World Neurosurg
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Acute traumatic isolated transverse process fractures (ITPFs) are increasingly identified in trauma patients owing to the increased use of routine computed tomography imaging. Despite repeated demonstrations that these fractures are treated only symptomatically, patterns of consultation with a spine service have not changed. We aim to provide information on long-term outcomes following conservative treatment to help clarify the role of the spine service in the treatment of ITPFs. ⋯ ITPFs can be treated conservatively without concern for long-term outcome sequelae such as pain, neurologic deficits, or ambulatory difficulties. Consequently, a spine service consult is not required for patients with ITPFs.
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Precisely defining complications, which are used to measure overall quality, is necessary for critical review of delivery of care and quality improvement in endovascular neurosurgery, which lacks common definitions for complications. Furthermore, in endovascular interventions, events that may be labeled complications may not always negatively affect outcome. Our objective is to provide precise definitions for quality evaluation within endovascular neurosurgery. Thus, we propose an endovascular-specific classification system of complications based on our own patient series. ⋯ We propose an endovascular-specific classification system of complications with 4 categories: mechanical, technical, judgment errors, and critical events. This system provides a framework for future studies and quality control in endovascular neurosurgery.
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Observational Study
Epidemiologic and Demographic attributes of Primary Spondylodiscitis in a Middle Eastern population sample.
The prevalence and characteristics of spontaneous spondylodiscitis in the Middle East are unknown. There seems to be an emerging dominance of pyogenic infections over tuberculosis and brucellosis. ⋯ Spontaneous infective spondylodiscitis affects older men with and without medical comorbidities equally. It often involves the lumbar spine and a third of patients are culture negative. Tuberculosis constitutes only about 17% of primary infections in the spine in this population sample.
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To introduce and assess a surgical treatment of occipitocervical (OC) dislocation with atlas assimilation and Klippel-Feil syndrome (KFS) using occipitalized C1 lateral mass and C2 fixation and reduction technique. ⋯ In patients with OC dislocation and KFS of C2-3 fusion and atlas assimilation, posterior manipulative reduction combined with occipitalized C1 lateral mass and C2 fixation provides a reliable and effective treatment.
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Choroid plexus papillomas (CPPs) of the cerebellopontine angle (CPA) are extremely rare. We present a series of 21 cases operated on in the last 7 years at our institution. ⋯ CPPs in the CPA region cannot be easily differentiated from other tumors preoperatively. Cysts and calcifications appear on neuroimaging. CPPs in the CPA region usually protrude inferiorly into the foramen magnum region. As much tumor should be removed as possible to avoid recurrence and malignant transition.