1
|
Baumgart L, Barz M, Delbridge C, Aftahy AK, Janssen IK, Jost PJ, Ryang YM, Meyer B, Gempt J. Spinal Lesions as Clinical Manifestations of Plasma Cell Neoplasia. Curr Oncol 2022; 29:6236-6244. [PMID: 36135059 PMCID: PMC9497614 DOI: 10.3390/curroncol29090490] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Plasma cell neoplasia can be separated into independent subtypes including multiple myeloma (MM) and solitary plasmacytoma of the bone (SBP). The first clinical signs patients present with are skeletal pain, most commonly involving ribs and vertebrae. (2) Methods: Retrospective analysis of 114 patients (38 female, 76 male) receiving spinal surgery from March 2006 until April 2020. Neurological impairments and surgical instability were the criteria for intervention in this cohort. Analysis was based on demographic data, Spinal Instability Neoplastic Score (SINS), location of the lesion, spinal levels of tumor involvement, surgical treatment, histopathological workup, adjuvant therapy, functional outcome, and overall survival (OS). (3) Results: The following surgical procedures were performed: posterior stabilization only in 9 patients, posterior stabilization and decompression without vertebral body replacement in 56 patients, tumor debulking and decompression only in 8 patients, anterior approach in combined approach without vertebral body replacement and without biopsy and/or without kyphoplasty in 33 patients, 3 patients received biopsies only, and 5 patients received kyphoplasty only. The histopathology diagnoses were MM in 94 cases and SBP in 20 cases. Median OS was 72 months (53.4–90.6 months). Preoperative KPSS was 80% (range 40–100%), the postoperative KPSS was 80% (range 50–100%). (4) Conclusions: Surgery for patients with plasma cell neoplasia is beneficial in case of neurological impairment and spinal instability. Moreover, we were able to show that patients with MM and a low number of spinal levels to be supplied have a better prognosis as well as a younger age at the time of the surgical intervention.
Collapse
Affiliation(s)
- Lea Baumgart
- Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University Munich, 81675 Munich, Germany
- Correspondence:
| | - Melanie Barz
- Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University Munich, 81675 Munich, Germany
| | - Claire Delbridge
- Department of Neuropathology, Klinikum rechts der Isar, School of Medicine, Technical University Munich, 81675 Munich, Germany
| | - Amir Kaywan Aftahy
- Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University Munich, 81675 Munich, Germany
| | - Insa Katrin Janssen
- Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University Munich, 81675 Munich, Germany
- Department of Neurosurgery, Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland
| | - Philipp J. Jost
- III. Medical Department of Hematology and Oncology, Klinikum rechts der Isar, School of Medicine, Tech-nical University Munich, 81675 Munich, Germany
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Yu-Mi Ryang
- Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University Munich, 81675 Munich, Germany
- Department of Neurosurgery, Helios Klinikum Berlin Buch, 13125 Berlin, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University Munich, 81675 Munich, Germany
| | - Jens Gempt
- Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University Munich, 81675 Munich, Germany
| |
Collapse
|
2
|
Janssen IK, Jörger AK, Barz M, Sarkar C, Wostrack M, Meyer B. Minimally invasive posterior pedicle screw fixation versus open instrumentation in patients with thoracolumbar spondylodiscitis. Acta Neurochir (Wien) 2021; 163:1553-1560. [PMID: 33655377 DOI: 10.1007/s00701-021-04744-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/27/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Due to the aging society, the incidence of pyogenic spondylodiscitis is still rising. Although surgical treatment for spondylodiscitis in general is increasingly accepted, an optimal surgical strategy for treatment of pyogenic spinal infection has not yet been established. The aim of this study was to investigate the suitability of percutaneous posterior pedicle screw fixation for surgical treatment in patients with spondylodiscitis of the thoracolumbar spine. METHODS We conducted a retrospective review of a consecutive cohort of patients undergoing surgical treatment for spondylodiscitis of the thoracolumbar spine between January 2017 and December 2019. We assessed intraoperative and clinical data, comparing for the classic open and the percutaneous approach. In total, we analyzed 125 cases (39 female, 86 male). The mean age was 69.49 years ± 12.63 years. RESULTS Forty-seven (37.6%) patients were operated on by a percutaneous approach for pedicle screw fixation, and 78 (62.4%) received open surgery. There was no significant difference in the mean age of patients between both groups (p= 0.57). The time of surgery for percutaneous fixation was statistically significantly shorter (p= 0.03). Furthermore, the estimated intraoperative blood loss was significantly lower in the minimally invasive group (p < 0.001). No significant difference could be observed regarding the recurrence rate of spondylodiscitis and the occurrence of surgical site infections (p= 0.2 and 0.5, respectively). CONCLUSION Percutaneous posterior pedicle screw fixation appears to be a feasible option for the surgical treatment of a selected patient group with spondylodiscitis of the thoracic and lumbar spine.
Collapse
|
3
|
Murphy M, Hernández-Durán S, Kim E, Al-Shehhi N, Broekman M, de Praeter M, Dubuisson A, Emery É, Gazioglu N, Grossman R, Janssen IK, Karampouga M, Khorbaladze L, Lambrianou X, Lippa L, Magnadottir H, Mihaylova S, Pajaj E, Rabiei K, Rodríguez-Hernández A, Tasiou A, Vayssiere P, Rosseau G. European women in neurosurgery: II - Historical characters and living legends. J Clin Neurosci 2021; 86:324-331. [PMID: 33558184 DOI: 10.1016/j.jocn.2021.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/14/2021] [Accepted: 01/16/2021] [Indexed: 10/22/2022]
Abstract
A collaborative global working group of women neurosurgeons in multiple countries at different stages of their neurosurgical careers undertook the task of researching the history of European women in neurosurgery. While doing so, we happened upon many remarkable female neurosurgeons who overcame great adversity, made tremendous contributions to society and institutional neurosurgery, and displayed numerous talents beyond the operating room. In the first part of this paper, we recounted a chronology of female neurosurgeons in Europe, highlighting the most remarkable achievements of women in every decade, from the 1920's to 2020. In this paper, we honor fascinating women in European neurosurgery, both historical characters and living legends. These women have overcome great adversity and have also excelled in a huge variety of pursuits. While some were themselves refugees, we also have uncovered noteworthy examples of women who immersed themselves in humanitarian missions and who tried to better the world through political action. There are stories of women beating the odds, taking on biased institutions and proving their worth, in spite of the prevailing system. Most inspirational, we have discovered through our comprehensive research on the history of women in European neurosurgery that the future is increasingly female.
Collapse
Affiliation(s)
- Mary Murphy
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - Silvia Hernández-Durán
- Department of Neurosurgery, Universitätsmedizin Göttingen, Göttingen, Germany; European Association of Neurosurgical Societies, Diversity in Neurosurgery Task Force, Brussels, Belgium.
| | - Eliana Kim
- University of California-San Francisco School of Medicine, San Francisco, CA, United States
| | | | - Marike Broekman
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, Zuid-Holland, the Netherlands; Department of Neurosurgery, Leiden University Medical Center, Leiden, Zuid-Holland, the Netherlands; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Mania de Praeter
- Department of Neurosurgery, Universitair Ziekenhuis Antwerpen, Edegem, Belgium
| | - Annie Dubuisson
- Department of Neurosurgery, Centre Hospitalier Universitaire Liège, Liège, Belgium
| | - Évelyne Emery
- Department of Neurosurgery, University Hospital of Caen, Caen Normandie University, Caen, France
| | - Nurperi Gazioglu
- Department of Neurosurgery, Demiroglu Bilim University - Medical School, İstanbul, Turkey
| | - Rachel Grossman
- Department of Neurosurgery, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Maria Karampouga
- Department of Neurosurgery, Nicosia General Hospital, Nicosia, Cyprus
| | - Lika Khorbaladze
- Neuroscience Department, JSC Evex, M.Iashvili Children''s Central Hospital, Tbilisi, Georgia
| | | | - Laura Lippa
- Department of Neurosurgery, Ospedali Riuniti di Livorno, Livorno, Italy
| | | | - Stiliana Mihaylova
- Department of Neurosurgery, University Hospital "St. Ivan Rilski" Sofia, Bulgaria
| | - Ermira Pajaj
- Department of Neuroscience, University Hospital "Mother Theresa", Tirana, Albania
| | - Katrin Rabiei
- European Association of Neurosurgical Societies, Diversity in Neurosurgery Task Force, Brussels, Belgium; Institution of Neuroscience & Physiology, Sahlgrenska Academy, Gothenberg, Sweden
| | - Ana Rodríguez-Hernández
- Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - Anastasia Tasiou
- Department of Neurosurgery, University Hospital of Larissa, Thessaly, Greece
| | - Pia Vayssiere
- European Association of Neurosurgical Societies, Diversity in Neurosurgery Task Force, Brussels, Belgium; Department of Neurosurgery, University Hospital Geneva, Geneva, Switzerland
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| |
Collapse
|