World Neurosurg
-
Traumatic spinal cord injury (SCI) guidelines recommend to maintain mean arterial pressures (MAPs) above 85 mm Hg for 7 days following SCI to minimize spinal cord ischemia. Some physicians doubt that patients with initially complete injuries benefit. ⋯ A positive correlation was observed between MAP values and neurologic recovery in AIS A, B, and C patients but not AIS D patients. These data raise the possibility that patients with an initially complete SCI may derive greater benefit from MAP augmentation than patients with initial AIS D injuries.
-
Constrains on neurosurgical residents' work hours demand innovative teaching models to complement the traditional "in the operating room" model. Stratathane ST-504 (Strata-Tech, Inc., Des Moines, Iowa, USA) has been proposed as a useful artificial neurosurgical tumor model. The consistency, dissectability, and radio-opacity of this model strongly depend on its preparation and storage. However, little work has addressed the interplay of these properties. Hence our study was undertaken to explore the properties of ST-504, its preparation, and storage and how these interactions affect its radio-opacity and consistency. ⋯ For any given ratio of ST-504/water, the time sequence after polymer solidification and the storage method determine the computed tomography appearance and consistency of the tumor block/model. When taking these properties into consideration, ST-504-based artificial tumor models can be customized for different dissection practices, from more solid (meningioma-like) to less solid (schwannoma-like) models.
-
Placement of intraventricular catheters in oncology patients can be associated with morbidity given their small to slit-like ventricles and underlying hematologic disorders. We studied the accuracy of placing Ommaya reservoirs using neuronavigation and a flexible neuroendoscope to verify catheter positioning. ⋯ A combined neuronavigation and neuroendoscopic approach improved catheter tip accuracy compared with accuracy rates described in the literature using other techniques. This approach can be adapted toward routine clinical practice of placing ventricular shunt catheters and Ommaya reservoirs.
-
Patients with cervical compression myelopathy (CCM) generally present bilateral neurological symptoms in their extremities. However, a substantial portion of patients with CCM exhibit laterality of neurological symptoms. The aim of this study was to assess the correlation between intrinsic structural damage and laterality of symptoms using spinal cord diffusion tensor imaging (DTI) of the corticospinal tract. ⋯ Using tract-specific DTI, we demonstrated that microstructural damages in the left and right corticospinal tracts correlated with corresponding neurological symptoms in the ipsilateral side and the FA asymmetry index could indicate laterality in neurological symptoms of patients with CCM.
-
The purpose of this report is to describe the surgical methodology and effectiveness of minimally invasive oblique lumbar interbody fusion (OLIF) assisted by spinal endoscopy, which can treat disk herniation from the central to contralateral foramen. OLIF showed indirect decompression effects on reduction of spondylolisthesis and a foraminal widening effect on disk height restoration. ⋯ OLIF with spinal endoscopic discectomy can achieve neural decompression without additional posterior decompression and can be used as an alternative treatment in selected cases.