World Neurosurg
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Review Case Reports
Spinal Intradural Arachnoid Webs Causing Spinal Cord Compression with Inconclusive Preoperative Imaging: A Report of Three Cases and a Review of the Literature.
Spinal arachnoid webs are a rare variant of spinal arachnoid cysts where 1 or multiple focal membranes of arachnoid tissue obstruct the subarachnoid space. Only 11 prior cases of arachnoid webs have been reported in the literature. We present a series of 3 consecutive cases of arachnoid webs from our institution and review the literature on this rare condition to provide recommendations for its management. ⋯ Intradural arachnoid webs causing spinal cord compression are rare. Preoperative imaging may be inconclusive. Because of the septated longitudinal nature of the visualized membranes, we propose a 1-way valve mechanism of cerebrospinal fluid obstruction causing gradual cord compression and resultant syringomyelia.
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Multicenter Study Controlled Clinical Trial
Effects of Smoking on Subjective and Objective Measures of Pain Intensity, Functional Impairment and Health-related Quality of Life in Lumbar Degenerative Disc Disease.
Numerous studies assessed the effects of smoking on lumbar degenerative disk disease (DDD); they focused on patient-reported outcome measures (PROMs) and yielded conflicting results. ⋯ PROMs measuring SFI for pain intensity, functional impairment, and health-related quality of life were similar in smokers and nonsmokers before surgery for lumbar DDD, as well as postoperatively. The smoking status has negligible impact on the Timed Up and Go test, which appears to be a robust assessment tool for OFI.
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Quasi-moyamoya disease (MMD) is characterized by moyamoya vasculopathy and well-recognized comorbidity. Whether the recently identified MMD susceptibility gene variant, p.R4810K (rs112735431), is associated with quasi-MMD remains unclear. ⋯ The p.R4810K variant was associated with atherosclerotic and autoimmune quasi-MMD in a Chinese population, and a lower prevalence of this variant in patients with quasi-MMD compared with patients with MMD was observed.
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The pterional/frontotemporal orbitozygomatic (FTOZ) approaches are the 2 most widely used procedures for resection of sphenoid wing meningiomas; however, a comparison of outcomes and complications of these 2 approaches has not been well described yet. Here, we investigated the outcomes, complications, and predictors of favorable outcomes of these 2 approaches. ⋯ In summary, sphenoid wing meningiomas undergoing extensive skull base approach (FTOZ) and GTR had a low recurrence rate and greater RFS. Even though FTOZ with GTR is preferable to resect the sphenoid wing meningiomas, the procedure should be tailored to each patient depending on the risks and surgical morbidity.
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We previously showed that cervical pedicle screw (CPS) placement is safe even with the freehand technique. The posterolateral fusion rate 1 year after CPS placement, as measured by computed tomography (CT), is reported here. The graft resorption rates when different graft materials were used were also analyzed. ⋯ CPS placement yielded a posterolateral cervical fusion rate of 98.2%. Despite the high resorption rate of allograft only, this material yielded fusion rates that were similar to those of the other materials. Thus, the strong fixation power of CPS might compensate for the delayed fusion and high resorption rates of allograft bone chips.