World Neurosurg
-
Treatment for circumferential vertebral artery dissecting aneurysms (VADAs) remains challenging. Stent-assisted coil embolization is the most common treatment technique. However, this approach presents high rates of incomplete occlusion and recurrence, often requiring the addition of second or third stents for reconstruction. A flow diverter may achieve favorable clinical outcomes, but it cannot result in immediate aneurysm occlusion and is limited by strict antiplatelets and expensive price. We report excellent results of a 1-stage modified balloon-in-stent technique for circumferential VADA. ⋯ We demonstrated an innovative modified BIS technique to treat circumferential VADA by using a coiling basket followed by the deployment of a self-expandable stent and in-stent Scepter balloon angioplasty. This strategy is safe, feasible, and cost effective and was not associated with recurrence or complications over at least 2 years of follow-up.
-
Proximal junctional kyphosis (PJK) is a common sagittal complication of adolescent idiopathic scoliosis (AIS) after corrective surgery, leading to new deformities, pain, and, even, revision surgery. In the present study, we investigated the risk and predictive factors for PJK in patients who had undergone Lenke type 5 AIS correction to identify the parameters relevant to intraoperative guidance. ⋯ The results of the present study have shown that the postoperative PJA and postoperative TK can be used to effectively predict for the occurrence of PJK in patients with Lenke type 5 AIS after corrective surgery, with a threshold of 9.45° and 25.25°, respectively.
-
Pelvic morphology is an important element in determination of spinal alignment. We retrospectively examined the correlation between spinal alignment, severity, and pelvic morphology in lumbar disc herniation (LDH) surgery. ⋯ For LDH cases, pelvic retroversion is important to avoid pain. The range of mobility for pelvic retroversion varies depending on pelvic morphology of individuals. In cases of LDH, ratio of pelvic tilt to pelvic incidence correlates strongly with severity.
-
In patients with new primary intradural spinal tumors, the best screening strategy for additional central nervous system (CNS) lesions is unclear. The goal of this study was to document the rate of additional CNS tumors in these patients. ⋯ Among patients without an underlying genetic syndrome, the likelihood of identifying additional CNS lesions requiring treatment is low. In appropriate cases, focused spine imaging may be a more cost-effective strategy.
-
Lateral ventricular meningioma (LVM) is a rare entity, accounting for 0.5%-5% of all intracranial meningiomas. This type of meningioma arises from meningothelial inclusion bodies in the tela choroidea and/or mesenchymal stroma of the choroid plexus. Although not yet fully characterized, a membranous structure is frequently observed around LVMs. This study analyzed quiescent and activated fibroblast phenotypes in LVMs with focus on the relationship between tumor growth and development of the membranous structure. ⋯ This study found an association between activated fibroblasts and dura mater-like membrane capsules in LVMs. The characteristics of membranous structure in LVMs may differ depending on tumor size.