By Robin Bhatia, Ian Sabin
A part of the difficult ideas in sequence, this booklet is a case-based consultant to not easy medical eventualities in neurosurgery protecting the most important sub-speciality components of oncology, vascular neurosurgery, mind and backbone trauma, paediatrics, spinal degenerative disorder, peripheral and cranial nerves, sensible neurosurgery and an infection. particular circumstances are tested with attention of scientific presentation, diagnostics, and surgical ideas, with a precis of proof from the neurosurgical literature highlighting parts of curiosity and controversy.
This ebook serves as an invaluable and fascinating source for experts and trainees in neurosurgery in addition to within the disciplines of neurology, maxillofacial surgical procedure, spinal surgical procedure and neuro-oncology.
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Extra info for Challenging Concepts in Neurosurgery: Cases with Expert Commentary
Weight loss and smoking 29 Case 3 Spondylolisthesis cessation should be encouraged. Flexion and extension core-strengthening exercises may increase the stability of the lumbar spine, and reduce pain and functional disability . Patients who do not improve with appropriate conservative therapy, whose symptoms progress despite conservative therapy, or who initially present with worsening neurological deficit or significant instability are candidates for surgery. The aim of surgery is to stabilize the affected segment and, in the presence of neural compression, decompress the relevant neural elements.
No significant survival advantage was seen in the primary analysis, however, a survival advantage for Gliadel® was observed in patients with GBM after adjustment for prognostic factors. This suggests that Gliadel® may increase overall survival in some patients with recurrent resectable malignant glioma. As such patients generally have a poor outlook, any treatment that has the potential for prolonging life without significant adverse events should be considered an option. However, given that no subgroups had been identified beforehand, the results of the subgroup analysis of GBM patients in that trial should be interpreted with caution.
A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 2001; 95(2): 190–8. Stummer W, Pichlmeier U, Meinel T, et al. Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol 2006; 7(5): 392–401. Vuorinen V, Hinkka S, Färkkilä M, et al. Debulking or biopsy of malignant glioma in elderly people—a randomised study. Acta Neurochir (Wien) 2003; 145: 5–10.