World Neurosurg
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The cervicothoracic junction (CTJ) has often been identified as an area of biomechanical vulnerability; however, few studies have examined the relative merits of extending fusions across this area. In this study, we sought to investigate the tradeoffs involved in fusing across the CTJ in cases of elective posterior cervical laminectomy and fusion. ⋯ Crossing the CTJ was associated with increased surgical time, estimated blood loss, and the rates of wound dehiscence. These tradeoffs should be considered in planning posterior cervical decompression and fusion procedures.
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Case Reports
Minimally Invasive Syringe Brain Port For Deep-seated Lesions: How To Make The System And Surgical Video.
Brain retraction is crucial for adequate exposure during many intracranial procedures. It facilitates the access to the area of interest inside the brain and gives the surgeon the ability to create a corridor to visualize the deeply seated lesions. Retraction-related injury is a well-known complication. ⋯ It can help the neurosurgeons to achieve brain retraction in a safe, simple, and cost-effective technique. We are presenting a video of how to make this system. Also, we are demonstrating an intraoperative application of this system in a case of a 36-year-old male with deep-seated recurrent right frontal glioblastoma multiforme grade IV.
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The benefit of adjuvant radiotherapy (RT) is uncertain in elderly patients diagnosed with World Health Organization (WHO) grade III meningiomas. ⋯ Adjuvant external beam RT may not provide any survival benefit for elderly patients with WHO grade III meningioma after gross total resection.
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Vascular complications during transsphenoidal surgery can be devastating. Direct vascular injury during surgery can lead to various complications including pseudoaneurysm formation. Postoperative hematoma and direct vascular handling due to arachnoid tear can induce vasospasm. The vasospasm might present with varying clinical symptomatology and at times masks the underlying pathology as well. ⋯ Angiograms at regular intervals should be performed in cases where intraoperative vascular injury is suspected to detect such aneurysms and prevent catastrophe.
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To assess factors that may predict failure to improve at 12 and 24 months after unilateral laminotomy with bilateral decompression (ULBD) for the management of lumbar spinal stenosis. ⋯ ULBD for the management of lumbar spinal stenosis leads to clinically important improvement that is maintained over a 24-month follow-up period. Female sex and tobacco smoking are associated with poorer outcomes.