23 results on '"Whiting, Benjamin"'
Search Results
2. Key factors for enhancing academic productivity and fostering mentorship in spine research: the Cleveland Clinic Center for Spine Health approach to sustaining success
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Sundar, Swetha J., Whiting, Benjamin B., Lubelski, Daniel, Steinmetz, Michael P., Mroz, Thomas E., and Benzel, Edward C.
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- 2024
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3. Age-adjusted alignment goals in adult spinal deformity surgery
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Greenberg, Jacob K., Whiting, Benjamin B., Martinez, Orlando M., Butt, Bilal B., Badhiwala, Jetan H., and Clifton, William E.
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- 2023
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4. Laser Interstitial Thermal Therapy for Epileptogenic Periventricular Nodular Heterotopia
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Whiting, Alexander C., Bingaman, Justin R., Catapano, Joshua S., Whiting, Benjamin B., Godzik, Jakub, Walker, Corey T., and Smith, Kris A.
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- 2020
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5. Clinical Outcomes After Nonoperative Management of Large Acute Traumatic Subdural Hematomas in Older Patients: A Propensity-Scored Retrospective Analysis.
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Kashkoush, Ahmed I., Whiting, Benjamin B., Desai, Ansh, Petitt, Jordan C., El-Abtah, Mohamed E., Mcmillan, Aubrey, Finocchiaro, Roman, Hu, Song, and Kelly, Michael L.
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- 2023
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6. 25 - Developmental Deformity in the Cervical Spine
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Whiting, Benjamin, Udayasankar, Unni, Ruggieri, Paul, Manjila, Sunil, and Onwuzulike, Kaine C.
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- 2022
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7. Comparative Effectiveness of Nonoperative Management in Large and Small Acute Traumatic Subdural Hematomas
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Kashkoush, Ahmed I., Whiting, Benjamin B., Desai, Ansh, Petitt, Jordan C., El-Abtah, Mohamed E., and Kelly, Michael L.
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- 2023
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8. List of Contributors
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Abtahi, Ali R., Adogwa, Owoicho, Ahmed, A. Karim, Ainechi, Ana, Alan, Nima, Albanese, Jessica, Aleem, Ilyas, Almeida, Joao Paulo, Alshabab, Basel Sheikh, Alvarado, Anthony M., Alvi, Mohammed Ali, Amer, Aboubakr, Ames, Christopher P., Ammanuel, Simon G., Anand, Neel, Anderson, Paul A., Angelov, Lilyana, Arnold, Paul M., Aubin, Carl-Eric, Bae, Junseok, Bain, Mark, Barber, Joshua, Baron, Eli M., Basi, Hersimren Kaur, Bawahab, Asef, Benzel, Edward C., Berven, Sigurd H., Bevan, Adam K., Bice, Miranda, Bilsky, Mark, Bisson, Erica F., Blaskiewicz, Donald, Boody, Barrett S., Bowles, Daniel, Branch, Charles, Brooks, Nathaniel, Buckland, Aaron J., Buell, Thomas J., Burch, Shane, Burke, John F., Butt, Bilal B., Bydon, Mohamad, Camara, Joaquin, Canseco, Jose A., Casper, David S., Cassidy, Matthew, Chao, Samuel T., Chatain, Grégoire P., Chieng, Lee Onn, Cho, Woojin, Choi, Hoon, Christopher, Susan R., Chung, Andrew S., Clark, Aaron J., Coric, Domagoj, Corriveau, Mark D., Cottrill, Ethan, Cychosz, Christopher, Daubs, Gregory, Daubs, Michael D., Davin, Sara, DeMicco, Russell C., de Padua, Ashley, Derman, Peter B., Dhall, Sanjay S., Diab, Mohammad, DiGiorgio, Anthony M., Dimar, John R., II, Dru, Alexander B., Dubousset, Jean, Dunbar, Melissa R., Ebrahim, Zeyd, Ehresman, Jeff, Elder, J. Bradley, Ellenbogen, Richard G., El Naga, Ashraf N., Emans, John B., Engstrom, John W., Errico, Thomas J., Farag, Ehab, Farber, S. Harrison, Fatima, Nida, Fedorak, Graham T., Fehlings, Michael G., Feigenbaum, Frank, Ferrara, Lisa, Fessler, Richard G., Finn, Michael, Fischgrund, Jeffrey S., Fisher, Mark D., Fontes, Ricardo B.V., Fox, Michael A., Freedman, Brett A., Frenkel, Mark, Fridley, Jared, Gabet, Joelle, Garg, Sumeet, German, John W., Ghogawala, Zoher, Gibbs, Christopher M., Gillick, John L., Gilligan, Christopher J., Gillis, Christopher C., Goel, Atul, Gokaslan, Ziya L., Goldstein, Zachary H., Grant, Gerald A., Grasso, Mackenzie, Grossbach, Andrew J., Guan, Jian, Guinn, Jeremy, Gupta, Raghav, Gussous, Yazeed M., Guyer, Richard D., Haddad, Alexander F., Hamilton, Kirsty, Harland, Tessa, Harrop, James S., Hart, David J., Hart, Robert A., Hassan, Waqaas A., Hayes, Amanda W., Heary, Robert F., Hedequist, Daniel, Henderson, Fraser C., Sr., Henzel, M. Kristi, Herring, Eric Z., Higgins, Dominique, Hilibrand, Alan S., Hindoyan, Kevork N., Hines, Kevin, Hitchon, Patrick W., Hoffmann, Jacob C., Hoh, Daniel J., Holt, Joshua, Hsia, Augusto, Hsieh, Jason, Hsu, Wellington K., Hurlbert, John, Hwang, Steven W., Iordanou, Jordan C., Jack, Andrew S., Janich, Karl, Jiang, Bowen, Jiang, Fan, Jimenez, Xavier F., Johnson, J. Patrick, Jones, G. Alexander, Jones, Kristen E., Joseph, Jacob R., Joshi, Rushikesh S., Juthani, Rupa G., Kalfas, Iain H., Kalra, Ricky R., Kang, James D., Kanter, Adam S., Kasliwal, Manish K., Kaushal, Mayank, Kerolus, Mena G., Kesler, Kyle, Kessler, Remi A., Khalaf, Tagreed, Khalil, Jad G., Kim, Terrence T., Kimball, Jon, Kisinde, Stanley, Klineberg, Eric O., Kondylis, Efstathios, Kramer, Dallas E., Krauss, William E., Krishnaney, Ajit A., Krogue, Justin, Kshettry, Varun R., Kumar, Neeraj, Kurpad, Shekar N., Labak, Collin M., Labelle, Hubert, Ladd, Bryan, Lafage, Virginie, Laratta, Joseph L., Lark, Robert, Lau, Darryl, Laufer, Ilya, Lavelle, William F., Le, Hai V., Lee, Andrew, Lee, Nathan J., Lee, Sang-Ho, Lehman, Ronald A., Jr., Lehner, Kurt, Lenke, Lawrence G., Li, Yingda, Lieberman, Isador H., Ling, Marcus Z., Lo, Victor P., Lollis, S. Scott, Lombardi, Joseph M., Long, Donlin, Long, Roger, Lotz, Jeffrey, Lyons, Joseph G., Mac-Thiong, Jean-Marc, Machado, Andre, Mallow, Gary M., Malone, David G., Manjila, Sunil, Maroon, Joseph C., Maslak, Joseph P., Massaad, Elie, Matsumoto, Morio, Martini, Michael L., Mayer, E. Kano, Mayer, Rory, Mazanec, Daniel J., McCormick, Kyle L., McCormick, Paul C., McGrath, Kyle, McNeill, Ian T., Medress, Zachary A., Mendelis, Joseph R., Mendis, Phillip G., Metz, Lionel, Midha, Rajiv, Miele, Vincent J., Mijatovic, Desimir, Mikula, Anthony L., Min, Elliot, Mizuno, Shuichi, Moghaddamjou, Ali, Molenda, Joseph E., Momin, Arbaz, Momin, Eric, Moore, Nina Z., Morris, Dylan, Morrissette, Cole R., Mroz, Thomas E., Mummaneni, Praveen V., Mundis, Gregory M., Munoz, Tess, Naderi, Sait, Nagel, Sean J., Nagoshi, Narihito, Nail, Tara Jayde, Nair, Dileep, NaPier, Zachary, Neifert, Sean N., Nemunaitis, Gregory, Nessim, Adam, Niu, Tianyi, Norwig, John A., Ong, Binnan, Onwuzulike, Kaine C., Oren, Jonathan, Orr, R. Douglas, O’Toole, John E., Ozpinar, Alp, Padua, Fortunato G., Page, Paul, Park, Paul J., Parmar, Vikas, Patel, Arati, Patel, Parthik, Patel, Rakesh, Pelle, Dominic, Peña, Enrique, Pendleton, Courtney, Pennicooke, Brenton, Pennington, Zach, Perez-Cruet, Mick J., Petersen-Fitts, Graysen R., Peterson, Thomas A., Piche, Joshua, Placide, Rick, Platt, Andrew, Polifka, Adam J., Polly, David W., Poree, Lawrence, Rajasekaran, S., Rammo, Richard, Rasouli, Jonathan J., Ratliff, John K., Rawlinson, Jeremy J., Ray, Wilson Z., Recinos, Pablo F., Recinos, Violette M., Reid, Patrick, Renfrow, Jackie, Resnick, Daniel K., Resser, Tina, Rhines, Laurence D., Richardson, Dusty, Riesenburger, Ron, Rispinto, Sarah, Rivera, Joshua, Rosenquist, Richard Wayne, Ross, Lindsey, Rossi, Vincent, Rudisill, Samuel S., Ruggieri, Paul, Ryu, Won Hyung A., Sabourin, Victor, Safaee, Michael M., Safain, Mina, Salaheen, Zaid, Samartzis, Dino, Samdani, Amer F., Samtani, Rahul G., Sasso, Rick, Satin, Alexander M., Savage, Jason W., Sawin, Paul D., Sawires, Andrew N., Sawyer, Aenor, Schmidt, Bradley T., Schmidt, Eric, Schmidt, Meic H., Schwab, Frank J., Sciubba, Daniel M., Sellin, Jonathan N., Shaaya, Elias, Shabani, Saman, Shaffrey, Christopher I., Shankar, Ganesh M., Shao, Jianning, Sharan, Alok D., Shaw, Jeremy D., Shen, Jian, Shenoy, Kartik, Shetty, Ajoy Prasad, Shin, John H., Shook, Steven J., Singh, Harminder, Singh, Rahul, Sissman, Ethan, Siyaji, Zakariah K., Smith, Gabriel A., Smith, John T., Smith, Justin S., Spinner, Robert J., Spurgas, Morgan P., Stefanelli, Anthony J., Steinmetz, Michael P., Sundar, Swetha J., Swarup, Ishaan, Takeoka, Yoshiki, Tatsui, Claudio E., Teferi, Nahom, Telfeian, Albert E., Theodore, Nicholas, Theologis, Alekos A., Thiyagarajah, Nishanth, Thorp, Brian D., Traynelis, Vincent C., Trost, Gregory R., Truong, Huy Q., Tsiang, John T., Tumialán, Luis M., Tymchak, Zane A., Udayasankar, Unni, Umansky, Daniel, Uribe, Juan S., Vaccaro, Alexander R., Vargovich, Alison M., Vaziri, Sasha, Veeravagu, Anand, Venezia, Michael, Verma, Kushagra, Vilarello, Brandon, Viljoen, Stephanus V., Viswanathan, Vibhu Krishnan, Volovetz, Josephine, Vorster, Sarel J., Walker, Corey T., Wallace, Daniel J., Wang, Anthony C., Wang, Jeffrey C., Wang, Marjorie C., Wang, Michael Y., Wang, Xiaoyu, Weinstein, Stuart L., Weisman, Michael H., Weissmann, Karen, Wentworth, Kelly, Whiting, Benjamin, Whitmore, Robert G., Wick, Joseph, Williams, Michelle, Wilson, James R., Wilson, Leslie, Witham, Timothy, Wolfla, Christopher E., Wolinsky, Jean-Paul, Woodard, Eric J., Wu, Hao-Hua, Yang, Michael, Yezdani, Samir G., Yoganandan, Narayan, Yolcu, Yagiz, Young, Robin, Zanation, Adam, Zehri, Aqib, and Zileli, Mehmet
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- 2022
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9. Gorham-Stout disease of the spine presenting with intracranial hypotension and cerebrospinal fluid leak: A case report and review of the literature.
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Yokoi, Hana, Chakravarthy, Vikram, Whiting, Benjamin, Kilpatrick, Scott E., Chen, Tsulee, and Krishnaney, Ajit
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SPINE diseases ,RIB fractures ,LITERATURE reviews ,MAGNETIC resonance imaging ,BONE diseases ,CEREBROSPINAL fluid leak - Abstract
Background: Gorham-Stout (GS) disease or "vanishing bone disease" is rare and characterized by progressive, spontaneous osteolysis resulting in loss of bone on imaging studies. Treatment modalities include combinations of medical and/or surgical treatment and radiation therapy. Case Description: A 14-year-old female with GS disease presented with a 1-year history of thoracic back pain and atypical headaches consistent with intracranial hypotension. Magnetic resonance imaging and operative findings demonstrated a spontaneous thoracic cerebrospinal fluid leak (CSF) (e.g., that extended into the pleural cavity) and complete osteolysis of the T9-10 posterior bony elements (e.g., including the rib head, lamina, and transverse processes). The patient underwent repair of CSF fistula followed by a T6-11 instrumented fusion. Conclusion: This case of GS disease, involving a thoracic CSF fistula and absence/osteolysis of the T9-T10 bony elements, could be successfully managed with direct dural repair and an instrumented T6-T11 fusion. [ABSTRACT FROM AUTHOR]
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- 2020
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10. Combined use of minimal access craniotomy, intraoperative magnetic resonance imaging, and awake functional mapping for the resection of gliomas in 61 patients.
- Author
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Whiting, Benjamin B., Lee, Bryan S., Mahadev, Vaidehi, Borghei-Razavi, Hamid, Ahuja, Sanchit, Xuefei Jia, Mohammadi, Alireza M., Barnett, Gene H., Angelov, Lilyana, Rajan, Shobana, Avitsian, Rafi, and Vogelbaum, Michael A.
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- 2020
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11. Thalamic Deep Brain Stimulation.
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Whiting, Benjamin B., Whiting, Alexander C., and Whiting, Donald M.
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- 2018
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12. Pleomorphic Hyalinizing Angiectatic Tumor Arising in the Hand: A Case Report.
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Kane, Patrick M., Gaspar, Michael P., Whiting, Benjamin B., and Culp, Randall W.
- Abstract
Background: Background: Pleomorphic hyalinizing angiectatic tumors (PHATs) are extremely rare, non-metastasizing tumors of uncertain origin that are typically seen in the lower extremities. To date, it is estimated that less than 100 cases have been reported worldwide since first described in 1996. Methods: The case of a 35-year-old male with a several-year history of a dorsal hand mass is presented. Although the patient was initially asymptomatic, in the months prior to presentation, the patient complained of pain with power grasp and direct pressure over the mass. The patient underwent uncomplicated surgical excision, during which the mass was noted to be adherent to the underlying extensor tendons. Results: Immunopathology confirmed the mass to be PHAT. We believe this is the first documented case of this rare tumor occurring in the hand. Conclusions: History and epidemiology of PHAT are reviewed. Then, in the context of the presented case, pre-operative evaluation, surgical management, pathologic findings and post-operative follow-up are all discussed. [ABSTRACT FROM AUTHOR]
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- 2016
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13. The Effects of Demographics and Health Insurance Status on Physician Treatment Decisions and Patient Outcomes of Acute Spinal Fractures at an Academic Level 1 Trauma Center
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Bhandutia, Amit K., Whiting, Benjamin B., and Altman, Daniel T.
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- 2014
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14. Model Theory & International Relations Theory: Positivism, Ontology and the Nature of Social Science.
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Whiting, Benjamin J. and Carlson, Jon
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INTERNATIONAL relations , *POSITIVISM , *ONTOLOGY , *SOCIAL sciences , *NATURAL history - Abstract
When it comes to scientific investigation, positivism is no longer the only game in town, nor is it even the most prominent theory of how science works. Model Theory has become ascendent within the natural sciences, yet is still not explicitly rpesent in IR Theorizing. This paper seeks to rectify this shortcoming. Model Theory is a fundamentally different understanding of the nature of science, including different ontological and explanatory commitments. This paper argues that Model Theory does a far better job than positivism in accounting for the descriptive nature of mainstream IR Theory, and we argue that much of IR Theory is already working in a Model Theoretic framework. In accepting such a framework, we posit that IR theorists may bypass a number of important (and often unquestioned) issues arising from their ontological commitments to positivism, while not betraying their commitment to keeping the discipline scientific. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]
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- 2008
15. Lateral hypothalamic area deep brain stimulation for refractory obesity: a pilot study with preliminary data on safety, body weight, and energy metabolism.
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WHITING, DONALD M., TOMYCZ, NESTOR D., BAILES, JULIAN, DE JONGE, LILIAN, LECOULTRE, VIRGILE, WILENT, BRYAN, ALCINDOR, DUNBAR, RICHARD PROSTKO, E., CHENG, BOYLE C., ANGLE, CYNTHIA, CANTELLA, DIANE, WHITING, BENJAMIN B., MIZES, SCOTT, FINNIS, KIRK W., RAVUSSIN, ERIC, and OH, MICHAEL Y.
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- 2013
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16. Utility of repeat magnetic resonance imaging in surgical patients with lumbar stenosis without disc herniation.
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Lee, Bryan S., Nault, Rod, Grabowski, Matthew, Whiting, Benjamin, Tanenbaum, Joseph, Knusel, Konrad, Poturalski, Matthew, Emch, Todd, Mroz, Thomas E., and Steinmetz, Michael P.
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DISCECTOMY , *MAGNETIC resonance imaging , *HERNIA , *SIMULATED patients , *STENOSIS , *LUMBAR vertebrae surgery , *LUMBAR vertebrae , *SURGICAL decompression - Abstract
Background Context: Routine use of magnetic resonance imaging (MRI) as a diagnostic tool in lumbar stenosis is becoming more prevalent due to the aging population. Currently, there is no clinical guideline to clarify the utility of repeat MRI in patients with lumbar stenosis, without instability, neurological deficits, or disc herniation.Purpose: To evaluate the utility of routine use of MRI as a diagnostic tool in lumbar stenosis, and to help formulate clinical guidelines on the appropriate use of preoperative imaging for lumbar stenosis.Study Design/setting: Retrospective radiographic analysis.Patient Sample: Retrospective chart review was performed to review patients with lumbar stenosis, who underwent lumbar decompression without fusion from 2011 to 2015 at a single institution.Outcome Measures: Previously established stenosis grading systems were used to measure and compare the initial and the subsequent repeat lumbar MRIs performed preoperatively. If patients were found to have a moderate or severe grade change, and if the surgical plan was altered due to such exacerbated radiographic findings, then their grade changes were considered clinically meaningful.Methods: We identified patients with lumbar stenosis without radiographic instability or neurological deficits, who had at least two preoperative lumbar MRIs performed and underwent decompressive surgeries. At each pathologic disc level, the absolute value of the change in grade for central and lateral recess stenosis, right foraminal stenosis, and left foraminal stenosis from the first preoperative MRI to the repeated MRI was calculated. These changed data were then used to calculate the mean and median changes in each of the three types of stenosis for each pathologic disc level. Identical calculations were carried out for the subsample of patients who only underwent discectomy or had a discectomy included as part of their surgery.Results: Among the 103 patients who met the inclusion criteria, 37 of those patients had more than one level surgically addressed, and a total of 161 lumbar levels were reviewed. Among the subset of patients that had any grade change, the majority of the grades only had a mild change of 1 (36 out of 42 patients, 85.7%, 95% confidence interval [CI]: 73.1%-94.1%); there was a moderate grade change of 2 in two patients (4.8%, CI: 0.8%-14.0%), and a severe change of 3 in one patient (2.4%, CI: 0.2%-10.1%). There were three patients with decreased grade change (7.1%, CI: 1.8%-17.5%). All clinically meaningful grade changes were from the subset of patients who had only discectomy or discectomy as part of the procedure. Lastly, both patients that had a clinically meaningful grade change had their MRIs performed at an interval of greater than 360 days.Conclusions: The radiographic evaluation of the utility of routinely repeated MRIs in lumbar stenosis without instability, neurological deficits, or disc herniations demonstrated that there were no significant changes found in the repeated MRI in the preoperative setting, especially if the MRIs were performed less than one year apart. The results of this present study can help to standardize the diagnostic evaluation of lumbar stenosis and to formulate clinical guidelines on the appropriate use of preoperative imaging for lumbar stenosis patients. [ABSTRACT FROM AUTHOR]- Published
- 2019
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17. Friday, September 28, 2018 1:00 PM–2:30 PM abstracts: a new look at imaging: 206. Utility of routinely repeated magnetic resonance imaging in surgical patients with lumbar stenosis.
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Lee, Bryan S., Nault, Rod J., Grabowski, Matthew M., Whiting, Benjamin B., Tanenbaum, Joseph E., Poturalski, Matthew, Emch, Todd M., Mroz, Thomas E., and Steinmetz, Michael P.
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LUMBAR vertebrae diseases , *STENOSIS , *MAGNETIC resonance imaging , *AGING , *COST effectiveness - Abstract
BACKGROUND CONTEXT Routine use of magnetic resonance imaging (MRI) as a diagnostic tool in lumbar stenosis is becoming more prevalent due to the aging population. However, as the health care expenditure in the United States is rapidly increasing, it is imperative to minimize the use of costly imaging modalities by investigating the utility and cost effectiveness of images routinely obtained. PURPOSE Our study was designed to clarify the utility of routinely repeated MRI in patients with lumbar stenosis, without instability or neurological deficits. STUDY DESIGN/SETTING Retrospective radiographic analysis was performed in the preoperative MRI's of all patients who underwent lumbar decompression via laminectomy, laminotomy, foraminotomy, and/or discectomy, performed at a single tertiary-care institution from 2011 to 2015. PATIENT SAMPLE Among the patients initially identified, those who had at least two preoperative MRI's and were without radiographic instability or clinical neurological deficits were selected. OUTCOME MEASURES For radiographic analysis, grading systems were adopted and modified from Schizas's grading system and Lee's et al. foraminal stenosis grading system, which were used to measure and compare the initial and the subsequent repeat lumbar MRI's performed preoperatively. If patients were found to have a moderate or severe grade change, and if the surgical plan was altered due to such exacerbated radiographic findings, then their grade changes were considered clinically meaningful. METHODS At each pathologic level, the absolute value of the change in grades for central or lateral recess stenosis, right foraminal stenosis, and left foraminal stenosis in the first preoperative MRI and the repeated MRI was calculated. These change data were used to calculate the mean and median change in each of the three types of stenosis for each pathologic level. Both the mean and median change in stenosis severity were also calculated for the subset of patients that actually had a change in severity. This analysis was undertaken to quantify the extent of change in stenosis severity that could be expected if a patient's stenosis changed at all. Finally, identical calculations were carried out for the subsample of patients who had discectomy as part of the procedure. RESULTS We identified 103 patients who met the inclusion criteria. A total of 17 of those patients had more than one level surgically addressed, and a total of 161 lumbar levels were reviewed. In the subset that had any change, the majority of the grades only had a mild change of one (33 out of 38 patients, 86.8%; 36 out of 41 levels, 87.8%); there was a moderate grade change of two in two levels (4.9%), and a severe change of three in one level (2.4%). There were three levels that had decreased grades (7.3%). All clinically meaningful grade changes were from the subset of patients who had only discectomy or discectomy as part of the procedure. CONCLUSIONS The radiographic evaluation of the utility of routinely repeated MRI's in lumbar stenosis without instability, neurological deficits, or disc herniations demonstrated that there were no significant changes found in the repeated MRI in the preoperative setting. The results of the present study can help to standardize the diagnostic evaluation of lumbar stenosis and to formulate clinical guidelines on the appropriate use of preoperative imaging for lumbar stenosis patients. [ABSTRACT FROM AUTHOR]
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- 2018
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18. Revision Thoracic Syringo-Subarachnoid Shunt for Recurrent Syrinx With Syringobulbia: Technique and Surgical Video.
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Sankarappan K, Pack A, Patel A, Whiting B, and Clifton W
- Abstract
Syringomyelia and syringobulbia continue to remain a diagnosis without widely accepted treatment paradigms. Furthermore, the currently available treatment options can be complicated by delayed symptom recurrence and the need for revision surgery. Revision intradural surgery is challenging, and currently, there is a paucity of literature describing safe techniques for revision syringotomy and shunt placement. In this technical report, we present a surgical video describing the technique of revision syringo-subarachnoid shunt placement in a 61-year-old female with a history of multiple intradural surgeries who presented with progressively symptomatic ascending syringobulbia., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2022, Sankarappan et al.)
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- 2022
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19. Difficult-to-Localize Epilepsy After Stereoelectroencephalography: Technique, Safety, and Efficacy of Placing Additional Electrodes During the Same Admission.
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Whiting AC, Bulacio J, Whiting BB, Jehi L, and Bingaman W
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- Electrodes, Implanted, Humans, Retrospective Studies, Stereotaxic Techniques, Electroencephalography, Epilepsy surgery
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Background: Stereoelectroencephalography (SEEG) is used to identify the epileptogenic zone (EZ) in patients with epilepsy for potential surgical intervention. Occasionally, the EZ is difficult to localize even after an SEEG implantation., Objective: To demonstrate a safe technique for placing additional electrodes in ongoing SEEG evaluations. Describe efficacy, complications, and surgical outcomes., Methods: An operative technique which involves maintaining previously placed electrodes and sterilely placing new electrodes was developed and implemented. All patients who underwent placement of additional SEEG electrodes during the same admission were retrospectively reviewed., Results: A total of 14 patients met criteria and had undergone SEEG evaluation with 198 electrodes implanted. A total 93% of patients (13/14) had nonlesional epilepsy. After unsuccessful localization of the EZ after a mean of 9.6 d of monitoring, each patient underwent additional placement of electrodes (5.5 average electrodes per patient) to augment the original implantation. At no point did any patients develop new hemorrhage, infection, wound breakdown, or require any kind of additional antimicrobial treatment. A total 64% (9/14) of patients were able to undergo surgery aimed at removing the EZ guided by the additional SEEG electrodes. A total 44% (4/9) of surgical patients had Engel class I outcomes at an average follow-up time of 11 mo., Conclusion: Placing additional SEEG electrodes, while maintaining the previously placed electrodes, appears to be safe, effective, and had no infectious complications. When confronted with difficult-to-localize epilepsy even after invasive monitoring, it appears to be safe and potentially clinically effective to place additional electrodes during the same admission., (Copyright © 2020 by the Congress of Neurological Surgeons.)
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- 2020
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20. Combined use of minimal access craniotomy, intraoperative magnetic resonance imaging, and awake functional mapping for the resection of gliomas in 61 patients.
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Whiting BB, Lee BS, Mahadev V, Borghei-Razavi H, Ahuja S, Jia X, Mohammadi AM, Barnett GH, Angelov L, Rajan S, Avitsian R, and Vogelbaum MA
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Objective: Current management of gliomas involves a multidisciplinary approach, including a combination of maximal safe resection, radiotherapy, and chemotherapy. The use of intraoperative MRI (iMRI) helps to maximize extent of resection (EOR), and use of awake functional mapping supports preservation of eloquent areas of the brain. This study reports on the combined use of these surgical adjuncts., Methods: The authors performed a retrospective review of patients with gliomas who underwent minimal access craniotomy in their iMRI suite (IMRIS) with awake functional mapping between 2010 and 2017. Patient demographics, tumor characteristics, intraoperative and postoperative adverse events, and treatment details were obtained. Volumetric analysis of preoperative tumor volume as well as intraoperative and postoperative residual volumes was performed., Results: A total of 61 patients requiring 62 tumor resections met the inclusion criteria. Of the tumors resected, 45.9% were WHO grade I or II and 54.1% were WHO grade III or IV. Intraoperative neurophysiological monitoring modalities included speech alone in 23 cases (37.1%), motor alone in 24 (38.7%), and both speech and motor in 15 (24.2%). Intraoperative MRI demonstrated residual tumor in 48 cases (77.4%), 41 (85.4%) of whom underwent further resection. Median EOR on iMRI and postoperative MRI was 86.0% and 98.5%, respectively, with a mean difference of 10% and a median difference of 10.5% (p < 0.001). Seventeen of 62 cases achieved an increased EOR > 15% related to use of iMRI. Seventeen (60.7%) of 28 low-grade gliomas and 10 (30.3%) of 33 high-grade gliomas achieved complete resection. Significant intraoperative events included at least temporary new or worsened speech alteration in 7 of 38 cases who underwent speech mapping (18.4%), new or worsened weakness in 7 of 39 cases who underwent motor mapping (18.0%), numbness in 2 cases (3.2%), agitation in 2 (3.2%), and seizures in 2 (3.2%). Among the patients with new intraoperative deficits, 2 had residual speech difficulty, and 2 had weakness postoperatively, which improved to baseline strength by 6 months., Conclusions: In this retrospective case series, the combined use of iMRI and awake functional mapping was demonstrated to be safe and feasible. This combined approach allows one to achieve the dual goals of maximal tumor removal and minimal functional consequences in patients undergoing glioma resection.
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- 2019
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21. Misplacement of Stent Into Epidural Venous Plexus With Resultant Cauda Equina Syndrome and Open Surgical Treatment: A Case Report.
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Whiting BB, Mulholland CB, Daniels L, Kakarla UK, Theodore N, and Snyder LA
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- Aged, Cauda Equina Syndrome surgery, Decompression, Surgical, Humans, Laminectomy, Male, Spinal Fusion, Treatment Outcome, Cauda Equina Syndrome etiology, Femoral Artery surgery, Peripheral Vascular Diseases surgery, Stents adverse effects
- Abstract
Background and Importance: Endovascular therapy has proven to be a safe, minimally invasive treatment for multiple etiologies, but proper precautions must be taken to avoid complications. When complications occur, they should be promptly identified and corrected when possible. This case report describes endovascular stents misplaced into the epidural spinous venous plexus rather than the iliofemoral arteries, causing cauda equina syndrome, as well as the spinal procedure performed to treat the resulting spinal canal compression., Clinical Presentation: A 67-yr-old man had undergone what he thought was iliofemoral arterial stenting at an outside hospital for peripheral vascular disease. He presented 8 d later to our hospital with cauda equina syndrome comprising back pain, right L5 radiculopathy, perianal numbness, urinary retention, and constipation. Scans demonstrated stents deployed into the venous system, traversing the spinal canal and the right L5-S1 neural foramen, resulting in severe spinal canal stenosis, right L5-S1 foraminal stenosis, and moderate left S1-S2 foraminal stenosis. The patient underwent an L5-S1 laminectomy with full right L5-S1 facetectomy and left S1-S2 medial facetectomy, with associated L5-S1 posterolateral fusion with fixation to remove the stent and decompress the neural elements., Conclusion: Although stent misplacement is an uncommon complication of endovascular therapy, this case demonstrates the importance of ensuring access to the proper vessel before stent placement. Once this complication was recognized, safe removal of the stents was possible and the patient demonstrated meaningful postoperative improvement in symptoms and strength.
- Published
- 2018
- Full Text
- View/download PDF
22. Comparison of Intervertebral ROM in Multi-Level Cadaveric Lumbar Spines Using Distinct Pure Moment Loading Approaches.
- Author
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Santoni B, Cabezas AF, Cook DJ, Yeager MS, Billys JB, Whiting B, and Cheng BC
- Abstract
Background: Pure-moment loading is the test method of choice for spinal implant evaluation. However, the apparatuses and boundary conditions employed by laboratories in performing spine flexibility testing vary. The purpose of this study was to quantify the differences, if they exist, in intervertebral range of motion (ROM) resulting from different pure-moment loading apparatuses used in two laboratories., Methods: Twenty-four (laboratory A) and forty-two (laboratory B) intact L1-S1 specimens were loaded using pure moments (±7.5 Nm) in flexion-extension (FE), lateral bending (LB) and axial torsion (AT). At laboratory A, pure moments were applied using a system of cables, pulleys and suspended weights in 1.5 Nm increments. At laboratory B, specimens were loaded in a pneumatic biaxial test frame mounted with counteracting stepper-motor-driven biaxial gimbals. ROM was obtained in both labs using identical optoelectronic systems and compared., Results: In FE, total L1-L5 ROM was similar, on average, between the two laboratories (lab A: 37.4° ± 9.1°; lab B: 35.0° ± 8.9°, p=0.289). Larger apparent differences, on average, were noted between labs in AT (lab A: 19.4° ± 7.3°; lab B: 15.7° ± 7.1°, p=0.074), and this finding was significant for combined right and left LB (lab A: 45.5° ± 11.4°; lab B: 35.3° ± 8.5°, p < 0.001)., Conclusions: To our knowledge, this is the first study comparing ROM of multi-segment lumbar spines between laboratories utilizing different apparatuses. The results of this study show that intervertebral ROM in multi-segment lumbar spine constructs are markedly similar in FE loading. Differences in boundary conditions are likely the source of small and sometimes statistically significant differences between the two techniques in LB and AT ROM. The relative merits of each testing strategy with regard to the physiologic conditions that are to be simulated should be considered in the design of a study including LB and AT modes of loading. An understanding of these differences also serves as important information when comparing study results across different laboratories.
- Published
- 2015
- Full Text
- View/download PDF
23. Accuracy of the freehand pass technique for ventriculostomy catheter placement: retrospective assessment using computed tomography scans.
- Author
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Huyette DR, Turnbow BJ, Kaufman C, Vaslow DF, Whiting BB, and Oh MY
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Infant, Intracranial Hypertension etiology, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Tomography, X-Ray Computed, Treatment Outcome, Catheterization methods, Critical Care, Intracranial Hypertension diagnostic imaging, Intracranial Hypertension surgery, Ventriculostomy methods
- Abstract
Objectives: The standard method of ventriculostomy catheter placement is a freehand pass technique using surface anatomical landmarks. This study was undertaken to determine the accuracy of successful ventriculostomy procedures performed at a single institution's intensive care unit (ICU). The authors hypothesized that use of surface anatomical landmarks alone with successful results frequently do not correlate with desirable catheter tip placement., Methods: Retrospective evaluation was performed on the head computed tomography (CT) scans of 97 patients who underwent 98 freehand pass ventriculostomy catheter placements in an ICU setting. Using the postprocedure CT scans of the patients, 3D measurements were made to calculate the accuracy of ventriculostomy catheter placement., Results: The mean distance (+/- standard deviation [SD]) from the catheter tip to the Monro foramen was 16 +/- 9.6 mm. The mean distance (+/- SD) from the catheter tip to the center of the bur hole was 87.4 +/- 14.0 mm. Regarding accurate catheter tip placement, 56.1% of the catheter tips were in the ipsilateral lateral ventricle, 7.1% were in the contralateral lateral ventricle, 8.2% were in the third ventricle, 6.1% were within the interhemispheric fissure, and 22.4% were within extraventricular spaces., Conclusions: The accuracy of freehand ventriculostomy catheterization at the authors' institution typically required 2 passes per successful placement, and, when successful, was 1.6 cm from the Monro foramen. More importantly, 22.4% of these catheter tips were in nonventricular spaces. Although many neurosurgeons believe that the current practice of ventriculostomy is good enough, the results of this study show that there is certainly much room for improvement.
- Published
- 2008
- Full Text
- View/download PDF
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