Review
Rehabilitation
Hui Ping Lee, Thuya Win, Sudha Balakrishnan
Summary: ITB therapy, when administered in carefully selected ambulatory patients with spasticity, does not result in a loss of ambulatory function.
CLINICAL REHABILITATION
(2023)
Article
Clinical Neurology
Adeel S. Zubair, Matthew Raymond, Huned S. Patwa
Summary: ITB is a safe and effective treatment for spasticity in PLS patients, with most patients experiencing significant improvement after treatment although a few may experience pump-related complications. The duration of treatment varies depending on individual cases, but the majority of patients benefit from it.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2021)
Article
Biotechnology & Applied Microbiology
Hiroki Tanikawa, Masahiko Mukaino, Shota Itoh, Hikaru Kondoh, Kenta Fujimura, Toshio Teranishi, Kei Ohtsuka, Satoshi Hirano, Hitoshi Kagaya, Eiichi Saitoh, Yohei Otaka
Summary: This study developed a simple mechanical measurement methodology for velocity-dependent spasticity based on an analysis of clinical maneuver and demonstrated its ability to effectively differentiate the presence and extent of spasticity.
FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY
(2022)
Article
Neurosciences
John Lopez, Gail F. Forrest, Einat Engel-Haber, Brittany Snider, Kam Momeni, Manikandan Ravi, Steven Kirshblum
Summary: This study investigates the effect of transcutaneous spinal stimulation on an implanted ITB pump and suggests that further studies can be considered, although communication with the programmer may be affected.
FRONTIERS IN NEUROSCIENCE
(2022)
Article
Clinical Neurology
Laura A. Bonouvrie, Karen E. Lagendijk, Heleen Beckerman, K. Mariam Slot, Laura A. van de Pol, Annemieke Buizer
Summary: This study assessed the complications of intrathecal baclofen treatment (ITB) in children, with the most common being catheter-related complications. The introduction of a new coated catheter in 2012 has led to a decrease in the rate of catheter-related complications.
EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY
(2022)
Article
Health Care Sciences & Services
Ahmad Zaheer Qureshi, Hasan Shacfe, Amara Ilyas, Saeed Bin Ayaz, Khalid Yousef Aljamaan, Imad Saeed Moukais, Mohammed Jameel, Waqas Sami, Sami Ullah
Summary: This retrospective cohort study analyzes the complications of intrathecal baclofen pump (ITB) treatment. The results indicate that catheter-related complications are the most common, and there is a significant relationship between catheter occlusion and the pattern of spastic quadriparesis.
Article
Biochemistry & Molecular Biology
Hongying Daisy Dai, Fang Qiu, Kimberly Jackson, Marcus Fruttiger, William B. Rizzo
Summary: Sjogren-Larsson syndrome (SLS) is a rare inherited neurocutaneous disease characterized by ichthyosis, spastic diplegia or tetraplegia, intellectual disability and a distinctive retinopathy. SLS is caused by bi-allelic mutations in ALDH3A2, which results in abnormal lipid metabolism. The biochemical abnormalities in SLS and the pathogenic mechanisms leading to symptoms are still unclear.
Article
Medicine, General & Internal
Sergio Pinho, Anabela Ferreira, Duarte Calado, Madjer Hatia, Filipa Faria
Summary: Intrathecal baclofen (ITB) administration is a common method for managing spasticity, but the conventional method of accessing the reservoir can be difficult and risky. This case demonstrates the successful use of ultrasound-guided pump refilling after multiple failed attempts. This groundbreaking instrument assists in minimally invasive procedures and reduces iatrogenic injury.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2022)
Article
Clinical Neurology
Simone Warrack, Terri Love, William B. Rizzo
Summary: Sjogren-Larsson syndrome is a rare neurologic disorder characterized by ichthyosis, spasticity, intellectual disability, and a crystalline retinopathy. While typically considered static, a minority of patients may experience a neurodegenerative course, which could potentially be triggered by factors such as febrile rotavirus infection.
JOURNAL OF CHILD NEUROLOGY
(2021)
Article
Medicine, Research & Experimental
Christina N. Feller, Ahmed J. Awad, Mary Elizabeth S. Nelson, Nicholas Ketchum, Peter A. Pahapill
Summary: This study retrospectively reviewed data from patients who underwent implantation of ITB pump systems with reinforced catheters from 2013 to 2020. The CRC rate was found to be 7.1% in 5.6% of patients, mainly attributed to catheter occlusions and fractures.
Article
Clinical Neurology
Janina Gburek-Augustat, Matthias Krause, Matthias Bernhard, Ina Sorge, Daniel Grafe, Manuela Siekmeyer, Ulf Nestler, Andreas Merkenschlager
Summary: This study presents six pediatric patients who experienced unusual mechanical failures of intrathecal baclofen pump systems. Through these case-vignettes, a systematic approach on interpreting the symptoms of ITB complications and recommendations for further diagnostic and therapeutic steps are provided. The seriousness of baclofen overdose, underdosing, or withdrawal is emphasized.
CHILDS NERVOUS SYSTEM
(2021)
Article
Biochemistry & Molecular Biology
Charalampos Konstantinidis, Eleni Moumtzi, Archodia Nicolia, Charalampos Thomas
Summary: Traumatic brain injury (TBI) often leads to spasticity, with neurogenic detrusor overactivity as a common complication. Our study investigated the effects of intrathecal baclofen (ITB) pump implantation on bladder function in TBI patients with spasticity. The results showed improved bladder function, with decreased incontinence and micturition episodes, and increased bladder capacity and reflex volume seen in urodynamic parameters. Further prospective studies are needed to fully understand the impact of ITB on bladder function.
Review
Rehabilitation
Nora W. Jacobs, Ellen M. Maas, Marjolein Brusse-keizer, Hans J. S. Rietman
Summary: The review evaluated the effectiveness and safety of intrathecal baclofen treatment of spasticity administered via a cervical catheter tip. Results showed improvement in upper extremity spasticity and function, with low complication rates, but further research is needed to confirm efficacy and safety.
JOURNAL OF REHABILITATION MEDICINE
(2021)
Article
Clinical Neurology
Erik Necking, Richard Levi, Per Ertzgaard
Summary: This retrospective study analyzed complications related to ITDD therapy in a regional center in Sweden from 1999 to 2014, finding common mishaps including catheter-, infection-, and pump-associated complications. Risk factors for complications included pump re-implantation, traumatic spinal cord injury (TSCI) diagnosis, and the use of cloxacillin as antibiotic prophylaxis. Prolonged surgical procedure time in re-implantations was also found to correlate with increased catheter-associated complications.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2021)
Article
Rehabilitation
Stina Gunnarsson, Dag Lemming, Siw Alehagen, Tommy Bergenheim, Bjorn Gerdle, Kersti Samuelsson
Summary: This study investigated patients' expectations, met/unmet expectations, and satisfaction with intrathecal baclofen treatment in relation to various factors. The results showed that overall satisfaction with treatment and occupational performance was moderate. The important factors that influenced satisfaction with occupational performance were improvements in performance, expectations, and performance before treatment. Therefore, a thorough discussion of goal setting before implementing intrathecal baclofen treatment is necessary to provide patients with individual and realistic expectations.
JOURNAL OF REHABILITATION MEDICINE
(2023)
Article
Clinical Neurology
Bethany Hung, Zach Pennington, Andrew M. Hersh, Andrew Schilling, Jeff Ehresman, Jaimin Patel, Albert Antar, Jose L. Porras, Aladine A. Elsamadicy, Daniel M. Sciubba
Summary: This study aimed to investigate whether race was an independent predictor of postoperative complications, nonroutine discharge, and prolonged length of stay (LOS) after surgery for spinal metastasis. The results showed that race was an independent predictor for nonroutine discharge, with Black patients having significantly higher odds of nonroutine discharge than White patients. Age, baseline functional status, marital status, and insurance status were also identified as potential predictive factors.
JOURNAL OF NEUROSURGERY-SPINE
(2022)
Editorial Material
Clinical Neurology
Andrew M. Hersh, Daniel Lubelski, Nicholas Theodore
Summary: Metastatic glioblastoma to the vertebral spine is rare, and treatment modalities vary depending on disease progression, with surgical intervention suitable for spinal instability or few metastases, and palliative radiotherapy and chemotherapy offering greater benefit for advanced disease.
WORLD NEUROSURGERY
(2022)
Article
Clinical Neurology
Aladine A. Elsamadicy, Andrew B. Koo, Margot Sarkozy, Benjamin C. Reeves, Zach Pennington, John Havlik, Mani R. Sandhu, Andrew Hersh, Saarang Patel, Luis Kolb, Sheng-Fu Larry Lo, John H. Shin, Ehud Mendel, Daniel M. Sciubba
Summary: This study investigated the relationship between affective disorders and health care resource utilization in patients undergoing surgery for spinal column metastasis. The results showed that affective disorders were significantly associated with higher hospital costs and nonroutine discharge, but not prolonged length of stay.
WORLD NEUROSURGERY
(2022)
Article
Clinical Neurology
Aladine A. Elsamadicy, Andrew B. Koo, Benjamin C. Reeves, Zach Pennington, Margot Sarkozy, Andrew Hersh, John Havlik, Josiah J. Z. Sherman, C. Rory Goodwin, Luis Kolb, Maxwell Laurans, Sheng-Fu Larry Lo, John H. Shin, Daniel M. Sciubba
Summary: This study investigated the impact of frailty using the Hospital Frailty Risk Score (HFRS) on patients undergoing surgery for primary tumors of the spinal cord and meninges. The results showed that frail patients were older, experienced more postoperative complications, had longer length of stay, higher rates of non-routine discharge, and increased hospital costs. Frailty was found to be an independent predictor of extended length of stay and non-routine discharge.
GLOBAL SPINE JOURNAL
(2023)
Article
Clinical Neurology
Aladine A. Elsamadicy, Andrew B. Koo, Margot Sarkozy, Wyatt B. David, Benjamin C. Reeves, Saarang Patel, Justice Hansen, Mani Ratnesh S. Sandhu, Astrid C. Hengartner, Andrew Hersh, Luis Kolb, Sheng-Fu Larry Lo, John H. Shin, Ehud Mendel, Daniel M. Sciubba
Summary: The aim of this study was to investigate the impact of Hospital Frailty Risk Score (HFRS) on health care resource utilization following anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy (CSM). The results showed that patients with a higher HFRS had higher rates of postoperative complications, longer hospital stays, and higher rates of non-routine discharge.
Article
Clinical Neurology
Aladine A. Elsamadicy, Mani Ratnesh S. Sandhu, Benjamin C. Reeves, Tamara Jafar, Samuel Craft, Josiah J. Z. Sherman, Andrew M. Hersh, Andrew B. Koo, Luis Kolb, Sheng-Fu Larry Lo, John H. Shin, Ehud Mendel, Daniel M. Sciubba
Summary: The aim of this study was to assess the impact of affective disorders (ADs) on inpatient narcotic consumption and healthcare resource utilization in patients undergoing spinal fusion for adult spinal deformity. The results showed that patients with ADs consumed more narcotic medications, had longer hospital stays, and had higher rates of nonroutine discharges and unplanned readmissions within 30 days.
WORLD NEUROSURGERY
(2023)
Article
Engineering, Biomedical
Yohannes Tsehay, Yinuo Zeng, Carly Weber-Levine, Tolulope Awosika, Max Kerensky, Andrew M. Hersh, Ze Ou, Kelly Jiang, Meghana Bhimreddy, Stuart J. Bauer, John N. Theodore, Victor M. Quiroz, Ian Suk, Safwan Alomari, Junfeng Sun, Shanbao Tong, Nitish Thakor, Joshua C. Doloff, Nicholas Theodore, Amir Manbachi
Summary: The study investigated the modulation of motor signals by low-intensity ultrasound (LIUS) applied to the spinal cord. LIUS was applied to the exposed spinal cord of rats, and motor evoked potentials (MEPs) were measured. The results showed a significant decrease in hindlimb MEP amplitude during sonication, while there were no significant changes in forelimb MEP amplitude. LIUS can suppress motor signals in the spinal cord and may be useful in treating movement disorders.
IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING
(2023)
Article
Clinical Neurology
Andrew M. Hersh, Tara Dedrickson, Jung Ho Gong, Adrian E. Jimenez, Joshua Materi, Anand Veeravagu, John K. Ratliff, Tej D. Azad
Summary: This study analyzed the utilization, charges, and reimbursement trends for neurosurgical procedures in the Medicare system from 2011 to 2019. The results showed a decrease in overall utilization, but a significant increase in utilization at ambulatory surgery centers and outpatient settings. There were also substantial differences in reimbursement across different procedural categories, indicating the importance of considering healthcare settings and procedure types in understanding the changes in neurosurgical costs.
Article
Clinical Neurology
Daniel Lubelski, James Feghali, Andrew Hersh, Srujan Kopparapu, Abdel-Hameed Al-Mistarehi, Allan J. Belzberg
Summary: This study aims to survey peripheral nerve surgeons on their management of brachial plexus injuries (BPI) and reveals substantial disagreement among surgeons regarding the optimal timing and treatment methods. The study also highlights the differences in operative approaches and nerve transfer choices for adult and pediatric BPI cases.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2023)
Article
Clinical Neurology
Andrew M. Hersh, Daniel Lubelski, Nicholas Theodore, Daniel M. Sciubba, George Jallo, Nir Shimony
Summary: Incidental intradural tumors of the spine in the pediatric population are rare lesions with unclear management. Surgeons must balance the risks of surgical resection against tumor growth. Thorough workup and close follow-up are recommended, with surgical intervention for expanding tumors or new-onset symptoms.
PEDIATRIC NEUROSURGERY
(2023)
Article
Clinical Neurology
Nicholas Theodore, Nikolay Martirosyan, Andrew M. Hersh, Jeff Ehresman, A. Karim Ahmed, Jill Danielson, Cindy Sullivan, Christopher D. Shank, Kaith Almefty, G. Michael Lemole Jr, U. Kumar Kakarla, Mark N. Hadley
Summary: The study aimed to evaluate the safety and feasibility of CSFD in improving SCPP and outcomes after acute SCI. The results showed that CSFD can reduce ITP, improve SCPP, and have positive effects on patients' motor function.
WORLD NEUROSURGERY
(2023)
Review
Oncology
Hallie Gaitsch, Andrew M. Hersh, Safwan Alomari, Betty M. Tyler
Summary: Gliomas are challenging primary brain tumors due to resistance to treatment and anatomical barriers. Dendrimers, nanomaterials with a branching structure, have shown potential for targeted delivery to gliomas. This review discusses the physical characteristics of dendrimers, strategies for targeting glioma cells, and novel applications in glioma models.
Article
Clinical Neurology
Daniel Lubelski, Andrew M. M. Hersh, James Feghali, Daniel M. M. Sciubba, Timothy Witham, Ali Bydon, Nicholas Theodore, Allan J. J. Belzberg
Summary: This study aimed to survey peripheral nerve surgeons on their management of C5 palsy (C5P) after cervical decompression surgery. The results showed that most surgeons agreed on using nerve transfers for severe motor weakness that failed to improve and advocated for early intervention in complete injuries. However, there were disagreements regarding the choice of nerve transfer, timing of surgery, and efficacy of foraminotomy.
GLOBAL SPINE JOURNAL
(2023)
Article
Clinical Neurology
Andrew M. Hersh, Anika Zahoor, Danielle Livingston, Anthony Galinato, Hannah Recht, Jason Hostetter, Craig K. Jones, Daniel Lubelski, Haris I. Sair
Summary: This study presents a technique for generating splayed slices that show the bilateral neuroforamina simultaneously and evaluates its reliability compared with traditional axial slices in assessing cervical neural foraminal stenosis (CNFS). The results show that the interrater agreement is higher for the splayed slices compared with the axial slices, suggesting that splayed reconstructions can improve the consistency of CNFS evaluation.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Andrew M. Hersh, Ann Liu, Jordina Rincon-Torroella, Haris I. Sair, Daniel Lubelski, Chetan Bettegowda, Nir Shimony, Sheng-Fu Larry Lo, Daniel M. Sciubba, George I. Jallo
Summary: Recognition of the ribbon sign on preoperative MRI can improve surgical decision-making and patient counseling for IMSC subependymomas.
WORLD NEUROSURGERY
(2023)