World Neurosurg
-
Review Case Reports
Severe Pott's Kyphosis in a 19 month old child - Case report and review of literature.
Spinal osseous tuberculosis, or Pott's spine, although very common in endemic countries, has a lower incidence in very young children. However, the infection has the propensity to cause greater vertebral destruction in this age group, leading to severe structural kyphotic deformity and associated neurologic deficits. We report the case of a 19-month-old child with severe tubercular kyphotic deformity of the upper thoracic spine managed with posterior vertebral column resection (VCR) and nonfusion posterior pedicle screw instrumentation. ⋯ Multilevel posterior VCR with a restricted fusion and nonfusion pedicle screw instrumentation beyond the resection site can be safely done in young children (age <3 years) requiring rigid tubercular kyphotic deformity correction. However, these patients require regular follow-up and may need multiple surgeries.
-
Review Case Reports
One-stage surgical resection of giant intracranial arteriovenous malformations in selected patients: a novel diffusion tenser imaging score.
The effective treatment of giant cerebral arteriovenous malformations (gAVMs) is challenging. The aim of this study was to determine the risk factors for 1-stage resection of gAVM and develop a reliable indicator for patient selection. ⋯ One-stage surgical resection of gAVMs in patients with a low DTI score (0-2) seems to be feasible. The DTI score could be a reliable indicator for patient selection.
-
Review Case Reports
Neurofibroma and Meningioma within a Single Dumbbell-Shaped Tumor at the Same Cervical Level without Neurofibromatosis: a Case Report and Literature Review.
Cases of multiple intracranial tumors are common; however, cases of multiple intraspinal tumors are rare. Except for cases of neurofibromatosis, it is very rare for tumors of different pathological types to exist concurrently at the same spinal level. Only 9 cases have been reported to date, with meningioma found with schwannoma in 7 cases and with neurofibroma in 2 cases. ⋯ To the best of our knowledge, the present case is the first reported case of intradural neurofibroma (not meningioma) and extradural meningioma growing mixed together at the same spinal level without neurofibromatosis. The precise mechanism underlying the formation of the tumor is unknown, and multidirectional differentiation of a common progenitor cell is one possibility. Intra- and extradural exploration and component biopsies are useful for treatment planning, especially when the magnetic resonance imaging is not sufficiently sensitive for the diagnosis of coexisting tumor types.
-
Meta Analysis
Association of endothelin receptor type A with intracranial aneurysm in 20,609 East Asians: An updated meta-analysis.
Genome-wide association studies have reported an association between the EDNRA gene and intracranial aneurysm (IA) in European and Japanese populations; however, there is no study on this polymorphism in other Asian populations. Therefore, we performed an extensive large-scale meta-analysis for association of the rs6841581 variant of EDNRA with IA susceptibility in East Asian population. ⋯ The genetic variant of EDNRA, rs6841581, was significantly associated with increased risk of IA. Our findings indicate that it could be used as an IA-predicting variant in East Asian populations.
-
Randomized Controlled Trial Comparative Study
Reoperation Following Primary Lumbar Discectomy With or Without Implantation of a Bone-Anchored Annular Closure Device: Surgical Strategies and Clinical Outcomes.
To determine whether presence of a bone-anchored annular closure device (ACD) impacts reoperation strategies and subsequent outcomes. ⋯ In patients undergoing post-discectomy reoperation, patients with an ACD were treated with similar operative techniques, were not exposed to additional surgical risks, and reported comparable clinical outcomes versus those without an ACD.