World Neurosurg
-
The aim of this study was to evaluate the safety and efficacy of the microscopic minimally invasive keyhole technique for surgical resection of thoracic spinal meningiomas. ⋯ Based on our results, the microscopic minimally invasive keyhole technique can be used safely and effectively for resection of thoracic spinal meningiomas.
-
We present a case of successful treatment of severe spinal deformity in a 4-year-old boy with achondroplasia. Using posterior segmental instrumentation with a sliding growing rod system, we were able to achieve reduction of thoracolumbal kyphosis from 45 to 11.3 degrees. Post surgery, the patient's spinal hump was completely corrected.
-
To determine outcomes of spinal anesthesia (SA) in high-risk patients undergoing lumbar spine surgery in whom general anesthesia (GA) was contraindicated. ⋯ SA is a safe, reliable, and satisfactory alternative to general anesthesia in high-risk lumbar spine surgeries. Postoperative morbidity and mortality can be reduced by SA and spinal analgesia techniques. SA allows good perioperative hemodynamic stability. It is also more cost-effective.
-
Although chronic subdural hematoma (CSDH) is generally benign, long-term survival (LTS) after CSDH is poor in a significant subgroup. This dichotomy has been compared to fractured neck of femur. However, although early postoperative mortality (within 30 days of CSDH) is well recorded with CSDH and similar to fractured neck of femur (4%-8%), scant accurate data exist regarding early postoperative morbidity (POMB). POMB, which prolongs length of stay (LOS) after major nonneurosurgery, is associated with decreased LTS. One recent CSDH study suggested a POMB standard of 10% i.e., notably less than with fractured neck of femur (45%). ⋯ POMB was frequently disabling, mostly neurologic, and as frequent and diverse as with fractured neck of femur. POMB was significantly correlated with LOS and discharge modified Rankin Scale score. Surprisingly, POSSUM, ACS-NSQIP, and ASA grades were not predictive and would not aid consent. Simple parameters (age, Glasgow Coma Scale, Markwalder grade, hypertension, and/or ≥1 other comorbidity) were instead predictive. Longitudinal follow-up will determine whether POMB affects LTS. CSDH, like fractured neck of femur, is distinct.
-
To assess the relationship between the ratio of C2-C7 Cobb angle to T1 slope (CL/T1S) and cervical alignment changes after laminoplasty. ⋯ The cervical alignment was kept well in the mid-range CL/T1S ratio group after laminoplasty. Patients with a high CL/T1S ratio were more likely to present with kyphotic alignment changes. Patients with a low CL/T1S ratio were more likely to have postoperative kyphosis.