World Neurosurg
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Sciatic neuralgia (SN) is a type of pain commonly associated with lumbosacral radiculopathy. May-Thurner syndrome (MTS) is a disease characterized by venous congestion in the left common iliac vein (LCIV) due to right common iliac artery compression. A case of MTS with SN as the first presenting symptom is described. ⋯ This is the first report of SN associated with MTS. MTS should be considered as one of the differential diagnoses of SN. Thus, symptoms such as pain, edema, and skin hyperpigmentation on the left leg should be closely noted.
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To evaluate a new technique in brainstem surgery, neuronavigation (NN)-guided corticospinal tract (CST) mapping, in a retrospective study of patients undergoing brainstem tumor surgery. ⋯ Brainstem tumor resection using NN-guided CST mapping achieved better preservation of motor function compared with routine NN and IONM. NN-guided CST mapping not only decreased the difficulty of the surgery, but also significantly improved the efficiency of surgery.
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Type 1 Chiari malformation (CM-I) is a craniospinal disorder historically defined by cerebellar tonsillar position greater than 3-5 mm below the foramen magnum (FM). This definition has come under question because quantitative measurements of cerebellar herniation do not always correspond with symptom severity. Researchers have proposed several additional radiographic diagnostic criteria based on dynamic motion of fluids and/or tissues. The present study objective was to determine if cardiac-related craniocaudal spinal cord tissue displacement is an accurate indicator of the presence of CM-I and if tissue displacement is altered with decompression. ⋯ These results support SCM measurement by PC-MRI as a possible noninvasive radiographic diagnostic for CM-I. Dynamic measurement of SCM provides unique diagnostic information about CM-I alongside static quantification of tonsillar position and other intracranial morphometrics.
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Retracted Publication
Inpatient Outcomes After Elective Lumbar Spinal Fusion for Patients with Human Immunodeficiency Virus in the Absence of Acquired Immunodeficiency Syndrome.
To our knowledge, no prior study has evaluated outcomes after elective lumbar spinal surgery in human immunodeficiency virus (HIV) patients without acquired immunodeficiency syndrome (AIDS). This review investigated the impact of HIV-positive status (without AIDS) on outcomes after elective lumbar fusion for degenerative disc disease (DDD). ⋯ Even in this selected cohort of well-controlled HIV patients, there were high complications, with concerning rates of death and respiratory complications. These data shed new light on elective spine surgery in HIV patients and may influence the treatment algorithm of surgeons who are familiar with older papers.
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Review Meta Analysis
Autologous Cranioplasty is Associated with Increased Reoperation Rate: A Systematic Review and Meta-Analysis.
Consensus regarding selection of synthetic versus autologous flap reimplantation for cranioplasty after decompressive craniectomy has not been reached and the multiple factors considered for each patient make comparative analysis challenging. This study examines the association between choice of material and related complications. ⋯ Autologous implants had significantly more reoperations primarily because if the intrinsic risk of resorption (level of evidence 3b).