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17. The Role of Magnetic Transcranial Stimulation in the Diagnosis and Post-Surgical Follow-Up of Cervical Spondylotic Myelopathy

Author

Vázquez-Sánchez, Fernando, primary, Lloria-Gil, María del Carmen, additional, Gómez-Menéndez, Ana Isabel, additional, Isidro-Mesas, Francisco, additional, Echavarría-Íñiguez, Ana, additional, Martín-Alonso, Javier, additional, González-Bernal, Jerónimo, additional, González-Santos, Josefa, additional, Berardi, Anna, additional, Tofani, Marco, additional, Galeoto, Giovanni, additional, and García-López, Beatriz, additional

Published
2023
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18. Patients awaiting surgery for neurosurgical diseases during the first wave of the COVID-19 pandemic in Spain: a multicentre cohort study

Author

Castaño-Leon, Ana M, primary, Paredes, Igor, additional, Lagares, Alfonso, additional, Gomez, Pedro A, additional, González-Leon, Pedro, additional, Perez-Nuñez, Angel, additional, Jiménez-Roldán, Luis, additional, Delgado-Fernández, Juan, additional, Eiriz Fernández, Carla, additional, García-Pérez, Daniel, additional, Moreno-Gómez, Luis M, additional, Esteban-Sinovas, Olga, additional, Delgado-López, Pedro D, additional, Martín-Alonso, Javier, additional, Kaen, Ariel, additional, Tirado-Caballero, Jorge, additional, Ordóñez-Carmona, Marta, additional, Arteaga-Romero, Francisco, additional, González-Pombo, Marta, additional, F Alén, José, additional, Gil-Simoes, Ricardo, additional, Torres, Cristina V, additional, Navas-García, Marta, additional, Blasco García de Andoain, Guillermo, additional, Frade-Porto, Natalia, additional, González-Tarno, Patricia, additional, Martin Segura, Adrian, additional, Gelabert-González, Miguel, additional, Menéndez-Cortezón, Beatriz, additional, Rodríguez-Botana, Brais, additional, Pérez-Alfayate, Rebeca, additional, Fernández-García, Carla, additional, Ferrández-Pujante, Borja, additional, Vargas-Jiménez, Andres C, additional, Cotúa, Carlos, additional, de la Lama, Adolfo, additional, Calero Félix, Lourdes, additional, Ruiz-Juretschke, Fernando, additional, García-Leal, Roberto, additional, Valera-Melé, Marc, additional, Casitas Hernando, Vicente, additional, Rivero, Belén, additional, Orduna-Martínez, Javier, additional, Casado Pellejero, Juan, additional, Fustero De Miguel, David, additional, Díaz Molina, Jorge, additional, Moles Herbera, Jesús, additional, Castelló-Ruiz, Maria J, additional, Gomar-Alba, Mario, additional, García-Pérez, Fernando, additional, Hernández-García, Borja J, additional, Villaseñor-Ledezma, Jorge J, additional, Otero-Rodríguez, Álvaro, additional, Ailagas de las Heras, Juan J, additional, Gonçalves-Estella, Jesus, additional, Sousa-Casasnovas, Pablo, additional, Pascual-Argente, Daniel, additional, Ruiz Martín, Laura, additional, Roa Montes de Oca, Juan C, additional, Arandia Guzmán, Daniel, additional, García Martín, Andoni, additional, Torres Carretero, Luis, additional, Garrido Ruiz, Alejandra, additional, Calvo, Marta, additional, Miranda-Lloret, Pablo, additional, Rodríguez-Cadarso, Miguel, additional, Antón, Joan, additional, Roca Barber, Amparo, additional, Quiroz-Tejada, Arnold, additional, Carbayo-Lozano, Guillermo, additional, Bermúdez, Garazi, additional, Paternain Martin, Clara, additional, De la Fuente Villa, Pablo, additional, Fidalgo De la Rosa, Marina, additional, Sistiaga-Gracia, Íñigo L, additional, and Zabalo, Gorka, additional

Published
2022
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19. Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: a nationwide study in Spain

Author

Paredes, Igor, primary, Castaño Leon, Ana Maria, additional, Lagares, Alfonso, additional, Jimenez Roldan, Luis, additional, Perez-Nuñez, Angel, additional, González-Leon, Pedro, additional, Delgado-Fernandez, Juan, additional, Eiriz, Carla, additional, García-Pérez, Daniel, additional, Moreno-Gomez, Luis Miguel, additional, Esteban-Sinovas, Olga, additional, Delgado-López, Pedro, additional, Martín-Alonso, Javier, additional, Kaen, Ariel, additional, Tirado-Caballero, Jorge, additional, Ordóñez Carmona, Marta, additional, Arteaga Romero, Francisco, additional, Gonzalez Pombo, Marta, additional, Alén, José F, additional, Gil-Simoes, Ricardo, additional, Torres, Cristina V, additional, Navas Garcia, Marta, additional, Blasco, Guillermo, additional, Frade-Porto, Natalia, additional, González-Tarno, Patricia, additional, Martin Segura, Adrian, additional, Gelabert-Gonzalez, Miguel, additional, Menendez Cortezon, Beatriz, additional, Rodriguez Botana, Brais, additional, Pérez-Alfayate, Rebeca, additional, Fernandez Garcia, Carla, additional, Ferrandez Pujante, Borja, additional, Vargas-Jiménez, Andres, additional, Cotúa, Carlos, additional, de la Lama, Adolfo, additional, Calero, Lourdes, additional, Ruiz-Juretschke, Fernando, additional, Garcia Leal, Roberto, additional, Valera Mele, Marc, additional, Casitas Hernando, Vicente, additional, Rivero Martín, Belén, additional, Orduna, Javier, additional, Casado Pellejero, Juan, additional, Fustero De Miguel, David, additional, Diaz-Molina, Jorge, additional, Moles Herbera, Jesus, additional, Castello Ruiz, Maria Jose, additional, Gomar Alba, Mario, additional, Garcia Perez, Fernando, additional, Hernandez Garcia, Borja Jesus, additional, Villaseñor Ledezma, Javier, additional, Otero Rodríguez, Álvaro, additional, Ailagas, Juan José, additional, Goncalves-Estella, Jesús, additional, Sousa Casasnovas, Pablo, additional, Pascual Argente, Daniel, additional, Ruiz Martín, Laura, additional, Roa Montes de Oca, Juan Carlos, additional, Arandia Guzmán, Daniel, additional, García Martín, Andoni, additional, Torres Carretero, Luis, additional, Garrido Ruíz, Patricia Alejandra, additional, Calvo, Marta, additional, Miranda-Lloret, Pablo, additional, Rodriguez-Cadarso Suarez-Vence, Miguel, additional, Anotn Oltra, Joan, additional, Roca Barber, Amparo, additional, Quiroz Tejada, Arnold, additional, Carbayo Lozano, Guillermo, additional, Bermudez Vilar, Garazi, additional, Paternain Martin, Clara, additional, Dela FuenteVilla, Pablo, additional, Fidalgo De la Rosa, Marina, additional, Sistiaga García, Íñigo L, additional, and Zabalo San Juan, Gorka, additional

Published
2021
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20. Polvo de vancomicina tópico para la prevención de infección de herida quirúrgica en cirugía electiva de columna por vía posterior

Author

Delgado-López, Pedro David, primary, Martín-Alonso, Javier, additional, Martín-Velasco, Vicente, additional, Castilla-Díez, José Manuel, additional, Galacho-Harriero, Ana, additional, Ortega-Cubero, Sara, additional, Herrero-Gutiérrez, Ana Isabel, additional, and Rodríguez-Salazar, Antonio, additional

Published
2020
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32. Total en blocspondylectomy for spinal tumours: Technical aspects and surgical details

Author

Delgado-López, Pedro David, Rodríguez-Salazar, Antonio, Martín-Velasco, Vicente, Castilla-Díez, José Manuel, Martín-Alonso, Javier, Galacho-Harriero, Ana, Gil-Polo, Cecilia, and Araus-Galdós, Elena

Abstract

To describe the specific surgical details and report the lessons learned with a series of patients suffering from spinal tumours that underwent total en bloc spondylectomy (TES).

Published
2017
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33. Predicción del grado histológico de la OMS en meningiomas sintomáticos mediante una estimación objetiva de la irregularidad de su superficie

Author

Delgado-López, Pedro David, Montalvo-Afonso, Antonio, Martín-Alonso, Javier, Martín-Velasco, Vicente, Diana-Martín, Rubén, and Castilla-Díez, José Manuel

Abstract

Predecir el grado histológico de los meningiomas es importante por cuanto los grados OMS II-III presentan mucha mayor tendencia a la recidiva local que los grado OMS I y, por tanto, pueden beneficiarse de una estrategia quirúrgica más agresiva. Se ha sugerido que los meningiomas con forma más irregular en la RM preoperatoria tienden a ser más agresivos. Sin embargo, dicha irregularidad es un concepto subjetivo y observador-dependiente. En este estudio se cuantifica de forma objetiva la irregularidad de una serie de meningiomas y se correlaciona con el grado histológico de la OMS.

Published
2023
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34. Need for head and neck repositioning to restore electrophysiological signal changes at positioning for cervical myelopathy surgery

Author

Delgado-López, Pedro David, Montalvo-Afonso, Antonio, Araus-Galdós, Elena, Isidro-Mesa, Francisco, Martín-Alonso, Javier, Martín-Velasco, Vicente, Castilla-Díez, José Manuel, and Rodríguez-Salazar, Antonio

Abstract

To evaluate the incidence of significant intraoperative electrophysiological signal changes during surgical positioning, and to assess the effectiveness of head and neck repositioning on the restoration of signals, among patients undergoing surgery for cervical myelopathy.

Published
2021
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35. [Rationale and complications of the anterior-lateral extrapleural retroperitoneal approach for unstable thoracolumbar fractures: Experience in 86 consecutive patients].

Author

Delgado-López PD, Rodríguez-Salazar A, Martín-Velasco V, Martín-Alonso J, Castilla-Díez JM, Galacho-Harriero A, and Araús-Galdós E

Subjects
Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Multiple Trauma surgery, Pleural Cavity, Retroperitoneal Space, Retrospective Studies, Young Adult, Fracture Fixation adverse effects, Fracture Fixation methods, Lumbar Vertebrae injuries, Lumbar Vertebrae surgery, Postoperative Complications etiology, Spinal Fractures surgery, Thoracic Vertebrae injuries, Thoracic Vertebrae surgery
Abstract

Objectives: To describe the rationale, pros and cons, and complications of the anterior-lateral extrapleural retroperitoneal approach for unstable (TLICS>4) thoracolumbar fractures., Patients and Methods: Clinical and radiological data and outcomes from a cohort treated surgically via said approach were retrospectively reviewed. All patients were operated on exclusively by 5 neurosurgeons trained in spine surgery., Results: Between June 1999 and December 2015, 86 patients underwent surgery (median age 42years, most common level: L1). Approximately 32.5% presented with a preoperative neurological defect. After surgery (mean duration: 275minutes), 75.6% presented with no neurological sequelae and only one-third required blood transfusion. Median postoperative stay was 7days. Correction of kyphosis was considered adequate and suboptimal but acceptable in 91% and 9% of the patients, respectively. Complications occurred in 36 patients, the majority being transient. We observed failure of the construct in 2 cases (collapse of an expandable cage and extrusion of a locking screw). No infections, vascular or visceral lesions, permanent neurological worsening or mortality occurred during hospitalisation. One patient ultimately needed additional posterior fixation due to persistence of pain. Median follow-up was 252days (27.9% was lost to follow-up)., Conclusions: The extrapleural extraperitoneal approach provides solid anterior reconstruction, allows wide decompression of the spinal canal, and permits adequate and long-lasting correction of kyphosis. The rates of infection, construct failure, need for reoperation and vascular or visceral lesions are minimal., (Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.)

Published
2017
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36. [Lumbar disc herniation: Natural history, role of physical examination, timing of surgery, treatment options and conflicts of interests].

Author

Delgado-López PD, Rodríguez-Salazar A, Martín-Alonso J, and Martín-Velasco V

Subjects
Adult, Conflict of Interest, Conservative Treatment, Diskectomy methods, Evidence-Based Medicine, Female, Humans, Intervertebral Disc Displacement diagnosis, Intervertebral Disc Displacement physiopathology, Intervertebral Disc Displacement therapy, Low Back Pain etiology, Low Back Pain therapy, Lumbar Vertebrae diagnostic imaging, Male, Meta-Analysis as Topic, Middle Aged, Minimally Invasive Surgical Procedures, Pain Management methods, Physical Examination, Remission, Spontaneous, Rest, Sciatica etiology, Sciatica therapy, Treatment Outcome, Intervertebral Disc Displacement surgery, Lumbar Vertebrae surgery
Abstract

Introduction: Indication for surgery in lumbar disc herniation (LDH) varies widely depending on the geographical area., Development: A literature review is presented on the natural history, role of physical examination, timing of surgery, evidence-based treatment, and conflicts of interests in LDH. Surgery is shown to provide significant faster relief of pain compared to conservative therapy, although the effect fades after a year. There is no treatment modality better than the rest in terms of pain control and neurological recovery, nor is there a surgical technique clearly superior to simple discectomy. The lack of sound scientific evidence on the surgical indication may contribute to its great geographical variability., Conclusions: Since LDH has a favourable natural history, neuroimaging and surgery should not be considered until after a 6-week period. It is necessary to specify and respect the surgical indications for LDH, avoiding conflicts of interests., (Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.)

Published
2017
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37. [Total en bloc spondylectomy for spinal tumours: Technical aspects and surgical details].

Author

Delgado-López PD, Rodríguez-Salazar A, Martín-Velasco V, Castilla-Díez JM, Martín-Alonso J, Galacho-Harriero A, Gil-Polo C, and Araus-Galdós E

Subjects
Adult, Aged, Child, Contraindications, Procedure, Disease-Free Survival, Female, Humans, Male, Middle Aged, Neuronavigation, Patient Selection, Postoperative Complications epidemiology, Postoperative Complications etiology, Prostheses and Implants, Prosthesis Implantation methods, Retrospective Studies, Spinal Neoplasms radiotherapy, Spinal Neoplasms secondary, Treatment Outcome, Orthopedic Procedures methods, Spinal Neoplasms surgery
Abstract

Objective: To describe the specific surgical details and report the lessons learned with a series of patients suffering from spinal tumours that underwent total en bloc spondylectomy (TES)., Methods: A retrospective case series review is presented, together with an analysis of the clinical and technical variables, as well as the outcomes., Results: A total of 10 patients underwent TES (2000-2016) for primary (osteosarcoma, chondrosarcoma, fibrosarcoma and chordoma) and secondary spinal tumours (lung, breast, thyroid, oesophagus, and meningioma metastases). According to the Tomita classification, 2 patients had intra-compartmental tumours, and the rest presented as extra-compartmental. All patients experienced an improvement in their pain level after surgery. Nine patients preserved ambulation post-operatively and one patient developed paraplegia. Six patients needed subsequent operations for wound debridement, tumour recurrence, or revision of the fixation. Other complications included pneumothorax, pleural effusion and venous thrombosis. Four patients remain alive (4 months to 15 years follow-up). The rest died due to primary tumour progression (6.5 months to 12 years). A detailed description of the surgical steps, tips, and pitfalls is provided. Modifications of the technique and adjuncts to resection are commented on. Observation of some considerations (selection of candidates, careful blunt vertebral dissection, strict blood loss control, careful handling of the spinal cord, and maintenance of the radical resection concept at all stages) is key for a successful operative performance., Conclusion: TES is a paradigmatic operation, in which the concept of radical resection provides functional effectiveness and improves survival in selected patients suffering from spinal tumours. Our preliminary experience allows us to highlight some specific and relevant features, especially those favouring a simpler and safer operation., (Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.)

Published
2017
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38. [Aneurysmal subarachnoid haemorrhage: Results after introducing endovascular therapy in a medium-low volume centre].

Author

Delgado-López PD, López-Martínez JL, Gero-Escapa M, Martín-Alonso J, Castaño-Blazquez M, Ossa-Echeverri S, Martín-Velasco V, and Castilla-Díez JM

Subjects
Humans, Hydrocephalus, Retrospective Studies, Treatment Outcome, Embolization, Therapeutic, Intracranial Aneurysm therapy, Subarachnoid Hemorrhage therapy
Abstract

Objective: To evaluate the impact of introducing endovascular therapy for patients with aneurysmal subarachnoid haemorrhage (aSAH) in a medium-low volume centre., Material and Methods: A retrospective observational study was conducted by comparing the clinical outcome of patients with aSAH before and after introducing endovascular therapy in our centre. The main variables analysed were: type of treatment, hospital and late mortality, intra-procedural morbidity, rate of re-bleeding and vasospasm, and clinical outcome according to the Glasgow Outcome Score (GOS)., Results: Seventy-one patients were treated in two periods: 2010-2011 (32 patients; 19 clipped, 6 coiled, 7 untreated), and 2012-2013 (39 patients, 3 clipped, 34 coiled, 2 untreated). No significant differences were found in age, sex, clinical grade at admission, type and location of aneurysm, Fisher score, or in hospital mortality (28.1% vs 25.6%, P=.35), GOS (except for GOS 5: 43.37% vs 53.8%, P=.045), rate of hydrocephalus and rate of vasospasm. The second cohort obtained better results for aggregated GOS 1+2+3 (36.3% vs 43.75%, P=.034) and for GOS 4+5 (61.5% vs 56.25%, P=.078). The percentage of patients left untreated was significantly lower in the second period (5.1% vs 21.8%, P<.01), as well as the rate of re-bleeding (0% vs 9.4%, P<.01). Patients were treated earlier (2.51 vs 3.95 days), and hospital and total stay were lower (15.2 and 24.6 vs 10.3 and 18 days) in the second period, these differences not reaching statistical significance., Conclusions: Endovascular therapy allowed treating more patients with aSAH, and with a lower re-bleeding rate. This led to a modest reduction in morbidity and mortality., (Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.)

Published
2016
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