World Neurosurg
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Three-column spinal osteotomies were developed to address severe and stiff kyphoscoliosis. However, the optimal choice of osteotomy in these patients is still unclear. This retrospective study aims to compare the outcomes and complications between grade 4 and grade 5 osteotomies in patients with severe and stiff thoracic kyphoscoliosis. ⋯ Similar clinical outcomes can be achieved with grade 4 and grade 5 spinal osteotomies. This may enrich the basis on moving down to a lower osteotomy grade when treating patients with severe and rigid thoracic kyphoscoliosis.
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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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The signs and pathomechanism of Miyazaki syndrome is presented through the case of a young female patient. ⋯ The article discusses the available literature suggesting the underlying cause in such cases to be the dysfunction of the Starling resistor mechanism due to an improperly adjusted ventriculoperitoneal shunt, which results in excessive cerebrospinal fluid loss accompanied by consequent cerebral venous overflow with vertebral venous engorgement and compressive cervical myelopathy.
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Case Reports
Delayed Intraventricular Pneumocephalus Following Shunting for Normal-Pressure Hydrocephalus.
Pneumocephalus is usually seen in trauma or cranial surgery. It is rarely reported as a delayed complication of ventriculoperitoneal shunt placement for hydrocephalus secondary to trauma, tumor, or aqueduct stenosis. We describe a case of intraventricular pneumocephalus manifesting 10 months after placement of a shunt for normal-pressure hydrocephalus. ⋯ Pneumocephalus after shunting for NPH is rare and described as a complication only during the first 2 postoperative months. This case is unique, as the pneumocephalus developed 10 months after shunting. The combination of an occult, possibly congenital, skull base defect and the insertion of a shunt resulted in delayed intraventricular and intraparenchymal pneumocephalus.