World Neurosurg
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Craniotomy has been performed in neurologic surgery for over a century. Replacement of free bone flaps in routine craniotomies is widely practiced, however, the rate of fusion after free flap replacement is unknown. ⋯ As expected, craniotomy fusion rates after free flap replacement increased steadily over time. We were not able to demonstrate that clinical factors such as age, sex, body mass index, diagnosis, fixation material, and radiation had an impact on fusion rate when time to fusion was accounted for. Patients receiving radiation, however, experienced fusion less frequently. Because of the scarcity of previous studies in this area, this current study serves as a platform for future studies on fusion rates after free flap replacement.
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Foraminal disc herniation is rare. When conservative treatment fails, it is often treated with discectomy via a paraspinal or Wiltse approach. In contained foraminal disc herniation, more symptoms arise from the foraminal compression of the exiting nerve root, including the dorsal root ganglion, than from the herniation itself. We aimed to evaluate the benefits of stand-alone decompression without discectomy for patients with contained foraminal disc herniation. ⋯ Stand-alone decompression without discectomy is an effective method for relieving symptoms and preserving the disc in contained foraminal disc herniation. A minimally invasive approach with thorough decompression techniques yields good results.
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Case Reports
Isolated Dorsal Thoracic Neuroenteric Cyst with Spinal Cord Compression: A Case Reports in Pediatrics.
Neuroenteric cysts are rare developmental anomalies of the central nervous system that account for approximately 0.7%-1.3% of all spinal cord lesions. The majority of spinal neuroenteric cysts are located ventral to the spinal cord. Dorsally located neuroenteric cysts are rare and are almost always associated with other spinal anomalies. Isolated dorsal spinal neuroenteric cysts, without other associated spinal anomalies, are extremely rare. These lesions can be mistaken for the more commonly encountered spinal cysts (e.g., arachnoid cysts, ependymal cysts, cystic teratomas). ⋯ Neuroenteric cysts can occur dorsal to the spinal cord without any associated spinal anomalies. The gold standard treatment for neuroenteric cysts is surgical resection, and the goal of surgery is complete resection.
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Endovascular coiling has emerged as an option for the management of unruptured intracranial aneurysms, which was traditionally treated via surgical clipping. Unlike aneurysms elsewhere, aneurysms of the middle cerebral artery (MCA) have several features that are favorable for surgery. However, endovascular treatment can be difficult for MCA aneurysms, especially if they have incorporated branches. We report the results of coil embolization of incorporated MCA aneurysms. ⋯ Branch-incorporated MCA aneurysms can be treated with coil embolization, with few procedural complications and midterm durability with appropriate techniques and devices.
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To introduce a method of accurately measuring the equivalent dose received by radiation-sensitive organs using the thermoluminescent dosimeter (TLD) and to provide reference values for future studies associated with radiation protection in patients undergoing lumbar spine surgeries. ⋯ Patients received significantly higher radiation doses from CT scans than from regular digital radiograph examinations. These radiation doses were concentrated in the regional area of scanning. Our results indicate the necessity and benefits of radiation protection measures, especially for the organs researched herein, when patients undergoing lumbar surgeries require radiographic diagnostic examinations.