Neurosurgery
-
Identifying the extent of involvement of the vessel and nerve, particularly in regard to preoperative evaluation and precise localization of the tumor and its relation to the structures of the extremities, has important applications for advancing the treatment of lower extremity diseases. ⋯ The proposed MP-SWI demonstrates the feasibility of simultaneously visualizing nerves and vessels of the lower extremities without using an exogenous contrast agent. It may enable straightforward localization of a disease process to a specific nerve and vessel.
-
Clinical Trial
Surgical treatment of low-grade isthmic spondylolisthesis with transsacral fibular strut grafts.
The ideal surgical treatment for adult low-grade isthmic spondylolisthesis (ALIS) remains unknown. Isolated anterior and posterior procedures are popular but have resulted in equivocal outcomes, whereas combined anterior and posterior procedures are associated with higher complication rates despite improved outcome. ⋯ Transsacral interbody fibular allograft can be used successfully to supplement a posterolateral instrumented fusion in selected patients with low-grade ALIS.
-
Many studies have found that patients admitted on the weekend have inferior outcomes compared with those admitted on a weekday, which may be due partially to decreased availability of procedures. ⋯ In this nationwide study examining patients with spinal metastases, those admitted on the weekend were significantly less likely to receive early intervention. Future studies are needed to delineate the reasons for differences in the timing of surgery.
-
Peritumoral edema is a recognized complication following stereotactic radiosurgery (SRS). ⋯ SRS meningioma treatment demonstrated a low incidence of toxicity; however, large tumor volumes and single-fraction SRS treatment had an increased risk for posttreatment edema. Risk factors for edema should be considered in meningiomas treatment.
-
Optimal management of bilateral vertebral artery dissecting aneurysms (bi-VDAs) causing subarachnoid hemorrhage (SAH) remains unclear. ⋯ Bilateral VDAs presenting with SAH were safely treated with endovascular methods. However, endovascular treatment may be limited for VDAs with PICA origin involvement.