World Neurosurg
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Vertebral hemangiomas (VHs) are the most common incidental lesions of vertebral body, but they are very challenging to treat if they become symptomatic. Several treatments have been proposed but none was superior to others. The aim of this study is to analyze blood loss and long-term clinical and neurological results of aggressive VHs treated with arterial embolization the day before operation, followed by vertebroplasty, posterior decompression, and short segment stabilization. ⋯ Polyvinyl alcohol microparticles embolization, short segment fixation, and vertebroplasty is an effective treatment option for aggressive VHs, with a fast surgical time, poor blood loss, and improvement of preoperative clinical and neurological outcomes.
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Rathke's cleft cysts (RCCs) may have various anatomic, clinical, and radiologic characteristics, which may be related to their differences in texture or consistency. The purpose of the study was to investigate RCCs based on consistency. ⋯ The proposed novel consistency classification of RCCs will provide a practical tool for more accurately estimating the nature of the pathology, because each type has its own specific characteristics. Furthermore, the new classification of RCCs may aid in planning a consistency-specific surgery.
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To establish microscope-based augmented reality (AR) support for degenerative spine surgery. ⋯ Reliable microscope-based AR support is possible because of automatic registration based on intraoperative imaging. Application of AR in degenerative spine surgery has a big potential; it might be especially helpful in complex anatomical situations and resident education.
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Cranioplasty is a technically simple procedure intended to repair defects of the skull to provide protection after craniectomy, improve functional outcomes, and restore cosmesis. Several materials have been used for the restoration of skull defects, including autologous bone grafts (AGs), polymethyl methacrylate (PMMA) flaps, and titanium mesh (T-mesh). However, the long-term results of cranioplasty after use of these materials are controversial. ⋯ Complications after cranioplasty are high, and the various types of cranioplasty materials used are associated with different complications. Surgeons need to be aware of these potential complications and should choose the appropriate material for each individual patient.
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Case Reports
An unusual cause of trigeminal neuralgia: The first report of intracranial migration of a spinal cord stimulator.
Spinal cord stimulation has been shown to be an effective treatment for some patients diagnosed with chronic pain and failed back syndrome. However, lead migration from the implantation site is a potential complication that may reduce treatment efficacy, produce unintended symptoms, and require invasive and costly surgical replacement or removal. ⋯ Although spinal cord stimulation has demonstrated effectiveness as a treatment for chronic pain, care must be taken to ensure that the spinal cord stimulator leads are properly placed within the epidural space and are firmly anchored to avoid migration. Intracranial migration of a spinal cord stimulator lead poses significant risks for injury to adjacent cortical structures and may produce pain syndromes including trigeminal neuralgia.