World Neurosurg
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Multicenter Study
Neurosurgical Infection Rates and Risk Factors: A NSQIP Analysis of 132,000 Patients, 2006-2014.
The existing body of literature on postoperative neurosurgical infections lacks large multicenter reports on postoperative neurosurgical infections. This is the largest study to date of postoperative neurosurgical infections rates, time to event, and risk factors. ⋯ The overall ACS-NSQIP reported rate of postoperative infections was 5.3% from 2006 to 2014. Multivariable analysis demonstrated several predictive factors for postoperative infections.
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Case Reports
Cyclic Sciatica and Back Pain Responds to Treatment of Underlying Endometriosis: Case Illustration.
Multiple causes outside the spine can mimic spinal back pain. Endometriosis is an important gynecologic disorder, which commonly affects the lower region of the female pelvis and less frequently the spine and soft tissues. The lumbosacral trunk is vulnerable to pressure from any abdominal mass originating from the uterus and the ovaries. Therefore symptoms of endometriosis include severe reoccurring pain in the pelvic area as well as lower back and abdominal pain. ⋯ It is critical for any clinician who deals with back pain to at least consider the diagnosis of endometriosis in female patients who have a history of pelvic pain. The diagnosis of endometriosis should be considered in candidate patients by asking whether there is a significant hormonal cyclic nature to the symptoms, to prevent such unnecessary surgical adventures.
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Case Reports
Ultrasonography monitoring with Superb Microvascular Imaging technique in brain tumor surgery.
Neuronavigation based on preoperative magnetic resonance imaging has been developed as a useful tool to improve visibility of the surgical site in the operative field. Ultrasonography (US) monitoring has also been used as a reliable imaging technique, providing real-time information during neurosurgical operations. We combined the latest innovative imaging technique for detecting very low-flow components, Superb Microvascular Imaging (SMI), with US monitoring during brain tumor surgery. ⋯ We combined SMI technique with US monitoring during brain tumor surgery and observed healthy and tumor vessels. Further research is important for the development of a more precise and reliable neurosurgery.
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Case Reports
Bilateral sub-axial rotational vertebral artery occlusion in a setting of a prior cervical construct.
Rotational vertebral artery occlusion, or bow hunter's syndrome, most commonly affects the C1-2 level because of its importance in regulating rotational movement. ⋯ A brief literature review and treatment options are discussed for this unusual presentation of a rare clinical entity.
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Although short-term clinical outcomes after basilar artery stent placement have been reported previously, effectiveness of intracranial stenting for vertebrobasilar artery occlusion in the acute phase of ischemic stroke is unclear. ⋯ Stent angioplasty may be a reasonably good treatment option for patients with technically favorable lesions, especially in vertebrobasilar atherosclerotic occlusion with medically or PTA only refractory symptoms. Despite a significant complication rate, most of our patients experienced good to excellent clinical outcomes and were free of vertebrobasilar ischemia at late midterm follow-up.