World Neurosurg
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Minimally invasive endoscopic spine surgery is useful for the treatment of various spinal conditions. Although surgery-related complications such as dural injury, exiting nerve root injury, incomplete decompression, and hematoma have been reported, there are few reports of late complications after endoscopic surgery. ⋯ The surgeon should carefully review risk factors such as isthmic type spondylolisthesis before planning spine surgery and minimize facet joint damage during endoscopic decompression.
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The aim of this study was to evaluate the radiologic outcomes and complication analysis of posterior vertebral column resection (PVCR) performed on previously operated patients with severe kyphoscoliosis (SK). ⋯ PVCR provides effective correction in patients with SK. However, expected surgical correction of a deformity may not always be achieved because of intraoperative neuromonitoring changes. Furthermore, PVCR can lead to a large number of major complications in patients with SK who have undergone previous spinal surgery.
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The objective of this study was to compare transcortical and posterior interhemispheric approaches to the atrium using a combined approach of white matter fiber dissections and magnetic resonance (MR) tractography. ⋯ A combined approach of cadaveric white matter fiber dissections and MR tractography were used to describe the main white matter tracts related to the posterior interhemispheric approach and the transcortical approach, providing an in-depth understanding of the three-dimensional anatomy of white matter fibers and the atrium. In the present study, among approaches examined, the posterior interhemispheric parasplenial transprecuneus approach placed fewer eloquent tracts at risk; however, traversing the sledge runner and the forceps major is unavoidable by this approach.
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Review Meta Analysis Comparative Study
Reduction versus In-situ fusion for Adult High-Grade Spondylolisthesis: A Systematic Review and Meta-analysis.
Surgical management of high-grade spondylolisthesis is controversial. Both reduction and in situ fusion are available options, but it remains unclear which approach provides better outcomes. We conducted a systematic review and meta-analysis of studies reporting outcomes following reduction or in situ fusion for adult high-grade spondylolisthesis. ⋯ In management of adult high-grade spondylolisthesis, both approaches appeared to be safe and effective. Reduction appeared to offer better disability relief and spinopelvic parameter correction than in situ fusion.
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Caudal regression syndrome (CRS) represents a spectrum of clinical phenotypes with varying degrees of malformation of the lower body with involvement of structures deriving from all 3 layers of the trilaminar embryo. We review areas of active investigation in the diagnosis, etiology, epidemiology, and treatment of the disease with a focus on underlying genetics. CRS pathobiology is complex and multifactorial with a significant contribution from environmental factors as evidenced in twin studies. ⋯ CRS represents a spectrum of caudal developmental abnormalities with treatment options limited to mild and moderate expressions of disease. Continued research is necessary to further clarify mechanisms of disease pathobiology and complex polygenetic and environmental interaction. Despite this, progress has been made in identifying genetic targets and downstream effectors contributing to preclinical and clinical progression.