Surg Neurol
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Ossification of the ligamentum flavum overlying the lower thoracic spine frequently produces myelopathy. This study analyzed the postoperative outcomes after decompressive laminectomy for thoracic OLF. ⋯ Decompressive laminectomy for excision of OLF resulted in clinical improvement using the Frankel grading system in 7 of 13 patients. In myelopathy patients with OLF, preoperative MR imaging of the entire spine is necessary because other coexisting spinal lesions may be present.
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Ureteral injury is a rare complication of posterior lumbar diskectomy and has been associated with the accidental perforation of the ALL by a rongeur-type instrument. Here we report on a case of ureteral injury that is somewhat different than previous reports after a rongeur was inadvertently passed through the intertransverse space by careless use of rongeur during a posterior lumbar diskectomy. ⋯ Although this injury was caused by our procedural error, one should keep in mind that posterior lumbar procedures that involve the transverse process or the intertransverse space such as far lateral diskectomy, PLF, transpedicular fixation, TLIF, and so on, as well as procedures involving the disk space (diskectomy, PLIF, etc) have a potential risk for causing ureteral injury. The careful use of surgical instruments is the key to preventing this iatrogenic complication, and awareness and suspicion of having created possible injury are essential for early detection and treatment.
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The purpose of this study was to investigate whether vancomycin CSF concentration can reach therapeutic level when administered intravenously after neurosurgical operation. ⋯ Neurosurgical operation may disrupt the integrality of BBB so that vancomycin can penetrate through the BBB easily and reach therapeutic concentration of CSF when administered intravenously after operation. This finding suggests that vancomycin can be administered intravenously when used to treat intracranial infection after neurosugical operation.