World Neurosurg
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Case Reports
One-stage wedge osteotomy through posterolateral approach for cervical postlaminectomy kyphosis with anterior fusion.
Osteotomy through anterior exposure is challenging with severe complications for upper cervical kyphosis (CK), especially for cases with previous anterior fusion. A novel technique comprising 1-stage osteotomy via a posterolateral-only approach is introduced for treatment of CK secondary to C2-4 laminectomy for neurofibroma removal and subsequent anterior fusion. ⋯ Preliminary outcomes reveal wedge osteotomy via piezosurgery through a posterolateral-only approach is feasible and effective in revision surgery for upper CK with previous anterior fusion.
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Minimally invasive surgery has become popular in recent times and has proved more advantageous than conventional open surgery methods, in terms of maximal preservation of natural anatomy and minimal postoperative complications. However, these advancements require a longer learning curve for inexperienced surgeons. ⋯ Appropriate instruments, a trained team, and an adept radiographer are important assets for a smooth transition during the learning period. Structured training with cadavers and lots of practice, preferably while working under the guidance of experienced surgeons, is helpful. The learning curve can be shortened when a proficient surgeon gains relevant knowledge, understands three-dimensional anatomy, and has surgical aptitude along with manual dexterity.
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The aim of this study is to determine the risk factors affecting intraoperative neurophysiologic monitoring (IONM) changes, when such changes take place, and clinical outcomes associated with IONM change during cervical open door laminoplasty (COL) for cervical compressive myelopathy. ⋯ IONM change during COL occurred immediately after decompression, and a risk factor of IONM change was ORA at the MCL. If the IONM change was not fully recovered, a new motor deficit occurred after COL.
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The purpose of this study was to analyze the risk factors for 14-day mortality in pediatric patients undergoing early decompressive craniectomy (DC) after traumatic brain injury (TBI). ⋯ In children undergoing early DC after TBI, risk factors for 14-day mortality include younger age and higher ISS.
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Infection follow-up in patients stabilized with the Dynesys system. Infection rates were determined in patients who had ≥5 segments stabilized with the Dynesys system. ⋯ We report that long-level stabilization with the Dynesys system results in a high infection rate.