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| 1 | Syringomyelia associated with cervical spondylosis: A rare condition显示文摘Spinal spondylosis is an extremely common condition that has only rarely been described as a cause of syringomyelia. We describe a case of syringomyelia associated with cervical spondylosis admitted at our division and treated by our institute. It is the case of a 66-yearold woman. At our observation she was affected by moderate-severe spastic tetraparesis. T2-weighted magnetic resonance imaging(MRI) showed an hyperintense signal within spinal cord from C3 to T1 with a more sharply defined process in the inferior cervical spinal cord. At the same level bulging discs, facets and ligamenta flava hypertrophy determined a compression towards subarachnoid space and spinal cord. Spinal cord compression was more evident in hyperextension rather than flexion. A 4-level laminectomy and subsequent posterior stabilization with intra-articular screws was executed. At 3-mo follow up there was a regression of tetraparesis but motor deficits of the lower limbs residuated. At the same follow up postoperative MRI was executed. It suggested enlargement of the syrinx. Perhaps hyperintensity within spinal cord appeared 'bounded' from C3 to C7 with clearer margins. At the level of surgical decompression, subarachnoid space and spinal cord enlargement were also evident. A review of the literature was executed using Pub Med database. The objective of the research was to find an etiopathological theory able to relate syringomyelia with cervical spondylosis. Only 6 articles have been found. At the origin of syringomyelia the mechanisms of compression and instability are proposed. Perhaps other studies assert the importance of subarachnoid space regard cerebrospinal fluid(CSF) dynamic. We postulate that cervical spine instability may be the cause of multiple microtrauma towards spinal cord and consequently may damage spinal cord parenchyma generating myelomalacia and consequently syrinx. Otherwise the hemorrhage within spinal cord central canal can cause an obstruction of CSF outflow, finally generating the syrinx. On the other hand in cervical spondylosis the stenotic elements can affect subarachnoid space. These elements rubbing towards spinal cord during movements of the neck can generate arachnoiditis, subarachnoid hemorrhages and arachnoid adhesions. Analyzing the literature these 'complications' of cervical spondylosis are described at the origin of syringomyelia. So surgical decompression, enlarging medullary canal prevents rubbings and contacts between the bone-ligament structures of the spine towards spinal cord and subarachnoid space therefore syringomyelia. Perhaps stabilization is also necessary to prevent instability of the cervical spine at the base of central cord syndrome or syringomyelia. Finally although patients affected by central cord syndrome are usually managed conservatively we advocate, also for them, surgical treatment in cases affected by advanced state of the symptoms and MRI. | Alessandro Landi Lorenzo Nigro Nicola Marotta Cristina Mancarella Pasquale Donnarumma Roberto Delfini | 2013 | World Journal of Clinical Cases2013，1，3： | 7 |
| 2 | Magnetic resonance diffusion tensor imaging and fibertracking diffusion tensor tractography in the management of spinal astrocytomas显示文摘Some specially imaging of magnetic resonance imaging,the diffusion-weighted imaging(DWI),the diffusion tensor imaging and fractional anisotropy(FA),are useful to described,detect,and map the extent of spinal cord lesions.FA measurements may are used to predicting the outcome of patients who have spinal cord lesions.Fiber tracking enable to visualizing the integrity of white matter tracts surrounding some lesions,and this information could be used to formulating a differential diagnosis and planning biopsies or resection.In this article,we will describe the current uses for DWI and fiber tracking and speculate on others in which we believe these techniques will be useful in the future. | Alessandro Landi Valeria Palmarini Alessandro D'Elia Nicola Marotta Maurizio Salvati Antonio Santoro Roberto Delfini | 2016 | World Journal of Clinical Cases2016，4，1： | 6 |
| 3 | Trans-sacral screw fixation in the treatment of high dyplastic developmental spondylolisthesis显示文摘We describe the case of a 67-year-old woman with L5-S1 ontogenetic spondylolisthesis treated with pedicle fixation associated with interbody arthrodesis performed with S1-L5 trans-sacral screwing according to the technique of Bartolozzi. The procedure was followed by a wide decompressive laminectomy. The patient had a progressive improvement of the symptoms which gradually disappeared in 12 mo. The radiograph at 6 and 12 mo showed complete fusion system. The choice of treatment in L5-S1 ontogenetic spondylolithesis is related to a correct clinical and diagnostic planning(X-ray, computer tomography magnetic resonance imaging, Measurement). In particular, the severity index and the square of unstable zone, and the standard measurements already described in the literature, are important to understand and to plane the correct surgical strategy, that require, in most of the times, fusion and interbody artrodesis. | Alessandro Landi Nicola Marotta Cristina Mancarella Roberto Tarantino Roberto Delfini | 2013 | World Journal of Clinical Cases2013，1，3： | 4 |
| 4 | 360° fusion for realignment of high grade cervical kyphosis by one step surgery: Case report显示文摘Surgical treatment for cervical kyphotic deformity is still controversial. Circumferential approach has been well described in the literature but long terms outcomes are not well reported. Important to decide the correct treatment option is the preoperative radiological exams to value the type of deformity(flexible or fixed). We report the case of a 67-year-old woman affected by a severe cervical kyphotic deformity who underwent combined anterior/posterior surgical approach, getting a good reduction of the deformity and an optimal stability in a long term follow up. | Alessandro Landi Nicola Marotta Cristina Mancarella Demo Eugenio Dugoni Roberto Tarantino Roberto Delfini | 2014 | World Journal of Clinical Cases2014，2，7： | 4 |
| 5 | First description of cervical intradural thymoma metastasis显示文摘Thymoma and thymic carcinoma are rare epithelial tumors, which originate from the thymus gland. According to the World Health Organization there are 'organotypic'(types A, AB, B1, B2, and B3) and 'non-organotypic'(thymic carcinomas) thymomas. Type B3 thymomas are aggressive tumors, which can metastasize. Due to the rarity of these lesions, only 7 cases of extradural metastasis are described in the literature. We report the first and unique case of a man with cervical intradural B3 thymoma metastasis. A 46-year-old man underwent thymoma surgical removal. The year after the procedure he was treated for a parietal pleura metastasis. In 2006 he underwent cervical-dorsal extradural metastasis removal and C5-Th1 stabilization. Seven years after he came to our observation complaining left cervicobrachialgia and a reduction of strength of the left arm. He underwent a cervical spine magnetic resonance imaging, which showed a new lesion at the C5-C7 level. The patient underwent a surgery for the intradural B3 thymoma metastasis. Neurological symptoms improved although the removal was subtotal. He went through postoperative radiation therapy with further mass reduction. Spinal metastases are extremely rare. To date, only 7 cases of spinal extradural metastasis have been described in the literature. This is the first case of spinal intradural metastasis. Early individuation of these tumors and surgical treatment improve neurological outcome in patients with spinal cord compression. A multimodal treatment including neoadjuvant chemotherapy, surgery and postoperative radiation therapy seems to improve survival in patients with metastatic thymoma. | Nicola Marotta Cristina Mancarella Davide Colistra Alessandro Landi Demo Eugenio Dugoni Roberto Delfini | 2015 | World Journal of Clinical Cases2015，3，11： | 3 |
| 6 | Choice of neurosurgical approach in the treatment of cranial base lesions 显示文摘 | Pasquale Ciappetta Roberto Delfini | 1994 | Neurosurg Rev1994，17，： | 1 |
| 7 | Lumbar ganglion cyst:Nosology, surgical management and proposal of a new classification based on 34 personal cases and literature review显示文摘AIM To analyze different terms used in literature to identify lumbar extradural cysts and propose a common scientific terminology; to elaborate a new morphological classification of this pathology, useful for clinical and surgical purposes; and to describe the best surgical approach to remove these cysts, in order to avoid iatrogenic instability or treat the pre-existing one. METHODS We retrospectively reviewed 34 patients with symptomatic lumbar ganglion cysts treated with spinal canal decompression with or without spinal fixation. Microsurgical approach was the main procedure and spinal instrumentation was required only in case of evident preoperative segmental instability. RESULTS The complete cystectomy with histological examination was performed in all cases. All patients presented an improvement of clinical conditions, evaluated by Visual Analogic Scale and Japanese Orthopaedic Association scoring. CONCLUSION Spinal ganglion cysts are generally found in the lumbar spine. The treatment of choice is the microsurgical cystectomy, which generally does not require stabilization.The need for fusion must be carefully evaluated: Preoperative spondylolisthesis or a wide joint resection, during the operation, are the main indications for spinal instrumentation. We propose the terms 'ganglion cyst' to finally identify this spinal pathology and for the first time its morphological classification, clinically useful for all specialists. | Maurizio Domenicucci Alessandro Ramieri Daniele Marruzzo Paolo Missori Massimo Miscusi Roberto Tarantino Roberto Delfini | 2017 | World Journal of Orthopedics2017，8，9： | 1 |
| 8 | Tumors of the lateral ventricles显示文摘 | Roberto Delfini Michele Acqui Piero Andrea Oppido Raffaela Capone Antonio Santoro Luigi Ferrante | 1991 | Neurosurgical Review1991，，2： | 1 |
| 9 | Atlantoaxial rotatory dislocation (AARD) in pediatric age: MRI study on conservative treatment with Philadelphia collar—experience of nine consecutive cases显示文摘 | Alessandro Landi Andrea Pietrantonio Nicola Marotta Cristina Mancarella Roberto Delfini | 2012 | European Spine Journal2012，，1： | 1 |
| 10 | Long-term Follow-up of Intramedullary Spinal Cord Tumors: A Series of 202 Cases显示文摘 | Antonino Raco Vincenzo Esposito Jacopo Lenzi Manolo Piccirilli Roberto Delfini Giampaolo Cantore | 2005 | Neurosurgery2005，，5： | 1 |
| 11 | Traumatic Intracerebellar Hemorrhage: Clinicoradiological Analysis of 81 Patients显示文摘 | Domenico d’Avella Franco Servadei Massimo Scerrati Giustino Tomei Gianluigi Brambilla Filippo F. Angileri Fulvio Massaro Luciano Cristofori Fulvio Tartara Eugenio Pozzati Roberto Delfini Francesco Tomasello | 2002 | Neurosurgery2002，，1： | 1 |
| 12 | Safety and Efficacy of Intensive Insulin Therapy in Critical Neurosurgical Patients显示文摘 | Federico Bilotta Remo Caramia Francesca P. Paoloni Roberto Delfini Giovanni Rosa | 2009 | Anesthesiology2009，，3： | 1 |
| 13 | Esmolol blunts postoperative hemodynamic changes after propofol-remifentanil total intravenous fast-track neuroanesthesia for intracranial surgery显示文摘 | Federico Bilotta Arthur M. Lam Andrea Doronzio Vincenzo Cuzzone Roberto Delfini Giovanni Rosa | 2008 | Journal of Clinical Anesthesia2008，，6： | 1 |
| 14 | Multilevel oblique corpectomies as an effective surgical option to treat cervical chordoma in a young girl显示文摘Chordomas are malignant tumors arising from notochordal remnants. They are the most frequent tumors of the spine after plasmacytomas. Only 6% of chordomas are localized to the cervical level. In young patients, chordomas are rare and unpredictable. Despite this, the treatment of choice remains the total resection, as much as possible, followed by proton beam radiation. This case was managed using a precarotid and retrocarotid approach at the same time. The tumor was completely resected with the edges free from disease. The cervical spine was stabilized with an anterior plating C2-C4. Eighteen months after surgery the patient is still free from illness. Multilevel oblique corpectomies are an available and safe option for the treatment of upper cervical chordomas. | Roberto Delfini Daniele Marruzzo Roberto Tarantino Nicola Marotta Alessandro Landi | 2014 | World Journal of Clinical Cases2014，2，3： | 0 |
| 15 | Giant xanthogranuloma of the pelvis with S1 origin: Complete removal with only posterior approach, technical note显示文摘Xanthogranulomas(XG) are benign proliferative disorder of histiocytes, a non-Langerhans cell histiocytosis. Whose etiology is unknown. The nature of these lesions is controversial and could be either reactive or neoplastic;the presence of monoclonal cells does, however, favor the second hypothesis. Xanthogranuloma is frequently found in young adults and children(under 20 years old), mainly in the skin. In about 5%-10% of all Juvenile XG(JXG) cases xanthogranuloma are extracutaneous. Within this group, the site most frequently involved is the eye. Other involved organs are heart, liver, adrenals, oropharynx, lung, spleen, central nervous system and subcutaneous tissue, although involvement of the spine is uncommon. Isolated lesions involving the sacral region are extremely rare. To date, this is the first reported case of a giant JXG arising from S1 with extension into the pelvic region in an adult spine. | Nicola Marotta Alessandro Landi Cristina Mancarella Pierluigi Rocco Andrea Pietrantonio Gaspare Galati Antonio Bolognese Roberto Delfini | 2015 | World Journal of Clinical Cases2015，3，1： | 0 |
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