Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Comparative Study
Stand-alone interbody cage versus anterior cervical plate for treatment of cervical disc herniation: sequential changes in cage subsidence.
Anterior cervical discectomy and fusion with an autogenous iliac bone graft is the gold standard treatment for cervical disc herniation. However, autologous bone grafts obtained from the anterior iliac crest are associated with significant donor-site morbidity and complications. To decrease bone graft-related problems, several types of interbody fusion cage have been developed and are used widely in clinical practice. ⋯ In contrast, in the cage-treated group, 44% of patients exhibited loss of lordotic alignment of more than 5 degrees and cage subsidence of 3 mm or more. All cage subsidence occurred within 3 months of surgery. Although the stand-alone cage was a less invasive and more effective procedure to treat cervical disc herniation, surgeons should consider the possible drawbacks of the associated subsidence.
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Sympathetic catecholaminergic fibers in the vagus nerve were immunohistochemically examined in formalin-fixed human cadavers using an antibody against the noradrenalin-synthetic enzyme tyrosine hydroxylase (TH). TH-positive fibers were extensively distributed in the vagal nerve components, including the superior and inferior ganglia, the main trunk and the branches (superior and recurrent laryngeal, superior and inferior cardiac, and pulmonary branches). The inferior ganglion and its continuous cervical main trunk contained numerous TH-positive fibers with focal or diffuse distribution patterns in each nerve bundle. From these findings, we conclude that sympathetic fibers are consistently included in the human vagus nerve, a main source of parasympathetic preganglionic fibers to the cervical, thoracic and abdominal visceral organs.
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Case Reports
Brainstem distortion from postoperative cerebellar herniation through a dural and bony defect.
We report a patient with a cerebellar encephalocele following excision of a cerebellar metastasis. This is a life-threatening condition that may be prevented with adequate dural and bony closure.