M H Bilsky

..A retrospective review of a prospectively maintained spine database was conducted...

..The evolution of these technologies will help to provide palliation and improve quality of life for patients with metastatic disease...

..Regardless of the treatment, diagnosis and treatment before the development of significant neurologic and functional deficits improve outcomes. Physician awareness and appropriate imaging greatly assist in the early detection of tumor...

..In this article, we report our initial clinical experience in treating 16 paraspinal tumors with IMRT in which the planning target volume was 2 mm or greater from the spinal cord...

..Rarely is open surgery for decompression and instrumentation indicated. The presence of diffuse osteoporosis in patients with multiple myeloma increases the probability of failed fixation in this population...

..Although patients with metastatic spine tumors often have numerous medical and oncologic issues, careful perioperative planning and surgical techniques can help limit complications and help improve patient outcomes significantly...

..The authors describe the preoperative assessment, intraoperative strategies, and long-term outcomes in 41 consecutive patients who underwent spinal reconstruction after resection of subaxial cervical neoplasms...

..The degree of ESCC often serves as a major determinant in the decision to operate or irradiate. The purpose of this study was to determine the reliability and validity of a 6-point, MR imaging-based grading system for ESCC...

..Patients with radioresistant tumors (O) who do not have significant spinal cord compression (N) are now offered IGIMRT as the best chance of controlling local tumor and avoiding an operation...

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..A combination of radiation techniques and advances in systemic therapy may ultimately provide improved local tumor control and cure for these treatment-resistant tumors...

..Several strategies have been developed to excise the disc without manipulating the spinal cord. The focus of this paper is the transpedicular approach...

..Systematic review and evidence appraisal...

..A single instance of brain and vertebral metastasis has been described. We report three examples of SEF distinguished by primary involvement of the neuraxis at initial presentation...

..Advances in spinal surgery, the application of magnetic resonance (MR) imaging, and improvements in neoadjuvant therapy require a reassessment of the potential for complete resection...

..This study is a retrospective analysis of the long-term outcomes of patients who had operations for sarcomas of the spine using modern surgical approaches, intralesional resections, and spinal instrumentation...

..This technique avoids the morbidity associated with anterior approaches and provides immediate stability. Vascular tumors may be removed safely after embolization. Patients can be mobilized early after surgery...

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..Involvement of the vertebral body or brachial plexus, areas once considered unresectable, is amenable to advanced techniques of spinal reconstruction and may lead to long-term survival in selected patients...

..Outcomes are analyzed outcomes following surgery, radiation therapy, and tumor embolization...

..Symptomatic pneumocephalus may result from a cerebrospinal fluid leak communicating with extradural air. However, it is a rare event after thoracic surgical procedures, and its management and physiology are not widely recognized...

..Singularly or combined with other endoscopic procedures, patients can be spared multiple and more invasive surgical procedures...

..Image-guided treatment tools such as cone beam computed tomography coupled with IMRT have reduced treatment errors associated with traditional radiotherapy, making highly accurate and conformal treatment feasible...

..To report tumor control and toxicity for patients treated with image-guided intensity-modulated radiotherapy (RT) for spinal metastases with high-dose single-fraction RT...

..We report our experience with multifractionated regimens using image-guided intensity-modulated radiotherapy to treat gross paraspinal disease to doses beyond cord tolerance...

..Craniofacial resection (CFR) for patients over 70 years of age is uncommon. This study examines a cohort of 36 patients who had CFR at a single institution with the aim of reporting mortality, complications, and outcome...

..Further studies with more patients and longer follow up are needed to evaluate toxicity, predictors of failure, and timing of radiation after surgical salvage...

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..Demonstration of biological effectiveness, as indicated by pathological response of a chordoma specimen after such radiotherapy, has not previously been reported...

..This review summarizes the significant contributions to the medical literature over the past calendar year...

..However, a negative result must be confirmed with either close follow-up or, preferably, open biopsy, especially in cases of sclerotic lesions for which diagnostic accuracy is decreased and the false-negative rate is high...

..This report presents clinical and physical data regarding the use of IMRT coupled with noninvasive body frames (stereotactic and image-guided) for multifractionated radiotherapy...

..Median overall survival was 2 months (range 2 days to 3.6 years) after VP shunt placement, but there was no procedure-related mortality. The prognosis of LM remained poor, but VP shunt can be an effective palliative tool when required...

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..Because the majority of malignant tumors requiring craniofacial resection involve the anterior skull base, this review focuses mainly on state-of-the-art surgical techniques as well as pertinent variations, complications and results...

..The ease of flap elevation and minimal donor site morbidity make it a useful, single-stage reconstructive option in these difficult wounds...

..Complication rates for patients reconstructed with free-tissue transfer techniques is similar to those patients reconstructed by conventional techniques, despite an increase in complexity of resection in this group...

..Chemotherapy may be avoided in low-risk patients who are offered potentially curative operations. Patients treated with operations for epidural disease are at high risk of subsequently developing spinal deformity...

..This study reviews the relevant literature regarding the management of craniovertebral junction (CVJ) metastases. These rare tumors present significant diagnostic and treatment challenges...

..In this procedure highly vascularized tissue is used to increase healing, accelerate clearance of bacteria, and fill any dead space...

..This technique achieved a high success rate for pain palliation, neurological preservation, and functional improvement, while avoiding the morbidity associated with combined approaches...

..To evaluate an integrated battery of preoperative functional magnetic resonance imaging (fMRI) tasks developed to identify cortical areas associated with tactile, motor, language, and visual functions...

..The objective of this study was to determine the prevalence of spinal metastasis, treatment outcomes, and optimal screening method for spinal metastasis in patients with MLS...

..The aim will be to familiarize non-surgical providers with the indications for and complications associated with these neurosurgical procedures as a component of the adjuvant treatment of leptomeningeal disease...

..The authors describe the presentation and treatment of five consecutive patients who presented with presacral ganglioneuromas; these cases represent the largest series to date. A review of the literature is also performed...

..To determine the accuracy of [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in the diagnosis of vertebral metastases in patients with cancer using needle-biopsy results and patient follow-up data...

..Superselective catheterization permits Grade D or E embolization in 80% of patients. Shared blood supply with an RMA is the most important factor precluding complete embolization...

..The prognostic factors identified in this retrospective study should be considered when making treatment decisions for patients with BM and used as stratification factors in future clinical trials...