World Neurosurg
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Pedicle screw instrumentation is widely used for spinal deformity correction and fusion in adolescents for idiopathic scoliosis. The goal is to achieve and sustain good alignment in all 3 planes. We compared 2 different cobalt-chromium (CoCr) rod designs with different stiffnesses with regard to the restoration of coronal and sagittal balance in adolescents operated on for idiopathic scoliosis. ⋯ Both circular and sagittal reinforced 6.0-mm CoCr rods provide adequate coronal correction for adolescents with idiopathic scoliosis. The use of sagittal reinforced rods provided better thoracic kyphosis restoration and a lower risk for postoperative hypokyphosis.
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Pragmatic Clinical Trial
Carotid Endarterectomy and Carotid Artery Stenting in a Predominantly Symptomatic Real-World Patient Population.
Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are well-established treatments that have been shown to decrease stroke recurrence in patients with underlying carotid artery disease. We assessed clinical outcome, safety, and restenosis rates for patients who underwent standardized CEA or CAS at our tertiary care center using patient selection criteria based on available scientific evidence. ⋯ Our findings in a real-world predominantly symptomatic cohort demonstrate that favorable patient outcomes and low restenosis and complication rates can be achieved with both CEA and CAS by the utilization of a consistent institutional patient selection and treatment process.
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To evaluate effects of holmium:yttrium-aluminum-garnet (Ho:YAG) laser ablation on postoperative low back pain and improving functional status in patients with lumbar disc herniation undergoing transforaminal endoscopic lumbar discectomy (TELD). ⋯ Performing Ho:YAG laser ablation with TELD prolonged low back pain relief and improved functional outcome during 2-year follow-up compared with TELD alone in patients with symptomatic lumbar disc herniation.
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Subependymomas are rare in the spinal cord. They are typically expansile, intramedullary spinal cord masses, eccentrically located with minimal gadolinium enhancement. ⋯ This is the first case, to our knowledge, where imaging revealed a mass appearing to be completely extramedullary with a primary exophytic component. Therefore, subependymomas should remain on the differential for masses in the spinal cord that appear extramedullary and exophytic.
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Case Reports
Percutaneous Transverse Sinus Cannulation for Dural Arteriovenous Fistula Coiling: Operative Video.
This is the case of an 84-year old woman, found to have a symptomatic transverse sinus dural arteriovenous fistula. The transverse sinus was isolated from all venous circulation and its arterial feeders stemmed from the occipital artery, precluding both arterial and venous access for effective obliteration of the fistula. Therefore the patient underwent a combined open surgical/endovascular approach, where the sinus was percutaneously cannulated through a single burr hole, allowing access for effective coiling of the fistula. In this video, we present the rationale, feasibility, and technical implications for this procedure.1.