World Neurosurg
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Multicenter Study Comparative Study
Revision extension to the pelvis versus primary spinopelvic instrumentation in adult deformity: comparison of clinical outcomes and complications.
To evaluate the outcomes and complications of patients with adult spinal deformity treated in a primary versus revision fashion with long fusions to the sacropelvis. ⋯ Patients requiring revision extension of instrumentation to the pelvis can be treated with the same expectation of radiographic and clinical success as patients treated primarily with fusion to the sacropelvis. The complication rate for the revision procedure is not insignificant and may be similar to a primary procedure that includes pelvic fixation.
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Review Historical Article
The pioneering contribution of italian surgeons to skull base surgery.
The origin of neurosurgery as a modern, successful, and separate branch of surgery could be dated back to the end of the 19th century. The most important development of surgery occurred in Europe, particularly in Italy, where there was a unique environment, allowing brilliant open-minded surgeons to perform, with success, neurosurgical operations. Neurosurgery began at the skull base. ⋯ In this paper, we report at a glance the contributions of Tito Vanzetti from Padua (1809-1888), for his operation on a destructive skull base cyst that had, indeed, an intracranial expansion; of Davide Giordano (1864-1954) from Venice, who described the first transnasal approach to the pituitary gland; and, most importantly, of Francesco Durante from Messina (1844-1934), who was the first surgeon in the history of neurosurgery to successfully remove a cranial base meningioma. They carried out the first detailed reported surgical excision of intracranial lesions at the skull base, diagnosed only through clinical signs; used many of the advances of the 19th century; and conceived and performed new operative strategies and approaches. Their operations were radical enough to allow the patient to survive the surgery and, in the case of Durante, for the first time, to obtain more than 12 years of good survival at a time when a tumor of this type would have been fatal.
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Review Historical Article
The carotid siphon: a historic radiographic sign, not an anatomic classification.
After the term carotid siphon was introduced by Moniz in 1927 to describe the radiographic appearance of the intracranial internal carotid artery (ICA), the concept gained popularity in decades following in both the anatomic and the medical literature. However, as conflicting definitions persist in the delineation of proximal and distal sites, does the term carotid siphon provide the precision needed for current anatomic and clinical studies? ⋯ Tracing the origin and usage of the term carotid siphon during 6 decades in the medical literature shows continued discrepancy rather than consensus. The term carotid siphon is historically relevant but can now be supplanted by definitive ICA classification systems, which continue to evolve in contemporary medical and anatomic communications.
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The global incidence of spinal cord injury (SCI) is 15-40 cases per million people, with the socioeconomic and healthcare costs amounting to nearly $10 billion per annum in the USA alone. Despite substantial advances in medical care and surgical technology, many patients with SCI still experience significant long-term neurologic disability. ⋯ Improved generation and transfection techniques, combined with positive experimental outcomes in SCI models, suggest that adult-derived induced pluripotent stem cells could be a genuine alternative to embryonic stem cells for clinical treatments. For translation from bench to bedside, the efficacy of induced pluripotent stem cell-derived neural stem and progenitor cells in suitable SCI models needs to be validated further and backed up with rigorous early-stage clinical trials.
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Review Case Reports
Usefulness of tumor blood flow imaging by intraoperative indocyanine green videoangiography in hemangioblastoma surgery.
Hemangioblastomas remain a surgical challenge because of their arteriovenous malformation-like character. Recently, indocyanine green (ICG) videoangiography has been applied to neurosurgical vascular surgery. The aim of this study was to evaluate the usefulness of tumor blood flow imaging by intraoperative ICG videoangiography in surgery for hemangioblastomas. ⋯ In surgery for hemangioblastomas, careful interpretation of dynamic ICG images can provide useful information on transit feeders and unexposed hidden vessels that cannot be directly visualized by ICG.