Journal of neurosurgery. Spine
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Review Case Reports
Inadvertent intrathecal vincristine administration: a neurosurgical emergency. Case report.
Vincristine has a high neurotoxicity level. If given intrathecally by accident, it can cause ascending radiculomyeloencephalopathy, which is almost always fatal. The authors report a rare case in which vincristine was accidentally injected intrathecally into a 32-year-old man. ⋯ The patient's first sensorimotor deficits occurred after 2 days, led to an incomplete sensorimotor dysfunction below T-9 within the next 17 days, but progressed no further. Supported by the scarce data culled from the reviewed literature, the authors hypothesize that prolonged CSF irrigation combined with antineurotoxic therapy contributed to the patient's satisfactory outcome. In conclusion, accidental intrathecal vincristine injection requires emergency and adequate neurosurgical therapy.
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Randomized Controlled Trial Multicenter Study Comparative Study
Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial.
The authors report the results of a prospective randomized multicenter study in which the results of cervical disc arthroplasty were compared with anterior cervical discectomy and fusion (ACDF) in patients treated for symptomatic single-level cervical degenerative disc disease (DDD). ⋯ The PRESTIGE ST Cervical Disc System maintained physiological segmental motion at 24 months after implantation and was associated with improved neurological success, improved clinical outcomes, and a reduced rate of secondary surgeries compared with ACDF.
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Randomized Controlled Trial
Split-spinous process laminotomy and discectomy for degenerative lumbar spinal stenosis: a preliminary report.
The authors evaluated a new minimally invasive spinal surgery technique to correct degenerative lumbar spinal stenosis involving a split-spinous process laminotomy and discectomy (also known as the "Marmot operation"). ⋯ A Marmot operation may provide effective spinal decompression. Although this method requires more operative time than a conventional method, it may involve only minimal muscular trauma, spinal stability maintenance, and early mobilization; shorten the duration of hospital stay; reduce postoperative back pain; and provide satisfactory neurological and functional outcomes.
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In experimental models of spinal cord injury (SCI) researchers have typically focused on contusion and transection injuries. Clinically, however, other injury mechanisms such as fracture-dislocation and distraction also frequently occur. The objective of the present study was to compare the primary damage in three clinically relevant animal models of SCI. ⋯ Given the pivotal nature of hemorrhagic necrosis and plasma membrane compromise in the initiation of downstream SCI pathomechanisms, the aforementioned differences suggest the presence of mechanism-specific injury regions, which may alter future clinical treatment paradigms.
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Editorial Comment
Cervical disc arthroplasty compared with allograft fusion.