World Neurosurg
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Anterior cervical discectomy and fusion (ACDF) has been a widely accepted procedure for the treatment of cervical disc diseases. However, due to several reports regarding postfusion exacerbation of adjacent segments, a motion-preserving prosthesis was developed. In the present retrospective analysis, total disc replacement (TDR) using ActivC (Aesculap AG, Tuttlingen, Germany) was compared with ACDF using a stand-alone cage. ⋯ In the present study, TDR using ActivC showed successful motion preservation at the operated level and equivalent results were observed with ACDF based on clinical and radiologic results.
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We have discussed the clinical features and neuroimaging findings and investigated the correlations between the clinical characteristics and different neuroradiologic phenotypes of cerebral small vessel disease (CSVD). ⋯ The present study has provided a comprehensive analysis of the clinical correlation of characteristics and neuroradiologic phenotypes in patients with CSVD. The insights from these findings could be used to refine the management strategy for patients with CSVD.
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To study whether and when mere dorsal decompression is enough in the full endoscopic key hole technique for foraminal stenosis. ⋯ Stenosis is mainly caused by dorsal structures; mere dorsal decompression is enough. In both cases, the ventral and dorsal structures contributed to the stenosis. When there is no herniated soft fragment contributing to the stenosis, ventral decompression is not always necessary. If intraoperative exploration detects less tension formed by the ventral abnormal structures, mere dorsal decompression is enough to settle the symptoms.
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Revascularization is an important strategy when treating cerebrovascular occlusive disease and complex aneurysms. Radial artery fascial flow-through free flaps (RAFFs) are flexible grafts that provide direct and indirect revascularization. RAFFs can be especially useful for large territory revascularization and can be combined with other direct bypasses. ⋯ Postoperative angiography demonstrated patency of both direct grafts. The patient suffered small pericallosal infarcts because of retraction and perforator sacrifice at the revascularization site. At early follow-up, the patient was at his neurologic baseline, and at 1-year follow up, the patient had no additional infarcts on imaging and was living independently.
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We explored the external ventricular drain (EVD) practices in Thailand. ⋯ The results of the present study have identified QI opportunities in EVD management in Thailand. The development of an EVD-related QI process, reliable tracking of EVD infection rates, adaptation of U.S. guidelines to create standardized EVD protocols, and examination of the association between EVD practices and clinical outcomes in low-to middle-income countries are urgently needed.