World Neurosurg
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Case Reports
Aberrant Vessel with potential catastrophic vascular complications in a patient with Chiari Malformation.
Craniovertebral junction anomalies are known to be associated with many bony, soft tissue, and vascular anomalies. We encountered a case of Chiari malformation type 1 with C2-D2 syrinx, in which computed tomography angiography showed an aberrant vessel (probably vein) coursing through the soft tissue along the posterior aspect of C1-C7 vertebral bodies along the right-sided joints, superiorly coursing posterior to C1-C2 joint and curving anteriorly over C1 to enter into the foramen magnum. Had this abnormality not been detected, catastrophic vascular consequences could have occurred.
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1) To investigate if implant-related factors such as cage size and cage position are associated with radiologic improvement after indirect decompression with oblique lateral interbody fusion (OLIF). 2) To investigate the risk factors associated with indirect decompression failure (IDF) at the surgical levels after OLIF. ⋯ OLIF is an effective procedure for indirect decompression. To avoid reoperation for lumbar spinal stenosis, surgeons should aim to place the center of the cage at the posterior half of the lower endplate. Surgical levels with a preoperative dural sac cross-sectional area <44 mm2 may not be suitable for indirect decompression.
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We compared the clinical outcomes of minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) and endoscopic transforaminal lumbar interbody fusion (Endo-TLIF). ⋯ Although there was no difference in the long-term outcomes between the treatments, Endo-TLIF had less blood loss and a lower postoperative drainage volume and low back pain visual analog scale score at discharge than Mis-TLIF. However, the longer operative time and potentially higher complication rate of Endo-TLIF suggest that surgeons may need to overcome the steeper learning curve than the procedure of Mis-TLIF.
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Low- and middle-income countries experience numerous challenges in the provision of neurosurgical care. However, limited information exists on the neurosurgical workforce and the constraints under which care is delivered in Ghana, West Africa. ⋯ The provision of neurosurgical care in Ghana has come a long way since the 1960s. However, the neurosurgical community continues to face significant challenges. Alleviating these barriers to care will call for systems-level changes that allow for the prioritization of neurosurgical care within the Ghanaian health care system.
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Observational Study
PREDICTORS OF CLINICAL OUTCOMES IN AUTOLOGOUS CRANIOPLASTY.
Cranioplasty is a common neurosurgical procedure and autologous grafts are preferred due to their aesthetic and biocompatibility benefits. Multiple risk factors are implicated as predictors for neurologic outcome. This study focuses on risk factors that may be associated with complications and analyzes the predictors of neurologic outcomes after autologous cranioplasty. ⋯ Autologous cranioplasty contributes to a quantifiable neurologic outcome. Pre-cranioplasty neurologic status, cranioplasty done for traumatic DC and early cranioplasty may have potential for enhanced neurologic recovery. Further clinical studies with better evidence may expound upon these findings.