World Neurosurg
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Review Meta Analysis
The Effects of Surgery and Adjuvant Therapy on Survival Outcomes in Clear Cell Ependymomas: A Systematic Review and Meta-Analysis of Individual Patient Data.
The survival outcomes of clear cell ependymomas are poorly understood. This study clarifies the role of surgery and adjuvant therapy when this morphologically distinct tumor is encountered. ⋯ Clear cell ependymomas are particularly aggressive in those aged >50 years. Gross total resection remains the cornerstone of management. Postoperative adjuvant therapy is likely to be of survival benefit only after subtotal resection.
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Review Meta Analysis
Clinical Results and Complications of Endoscopic Lumbar Interbody Fusion for Lumbar Degenerative Disease: A Meta-Analysis.
Although endoscopic transforaminal lumbar interbody fusion (TLIF) may combine the advantages of minimally invasive fusion and endoscopic spine surgery, little evidence exists on endoscopic TLIF. This meta-analysis investigated the clinical results of endoscopic TLIF. ⋯ The early clinical results of endoscopic TLIF with percutaneous pedicle screw fixation are favorable. However, long-term outcomes should be investigated and randomized controlled trials should be conducted.
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Review Historical Article
Technologic Evolution of Navigation and Robotics in Spine Surgery: A Historical Perspective.
Spine surgery is continuously evolving. The synergy between medical imaging and advances in computation has allowed for stereotactic neuronavigation and its integration with robotic technology to assist in spine surgery. The discovery of x-rays in 1895, the development of image intensifiers in 1940, and then advancements in computational science and integration have allowed for the development of computed tomography. ⋯ Growing at a rapid rate, the second-generation spinal robotics have overcome preliminary limitations and errors. However, comparatively, robotics in spine surgery remains in its infancy. By leveraging technologic advancements in medical imaging, computation, and stereotactic navigation, robotics in spine surgery will continue to mature and expand in utility.
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Review Case Reports
Intracranial Capillary Hemangiomas: A Peripartum Presentation and Review of the Literature.
Intracranial capillary hemangiomas (ICHs) are rare vascular tumors composed of a bed of many narrow thin-walled vessels. Within the confines of the skull, these tumors can lead to serious neurologic deficits including cranial nerve dysfunction, mood/personality disturbances, and signs of intracranial mass effect. ⋯ We conclude that, in experienced hands, the endoscopic endonasal approach can be used to access the cavernous sinus for complete resection of ICHs of the cavernous sinus. We also suggest that further attention be paid to such cases in pregnant and peripartum women as these tumors may progress more quickly in this subpopulation.
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The objective of this review was to understand the clinical utilization, utility, and variability in the usage of adjunctive hyperbaric oxygen therapy (HBOT). Surgical site infection is associated with high morbidity and mortality, increased health care expenditure, and decreased quality of life. With the increasing prevalence of adult spinal deformity and spinal fusion surgery, it is imperative to understand the potential benefits of adjunctive treatments. ⋯ The most common treatment protocol consists of 90-minute sessions of 100% Fio2 at 2-3 atmosphere absolute with a mean of 35.3 ± 11.6 sessions for 5.2 ± 1.4 weeks. Adjunctive HBOT should be considered in select high-risk patients. Further improvements in diagnosis and categorization of spinal infections are necessary and will indelibly aid the decision making for the initiation of HBOT.