World Neurosurg
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Percutaneous kyphoplasty (PKP) is effective in treating osteoporotic vertebral compression fractures (OVCFs). Intervertebral bridging ossification can sometimes be detected after surgery, but studies related to its formation mechanism and its influence on outcome are few. ⋯ We deemed that spinal degeneration, mechanical instability, bone cement, and fracture pattern are all potential promoting factors for intervertebral bridging ossification. Solid bridging ossification may increase local spinal stability, but it also increases the risk of adjacent vertebral fractures.
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Progressive myoclonic epilepsy (PME) is a syndrome characterized by development of progressive myoclonus, cognitive impairment, and other neurologic deficits. Despite major advances in medical treatment of epilepsy, some PME patients remain refractory to antiepileptic drugs. This may further accentuate cognitive impairment and deteriorate functional capacity. Corpus callosotomy (CC) is used in patients with drug-resistant epilepsy who are not candidates for either excisional epilepsy surgery or neurostimulation. We report the application of the standard complete callosotomy to control medically refractory status epilepticus in a patient with PME. ⋯ Inasmuch as surgery was the last resort to control severe disabling status epilepticus, because most of the epileptogenic discharges were originating from the parieto-occipital regions and profound cognitive impairment was present, we decided to perform a complete rather than just an anterior callosotomy. CC may be considered to prevent secondary generalized seizures as the most disabling attacks in patients with certain epilepsy syndromes. Nevertheless, the impact of palliative surgical intervention on the overall disease course of patients with an underlying diffuse pathologic state remains to be determined.
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To analyze the correlation between C2 incidence (C2I) and cervical and thoracolumbar sagittal parameters and determine the effectiveness of C2I for evaluating global spinopelvic sagittal alignment. ⋯ C2I was significantly correlated with both cervical and thoracolumbar sagittal parameters, and different sagittal alignment patterns were presented regarding the amount of C2I. As the geometric summation from the pelvis to C2 vertebra, C2I would be a beneficial clue to connect correlation chains of spinal sagittal alignment.
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To evaluate the efficacy and clinical results of full endoscopic debridement and drainage (FEDD) for high-risk patients with spondylodiscitis. ⋯ FEDD may be an effective alternative to extensive open surgery in patients with infectious spondylodiscitis, especially those who are high-risk candidates for surgery (elderly patients with multiple comorbidities and patients in poor general condition).
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To study the prevalence of OTX1 and OTX2 gene expression in 60 medulloblastoma specimen samples and to establish correlations between gene expression and clinical and histopathological aspects. ⋯ The relative expression of OTX1 and OTX2 was dependent on patient age, tumor location, and histological variant. In addition, OTX2 expression might be a predictive factor for leptomeningeal metastases of medulloblastoma. The OTX pathway should be consider as an important venue for medulloblastomas development.