World Neurosurg
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We document the results of a protocol to reduce the incidence of cerebrospinal fluid (CSF) leak and other wound complications in patients undergoing tethered cord surgery (TCS). ⋯ Postoperative prone nursing with Trendelenburg position minimizes the incidence of CSF leak and other wound complications.
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An epidural nerve block injection is the most common modality of treatment for control of low backache associated with radiating pain. Epidural catheter injections are also widely used by pain physicians to control cancer pain. Epidural catheters could be associated with procedure-related complications, such as epidural hematoma, epidural abscess, and post-dural puncture headache, and rare complications, such as shearing or breakage of the catheter tip. In this report, we describe the full-endoscopic removal of a sheared epidural catheter fragment. ⋯ Interlaminar full-endoscopic procedure could be used for the removal of the retained epidural catheter as a practical option.
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Case Reports
Spinal cοrd compression secondary to a brοwn tumοr as a first manifestation of primary hyperparathyroidism.
Brown tumors (BTs) represent the typical nonmalignant lesions of hyperparathyroidism. Mandibles, ribs, and large bones are the most usual localization of BT. The diagnosis of these tumors requires biological and radiologic assessments. Their treatment is essentially based on parathyroidectomy. ⋯ The brown tumor, when localized at the level of the spine, can be life-threatening and must be managed as soon as possible.
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To determine whether Thoracolumbar Injury Classification and Severity Score (TLICS) and the Thoracolumbar AOSpine Injury Score (TL AOSIS) have any superiority to each other in terms of the reliability of their recommendations for guiding the treatment strategy of thoracolumbar spine injuries. ⋯ Recommendations of TL AOSIS might be more reliable than those of TLICS particularly for guiding the surgical management of complete burst fractures.
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Case Reports
Postoperative CSF Leak After Lumbar Total Disc Replacement (TDR): A Diagnostic and Management Challenge.
Lumbar total disc replacement is increasingly becoming a more common treatment for discogenic low back pain refractory to conservative measures. Nevertheless, several complications have been reported, including, among others, wound infection, vascular injury, retrograde ejaculation, postsympathectomy syndrome, ileus, and cerebrospinal fluid (CSF) leak. Although CSF leakage is rare, we discuss a case of CSF leakage and the diagnosis and management of CSF leakage after lumbar total disc replacement. ⋯ Our patient ultimately required device removal, direct repair, and replacement with a different prosthesis to treat his CSF leak.