World Neurosurg
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This study aimed to summarize the diagnosis, therapy, and prognosis of pituitary metastasis. ⋯ Pituitary metastasis is a rare disease. Its diagnosis depends on the clinical manifestations and radiologic results. The primary therapeutic method is surgery and subsequent radiotherapy and chemotherapy; however, the prognosis of this disease is poor.
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Comparative Study
Comparative Utility of Dynamic and Static Imaging in the Management of Lumbar Spondylolisthesis.
Segmental instability traditionally is investigated with flexion and extension (F/E) radiographs. We sought to determine whether motion between upright and supine (U/S) views can serve as an alternative sensitive diagnostic tool that predicts similar outcomes. ⋯ No differences in outcomes were noted between patients based on either imaging criteria. These data suggest that static U/S imaging may identify a distinct group of patients who may benefit from transforaminal lumbar interbody fusion surgery.
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Primary solitary intracranial malignant melanoma (PIMM) is extremely rare. In 1992, an extensive review of 81 patients with PIMM was undertaken. Imaging studies, microsurgery, and adjuvant therapy have developed considerably over the last 25 years, and targeted therapy recently has been proven successful for metastatic melanoma. These factors could influence current and future clinical PIMM results. ⋯ Gross total removal of the PIMM was the most promising treatment. Currently adjuvant therapy has not been associated with the survival period. To improve clinical outcome, immunotherapy and targeted therapies are likely to become more important.
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Multicenter Study
Rod Fracture After Apparently Solid Radiographic Fusion in Adult Spinal Deformity Patients.
Rod fracture occurs with delayed fusion or pseudarthrosis after adult spinal deformity (ASD) surgery. Rod fracture after apparent radiographic fusion has not been previously investigated. ⋯ Rod fracture occurred in 9.5% of patients with apparently solid radiographic fusion after ASD surgery. Advanced age, obesity, small diameter rods (5.5 mm), osteotomy, and lower comorbidity burden were significantly associated with rod fracture. Nearly one-half of these patients noted worsening pain, and 21.1% required revision surgery. Instrumentation failure may occur and may be symptomatic even in the setting of apparent fusion on plain radiographs.
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Case Reports
Management of Recurrent Glossopharyngeal Neuralgia Following Microvascular Decompression Surgery.
Glossopharyngeal neuralgia (GPN) is a rare condition, commonly misdiagnosed as trigeminal neuralgia. Microvascular decompression (MVD) is considered the first line of treatment in medically refractive idiopathic GPN, and the recurrence rate is reported to be 7.1%. We present our first case report on the surgical management of a patient with recurrent GPN and analyze the possible causes for recurrence after MVD. ⋯ MVD is considered the first line of treatment in drug-resistant idiopathic GPN. Thorough exploration of REZ for small arteries and veins is mandatory to prevent recurrence. Vascular compression can occur at the cisternal portion or at the REZ. In recurrent cases, splitting of the glossopharyngeal nerve rootlets adds to the good outcome.