Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Sep 2014
Protective effect of external ventricular drainage on cerebral vasospasm. A retrospective study on aneurysmal SAH treated endovascularly.
Cerebral vasospasm (VS) is one of the factors that can most significantly worsen the prognosis after aneurysmal subarachnoid hemorrhage (SAH). A substantial body of evidence supports the idea that CSF diversion could prevent VS, even if this issue is still much debated. External ventricular drainage (EVD) is the recommended procedure for post-hemorrhagic hydrocephalus. In this study we analyzed whether EVD, placed for acute hydrocephalus, is effective in reducing the incidence of clinical and radiological cerebral vasospasm in patients who underwent endovascular treatment for aneurysmal SAH. ⋯ Our data indicate that CSF drainage reduces the risk of vasospasms in patients with endovascular treatment for aneurysmal SAH.
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Clin Neurol Neurosurg · Sep 2014
Percutaneous pedicle screw and rod fixation with TLIF in a series of 14 patients with recurrent lumbar disc herniation.
To determine if minimally invasive transforaminal lumbar interbody fusion (TLIF) using the Medtronic Sextant system is a reliable surgical treatment option in patients with recurrent lumbar disc herniation, compared with the traditional open procedure. ⋯ Percutaneous minimally invasive TLIF technique with the Medtronic Sextant system is a gentle, tissue protecting and safe alternative procedure for lumbar fusion in patients with recurrent lumbar disc herniation and erosive chondrosis.
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Clin Neurol Neurosurg · Sep 2014
Review Case ReportsMinimally invasive lateral transpsoas interbody fusion using a stand-alone construct for the treatment of adjacent segment disease of the lumbar spine: review of the literature and report of three cases.
We describe 3 patients who presented with radiographic signs and clinical symptoms of adjacent segment disease several years after undergoing L4-S1 posterior pedicle screw fusion. All patients underwent successful lateral lumbar interbody fusion (LLIF) at 1-2 levels above their previous constructs, using stand-alone cages, with complete resolution of radiculopathy and a significant improvement in low-back pain. In addition to a thorough analysis of these cases, we review the pertinent literature regarding treatment options for adjacent segment disease and the applications of the lateral lumbar interbody technique.
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Clin Neurol Neurosurg · Sep 2014
ReviewManagement of asymptomatic cervical spinal stenosis in the setting of symptomatic tandem lumbar stenosis: a review.
This article reviews the literature regarding tandem asymptomatic cervical stenosis in the setting of symptomatic lumbar stenosis. The presenting features of cervical spondylotic myelopathy are insidious and consistent with upper motor neuron loss. Often, asymptomatic cervical stenosis is encountered in the clinical setting during the workup of a symptomatic lumbar stenosis and degenerative disease. ⋯ There is insufficient evidence in the literature to support the need for preemptive decompression for asymptomatic cervical cord compression with or without a correlative T2 hyperintense cord signal. Early diagnosis of radiculopathy or myelopathy in patients with cervical stenosis (i.e., through conversion of asymptomatic to symptomatic state) is important as each patient with in this clinical setting should be followed closely, as the literature shows the tendency for a clinical progression to eventual cervical myelopathy.