World Neurosurg
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Meningeal melanocytoma is a rare benign lesion found in the central nervous system. Preoperative diagnosis of meningeal melanocytoma is often a diagnostic challenge, as the clinical and neurologic features are often nonspecific. Various characteristics, including the natural course of this tumor, remain poorly understood. We report a case of a rapidly growing dumbbell-shaped melanocytoma compressing the spinal cord that manifested 2 years after a tumor was identified at the right C2-C3 foramen. ⋯ It is important to include meningeal melanocytoma in the differential diagnosis of dumbbell tumors, as meningeal melanocytomas may show rapid progression.
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Although research shows that the ossified masses of ossification of the posterior longitudinal ligament (OPLL) continue to grow postoperatively, information regarding thoracic OPLL (T-OPLL) is lacking. To date, no study has investigated the progression of T-OPLL within each motion segment. The purpose of this study was to analyze the progression of T-OPLL in each motion segment using a 3-dimensional measurement and evaluate whether the type of T-OPLL and surgical methods affect its progression postoperatively. ⋯ The mean AGRO does not decrease even after stabilization and CD. Type 2 intervertebral space was a risk factor for T-OPLL progression. Cases of type 2 without CD need close follow-up.
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Polycythemia vera (PV) is a chronic myeloproliferative neoplasm that is associated with increased risk for venous and arterial thromboembolism. The aim of this study was to evaluate outcomes following elective posterior lumbar fusion (PLF) and/or posterior interbody fusion (PLIF) among patients with PV. ⋯ Patients with PV undergoing elective PLF and/or PLIF have a significantly increased risk for pulmonary embolism, lower extremity deep vein thrombosis, and surgical site infection.
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To measure the incidence and severity of cement extravasation in adult patients undergoing prophylactic vertebroplasty as part of a spinal reconstruction procedure. ⋯ Although no patients in this study experienced known long-term consequences of prophylactic vertebroplasty, 26.5% of patients had cement extravasation that threatened end-organs or neural elements. These results prompted us to change our practice from cementing upper thoracic VBs to using hooks instead. Cement injection is associated with serious risks and should be performed selectively. Larger prospective studies are needed to verify these results.
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To evaluate the feasibility, success rate, and safety of endovascular revascularization of nonacute symptomatic proximal extracranial vertebral artery occlusion (PEVAO). ⋯ Endovascular revascularization of nonacute symptomatic PEVAO is feasible and associated with a high rate of procedural success and low rate of procedural complications. A large, multicenter, randomized study is warranted to confirm the findings.