World Neurosurg
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We sought to explore whether additional bone grafting of the atlantoaxial joint increases the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion surgery. ⋯ Additional bone grafting of the atlantoaxial joint could increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion.
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Comparative Study
Outcome of Ruptured Posterior Communicating Artery Aneurysm Treatment Comparing Between Clipping and Coiling Techniques.
Very few data stratify the functional outcome of ruptured posterior communicating artery (PCoA) aneurysm treatment based on each treatment strategy. Therefore, the authors aimed to evaluate the outcome of PCoA aneurysm treatment to compare the clipping and coiling techniques and find the factors that determined the treatment outcomes. ⋯ Neurosurgical clipping and endovascular coiling are effective treatments for aneurysm obliteration in ruptured PCoA aneurysm. An aneurysm on the left side and a medially projected PCoA aneurysm were the factors correlated with poor outcome.
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Bony anomaly of axis (C2) vertebra is well known. However, expansion of the posterior element is less documented. We describe a case of additional bony ring attached to the posterior spinous process in a 10-year-old male who presented with the complaint of progressive swelling at the upper cervical region. ⋯ Complete surgical excision of the mass was done. Anomalous expansion of the spinous process of the C2 vertebra may remain silent. Surgery may be necessary for cosmetic purposes.
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Anterior or posterior decompression has been widely used to treat patients with ossification of the posterior longitudinal ligament (OPLL). However, when OPLL extends to the C2 level, the complex anatomic structures around the C2 vertebral body and postoperative destabilization or kyphosis would make it difficult to perform anterior or posterior surgery. This study proposed a novel technique named "shelter technique" to deal with C2 OPLL. ⋯ The shelter technique can be relatively effective and safe for patients with OPLL involving the C2 segment. However, further studies with more cases and longer follow-up will be required to reveal the surgical value of the technique.
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For effective minimally invasive lumbar decompression, we changed the routine of segmental decompression. Using a high-speed drill or an ultrasound knife, we created a working channel, starting at the base of the spinous process of the upper vertebra slightly above the disc level, to target and decompress the contralateral recess, and termed it the translaminar crossover decompression (TCD). We evaluated the feasibility and compared the outcomes of a navigation-guided endoscopic translaminar crossover approach for segmental decompression (eTCD) in elderly patients with microscopic decompression using the same approach (mTCD). ⋯ TCD inherently eliminated central stenosis and facilitated decompression of both recesses via mutual undercutting, with preservation of facet joint integrity.