World Neurosurg
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Review Case Reports
Minimally Invasive Tubular Approach for Occipital Condylar Biopsy and Resection: Case Report and Review of Literature.
Patients with isolated occipital condyle lesions concerning for metastases rarely undergo surgical biopsies and are more commonly treated with empirical radiation with or without chemotherapy. This is likely related to the morbidity associated with open condylar approaches and the importance of surrounding structures. We present a minimally invasive technique to approach the occipital condyle using a tubular dilating retractor system. ⋯ This report, to our knowledge, presents the first case of a minimally invasive tubular retractor system-based approach for biopsy and resection of an occipital condylar metastasis causing occipital condyle syndrome. This approach allows for tissue diagnosis to precisely dictate medical management and minimizes the morbidity associated with traditional open surgical approaches.
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All interbody fusions are associated with a risk of subsidence. In the case of lateral lumbar interbody fusion (LLIF), an interbody device that spans the apophyseal rings reduces subsidence. Small interbody device size, aggressive end plate preparation, and poor bone quality are contributors to subsidence. The goal of this study was to analyze the perioperative morbidity, particularly the timing of subsidence (intraoperative vs. postoperative), associated with transpsoas LLIF. ⋯ As LLIF becomes more common, it is important to better understand common complications, such as subsidence, and the specific rates at which they occur. A unique finding of exclusive intraoperative subsidence was observed. The use of cage size to obtain segmental lordotic correction and indirect decompression must be weighed against the potential risk of subsidence.
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Surgical scalpel broken is rarely reported in posterior lumbar discectomy or fusion surgeries, but when it happens and even the broken part is deeply located in the disk space, there is no guideline to remove it during the initial surgery. ⋯ Arthroscopic retrieval of a broken scalpel deeply located in the intradiskal space is recommended as an alternative method when conventional effort is unable to remove it, especially when the broken blade migrates anteriorly, which may provoke catastrophic consequences.
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Review
Review of the Highlights from the First Annual Global Neurosurgery 2019: A Practical Symposium.
This paper provides a detailed report of Global Neurosurgery 2019: A Practical Symposium held January 18-19, 2019, at Weill Cornell Medical College, New York, New York, USA. The meeting convened an international faculty and audience, leaders in the world of global neurosurgery (GNS), and junior faculty and residents beginning their contribution to the field. ⋯ The goal of the symposium was to present the state of the union of GNS initiatives worldwide, to use this forum as a means to centralize resources and converge parallel efforts, and to identify the largest areas of need and successful means of advancing training and care in these areas. The meeting also served as a conduit for the presentation of funding and training opportunities for junior faculty and trainees looking for avenues to gain support and mentorship in pursuing academic and clinical endeavors globally.
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The increasing competitiveness of the neurosurgical residency match has made it progressively difficult for foreign medical graduates (FMGs) to match in neurosurgery. We compared FMG to U.S. medical graduate (USMG) match rates in neurosurgery and identified factors associated with match outcomes for FMGs in neurosurgery. ⋯ Although FMGs have lower match rates into U.S. neurosurgery residencies than USMGs, several demographic, professional, and academic factors could increase the chances of successful FMG neurosurgical match.