Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Dec 2015
Effects of minimally invasive decompression surgery on quality of life in older patients with spinal stenosis.
Lumbar spinal stenosis (LSS) in the elderly may result in a progressive narrowing of the spinal canal leading to compression of nerve roots in some individuals. The aim of this study was to evaluate the quality of life changes after minimally invasive decompression surgery without instrumentation in geriatric patients with lumbar spinal stenosis. ⋯ Minimally invasive decompression surgery, without instrumentation, for lumbar spinal stenosis in geriatric patients significantly improves the patients' quality of life.
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Clin Neurol Neurosurg · Dec 2015
Efficacy of ultra-short single agent regimen antibiotic chemo-prophylaxis in reducing the risk of meningitis in patients undergoing endoscopic endonasal transsphenoidal surgery.
The study aims to evaluate the incidence of infectious complications (namely meningitis) within 30 days after endoscopic endonasal transspheinodal neurosurgery (EETS) in patients receiving an ultra-short peri-operative chemo-prophylaxis regimen with 2 doses of 1st generation cephalosporin or macrolide. ⋯ This study suggested that an ultra-short single-antibiotic prophylaxis is a safe, cheap and effective regimen to prevent post-operative meningitis in patients undergoing EETS and who do not require lumbar drainage after surgery. In these patients also the rate of minor infective complications was acceptable when compared with the previous more expensive regimen based on 3rd generation cephalosporin plus aminoglycoside or alone, that could be suitable only for at-risk patients (e.g. smokers, cerebrospinal leak or Cushing's diseases).
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Clin Neurol Neurosurg · Dec 2015
Comparative StudyComparison of two surgeries in treatment of severe kyphotic deformity caused by ankylosing spondylitis: Transpedicular bivertebrae wedge osteotomy versus one-stage interrupted two-level transpedicular wedge osteotomy.
To explore a simple and effective surgery for correcting severe kyphotic deformity caused by ankylosing spondylitis (AS). ⋯ For correcting severe kyphosis in patients with AS, the one-stage interrupted two-level transpedicular wedge osteotomy is a safe and effective technique which can significantly improve the thoracolumbar kyphosis angle.
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Clin Neurol Neurosurg · Dec 2015
ReviewIatrogenic neurologic deficit after lumbar spine surgery: A review.
Iatrogenic neurologic deficits after lumbar spine surgery are rare complications, but important to recognize and manage. Complications such as radiculopathy, spinal cord compression, motor deficits (i.e. foot drop with L5 radiculopathy), and new onset radiculitis, while uncommon do occur. Attempts at mitigating these complications with the use of neuromonitoring have been successful. ⋯ Despite the introduction of neuromonitoring, these complications still occur. Interpretation of neurologic injury rates for lumbar surgery is limited by the few prospective and cohort-matched controlled studies. Likewise, most injuries were associated with the placement of instrumentation despite the type of approach.