World Neurosurg
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Osteogenesis imperfecta (OI) is characterized by bone fragility and is often accompanied by spinal deformity. Surgical treatment for early-onset scoliosis in patients with OI is hazardous and difficult due to the bone fragility and rigidity of the deformity. A case of early-onset scoliosis with OI that was treated using growing-rod surgery is presented. ⋯ This case demonstrates the successful use of the growing rod for early-onset scoliosis in patients with OI. The treatment strategy, which included pedicle screw insertion as anchors to create the foundations in advance, sublaminar tape, intraoperative traction, and preoperative bisphosphonate administration, might have led to the good outcome.
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The reach to expose the peritrigonal/atrial territories poses special challenges. The highly functional overlying cortices and white matter tracts, such as the optic radiations lateral to the ventricle, postcentral gyrus laterally and more superficially, and the thalamus anteroinferiorly, constrain the surgical corridors to the atrium. ⋯ In summary, the PITTA is founded on the concept of using a contralateral operative trajectory to augment a more tangential working angle to the more difficult-to-reach lateral target through a midline route. The PITTA emphasizes the importance of operative working angles (versus necessary operative space) through less disruptive exposures as a more viable parameter for achieving desirable results.
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The popularity of the ventriculoatrial shunt as a means for cerebrospinal fluid diversion was temporally limited, overcome by the success of the peritoneum as a site for distal drainage. Nevertheless, it remains an important tool for patients for whom ventriculoperitoneal shunting is not an option. ⋯ Recognizing the potential for atrial thrombus formation and using a team approach can help avoid a poor outcome.
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Neuromuscular electrical stimulation (NMES) has emerged as a viable alternative for venous thromboembolism prophylaxis. Electrical stimulation of the peroneal nerve using NMES may potentially interfere with somatosensory-evoked potential (SSEP) acquisition. This feasibility study evaluates a NMES device and its effect on SSEP acquisition as an initial step in a randomized clinical trial to assess NMES for intraoperative venous thromboembolism prophylaxis. ⋯ As a preliminary step to testing NMES intraoperatively for venous thromboembolism prophylaxis, interference with SSEP acquisition was investigated in the outpatient laboratory setting. Within a small sample of healthy volunteers, no significant changes were seen in P37 cortical latencies to suggest interference between the NMES device and SSEP waveforms.
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Patients, including patients with chronic pain conditions, increasingly turn to the Internet for health information. To facilitate comprehension, this information ought to be written at or below the 8th grade reading level, which is the average American adult's reading level. This study measured the reading level of popular online sources for trigeminal neuralgia. ⋯ The writing of popular online education materials for trigeminal neuralgia is likely too complex for the average American adult to comprehend. This material should be revised to be readable at or below the 8th grade reading level. A variety of easily readable online education materials for trigeminal neuralgia can assist patients in understanding their illness and potentially improve patient decision making and outcomes.