World Neurosurg
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Unfamiliarity with the morphometry of the assimilated C1 lateral mass (C1LM) could make screw placement dangerous. In the present study, we defined the morphometric dimensions of the occipitalized C1LM to provide surgeons with valuable information for preoperative planning. ⋯ Although the hypoplastic C1LM brings limitations to screw insertion to some extent, it is still broad enough to accommodate a screw safely in both female and male patients. Considering the irregularity of the C1LM in patients with OA, the preoperative imaging assessment is critical, and C1LM screw placement should be performed individually.
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Intradural intramedullary lipomas without dysraphism are rare tumors. Although they appear extramedullary on imaging, they invade into the intramedullary substance of the spinal cord. We present 2 cases and discuss their clinical presentation, radiologic findings, and surgical management. ⋯ Intramedullary thoracic spinal lipomas without spinal dysraphism are rare. Although these tumors may appear completely extramedullary on imaging, extreme care should be taken during surgery because the lesions eventually become intramedullary, intercalating within the substance of the spinal cord, precluding gross total resection.
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To report the establishment of a new center for deep brain stimulation (DBS) as a surgical treatment for Parkinson disease and the surgical outcomes, from 2014 to 2017 in Shiraz, Southern Iran. ⋯ Bilateral STN DBS is a satisfactory and safe treatment for carefully selected patients with advanced Parkinson disease. According to the results, the procedure can be performed safely and with comparable results in developing countries around the world.
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Although pterional craniotomy and its variants are the most used approaches in neurosurgery, few studies have evaluated their precise indications. We evaluate the pterional (PT), pretemporal (PreT), and orbitozygomatic (OZ) approaches through quantitative measurements of area, linear, and angular exposures of the major intracranial vascular structures. ⋯ The OZ approach offered notable surgical advantages compared with the traditional PT and PreT regarding to the area of exposure and linear exposure to basilar artery. Regarding angle of attack, the orbital rim and zygomatic arch removal provided quantitatively wider exposure and increased surgical freedom. A detailed anatomic study for each patient and surgeon experience must be considered for individualized surgical approach indication.
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The purpose of this study was to determine reference values for the sagittal plane alignment of the thoracolumbar junction (TLJ) in a young adult Korean population. ⋯ This study provides reference values with a wide physiologic range for the sagittal alignment of the TLJ of the spine in a young adult Korean population.