Surg Neurol
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In degenerative lumbar spinal disease with nerve root compression, the L5 and S1 nerve roots are the most often affected and the L3 nerve root is involved infrequently. The purpose of this study was to investigate the characteristics of L3 nerve root radiculopathy. ⋯ L3 radiculopathy was characterized by various lower limb pain and neurologic deficit. Selective nerve root injection was effective for most patients. In elderly patients who do not respond to treatment for hip and/or knee joint diseases, L3 nerve root radiculopathy should be considered as the cause of lower limb pain.
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Acromegaly is an excessive GH secretion, which in most cases, is caused by a pituitary GH-secreting adenoma. Traditional treatment of acromegaly consists of surgery, drug therapy, and eventually radiotherapy. The aim of this retrospective study is to evaluate the results of transsphenoidal endoscopic surgery in a group of patients with intrasellar GH adenoma who were operated by a pituitary specialist surgeon. We shall then argue about the economical advantages, for the NHS of a developing country, between surgical and medical treatment. ⋯ Our patients, with intrasellar GH tumor, operated by a pituitary specialist neurosurgeon had remission rates approaching those obtained by most specialized neurosurgical centers worldwide. For equal results, our study shows that the surgical treatment is the best issue for the patient and for the NHS.
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Case Reports
C1 arch regeneration, tight cisterna magna, and cervical syringomyelia following foramen magnum surgery.
Although bone regrowth following craniocervical decompression has been rarely reported to cause late recurrence of Chiari symptoms, syringomyelia has not been observed in such cases. We report a unique case of cervical syringomyelia resulting from spontaneous regeneration of the posterior C1 arch after foramen magnum decompression. ⋯ Spontaneous bone regrowth and arachnoid scarring may lead to the development of cervical syringomyelia several years after foramen magnum surgery. Neurosurgeons should be aware of this rare complication whose management is similar to that of Chiari malformations, namely craniocervical decompression and establishment of a patent foramen of Magendie.