World Neurosurg
-
The Arab world is lagging behind in the world of publications and research, especially in the biomedical-related field. This is a bibliometric analysis that aims to assess the neurosurgical research productivity across different Arab countries. ⋯ The results reached by this study reflect an undoubtable need for more research on neurosurgery by Arab countries. This goes back to the different obstacles facing Arab countries every day, affecting the economic, educational, and health care systems.
-
Case Reports
Transcondylar Fossa Approach for Resection of Anterolateral Foramen Magnum Meningioma: 2D Operative Video.
Among the posterolateral corridors to the ventral foramen magnum (FM), the transcondylar fossa (supracondylar transjugular tubercle) approach (TCFA) is indicated for lesions lying anteriorly to the dentate ligament and above the jugular foramen and hypoglossal canal.1-13 It involves the drilling of the condylar fossa, namely the exocranial surface of the jugular tubercle. Despite the anatomic variability of the condyle and posterior condylar emissary vein,14,15 they are important landmarks for the TCFA. The extradural jugular tuberculectomy has no risk of iatrogenic mechanical instability compared with the transcondylar approach. ⋯ Postoperative magnetic resonance imaging confirmed complete resection of the tumor, and the patient was discharged neurologically intact on the third postoperative day. TCFA is a valuable technical option for selected anterolateral FM meningiomas. The perfect knowledge and intraoperative use of specific anatomic landmarks are critical to safely perform the TCFA while maximizing the exposure of the surgical target and decreasing the risk of postoperative mechanical instability of the craniovertebral junction.
-
Von Hippel-Lindau (VHL) disease is a multisystem disease cause by germline mutations of the VHL tumor suppressor gene. Hemangioblastomas are the most common manifestation of VHL disease and can occur in the central nervous system in up to 90% of these patients. By contrast, we found only one true case of a peripheral nervous system (PNS) hemangioblastoma in the setting of VHL. We explore the possible reasons behind the lack of PNS hemangioblastomas in VHL disease.
-
Pelvic fixation is becoming an increasingly important caudal anchor point for long lumbar constructs, high-grade spondylolisthesis, fixation of sacral fractures, and support for 3-column osteotomies, by adding lumbosacral fixation anterior to the McCord pivot point. Iliac bolts were once common but have become less favorable due to screw head irritation and complications associated with connecting rods. S2-alar-iliac (S2AI) screws have been shown to achieve equivalent anchoring strength of constructs to the pelvis, while being lower profile and in line with the lumbar instrumentation. ⋯ Video 1 shows the placement of an S2AI screw and triangular titanium implant for pelvic fixation. The patient is a 68-year-old woman who presented with flat back syndrome, spinal stenosis, degenerative spondylolisthesis, pseudarthrosis of previously instrumented levels, and bilateral sacroiliitis. She underwent posterior instrumentation and fusion of L1 to S1 with pelvic fixation, open bilateral sacroiliac joint fusion, and multilevel Smith-Peterson osteotomies and transforaminal lumbar interbody fusions.
-
An anterior approach is applied to establish the majority of rabbit intervertebral disc degeneration (IDD) models in current studies. However, for research on disc repair via biomaterial implantation and tissue engineering, this traditional model establishment method has many shortcomings, such as the risk of general anesthesia, unnecessary tissue damage, and the influence of scar formation on the visual field for secondary implantation surgery. The aim of this study was to report a modified method of establishing an IDD model by applying percutaneous posterolateral puncturing for rabbit lumbar disc surgery under local anesthesia. ⋯ Our results show that percutaneous posterolateral AFP/NPA of rabbit lumbar discs under local anesthesia is a minimally invasive, safe and reproducible method of establishing an IDD model. The posterolateral surgical approach is especially suitable for disc regeneration studies that require secondary biomaterial implantation via an anterior approach after the IDD model is established.