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Byvaltsev VA, Kalinin AA. [Minimally invasive removal of dumbbell shaped schwannomas with transforaminal lumbar fusion: a retrospective study with a minimum 3-year follow-up]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2024; 88:47-53. [PMID: 38549410 DOI: 10.17116/neiro20248802147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Currently, there are no standards in surgical treatment of dumbbell-shaped tumors of lumbo-foraminal region. OBJECTIVE To evaluate the effectiveness and long-term results of minimally invasive resection of dumbbell-shaped lumbar schwannomas Eden type 2 and 3 combined with transforaminal lumbar interbody fusion and transpedicular stabilization. MATERIAL AND METHODS A retrospective study included 13 patients (8 men and 5 women) with lumbar dumbbell tumors Eden type 2 and 3 who underwent minimally invasive facetectomy through posterolateral anatomical corridor, microsurgical tumor resection and MI TLIF. We analyzed intraoperative parameters, neurological functions (ASIA scale), clinical characteristics (ODI, SF-36), and complications. Resection quality and area of the multifidus muscle were assessed according to MRI data. All patients were followed-up throughout at least 3-year. RESULTS Surgery time was 147 min, blood loss - 118 ml, hospital-stay - 7 days. Clinical parameters significantly improved in the follow-up period: ODI score decreased from 72 to 12 (p=0.004), SF-36 PCS increased from 26.24 to 48.51 (p=0.006) and MCS score increased from 29.13 to 53.68 (p=0.002). According to MRI data, no tumor recurrences and severe muscle atrophy (>30%) were observed after 3 years in all cases. Superficial wound infection occurred in 1 (7.7%) case. There were normal neurological functions (ASIA type E) in all patients. CONCLUSION Minimally invasive facetectomy through posterolateral approach with MI TLIF technology can be used for safe and effective resection of dumbbell-shaped schwannomas Eden type 2 and 3.
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Affiliation(s)
- V A Byvaltsev
- Irkutsk State Medical University, Irkutsk, Russia
- Russian Railways-Medicine Clinical Hospital, Irkutsk, Russia
- Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russia
| | - A A Kalinin
- Irkutsk State Medical University, Irkutsk, Russia
- Russian Railways-Medicine Clinical Hospital, Irkutsk, Russia
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Byvaltsev VA, Samartzis D, Giers MB. Editorial: MISS innovations: Approaches, predictive outcomes, and risk avoidance. Front Surg 2023; 9:1105855. [PMID: 36700023 PMCID: PMC9868804 DOI: 10.3389/fsurg.2022.1105855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 01/12/2023] Open
Affiliation(s)
- Vadim A. Byvaltsev
- Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia,Department of Neurosurgery, Railway Clinical Hospital, Irkutsk, Russia,Department of Traumatology, Orthopedic, and Neurosurgery, Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russia,Correspondence: Vadim A. Byvaltsev
| | - Dino Samartzis
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Morgan B. Giers
- School of Chemical, Biological, and Environmental Engineering, Oregon State University, Corvallis, OR, United States
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Byvaltsev VA, Kalinin AA, Polkin RA, Shepelev VV, Aliyev MA, Dyussembekov YK. Minimally invasive corpectomy and percutaneous transpedicular stabilization in the treatment of patients with unstable injures of the thoracolumbar spine: Results of retrospective case series. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2021; 12:294-301. [PMID: 34728997 PMCID: PMC8501818 DOI: 10.4103/jcvjs.jcvjs_47_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/07/2021] [Indexed: 12/02/2022] Open
Abstract
Objective: The objective of this study was to analyze the results of surgical treatment of patients with unstable injuries of the thoracolumbar spine using simultaneous minimally invasive corpectomy and percutaneous transpedicular stabilization. Materials and Methods: The retrospective study included 34 patients with isolated single-level unstable injuries of the thoracolumbar spine (5 or more points according to the Thoracolumbar Injury Classification and Severity Score (TLICS), operated on from the moment of injury from 8 to 24 h using the technique of minimally invasive corpectomy and percutaneous transpedicular stabilization simultaneously. The technical features of surgery, clinical data (pain level according to the Visual Analog Scale, quality of life according to the SF-36 questionnaire, subjective satisfaction with the operation according to the MacNab scale, and the presence of complications), and instrumental data (angle of segmental kyphotic deformity and sagittal index to and after surgery). The assessment of clinical data was carried out before surgery, at discharge, after 6 months, and in the long-term period, on average, 30 months after surgery. Results: When evaluating the clinical data, a significant decrease in the severity of pain syndrome was found on average from 90 mm to 5.5 mm in the late follow-up (P < 0.001), as well as a significant improvement in the physical and psychological components of health according to the SF-36 questionnaire on average from 28.78 to 39.26 (P < 0.001), from 36.93 to 41.43 (P = 0.006), respectively. In the long-term period, according to the MacNab scale, the patients noted the result of the operation: excellent – 18 (52.9%), good – 13 (38.3%), and satisfactory – 3 (8.8%); no unsatisfactory results were registered. Four (11.8%) perioperative surgical complications were registered, which were successfully treated conservatively. A significant restoration of the sagittal profile with an insignificant change in blood pressure was recorded in the long-term postoperative period. An average follow-up assessment of 30 months according to the American Spinal Injury Association scale showed the presence of E and D degrees in 85.4% of patients. Conclusion: Minimally invasive corpectomy with percutaneous transpedicular stabilization in the treatment of patients with unstable injuries of the thoracolumbar spine can effectively eliminate kyphotic deformity and prevent the loss of its reduction with a low number of postoperative surgical complications. The technique has minimal surgical trauma with the possibility of early postoperative rehabilitation and provides a significant stable reduction in vertebrogenic pain syndrome, improvement of neurological deficits, and restoration of the quality of life of patients and in the follow-up.
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Affiliation(s)
- Vadim A Byvaltsev
- Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia.,Department of Neurosurgery, Railway Clinical Hospital, Irkutsk, Russia
| | - Andrei A Kalinin
- Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia.,Department of Neurosurgery, Railway Clinical Hospital, Irkutsk, Russia
| | - Roman A Polkin
- Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia.,Department of Neurosurgery, Railway Clinical Hospital, Irkutsk, Russia
| | - Valerii V Shepelev
- Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia
| | - Marat A Aliyev
- Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia.,Department of Neurosurgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Yermek K Dyussembekov
- Department of Neurosurgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
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Kalinin AA, Goloborodko VY, Shepelev VV, Pestryakov YY, Biryuchkov MY, Satardinova EE, Byvaltsev VA. Accelerated Recovery Program for Patients with Polysegmental Degenerative Lumbar Spine Disease. Sovrem Tekhnologii Med 2021; 13:74-81. [PMID: 34513080 PMCID: PMC8353713 DOI: 10.17691/stm2021.13.2.09] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Indexed: 11/16/2022] Open
Abstract
The aim of the study was to evaluate the effectiveness of the accelerated recovery program for patients with polysegmental degenerative diseases of the lumbar spine.
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Affiliation(s)
- A A Kalinin
- Associate Professor, Department of Neurosurgery and Innovative Medicine, Irkutsk State Medical University, 1 Krasnogo Vosstaniya St., Irkutsk, 664003, Russia; Neurosurgeon, Neurosurgery Center, Road Clinical Hospital, 10 Botkin St., Irkutsk, 664005, Russia
| | - V Yu Goloborodko
- Head of the Department of Anesthesiology and Resuscitation No.12
| | - V V Shepelev
- Doctoral Student, Department of Neurosurgery and Innovative Medicine, Irkutsk State Medical University, 1 Krasnogo Vosstaniya St., Irkutsk, 664003, Russia
| | - Yu Ya Pestryakov
- Doctoral Student, Department of Neurosurgery and Innovative Medicine, Irkutsk State Medical University, 1 Krasnogo Vosstaniya St., Irkutsk, 664003, Russia
| | - M Yu Biryuchkov
- Professor, Head of the Department of Neurosurgery with Traumatology Course, West Kazakhstan Marat Ospanov Medical University, 68 Maresyev St., Aktobe, 030019, Kazakhstan
| | - E E Satardinova
- Associate Professor, Department of Reflexotherapy and Cosmetology, Irkutsk State Medical Academy for Postgraduate Education, 100 Yubileyny Microdistrict, Irkutsk, 664049, Russia
| | - V A Byvaltsev
- Professor, Head of the Department of Neurosurgery and Innovative Medicine, Irkutsk State Medical University, 1 Krasnogo Vosstaniya St., Irkutsk, 664003, Russia; Chief of the Neurosurgery Center, Road Clinical Hospital, 10 Botkin St., Irkutsk, 664005, Russia; Professor, Department of Traumatology, Orthopedics, and Neurosurgery, Irkutsk State Medical Academy for Postgraduate Education, 100 Yubileyny Microdistrict, Irkutsk, 664049, Russia
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Byvaltsev VА, Kalinin АА. Assessment of Clinical Decision Support System Efficiency in Spinal Neurosurgery for Personalized Minimally Invasive Technologies Used on Lumbar Spine. Sovrem Tekhnologii Med 2021; 13:13-21. [PMID: 35265345 PMCID: PMC8858415 DOI: 10.17691/stm2021.13.5.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Indexed: 11/14/2022] Open
Abstract
The aim of the study was to assess clinical decision support system (CDSS) in spinal surgery for personalized minimally invasive technologies on lumbar spine. Materials and Methods The prospective study involved 59 patients operated on using CDSS based on a personalized surgical algorithm considering patient-specific parameters of lumbar segments. Among them, 11 patients underwent total disk replacement (TDR), 25 and 23 patients had minimally invasive (MI-TLIF) and open (O-TLIF) dorsal rigid stabilization, respectively, according to an original technology. The comparative analysis was carried out using retrospective findings of 196 patients operated on involving TDR (n=42), MI-TLIF (n=79), and O-TLIF (n=75). The efficiency of CDSS medical algorithms was assessed by pain syndrome in the lumbar spine and lower limbs, as well as by patients' functional status on discharge according to ODI, 3 and 6 months after the operation. Results The comparison by gender characteristics and anthropometric data revealed no significant intergroup differences among the groups under study (p>0.05). Intergroup analysis of functional status by ODI, pain intensity in lower limbs and lumbar spine showed better clinical outcomes in patients operated using CDSS compared to a retrospective group (p<0.05): 6 months after TDR and O-TLIF, and 3 months after MI-TLIF. Conclusion The study findings demonstrated high efficiency of CDSS developed for personalized surgical treatment of patients with degenerative lumbar spine diseases taking into consideration individual biometric parameters of lumbar segments.
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Affiliation(s)
- V А Byvaltsev
- Professor, Head of the Department of Neurosurgery and Innovative Medicine Irkutsk State Medical University, 1 Krasnogo Vosstaniya St., Irkutsk, 664003, Russia;; Chief of Neurosurgery Center Road Clinical Hospital, 10 Botkin St., Irkutsk, 664005, Russia;; Professor, Department of Traumatology, Orthopedics and Neurosurgery Irkutsk State Medical Academy for Postgraduate Education, 100 Yubileyny Microdistrict, Irkutsk, 664049, Russia
| | - А А Kalinin
- Associate Professor, Department of Neurosurgery and Innovative Medicine Irkutsk State Medical University, 1 Krasnogo Vosstaniya St., Irkutsk, 664003, Russia;; Neurosurgeon, Neurosurgery Center Road Clinical Hospital, 10 Botkin St., Irkutsk, 664005, Russia
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Luo Y, Li Z, Jiang S, Hu L, Liu W, Li W. A novel fluoroscopy-based robot system for pedicle screw fixation surgery. Int J Med Robot 2020; 16:1-8. [PMID: 32949442 DOI: 10.1002/rcs.2171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/01/2020] [Accepted: 09/17/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Robot-assisted pedicle screw insertion has gained popularity in the spinal surgery field. Due to high cost, these spinal robots are not extensively applied in clinical surgeries. Developing an effective robot system with low cost and high clinical acceptability is one of the future trends. METHODS We developed a novel fluoroscopy-based robot system for pedicle screw insertion. Four live pigs were conducted with percutaneous pedicle screw insertion. Robot-assisted surgery was performed on the left side of pedicle, while the right opposite side is placed by freehand. The respect accuracy, surgical time and fluoroscopy time were recorded. RESULTS Robot-assisted group achieved 100% (23/23) accuracy. The average times (6.4 ± 1.7) for intraoperative fluoroscopy usage per procedure were lesser than freehand group (12.5 ± 3.6), and the surgical time (6.8 ± 2.1 min) per screw was reduced compared with freehand group (12.1 ± 4.8 min). CONCLUSIONS Our robot system is cost-effective and feasible for pedicle screw placement. Low economic cost makes it easier for extensive application in primary hospitals.
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Affiliation(s)
- Yanzhong Luo
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Zhuofu Li
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Shuai Jiang
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Lei Hu
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Wenyong Liu
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China.,Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - Weishi Li
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
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