World Neurosurg
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Type II odontoid fractures are the commonest C2 fractures. The management of dens fractures remains controversial with various radiological and fracture morphological factors affecting the approach and outcomes. ⋯ Anterior odontoid screw fixation is technically straightforward, less morbid, and preserves biomechanical cervical mobility, when compared with the posterior instrumentation. With careful patient selection, meticulous surgical planning, and intraoperative image-guided screw insertion, good fracture union outcomes can be obtained. In the current study, we were able to achieve stable fracture union in 83.7% patients.
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Choroid plexus carcinoma is a central nervous system tumor pathologically corresponding to World Health Organization grade III. Choroid plexus carcinoma mainly affects pediatric patients with a poor prognosis. Due to its rarity, standardized treatment has not yet been outlined. ⋯ In this study, we described the clinicoradiologic characteristics of choroid plexus carcinomas. Surgical resection is the mainstream treatment. Due to the paucity of clinical evidence, the standard regimen of adjuvant therapies still needs further research.
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Magnified intraoperative visualization is of paramount importance during microsurgical procedures. Although the introduction of the operating microscope represented one of the most relevant innovations in modern neurosurgery, surgical vision and maneuverability can be limited in cases with unfavorable angles of attack. In such cases, the placement of the operating microscope can be difficult and result in significant discomfort to the surgeon. In previous decades, exoscopes were introduced as alternative tools to provide optimal ergonomics by decoupling the line of sight of the surgeon from the binocular lenses. However, exoscopic platforms entail interim manual adjustments of the camera position and setting. To overcome this limitation, robotic-assisted digital microscopy was developed. We have reported our preliminary experience with the RoboticScope to investigate the feasibility and safety of this novel digital system for intraoperative magnification. ⋯ The RoboticScope is a promising device that might represent a valuable alternative to conventional tools for intraoperative visualization in the resection of intracranial tumors.
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Acute subdural hematoma (ASDH) is known to be devasting sport-related head injury but it is relatively rare in rugby compared with other contact sports. Certain cases of ASDH have happened in high school rugby players in Japan. To prevent them from the injury we report a background of the players. ⋯ Playing experience in high school rugby players should be considered as an important factor for prevention of ASDH-in particular, phase of being tackled is riskier than that of tackling for first year novice players.
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The American Medical Association and National Institutes of Health have recommended that patient education materials should be written at the sixth-grade reading level to maximize patient comprehension. The objective of the present study was to evaluate the readability of Internet information for the 9 most common spinal surgeries. ⋯ The most accessed online materials for common spinal surgeries, not only exceeded the readability limits recommended by both the American Medical Association and the National Institutes of Health, but they also exceeded the average reading ability of most adults in the United States. Patients, therefore, might not fully comprehend the information from commonly accessed websites regarding surgical spine treatment options.