World Neurosurg
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To identify trends in mobility and daily pain levels among a cohort of patients with clinically diagnosed spine disease. ⋯ Patients with spine disease who reported greater pain had reduced mobility, as measured by the passively collected smartphone GPS data. Smartphone-based digital phenotyping appears to be a promising and scalable approach to assess mobility and quality of life of patients with spine disease.
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The postoperative infection rates for transforaminal lumbar interbody fusion (TLIF) have ranged from <2% to 4%. However, no consensus has been reached on the treatment strategies. TLIF cage preservation or revision surgery for lumbar spine reconstruction are 2 possible treatments. We aimed to determine the most effective method for organ/space infection control. ⋯ The most important factor contributing to TLIF cage retention failure was epidural fibrosis of the previous transforaminal route and biofilm adhesion on interbody devices affecting infection clearance. Thus, we would recommend a combined anterior and posterior approach or the transforaminal route for radical debridement with cage removal and fusion to achieve better clinical outcomes.
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Adults with Chiari malformation type 1 (CM1) often report cognitive impairment. This cross-sectional study investigates the cognitive and emotional functioning of a sample of adults with CM1 who presented for neurosurgical evaluation prior to intervention. ⋯ The CM1 group displayed subtle learning, semantic fluency, and complex construction difficulties compared with healthy control subjects. Although not correlated with cognition, adults with CM1 are at high risk for clinical depression.
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von Hippel-Lindau disease-related hemangioblastoma is likely to occur in the cerebellum and accompany a cyst. As multiple hemangioblastomas commonly occur in von Hippel-Lindau disease, and multiple surgeries may thus be necessary, a minimally invasive surgical strategy is of great importance. ⋯ Small nodular tumors accompanying a large cyst are plausible candidates for endoscopic transcranial surgery. The spatial relationship of nodules, cyst, and cerebellar parenchyma is important to determine the applicability of the present technique. Preoperative three-dimensional virtual reality simulation helps assess the feasibility of this approach.
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Persistent idiopathic facial pain (PIFP) can be refractory to conventional management approaches. Neuromodulatory procedures such as percutaneous trigeminal nerve stimulation (TNS) have been sparsely reported as potential treatment options for amelioration of debilitating refractory pain associated with PIFP. The present study investigated the use of percutaneous TNS in a series of patients with PIFP to evaluate the potential efficacy of pain relief. ⋯ The results from the present study have indicated that percutaneous stimulation of the trigeminal nerve is efficacious in the treatment of PIFP and can significantly decrease morphine equivalent use. Further longitudinal studies are required to validate our results.