World Neurosurg
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This study examined the use of noninstrumented posterolateral lumbar fusion with bone morphogenetic protein (BMP) and compared its effectiveness with that of instrumented fusion for the treatment of lumbar spinal stenosis (LSS) with spondylolisthesis in elderly patients. ⋯ Noninstrumented posterolateral lumbar fusion with rhBMP-2 in elderly patients with LSS and spondylolisthesis is a viable alternative to instrumented fusion based on clinical outcomes measured in this study.
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Significant morbidity and mortality is associated with surgical evacuation of acute subdural hematomas (ASDHs) in the elderly population. The literature remains mixed on risk factors associated with poor outcomes, specifically preoperative antithrombotic usage and postoperative seizures. ⋯ A high percentage of morbidity and mortality remains in the management of ASDHs in the elderly population; however, a significant percentage (27%) can still go on to have a favorable outcome.
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Observational Study
Normal Atlanto-Occipital Interval In Adults Of South-East Nigeria: An evaluation of the effect of age, gender and race.
Imaging of the craniocervical junction (CCJ) after trauma is crucial for injury detection and description. Of all the anatomic measurements of the CCJ, the normal value of atlanto-occipital interval (AOI) is not yet well established in adults. The aim of our study is to determine the normal values of the AOI in Nigerians aged between 21 and 60 years using multidetector computed tomography (MDCT) scan and to determine racial, age, and sex differences. ⋯ AOI values in this study were higher than previous MDCT-based values in non-African populations. The AOI decreased linearly with age and did not show any sex difference.
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Spine surgeries performed via the posterior approach have a higher infection rate. Several theories have been proposed, including poor hygienic condition of bed sheets and traumatized muscle associated with supine position promoting circulatory impairment. We investigated the influence of supine position on the rate of deep wound infection after spine surgery by the posterior approach. ⋯ Supine position was significantly correlated with higher rates of wound infection among patients who underwent spine surgery by the posterior approach. Avoidance of supine position may represent a modifiable risk factor to diminish postoperative spine infection rates.
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Primary intracranial myxomas (PIMs) are extremely rare benign tumors that arise from the skull base. The aim of this study was to characterize the radiologic manifestation of PIMs in a series of 14 cases. ⋯ Radiologic findings of PIMs include calcified foci or bone debris on computed tomography, heterogeneous hypointensity on T1WI and predominantly hyperintensity on T2WI, and honeycomb appearance on enhanced T1WI.