World Neurosurg
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The purpose of this study is to discuss the causes of implant migration after cervical arthroplasty with clinical cases. ⋯ The following situations should be considered in the prevention of dislocation and migration of the implant in cervical arthroplasty: protection of the structure of the end plate, selection of the appropriate implant size, and proper surgical construction. In the preoperative period, computed tomography scan may be useful for determining the implant size and details of the bone structure. Foreign body reactions or postoperative trauma may be a rare and unpreventable reason for prosthesis dislocation despite all of the preoperative and perioperative measures and well-made prosthesis designs.
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Early readmission after spine surgery is being used as a proxy for quality of care. One-fifth of patients are rehospitalized within 30 days after spine surgery, and more than one-third within 90 days; however, there is a paucity of data about the cause of early readmissions in elderly patients after elective spine surgery. ⋯ Our study suggests that in elderly patients undergoing elective spine surgery, infection or a concern for infection, pain, and altered mental status were the most common primary reasons for unplanned readmission.
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The natural history of degenerative disease after instrumented lumbar fusion can result in symptomatic radiculopathy at the adjacent segment. Here we describe our experience with transforaminal endoscopic decompression for the treatment of adjacent segment radiculopathy. ⋯ Transforaminal endoscopic surgical access to adjacent level disease pathology may be a unique approach to the treatment of adjacent segment disease because it allows for neural decompression of disc and foraminal pathology without requiring significant destabilizing bone removal. However, the 2-year failure rate presented here is 33%, which indicates that the benefit of this technique may ultimately be temporary.
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Multimodal intracranial monitoring is becoming an increasingly common tool in the management of patients with traumatic brain injury. Although numerous reports detailing the benefits of such advanced monitoring exist in the literature, there is minimal discussion of the possible complications that may arise in this patient population. ⋯ To our knowledge, this is the first reported incidence of a subdural empyema developing in this setting. Although the safety profile of multimodal intracranial modeling is excellent, with increasing numbers of invasive bedside procedures, neurosurgeons must remain acutely vigilant for the development of infectious complications.
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The preservation of normal peri/intralesional bridging veins is extremely important in every microneurosurgical operation. The purpose of our study was to describe the "squeeze maneuver" assisted by indocyanine green videoangiography (ICGV), a simple technique to "resuscitate" partially occluded bridging veins during microneurosurgical operations. ⋯ The "squeeze maneuver" assisted by ICGV represents a safe, clean, fast, and even cheap method for restoring the flow of partially occluded bridging veins during microneurosurgical operations.