World Neurosurg
-
To investigate the incidence, distribution characteristics, risk factors, and clinical outcomes of intraoperative endplate injury (EI) following transforaminal lumbar interbody fusion. ⋯ Rates of EI were 19.6% of patients and 9.9% of endplates. Superior endplates were more susceptible to injury than inferior endplates. Older age, lower disc height index, and taller cage height were independent risk factors for intraoperative EI. Clinical outcomes were not affected by intraoperative EI during early postoperative follow-up.
-
Neck clipping of the aneurysms arising from the middle cerebral artery (MCA) proximal to the limen insulae is often difficult because of difficulties in securing a bright and wide operative field to observe the aneurysms and surrounding structures, such as the anterior perforated substance, lenticulostriate arteries, and early frontal branch. Our objective was to determine the usefulness of the orbitocranial approach in neck clipping of the aneurysms arising from the MCA proximal to the limen insulae. ⋯ The orbitocranial approach to aneurysms arising from the MCA proximal to the limen insulae provides us a bright and wide operative field compared with the conventional pterional approach, which is useful to secure complete and safe neck clipping by avoiding cerebral contusion and unexpected obstruction of the early frontal branch.
-
Clinical paradigms and consensus recommend dopamine agonists (DAs) as the primary treatment for prolactinomas. However, medically treated patients also encounter challenges such as DA resistance, intolerable side effects, and recurrence of hyperprolactinemia after DA withdrawal. Technical advances in transsphenoidal resection, with an endoscopic endonasal approach, have led to improved visualization of tumor, decreased postoperative morbidity, and shortened length of stay. We examined the indications and outcomes in patients with prolactinomas who underwent surgical resection at our center. ⋯ Endoscopic endonasal resection is a viable option for management of patients with prolactinomas in the setting of a high-volume pituitary center, with minimal postoperative complications.
-
To compare postoperative outcomes after cranioplasties performed by neurosurgery only (N) versus neurosurgery and plastic surgery combined (N+P). ⋯ Despite similar complication and reoperation rates between groups, reoperations in the N group occurred sooner, whereas the N+P group more commonly used drains and kept drains in for longer.
-
Uniportal interlaminar contralateral endoscopic lumbar foraminotomy (ICELF) aims to achieve decompression of lumbar spinal stenosis in the contralateral lateral recess and foraminal and extraforaminal regions of the same segment. This technique is performed under normal saline irrigation using an endoscope with optical lens magnification close to the targeted stenotic segment and has the potential of lower incidence of exiting nerve root dorsal root ganglion irritation. ⋯ There is low-level evidence that ICELF when performed by an experienced spinal endoscopic surgeon is effective in providing pain relief and improved function with low rate of complications in select patients.