World Neurosurg
-
Lumbar puncture is a common procedure that can be safely performed in most patients. Certain populations may have increased risk for complications following lumbar puncture, but the significance of basilar invagination is often underappreciated. ⋯ Basilar invagination is a risk factor for devastating neurologic complications following lumbar puncture. Awareness of this complication and prompt recognition of its occurrence may prevent future morbidity of lumbar puncture in patients with basilar invagination.
-
Most patients with spinal tumors suffer no symptoms or have mild symptoms, but about 14% of patients have refractory pain caused by mechanical instability, or symptoms of spinal cord damage caused by epidural spinal cord compression. The Spinal Instability Neoplastic Score (SINS) and Kostuik classification are commonly used to evaluate spinal stability, and help to make a more detailed operation plan. The objectives of this study are to evaluate the reliability and reproducibility of the SINS and Kostuik classification, and to explore their clinical application value. ⋯ Compared with the Kostuik classification system, the SINS scoring system has better interobserver reliability and intraobserver reproducibility, which can be widely used in clinical practice and has great significance in the decision-making of spinal tumor treatment. Although the Kostuik classification system is often used in clinical practice, it shows inferior reliability and reproducibility in our study.
-
Comparative Study
Midline and paramedian supracerebellar infratentorial approach to the pineal region: a comparative clinical study in 112 patients.
The midline supracerebellar infratentorial (SCIT) approach and its paramedian development are commonly used for dealing with pineal lesions. Comparative clinical studies are lacking, however. We aim to establish the better performance of the paramedian SCIT approach in terms of clinical safety in surgically treated pineal cysts and pineal region tumors. Procedural functionality and effectiveness have been also analyzed. ⋯ The SCIT approach represents a safer and more functional approach for the removal of cysts and tumors of the pineal region than the classic midline approach, while maintaining the same effectiveness.