World Neurosurg
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Large schwannomas with intradural and extradural extensions are often challenging surgical lesions. A variety of approaches, usually requiring large exposures, removal of facets and pars interarticularis, and spinal stabilization, have been described. The aim of this study is to describe the "dual approach," a less invasive technique for the excision of these lesions. ⋯ The dual approach is a novel and unique technique that allows complete and safe removal of large intradural and extradural dumbbell tumors through a less invasive approach and no need for instrumentation.
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Multiple osseous loose bodies in the lumbar spine have never been reported. We describe a rare surgical case of multiple osseous loose bodies associated with lumbar isthmic spondylolisthesis. ⋯ We described the first instance of multiple loose bodies in the spinal canal with lumbar canal stenosis. It is presumed that long standing minor trauma due to dynamic instability with a trend of hyperossification induced secondary synovial osteochondromatosis forming multiple loose bodies.
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We recently performed a comprehensive bibliometric analysis of 103 U.S. neurosurgical departments and found the ih(5)-index as meaningful and reproducible using public data. The present report expands this analysis by adding 14 Canadian and 2 additional U.S. programs. ⋯ This is the most accurate comprehensive analysis to date of contemporary bibliometrics among North American neurosurgery departments. Using the ih(5)-index for institutional ranking allows for informative comparison of recent scholarly efforts.
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Hemiballismus is a rare presentation of symptomatic carotid stenosis that is underreported in the neurosurgical literature. It is characterized by severe large-amplitude movements that are classically caused by lesions of the subthalamic nucleus. Given the arterial border zone position of the subthalamic nucleus between the anterior and posterior circulation, hemodynamically compromising carotid stenosis can lead to hypoperfusion in this location. ⋯ We suggest that neurovascular imaging should be part of the initial workup of this condition and that prompt diagnosis and treatment of carotid artery stenosis in patients who present with new-onset hemiballismus are essential for reducing risk of imminent stroke.
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To evaluate spinal implant density and proximal junctional kyphosis (PJK) in adult spinal deformity (ASD). ⋯ PJK, although influenced by a multitude of factors, may be statistically related to implant density and LL.