World Neurosurg
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Review Meta Analysis
Atlantoaxial fusion with screw-rod constructs: meta-analysis and review of literature.
To review published series describing C1-2 posterior instrumented fusions and summarize clinical and radiographic outcomes of patients treated with screw-rod constructs (SRC). ⋯ SRC is a safe and effective treatment option for C1-2 instability. The low but nonzero incidence of screw malposition and VAI emphasizes the necessity of having a thorough knowledge of atlantoaxial anatomy for successful insertion of screws.
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Review Case Reports
Controversy in the management of lenticulostriate artery dissecting aneurysm: a case report and review of the literature.
Intracranial arterial dissection is an uncommon but well-recognized entity. Treatment remains variable, ranging from observation to intervention via the use of either surgical or endovascular techniques. Aneurysms along the lenticulostriate artery have been reported in only 41 patients. With the current case study we illustrate the effectiveness of observation in the context of a dissecting lenticulostriate aneurysm and discuss other approaches that have been used in the treatment of this particular entity. ⋯ There is no common consensus in the literature on a single treatment strategy for a lenticulostriate artery aneurysm. The present case illustrates that observation and follow-up vascular imaging can be an important treatment strategy, allowing healing of the vessel wall and disappearance of the dissecting aneurysm.
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Review Case Reports
Ruptured spinal artery aneurysm associated with coarctation of the aorta.
Spinal artery aneurysms associated with aortic coarctation are exceptionally rare, with only eight cases reported in the literature that we are aware of, and treatment of the aneurysm described only in one of them. Aortic coarctation often results in an aberrant collateral circulation with hyperdynamic flow and potential spinal artery aneurysm formation, growth, and rupture. Microsurgical, interventional, and medical management of these lesions can be challenging and has rarely been reported. Complication avoidance requires thorough knowledge of the clinical presentation of the disease, the hemodynamic factors involved, and the therapeutic tools available. ⋯ Spinal artery aneurysms induced by aortic coarctation are rare and complex entities. They pose unique surgical and medical challenges. Securing the aneurysm should be prioritized specifically in cases of subarachnoid hemorrhage. Blood pressure should be closely monitored and balanced to reduce the risk of rehemorrhage and at the same time allow for sufficient end-organ perfusion.
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Comparative Study
Identification of knowledge gaps in neurosurgery through analysis of responses to the Self-Assessment in Neurological Surgery (SANS).
To examine the gaps in knowledge of neurosurgeons responding to the Self-Assessment in Neurological Surgery (SANS). ⋯ SANS demonstrated areas of knowledge gaps in a broad group of neurosurgeons. There were also significant differences between residents and attending neurosurgeons. Identification of areas of deficiency could prove useful in future educational endeavors.
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Few reports have addressed long-term outcomes, as well as the safety and efficacy of the cervical microendoscopic foraminotomy (CMEF) and cervical microendoscopic diskectomy (CMED) procedures used in modern spine practice to treat degenerative disease of the cervical spine. Accordingly, we present long-term outcomes from a cohort of patients treated for foraminal stenosis or disk herniation with the CMEF or CMED procedure, respectively. ⋯ Posterior CMEF and CMED are safe and effective procedures for minimally invasive decompression in the cervical spine.