World Neurosurg
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Review Case Reports
The rare association of spina bifida and extrarenal Wilms tumor: a case report and review of the literature.
The diagnosis of nephroblastoma outside of the kidneys, in the absence of a renal primary tumor, is known as extrarenal Wilms tumor (ERWT). ERWT is an uncommon entity that typically involves the embryonic path of the developing kidneys and gonads. The occurrence of ERWT in a dysraphic spine is uncommon, with no reported cases of preoperative diagnosis, with all cases diagnosed at pathology. These tumors are malignant and ideally should be completely excised. Thus, preoperative diagnosis would be highly desirable. ⋯ The lack of pathognomonic radiologic features makes the preoperative diagnosis extremely difficult, but a diagnosis of ERWT should be considered in the context of a soft tissue mass without the typical imaging features of a hemangioma or teratoma.
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Review Historical Article
Trepanation to treat a head wound: a case of neurosurgery from 13(th) century Tuscany.
During the archaeological excavations conducted in the 13th century cemetery of the Church of Sant'Agostino in Poggibonsi (Tuscany, Italy), a skull with evidence of neurosurgical intervention was brought to light. The skull, belonging to an adult male, shows two traumatic lesions produced by bladed instruments. The first lesion, located on the anterior part of the parietal bones, involved only the outer cranial table; bone remodeling indicates that the individual survived the injury for a long time. ⋯ However, the surgical intervention failed, and the patient died soon afterwards. Trepanation for the treatment of cranial traumas is described by several medical classical and medieval authors, whose texts were available in the 13th century. This case represents rare Middle Ages evidence of neurosurgery used to treat a bone injury.
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Randomized Controlled Trial Comparative Study
Preoperative Planning of Lateral Entry Point is Necessary in Percutaneous Lumbar 5th Vertebroplasty.
To compare treatment outcomes and complications between the computer-assisted preoperative planning of lateral entry approach and the traditional approach for L5 percutaneous vertebroplasty. ⋯ Owing to the hemispherical morphology and convergent pedicle axis of the L5 vertebrae, a more lateral skin entry point and convergent angle of the puncture needle should be emphasized to reach the optimal point according to the preoperative assessment. The approach involving computer-assisted preoperative planning of the lateral entry point was associated with a higher rate of bilateral cement infiltration with fewer complications.
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Review Case Reports
Spinal Cord Compression Secondary to Epidural Fibrosis Associated with Percutaneously Placed Spinal Cord Stimulation Electrodes: Case Report and Review of the Literature.
Spinal cord stimulation is a safe method for treating chronic pain syndromes. Spinal cord stimulators can be placed either surgically by creating a laminectomy defect for paddle leads or percutaneously by inserting electrodes. They are usually not associated with major complications. ⋯ We also reviewed the PubMed and Medline databases for all cases of significant epidural fibrosis related to spinal cord stimulator lead placement, including both surgically implanted paddles and percutaneously implanted leads. This is an uncommon complication after placement of spinal cord stimulators, but it can carry a clinically significant impact and be the source of severe morbidity. It should especially be suspected if the successful placement of the device is followed by development of a "tolerance" phenomenon, with progressive loss of satisfactory pain control and development of new myelopathic symptoms.
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Review Biography Historical Article
Gerard Blaes (Blasius) (1627-1682): The Dutch Physician and Chemist, his Work and his Description of the Spinal Cord.
In this historical review we summarize the work of the Dutch physician, chemist, and anatomist Gerard Blaes (Blasius). A detailed account of his life and work is presented with emphasis on his contribution to anatomy. In particular, special reference is made to his innovative description of the spinal cord and spinal nerves. ⋯ As a true man of his era, he made significant contributions in research and teaching of anatomy, botany, and chemistry. He published a detailed description of the spinal cord with its gray and white matter and the spinal nerve roots, which significantly increased the knowledge of neuroanatomy in his era. He also is considered one of the founders of comparative anatomy through his work in both humans and animals.