World Neurosurg
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Stable water dynamics during endoscopic spine surgery improves the surgeon's comfort and patient's outcomes. We aimed to measure the water dynamics during spinal surgery and identify the factors that facilitate stable water dynamics. ⋯ During biportal endoscopy, we suggest maintaining water pressure between 4.41 cm H2O (2.41 mm Hg) and 31.00 cm H2O (22.83 mm Hg). Compared to physical characteristics, placement of the cannula and appropriate cannula length are important factors that affect water dynamics.
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Giant paraspinal thoracic schwannomas (GPTSs) are benign, slow-growing, encapsulated lesions. They can be intracanalicular, span more than 2 vertebral bodies, and/or have a foraminal component with extraspinal extension >2.5 cm. They pose surgical challenges because of the often unfamiliar complex regional anatomy. We report the largest series of GPTSs and discuss regional surgical strategies for tumors in the thoracic spine. ⋯ A number of approaches are available to resect GPST in specific locations in the thoracic spine. Total resection is achievable despite complex regional anatomy, location, and tumor extension but often requires anterior or combined approaches.
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The T2-FLAIR mismatch sign is a useful imaging sign in clinical magnetic resonance imaging studies for detecting isocitrate dehydrogenase (IDH)-mutant 1p/19q non-codeleted astrocytomas. However, the association between the mismatch sign and pathologic findings is poorly understood. Therefore, the aim of this study was to elucidate the relationship of histopathologic and radiologic features with the mismatch sign in IDH-mutant 1p/19q non-codeleted astrocytomas. ⋯ This study provides evidence that a region-dependent microstructural difference could reflect the mismatch sign in IDH-mutant 1p/19q non-codeleted astrocytomas. Core of the mismatch sign characteristically had microcystic changes accompanied by higher ADC values, whereas Rim had abundant neuroglial fibrils and cellularity accompanied by lower ADC values.
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Observational Study
Neurologic factors in patients with vascular mild cognitive impairment based on fMRI.
This study focused on the application of functional magnetic resonance imaging and neuropsychology in diagnosis of vascular mild cognitive impairment (MCI) and the exploration of its relevant factors. The study enrolled 28 patients with vascular MCI in an observation group and 30 healthy individuals in a control group. All patients underwent magnetic resonance imaging. ⋯ Heart disease, such as myocardial infarction and atrial fibrillation, is a high risk factor for vascular MCI. Functional magnetic resonance imaging combined with an automatic segmentation algorithm can noninvasively observe the changes of a patient's brain tissue, which can be used in the recognition of vascular MCI. The global network attributes of patients with depression tend to be more randomized and have stronger resilience under targeted attacks.
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To report the clinical use of uniplanar cannulated pedicle screws for the correction of Lenke type 1 adolescent idiopathic scoliosis (AIS), and to evalute its safety and clinical outcomes. ⋯ Collectively, uniplanar cannulated pedicle screws could effectively increase the accuracy of pedicle screws and facilitate the derotation of the apical vertebra compared with the multiaxial pedicle screws.