Neurosurgery
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There is considerable variation in practice regarding the use of prophylactic antibiotic therapy in spinal operations. To date, individual studies have not demonstrated a significant benefit for prophylactic antibiotic therapy in spinal operations. ⋯ Prophylactic antibiotic therapy is beneficial for spinal surgery, even when expected infection rates without antibiotic treatment are low.
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We describe a case of a posterior spinal epidural abscess that was successfully treated with percutaneous, computed tomography-guided, needle aspiration and parenteral antibiotic therapy. ⋯ Surgical decompression and antibiotic therapy are the treatments of choice for patients with spinal epidural abscesses. Selected patients may be treated nonsurgically. Rarely, percutaneous drainage of the abscess has been reported to be helpful. Our case suggests that percutaneous, computed tomography-guided, needle aspiration might be a rational alternative to surgical decompression for treatment of spinal epidural abscesses.
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THE TRANSSPHENOIDAL APPROACH for sellar tumors has evolved significantly since it was described initially during the first decade of the 20th century. The approach currently incorporates technological advancements and refinements in patient selection, operative technique, and postoperative care. ⋯ This variability is a reflection of surgeon's preference, the lessons of experience, and the bias inherent in neurosurgical training. The methods and preferences described herein embody the distillation of an experience gained from 3900 transsphenoidal operations.
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Comparative Study Clinical Trial
Use of the telescopic plate spacer in treatment of cervical and cervicothoracic spine tumors.
We investigated the mechanical and in vivo properties of a novel device, called the telescopic plate spacer (TPS), designed to promote restoration of height, alignment, and stability after cervical corpectomy for tumor. ⋯ The TPS can be used to restore height, alignment, and stability after corpectomy.