World Neurosurg
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Observational Study
Effect of Disc Height and Degree of Distraction on Heterotopic Ossification After Cervical Disc Replacement.
Heterotopic ossification (HO) is a potential and severe complication of cervical disc replacement (CDR). However, the underlying mechanism of CDR and its association with preoperative disc height loss (DHL) and postoperative degree of distraction remain unclear. We hypothesized that DHL and postoperative degree of distraction could predict HO after CDR. ⋯ DHL and ADD are associated with the development of HO after CDR. The cutoff value of DHL may narrow the criteria for CDR with the aim of reducing HO formation. The combined parameter may help surgeons to select the most suitable implant height to reduce the prevalence of HO.
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Meningiomas are mostly benign intradural tumors. Concerning the spine, some of them can extend outside the canal or even develop extradurally but their primary attach is often located in the vertebral canal. Here we present the case of an exceptional purely intraforaminal meningioma mimicking a neurogenic tumor, involving the vertebral artery and presenting with cervicobrachial neuralgia and slight motor deficit.
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Spine osteoblastomas (OBs) are relatively rare. In contrast to osteoid osteoma, radiologic and clinical manifestations of OB can be varied and atypical. Typical radiographic features in spinal OB include peritumoral bone sclerosis, bone marrow edema, and soft tissue edema. Atypical radiographic features include lesions involving ≥3 segments, lesions with extensive (≥3 segments) bone sclerosis, excessive edema (≥3 segments) of soft tissue and bone marrow, no intralesional calcification, and location in the vertebral body only. The aim of this study was to identify typical and atypical features of OB. ⋯ Our results show that >30% of spinal OB cases might have atypical radiographic features. In cases with atypical radiographic features, computed tomography-guided biopsies are recommended.
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As previous studies reported, the balloon guide catheter is useful for identifying the fistula point during diagnosis of direct carotid-cavernous sinus fistula (d-CCF). We demonstrate an additional advantage of the balloon guide catheter during intraarterial endovascular treatment of d-CCF. ⋯ Using a balloon guiding catheter can reduce internal carotid artery flow near the fistula point at the cavernous segment of the internal carotid artery. As a result, better identification of the fistula point can be made, which allows easier placement of the microcatheter into the fistula point and more stable coil deployment.
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Case Reports
Transpedicular Approach for Ventral Epidural Abscess Evacuation in the Cervical Spine - A Technical Note.
Spinal epidural abscess may require prompt surgical intervention. Ventral cervical abscesses pose a particular challenge regarding the approach for surgical evacuation. The aim of this article was to describe the technical nuances of a posterior transpedicular cervical approach for evacuation of a ventral epidural abscess. ⋯ Access to the ventral epidural space is feasible using a transpedicular approach in the cervical spine for evacuation of an epidural abscess.