of the most competitive specialties, and navigating the match process is often challenging for aspiring applicants. Here, we analyze insights from the National Resident Matching Program Director Surveys, illustrating evolving trends in applicant selection for interviews and for the ranking process, and providing a comparison with other specialties.

Methods: We evaluated 7 surveys administered from 2012 to 2022.

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Background And Objectives: Spontaneous spinal cord infarction (SCInf) is a rare condition resulting in acute neurological impairment. Consensus on diagnostic criteria is lacking, which may present a challenge for the physician. This review aims to analyse the current literature on spontaneous SCInf, focusing on epidemiology, the diagnostic process, treatment strategies and neurological outcomes.

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Spinal schwannomas are the second most common primary intradural spinal tumor. This study aimed to assess health-related quality of life (HRQoL) and the frequency of return to work after the surgical treatment of spinal schwannomas. HRQoL was compared to a sample of the general population.

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Purpose: We aimed to investigate surgical outcomes in octogenarians with subaxial cervical spine injuries and determine the predictors of complications and mortality.

Methods: Eligible for inclusion were all patients surgically treated between 2006 and 2018, with either anterior or posterior fixation for subaxial spine injuries. A cohort of octogenarians was identified and matched 1:1 to a corresponding cohort of younger adults.

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In brain tumor surgery, maximal tumor resection is typically desired. This is complicated by infiltrative tumor cells which cannot be visually distinguished from healthy brain tissue. Optical methods are an emerging field that can potentially revolutionize brain tumor surgery through intraoperative differentiation between healthy and tumor tissues.

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Objective: Chordomas are rare tumors of the skull base and spine believed to arise from the vestiges of the embryonic notochord. These tumors are locally aggressive and frequently recur following resection and adjuvant radiotherapy. Proton therapy has been introduced as a tissue-sparing option because of the higher level of precision that proton-beam techniques offer compared with traditional photon radiotherapy.

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