Neurosurgery
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Cervical alignment has become increasingly important in the planning of spine surgery. A relationship between the slope of T1 (T1S), the cervical lordosis (CL), and the overall cervical sagittal vertical axis (cSVA) has previously been demonstrated, but the exact nature of this relationship is poorly understood. In this study, we derive theoretical and empirical equations to better understand how T1S and CL affect cSVA. ⋯ The empirical equation determined that value of cSVA could be expressed as: $cSVA=({1.1*T1} )\ - ( {0.43*CL} ) + 6.69$. In both, the sagittal alignment of the head over the shoulders is directly proportional to the T1S and inversely proportional to CL/2. These 2 equations may allow surgeons to better understand how the CL compensates for the T1S, to accurately predict the postoperative cSVA, and to customize cervical interbody grafts by taking into consideration each individual patient's specific cervical spine parameters.
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The incidental discovery of brain lesions in children has increased due to greater utilization of neuroimaging. Standardized surveillance and management guidelines following the discovery of such lesions remain nonexistent. ⋯ Most incidental brain lesions indeterminate for neoplasm have an indolent, benign course. For asymptomatic patients with radiologically stable lesions, we recommend conservative management with MRI and clinical surveillance at 6, 12, 24, 36, and 60 mo after detection.
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Although most severe peripheral nerve injuries result from high-speed mechanisms, there is no laboratory model to replicate this clinical condition. ⋯ Nerve architecture is injured in a graded fashion during stretch injury, which likely reflects tissue biomechanics. This study suggests new considerations in the theoretical framework of nerve stretch trauma.