World Neurosurg
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Management of adolescent idiopathic scoliosis (AIS) in neurosurgery residency training may have a significant impact on resident experience, even though few trainees are likely to pursue careers in the field of AIS. The impact of this exposure on resident knowledge in adult spinal disease management is the subject of our retrospective analysis. ⋯ Treatment of AIS by surgeons with specialized training can be effective and safe. Resident exposure to these patients enhances their understanding of spinal biomechanics and deformity correction, which is applicable to treating AIS and adult spinal deformity.
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Paraganglioma in cavernous sinus is a rare entity often misdiagnosed as meningioma or schwannoma on radiology. The embryological origin, from cells of neural crest, does not explain the location per se. Because of its highly vascular nature and close proximity to the carotid artery, surgical excision is a challenge. We herein report the first case of cavernous sinus paraganglioma, without the characteristic "salt and pepper appearance," excised near completely by the subtemporal approach. ⋯ Paraganglioma must be considered in the differential diagnosis of parasellar tumors, even when secretory symptoms are absent. The radiologic findings are obscure, and it is difficult to differentiate it from more common tumors of this region such as meningioma, schwannoma, and pituitary adenoma. Surgical excision followed by radiotherapy is the mainstay of management.
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Carotid endarterectomy, especially eversion carotid endarterectomy (ECEA), is a standard treatment of carotid artery stenosis but continues to have deficiencies. We have described a modified ECEA technique that focuses on the quality of life (QoL), called Q-modified eversion carotid endarterectomy (QCEA). The modifications mainly include the skin incision, surgical approach, and arterial anastomosis. The purpose of the present study was to evaluate the clinical efficacy of QCEA and the QoL of patients after QCEA. ⋯ Our results suggest that QCEA can reduce incision numbness, facial edema, and scar length, thereby improving the QoL of patients.
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Case Reports
Ossification of the Ligamentum Flavum at the Thoracic and Lumbar Region in an Achondroplastic Patient: A Case report.
Achondroplasia, a genetic disorder of bone growth, produces specific clinical features of the extremities and spine. Spinal stenosis, seen in patients with achondroplasia, is a congenital disorder related to premature fusion of the pedicles to the lamina. It can be caused by ossification of the ligamentum flavum, which is rare in patients with achondroplasia. ⋯ Treatment of the deformity and the rare condition of ligamentum flavum in a patient with achondroplasia resulted in improved neurologic status and symptoms. To our knowledge, this is the first case report including treatment for both the deformity and thoracic and lumbar ossified ligamentum flavum lesion in a patient with achondroplasia.
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Ependymoma is the most frequent spinal tumor in adults but it is rather uncommon in children. The aim of the present study was to retrospectively summarize the clinical and therapeutic experience in the treatment of pediatric spinal ependymomas in France. ⋯ Our data suggest that initial adjuvant RT might improve PFS after GTR but will not prevent relapse in patients with STR. Further studies are needed to define more specific treatments for the latter group.