World Neurosurg
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The Latin American Federation of Neurosurgical Societies (FLANC) is a nongovernmental, nonprofit civil association, founded to promote neurosurgery in the Latin American countries. The American College of Surgeons and American Association of Neurological Surgeons has recommended a ratio of 1 neurosurgeon/100,000 inhabitants. We aimed to estimate the neurosurgical workforce of the FLANC in 2020. ⋯ The FLANC has significant disparities in neurosurgical workforce ratios among the member countries. Central American countries probably have the greatest needs. Gender equity should also be improved among the training institutions. We encourage readers to develop future research into the local geographical distribution of neurosurgeons among the countries to better understand their needs and barriers to providing high-quality standards of care.
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Anatomical barriers (e.g., pedicles, narrow foramina) can hinder direct access to, and removal of, disc fragments that have migrated far downward. Using transforaminal full-endoscopic lumbar discectomy (FELD), we devised a modified technique, the suprapedicular retrocorporeal approach, for herniations in which the disc has migrated to the axilla of the traversing nerve roots. In the present report, we have described our preliminary results. ⋯ The suprapedicular retrocorporeal technique is a feasible and effective surgical option in transforaminal FELD for the treatment of herniation in which the disc has migrated to the axilla of the traversing nerve roots.
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Absence of the internal carotid artery (ICA) is a rare congenital anomaly. Six pathways of alternative collateral circulation have been described. ⋯ Recognition of this vascular anatomic variant is important to understand thromboembolic disease in these patients and the increased risks of surgery, such as transsphenoidal pituitary surgery. Also, it highlights the importance of imaging these patients to detect and monitor associated cerebral aneurysms.
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A detailed understanding of the anatomy of Sylvian veins preoperatively is needed for venous-preserving Sylvian dissection. Better visualization of the venous architecture will facilitate surgical strategies for Sylvian dissection. This study evaluated and compared the image quality of the Sylvian veins and their tributaries using high-resolution cone-beam computed tomography angiography (CBCT-A) and three-dimensional computed tomography angiography (3D-CTA). ⋯ CBCT-A was superior to 3D-CTA for visualizing the Sylvian veins and their tributaries. CBCT-A will provide important information on the anatomy of the Sylvian veins preoperatively.