World Neurosurg
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To evaluate the differences in surgical outcomes of patients with cervical spondylotic myelopathy with and without congenital cervical spinal stenosis (CCSS). ⋯ Postoperatively, compared with non-CCSS patients, patients with congenital cervical stenosis reported equal quality of life for all markers. Our findings suggest that in patients with CCSS and relatively mild symptoms of myelopathy, equal consideration should be given for surgical intervention. The findings of this study warrant further large-scale, multi-institutional investigation to further understand the generalizability of these surgical outcome results.
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The robotic surgery is an advanced modern minimally invasive technology, widely used in urologic oncology, and it has become useful in particular conditions. Over time, different surgical specialties made use of the robotic properties to minimize complications for high-risk procedures. A combined 1-staged robot-assisted multidisciplinary surgery with intraoperative neurophysiological monitoring can be a safe procedure to remove a sacral chordoma with low morbidity rates. ⋯ This combined technique represents a promising treatment option in selected cases. The robotic technology combined with the experience of highly qualified staff can improve the surgical result by minimizing complications. However, longer follow-up is necessary to confirm the long-term effects in terms of recurrence and survival.
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This study compared the surgical outcomes of atlantoaxial fusion with transarticular screws (TASs) and C1 lateral mass-C2 screws (screw-rod constructs [SRCs]) using the intraoperative O-arm navigation system (O-arm). ⋯ O-arm-assisted TAS fixation had less intraoperative blood loss, shorter operative time, and fewer screw insertion complications than O-arm-assisted SRC fixation. O-arm-assisted TAS fixation is preferable for atlantoaxial fusion in patients without hVA.
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Case Reports
Giant intracranial extra-axial parietal-occipital cavernous hemangioma in an adolescent: case report.
Extraaxial cavernous hemangiomas (EACHs) are an extremely rare form of cerebral vascular malformations, occurring infrequently in children and rarely exceeding 6.0 cm in diameter (labeled as "giant"). Our case study highlights the radiographic, diagnostic, and interventional uncertainties in the management of giant EACHs in a pediatric population. ⋯ EACHs are difficult to characterize radiographically and are often mistaken to be meningiomas before resection and pathologic confirmation. Therefore cavernous hemangiomas should be considered in the differential diagnosis of pediatric extraaxial masses. Additionally, preoperative hemorrhage control efforts should be pursued to reduce adverse outcomes stemming from resection of vascular malformations such as EACHs.
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Although endoscopic approaches are widely used for resection of colloid cysts because of the lower invasiveness, removal of the recurrent colloid cyst is still challenging. Total removal is sometimes difficult to achieve with single-port endoscopy because of the restricted access and working space. To compensate for these limitations, the dual endoscope technique via the bilateral transforaminal approach was chosen. ⋯ The dual endoscope technique via the bilateral transforaminal approach can achieve better surgical outcome by obtaining direct visualization of the cyst attachment. Although the indication should be limited, this approach can be considered especially for patients with recurrent lesions involving possible adhesion to vital structures.