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Castillo J, Soufi K, Zhou J, Kulubya E, Javidan Y, Ebinu JO. Minimally Invasive Techniques in the Surgical Management of Traumatic Pediatric Thoracolumbar Fractures. World Neurosurg 2024; 182:e292-e300. [PMID: 38008163 DOI: 10.1016/j.wneu.2023.11.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Thoracolumbar (TL) fractures are uncommon in children. While surgical treatment is recommended for unstable TL fractures, there is no consensus on appropriate surgical treatment. We present a case series of pediatric patients with traumatic TL fractures treated with minimally invasive techniques. We discuss our early experience and technical challenges with navigation and robotic-assisted fixation. METHODS A retrospective review of a prospectively maintained trauma database from February 2018 to February 2023 of all pediatric patients (<18 years old) undergoing percutaneous fixation for unstable TL fractures was performed. Minimally invasive techniques included fluoroscopy and/or navigation-guided or robotic-assisted surgery. Clinical course, radiographic findings, and technical challenges were reviewed. RESULTS A cohort of 12 patients (age range, 4-17 years) with 6 (50%) Chance fractures, 2 (16%) pars fractures, 2 (16%) pedicle fracture, 1 (8%) burst fracture, and 1 (8%) other fracture were identified. Nine patients had fractures involving the lumbar spine, and the remaining 3 had thoracic fractures. In all cases, percutaneous pedicle screws were placed above and below the fracture with the use of neuronavigation or robotic-assisted navigation (n = 2). Blood loss was <30 mL for single-level fractures and instrumented fusion. Two patients had hardware-related complications. At follow-up (mean 9.67 months after surgery), patients were doing well clinically, and most imaging showed stable alignment. CONCLUSIONS Our early experience shows that short segment instrumentation through a minimally invasive approach is a safe and effective surgical option for young pediatric patients with good clinical outcomes and favorable radiographic postoperative finding.
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Affiliation(s)
- Jose Castillo
- Department of Neurological Surgery, University of California, Sacramento, California, USA
| | - Khadija Soufi
- Department of Neurological Surgery, University of California, Sacramento, California, USA
| | - James Zhou
- Department of Neurological Surgery, University of California, Sacramento, California, USA
| | - Edwin Kulubya
- Department of Neurological Surgery, University of California, Sacramento, California, USA
| | - Yashar Javidan
- Department of Orthopedic Surgery, University of California, Sacramento, California, USA
| | - Julius O Ebinu
- Department of Surgery, Division of Neurosurgery, Queen's University, Kingston, Ontario, Canada.
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Castillo JA, Soufi K, Rodriguez F, Ebinu JO. Intraoperative Ultrasound: Real-Time Surgical Adjunct for Complete Resection of Spinal Arachnoid Webs. World Neurosurg 2023; 179:143. [PMID: 37619841 DOI: 10.1016/j.wneu.2023.08.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/10/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
Spinal arachnoid webs are abnormal formations of arachnoid membranes that reside in the arachnoid space. Clinically, they may present as an incidental finding or in patients with progressively worsening myelopathy. Early detection and surgical intervention are recommended in patients with progressive symptoms. Several methods have been described for the surgical treatment of these web formations.1-4 The success of surgery and the ability to prevent recurrence is dependent on complete surgical resection of these lesions, which in some cases can appear complex and intricate in nature. A few reports have highlighted the use of intraoperative ultrasound to localize the lesion; however, none have highlighted its value in establishing successful web resection and restoration of normal cerebrospinal fluid flow.3,4 Herein, we demonstrate the use of intraoperative ultrasound as an effective adjunct to assessing and establishing complete resection of arachnoid webs. We illustrate how intraoperative ultrasound allows for real-time, direct visualization of arachnoid lysis with restoration of normal cerebrospinal fluid flow (Video 1). Our patient was symptomatic for 12 months with rapid progression of myelopathic symptoms in the 3 months before presentation. Following surgery, she remained asymptomatic at 4-year follow-up with no reoccurrence at 24-month magnetic resonance imaging. Intraoperative ultrasound is a useful adjunct to successfully performing dorsal arachnoid web surgery and ensuring improved surgical outcomes through complete web resection and decompression of the spinal cord.
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Affiliation(s)
- Jose A Castillo
- Department of Neurological Surgery, University of California Davis, Sacramento, California, USA
| | - Khadija Soufi
- Department of Neurological Surgery, University of California Davis, Sacramento, California, USA
| | - Freddie Rodriguez
- Department of Neurological Surgery, University of California Davis, Sacramento, California, USA
| | - Julius O Ebinu
- Division of Neurosurgery, Department of Surgery, Queens University, Kingston, Ontario, Canada.
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Bakr O, Soufi K, Jones Q, Bautista B, Van B, Booze Z, Martin AR, Klineberg EO, Le H, Ebinu JO, Kim KD, Javidan Y, Roberto RF. Laminoplasty versus laminectomy with fusion for treating multilevel degenerative cervical myelopathy. N Am Spine Soc J 2023; 15:100232. [PMID: 37416091 PMCID: PMC10320595 DOI: 10.1016/j.xnsj.2023.100232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 07/08/2023]
Abstract
Background Laminectomy with fusion (LF) and laminoplasty (LP) are common posterior decompression procedures used to treat multilevel degenerative cervical myelopathy (DCM). There is debate on their relative efficacy and safety for treatment of DCM. The goal of this study is to examine outcomes and costs of LF and LP procedures for DCM. Methods This is a retrospective review of adult patients (<18) at a single center who underwent elective LP and LF of at least 3 levels from C3-C7. Outcome measures included operative characteristics, inpatient mobility status, length of stay, complications, revision surgery, VAS neck pain scores, and changes in radiographic alignment. Oral opioid analgesic needs and hospital cost comparison were also assessed. Results LP cohort (n=76) and LF cohort (n=59) reported no difference in neck pain at baseline, 1, 6, 12, and 24 months postoperatively (p>.05). Patients were successfully weaned off opioids at similar rates (LF: 88%, LP: 86%). Fixed and variable costs respectively with LF cases hospital were higher, 15.7% and 25.7% compared to LP cases (p=.03 and p<.001). LF has a longer length of stay (4.2 vs. 3.1 days, p=.001). Wound-related complications were 5 times more likely after LF (13.6% vs. 5.9%, RR: 5.15) and C5 palsy rates were similar across the groups (LF: 11.9% LP: 5.6% RR: 1.8). Ground-level falls requiring an emergency department visit were more likely after LF (11.9% vs. 2.6%, p=.04). Conclusions When treating multilevel DCM, LP has similar rates of new or increasing axial neck pain compared to LF. LF was associated with greater hospital costs, length of stay, and complications compared to LP. LP may in fact be a less morbid and more cost-effective alternative to LF for patients without cervical deformity.
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Affiliation(s)
- Oussama Bakr
- School of Medicine, University of California, Davis, CA, USA
| | - Khadija Soufi
- School of Medicine, University of California, Davis, CA, USA
| | - Quincy Jones
- School of Medicine, University of California, Davis, CA, USA
| | - Barry Bautista
- School of Medicine, University of California, Davis, CA, USA
| | - Benjamin Van
- School of Medicine, University of California, Davis, CA, USA
| | - Zachary Booze
- School of Medicine, University of California, Davis, CA, USA
| | - Allan R. Martin
- Department of Neurological Surgery, University of California, Davis, Sacramento, CA 95817, USA
| | - Eric O. Klineberg
- Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA 95817, USA
| | - Hai Le
- Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA 95817, USA
| | - Julius O. Ebinu
- Department of Neurological Surgery, University of California, Davis, Sacramento, CA 95817, USA
| | - Kee D. Kim
- Department of Neurological Surgery, University of California, Davis, Sacramento, CA 95817, USA
| | - Yashar Javidan
- Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA 95817, USA
| | - Rolando F. Roberto
- Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA 95817, USA
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Soufi K, Castillo J, Ghaffari-Rafi A, Martin AR. Small bowel incarceration in the lumbar spinal canal from hyperextension seat belt injury. BMJ Case Rep 2023; 16:e255743. [PMID: 37553168 PMCID: PMC10414055 DOI: 10.1136/bcr-2023-255743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Affiliation(s)
- Khadija Soufi
- Department of Neurological Surgery, University of California Davis, Sacramento, California, USA
| | - Jose Castillo
- Department of Neurological Surgery, University of California Davis, Sacramento, California, USA
| | - Arash Ghaffari-Rafi
- Department of Neurological Surgery, University of California Davis, Sacramento, California, USA
| | - Allan R Martin
- Department of Neurological Surgery, University of California Davis, Sacramento, California, USA
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Castillo J, Soufi K, Rodriguez F, Ebinu JO. Traumatic bilateral lumbosacral facet dislocation without fracture: illustrative case. J Neurosurg Case Lessons 2023; 6:CASE23261. [PMID: 37458364 PMCID: PMC10555645 DOI: 10.3171/case23261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/13/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Traumatic bilateral lumbosacral facet dislocations without fractures are extremely rare. Only 7 cases have been documented since the first description by Watson-Jones in 1974. Although various treatment strategies have been reported, no consensus has been reached regarding the best surgical approach. OBSERVATIONS A 35-year-old female presented for medical attention following a high-speed motor vehicle collision. She sustained multiple injuries, including an abdominal aortic injury requiring emergent thoracic endovascular aortic repair. She was found to have bilateral lumbosacral dislocation without fracture (L5-S1) and was noted to be neurologically intact. Once medically stabilized, the patient was taken to the operating room for minimally invasive reduction and stabilization of her lumbosacral spine. Postoperatively, the patient was neurologically intact and remained stable with no deficits and appropriate lumbosacral alignment throughout her 2-year follow-up. LESSONS The authors report a minimally invasive approach to the management of bilateral lumbosacral facet dislocation without fracture. Although conventional open approaches have been described previously, consideration should be given to minimally invasive strategies in select patients to facilitate their rehabilitative postoperative course.
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Castillo JA, Soufi K, Moskalik A, Ghaffari-Rafi A, Kulubya E, Basco C, Shahlaie K, Zwienenberg M. Pressure control cam displacement in the Codman-Hakim programmable valve after a 3T MRI: Case report and review of the literature. Radiol Case Rep 2023; 18:1924-1928. [PMID: 37069953 PMCID: PMC10105129 DOI: 10.1016/j.radcr.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/04/2023] [Indexed: 03/14/2023] Open
Abstract
Pressure control cam dislocation is a rare finding in patients with a programmable shunt valve that should be considered when evaluating patients with signs and symptoms of shunt malfunction. The objective of this paper is to review the mechanism, clinical presentation, and radiographic findings associated with pressure control cam (PCC) dislocation, in addition to presenting a novel case to add to the scarce literature on this topic. A systematic review of the literature were performed using PubMed, Embase, and Cochrane from database inception. PCC dislocation is exceedingly rare and can present with no symptoms, positional headache, neck pain, nausea, or vomiting. Skull x-ray findings demonstrate a clear black "X" at the distal end of the valve, due to the PCC disarticulation from atop the base plate of the plastic valve housing. Intraoperatively, a "Y"-shaped crack atop the plastic valve housing may be present and the PCC may be fully separated from the shunt or found at the distal end of the plastic valve housing. Prior reports of dislocation of the PCC have occurred 7-9 years after implantation, with inciting events including direct trauma, programmable valve adjustment, and utilization 3-Tesla magnetic resonance image scan.
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Moskalik AD, Castillo JA, Soufi K, Perez T, Kercher M, Karnati T, Goodrich D, Kim K, Ebinu JO, Martin AR. 493 One and Two-Level Robotic MIS TLIF With Expandable Implants Demonstrates a Favorable Safety Profile and Improved Alignment Parameters. Neurosurgery 2023. [DOI: 10.1227/neu.0000000000002375_493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
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Soufi K, Abbasi F, Wei D, Verma R. Rectal Melanoma: Rare Cancer with Grave Prognosis. Case Rep Gastroenterol 2023; 17:235-241. [PMID: 37383983 PMCID: PMC10294269 DOI: 10.1159/000529434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/23/2023] [Indexed: 06/30/2023] Open
Abstract
Malignant melanoma of the rectum is an exceedingly rare type of cancer with an aggressive presentation, comprising up to 4% of all anorectal cancers. Presentation of this cancer tends to occur in individuals in their late 80s, with nonspecific symptoms such as anal pain or rectal bleeding. Diagnosing rectal melanoma, especially in early stages, is difficult due to its amelanotic presentation and lack of pigmentation, which results in poor remission rates and prognosis. Furthermore, surgical treatment is difficult as these types of malignant melanomas tend to spread along submucosal planes; thus, complete resections are impractical, especially if caught later. In this case report, we present the radiological and pathological features as seen in a 76-year-old man diagnosed with rectal melanoma. Based on his presentation of a heterogeneous bulky anorectal mass with extensive local invasion, initial impressions were colorectal carcinoma. However, surgical pathology found the mass to be a c-KIT+ melanoma, with positive SOX10, Melan-A, HMB-45, and CD117 biomarkers. While the patient was treated with imatinib, the melanoma was too widespread and aggressive, leading to progression and ultimately death.
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Affiliation(s)
- Khadija Soufi
- Department of Oncology, Comprehensive Cancer Center, UC Davis, Sacramento, CA, USA
| | - Ferheen Abbasi
- Department of Oncology, Comprehensive Cancer Center, UC Davis, Sacramento, CA, USA
| | - Dongguang Wei
- Department of Pathology and Laboratory Medicine, UC Davis, Sacramento, CA, USA
| | - Rashmi Verma
- Department of Oncology, Comprehensive Cancer Center, UC Davis, Sacramento, CA, USA
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Soufi K, Nouri A, Martin AR. Degenerative Cervical Myelopathy and Spinal Cord Injury: Introduction to the Special Issue. J Clin Med 2022; 11:jcm11154253. [PMID: 35893344 PMCID: PMC9331834 DOI: 10.3390/jcm11154253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/19/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Khadija Soufi
- Department of Neurosurgery, University of California, Davis, CA 95817, USA;
| | - Aria Nouri
- Division of Neurosurgery, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Allan R. Martin
- Department of Neurosurgery, University of California, Davis, CA 95817, USA;
- Correspondence:
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Brahimi M, Le Clésiau H, Ouazen Z, Soufi K, Michault A, Pariès J, Cosson E, Valensi P. [Microalbuminuria, a marker of artery rigidity and cardiac dysfunction]. Arch Mal Coeur Vaiss 2007; 100:673-676. [PMID: 17928774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Microalbuminuria is considered as a marker of endothelial dysfunction and is associated with an increase in cardiovascular risk. The aim of this study was to evaluate this parameter as a potential marker of artery rigidity and left ventricle (LV) function. SUBJECTS AND METHODS We included 375 subjects referred to a health assessment center. They were 228 men and 147 women aged in means of 52.7 and 53.1 years, respectively. Among this population, 57 had type 2 diabetes, 28 of them with hypertension, 65 were hypertensive but free of diabetes, and 39 were free of diabetes but exhibited a metabolic syndrome (NCEP-ATP III). Urinary albumin excretion rate (UAER) was determined. Artery rigidity was evaluated by pulse pressure of the brachial artery (plethysmographic method), pulse pressure of the radial artery and aorta and pulse wave velocity (PWV) measured by aplanation tonometry (SphygmoCor). LV afterload was appreciated by LV telesystolic pressure and coronary perfusion by the diastolic area/systolic area ratio for aortic pressure curve (Buckberg index). RESULTS UAER correlated with PWV in the overall population (p<0.0001) and in the diabetic sub-group (p<0.001). In the overall population UAER correlated with LV telesystolic pressure (p=0.006) but not with Buckberg index. In the overall population and the diabetic subgroup, the artery rigidity indexes correlated strongly with LV telesystolic pressure, and radial and aortic pulse pressure correlated negatively with Buckberg index. CONCLUSION These data suggest that 1) microalbuminuria may be considered as a marker of artery rigidity, in line with experimental data which indicate the deleterious role of endothelial dysfunction on artery compliance; 2) artery rigidity is a potent determinant of LV afterload and coronary perfusion, in particular in diabetic patients.
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Affiliation(s)
- M Brahimi
- Service d'endocrinologie-diabétologie-nutrition, Hôpital Jean Verdier, AP-HP, CRNH-IdF, Université Paris-Nord, Bondy
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Phan chan the E, Bauer L, Borgne A, Grassulo V, Guillaud F, Hebreard L, Moncourtois F, Romain J, Soufi K, Visier J. Comité pluridisciplinaire de prévention du tabagisme en entreprise. Exemple de la Seine-Saint-Denis. ARCH MAL PROF ENVIRO 2006. [DOI: 10.1016/s1775-8785(06)78103-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Consoli SM, Birouste J, Joubert M, Soufi K. [Psychosocial distress and its moderating factors in patients living in precarious socioeconomic conditions consulting in a preventive health and social work center]. Rev Epidemiol Sante Publique 2000; 48:351-62. [PMID: 11011302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The effects of a precarious socioeconomic condition on mental health have already been widely described. Nevertheless, sociodemographic, biographical, and mainly psychological determinants of psychosocial distress in these populations are still incompletely known. METHODS 2315 consecutive subjects, aged 16 to 59, consulting for a free work-up in a preventive health center supported by the National French Health Insurance system, were invited to fill out a series of questionnaires, mainly the GHQ-28 (psychosocial distress), the LOT (dispositional optimism) and the WCCL (coping mechanisms). Socioeconomic and administrative criteria were adopted to define populations living in precarious conditions. RESULTS A total of 78.9% complete records could be analyzed: 55% of the studied population constituted the precarious condition group (44.5% males and 55.5% females; mean age 36.2+/-11). This group was characterized by higher psychosocial distress and higher sub-scores of anxiety, social dysfunction and depression, but not somatisation, as well as by increased emotion focused coping and impaired optimism. Globally, GHQ score was positively correlated with emotion focused coping (r=0.36) and negatively with problem focused coping (r=-0.17) and with optimism (r=-0.39). In a multivariate analysis a set of 9 independent variables explained 38% of GHQ-28 total variance: perceived stress, optimism, emotion focused coping, problem focused coping, age, educational degree, precariousness, money problems and parental quarrels during youth. Introducing precariousness in the model constituted of the set of the remaining variables could explain only 2% of additional variance. CONCLUSION These results confirm the presence of higher levels of psychosocial distress in subjects living in precarious conditions and underline the moderating role of several psychological variables. They could guide support interventions aimed at helping subjects living in precarious conditions, focused on enhancing their coping resources.
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