Neurosurgery
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To review current classification systems for adolescent and adult scoliosis. ⋯ The importance of scoliosis classification schemes lies in their ability to standardize communication among health care providers. With regard to the classification of adolescent scoliosis, the Lenke system has addressed many of the significant limitations of the King system and is now the standard classification scheme. Classification schemes for adult scoliosis have been reported only recently, and each offers specific advantages (the simple pathogenesis-based system of Aebi, the strong clinical relevance of the Schwab system, and the richly descriptive Scoliosis Research Society system). This article highlights the salient features of currently used scoliosis classification systems.
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Congenital thoracolumbar spinal deformities are a common and frequent reason for referral to spine surgeons. Neurosurgeons also treat many neurological diagnoses which may result in a progressive spinal deformity, such as scoliosis. ⋯ Advances in the field of spinal deformity correction now allow us to better treat individuals with these types of deformities. It is important for the practicing neurosurgeon to be knowledgeable of surgical and nonsurgical treatments of patients with congenital thoracolumbar spinal deformities in order to better understand which patients will ultimately progress and necessitate surgical treatment.
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Scoliosis is a three-dimensional spinal deformity for which surgery may be indicated when patients experience severe pain, curve progression, or progressive disability. Operative treatment has conventionally involved extensive posterior stabilization, either alone or in combination with anterior release procedures. Anterior-only approaches have a more limited role, but they should be considered in the appropriate setting when addressing this disease. ⋯ Technological advances, including minimally invasive thoracic access as well as evolving instrumentation, may minimize the stated disadvantages and expand the scope of scoliosis cases that may be treated by anterior-only approaches. Hence, the enhanced corrective ability and biomechanical advantages of the anterior column can be used in the treatment of these patients. Although the indications for anterior-only strategies in scoliosis remain limited, such operations should be considered in the appropriate setting when addressing spinal deformity.
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Case Reports Comparative Study
Results of endovascular treatment of traumatic intracranial aneurysms.
To present results of early angiographic diagnosis and endovascular treatment of traumatic intracranial aneurysms (TICA). ⋯ Early angiographic diagnosis with immediate endovascular treatment provided an effective approach for TICA detection and management. Endovascular therapy is versatile and offers a valuable alternative to surgery, allowing early aneurysm exclusion with excellent results.
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Comparative Study
Predictors of peritumoral edema after stereotactic radiosurgery of supratentorial meningiomas.
Anecdotal evidence suggests that radiosurgical ablation of parasagittal meningiomas may be associated with increased risk of subsequent edema. Potential predictors of postradiosurgical peritumoral edema, including parasagittal tumor location, tumor size, and treatment dose, were evaluated. ⋯ Patients with parasagittal meningiomas are at greater risk of developing peritumoral symptomatic edema after SRS. Close follow-up after SRS may be particularly important in such patients. These results highlight the need to pursue strategies that could decrease the incidence of postradiosurgical edema in patients with parasagittal meningioma.