World Neurosurg
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Metastatic vertebral compression fractures pose a significant clinical problem to cancer patients including pain, spinal deformity, and neurologic deficit. Treatment of metastases to the spine is complex and challenging and may require local and systemic therapies. ⋯ Complications of PVP in malignant compression fractures are more common than in nonmalignant ones. We present 1 case of tumor seeding along the needle tract of a breast cancer patient who had undergone PVP.
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Case Reports
Transpedicular Intrabody Cage Insertion with Posterior Spine Stabilization in Kümmell Disease: Report of 2 Cases.
Kümmell disease has been treated with multiple surgical approaches, as described in the literature. However, there are few reports describing the technique of transpedicular intrabody cage insertion to enhance bony fusion and maintain the height of the vertebral body. We describe the technique of transpedicular intrabody cage insertion with posterolateral fusion in patients with Kümmell disease. ⋯ Transpedicular intrabody cage insertion is a safe and effective procedure for treating vertebral osteonecrosis to achieve bone formation at the site of vertebral osteonecrosis and to maintain body height.
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Vessel transposition is the standard procedure in microvascular decompression (MVD), which necessitates more complex and difficult surgical techniques, including suturing in the deep operative field. We recently reported the usefulness of TachoSil tissue sealing sheets soaked with fibrin glue for vessel transposition in MVD, known as the "birdlime" technique. Here we describe various technical variations and improved adhesive strength of this material for safe and optimal vessel transposition without complications. ⋯ Modifications of the birdlime technique and reinforcement of the adhesive strength provide an easy and adjustable way to perform MVD safely and effectively to reduce the risk of intraoperative neurovascular injury.
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A frequently encountered problem during posterolateral fusion (PLF) is bone graft displacement from the posterolateral space during closure. Commercially available solutions to this problem are seldom used because of their exceptionally high cost. The purpose of this report is to describe 3 novel, low-cost techniques we developed for bone graft containment during PLF. ⋯ These 3 novel surgical techniques for bone graft containment in the posterolateral space add minimally to the cost and length of the procedure. Our early clinical experience suggests that these techniques are safe and effective. Additional clinical experience is warranted, and prospective data collection is ongoing.
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Cervical spondylotic myelopathy (CSM) occurs due to chronic degenerative changes in the cervical spine causing compression of the spinal cord. CSM has been studied for decades, and numerous articles have been published on the topic. We sought to identify the top 50 most-cited articles on CSM. ⋯ There is a deficiency of high-level articles in the top 50 most-cited list. This study provides an important overview of historical development of treatment methods, as well as publication trends related to this pathology. Regardless, this comprehensive list of the top 50 most-cited articles can serve as a resource for future trainees and surgeons to draw on to build their knowledge base.