Journal of neurosurgery
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The authors describe a simple, new method for removing broken pedicle screws. Under microscopic visualization a straight, narrow slot is etched in the broken surface of the pedicle screw by using a power drill with a 2-mm diamond burr. A minus screwdriver is then inserted into the slot, and the broken screw is rotated and removed. ⋯ This method allows preservation of both the pedicle and the screw hole. Consequently, it is possible to insert new pedicle screws into the same hole without losing the strength and stability of pedicle screw fixation. The authors recommend this simple and new method for removal of broken pedicle screws.
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Journal of neurosurgery · Jul 2001
Case ReportsHematogenous pyogenic facet joint infection of the subaxial cervical spine. A report of two cases and review of the literature.
Two cases of hematogenous, pyogenic, subaxial cervical facet joint infection are reported, and the literature is reviewed. Infection of the cervical facet joint is a rarely diagnosed condition; only one case has been reported in the literature. Lumbar facet joint infections are also rare but more commonly reported. ⋯ Hematogenous cervical facet joint infection is a rare clinical entity that has many characteristics in common with the more-common lumbar homolog. All three reported cases, however, have been complicated by epidural abscess or granulation tissue formation that has led to a neurological deficit. This finding suggests that a facet joint infection in the cervical spine may have a less benign clinical course than that in the lumbar spine.
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Journal of neurosurgery · Jul 2001
Associated change in plantar temperature and sweating after transthoracic endoscopic T2-3 sympathectomy for palmar hyperhidrosis.
Transthoracic endoscopic T2-3 sympathectomy is currently the treatment of choice for palmar hyperhidrosis. Compensatory sweating of the face, trunk, thigh, and sole of the foot was found in more than 50% of patients who underwent this procedure. The authors conducted this study to investigate the associated intraoperative changes in plantar skin temperature and postoperative plantar sweating. ⋯ In contrast to compensatory sweating in other parts of the body after T2-3 sympathetomy, improvement: in plantar sweating was shown in 72% and worsened symptoms in 6% of patients. The intraoperative plantar skin temperature change and perioperative SSR demonstrated a correlation between these changes.
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Journal of neurosurgery · Jul 2001
Review Case ReportsTarlov cysts: a study of 10 cases with review of the literature.
Tarlov or perineurial cysts are lesions of the nerve root most often found in the sacral region. Although there is agreement that asymptomatic Tarlov cysts should be followed, it is still debated whether patients with symptomatic Tarlov cysts should be treated surgically. The authors assessed the outcome and efficacy of cyst wall resection in 10 patients with symptomatic Tarlov cysts. The medical literature is reviewed, theories of origin are evaluated, and suggestions as to their cause and pathogenesis are offered. ⋯ Large cysts (> 1.5 cm) and the presence of associated radicular symptoms strongly correlate with excellent outcome. Tarlov cysts may result from increased hydrostatic pressure and trauma.
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The authors sought to analyze prospectively the outcome of surgery for complex spinal deformity in the pediatric and young adult populations. ⋯ Compared with other major neurosurgical operations, segmental instrumentation for pediatric and adolescent spinal deformity is a safe procedure with minimal morbidity and there is a low risk of needing to use allogeneic blood products.