World Neurosurg
-
Case Reports
Microsurgical Posterolateral Foraminotomy on Patients with Adult Isthmic Spondylolisthesis.
The standard surgical treatment for adult isthmic spondylolisthesis consists of various techniques of arthrodesis supplemented with instrumentation. However, the superiority of this strategy has not been irrefutably proved. Considering the risk associated with the instrumentation surgery, examining a less invasive approach is justified. ⋯ Microsurgical decompression through the posterolateral intermuscular approach was effective in producing good 2-year outcome in patients with adult isthmic spondylolisthesis. This procedure may be considered as a less invasive alternative in the surgical treatment of adult isthmic spondylolisthesis.
-
Various reports have described the transuncus (TU) approach as a selective route to the amygdala and hippocampus, but this approach has not yet been submitted to solid postoperative imaging analysis. The objective of this study was to evaluate the anatomy, surgical technique, postoperative imaging analysis, and outcome in a series of patients with temporal lobe epilepsy who underwent selective amigdalohippocampectomy via a TU approach. ⋯ A TU approach is a feasible and efficient approach to selective amigdalohippocampectomy for surgical treatment of temporal lobe epilepsy. Postoperative DTI analysis suggests that a TU approach results in more injury to the temporal stem and its associated white matter fiber tracts than expected by previous anatomic studies; however, it was efficient in preserving OR.
-
To investigate the efficacy of immune checkpoint therapy (ICT) administered with stereotactic radiosurgery (SRS) and determine the effects of relative treatment timing on lesion response. ⋯ ICT combined with SRS was associated with greater lesion regression of melanoma brain metastases and decreased LF. When given concurrently, combined SRS and ICT may result in improved freedom from DBF.
-
Decompressive spinal surgery patients have high expectations of recovering functionally, both at work and with leisurely activities. Affective disorders, such as depression or anxiety, are increasingly prevalent in this population and are associated with poorer baseline quality-of-life measures and worse postoperative outcomes. The study examined the results of affective disorders on self-reported recovery of baseline function (RBF) following decompressive spinal surgery. ⋯ This study suggests that affective disorders are an independent risk factor for decreased recovery of baseline functionality after decompressive spinal surgery. Preoperatively identifying these patients could improve management of postoperative expectations and thereby improve surgical outcome.
-
Adverse effects of increased use of cerebral digital subtraction angiography (DSA) include radiation-induced skin reactions and increased risk of malignancy. This study aimed to identify a method for reducing radiation exposure during routine cerebral DSA. ⋯ Increased awareness of radiation risks, as well as the establishment of strategies to reduce radiation dose, led to lower radiation doses for DSA. The use of appropriate examinations and low-dose parameters in fluoroscopy contributed significantly to the radiation dose reductions.