World Neurosurg
-
As an emerging minimally invasive endoscopic technique, unilateral biportal endoscopic spinal surgery (UBESS) has the advantages of flexibility, a wide and clear field of view, and less soft tissue damage. However, the clinical evidence is insufficient and controversy exists regarding UBESS for the treatment of lumbar spinal stenosis (LSS). In the present meta-analysis, we investigated the clinical efficacy and complications of UBESS for the treatment of LSS. ⋯ From the available clinical results and experience from reported studies, UBESS for LSS is a feasible and effective approach and a worthwhile choice for clinicians. However, the complications associated with the procedure should also be seriously considered.
-
In the present study, we evaluated the efficacy and safety of different stem cell types for spinal cord injury (SCI) therapy to determine the superior treatment of SCI. ⋯ BMSCs plus rehabilitation might be superior to other stem cell treatments of SCI in improving the ASIA impairment scale grade, ASIA motor score, ASIA sensory functional score, and Barthel index. The therapeutic effects of UCMSCs and MNCs remain to be confirmed.
-
Review
Resection of Brainstem Cavernous Malformations: Pearls and Pitfalls for Minimizing Complications.
Surgical management of brainstem cavernous malformations (CMs) is a controversial topic in the field of neurosurgery. These lesions have a propensity to hemorrhage, thereby disrupting surrounding brainstem eloquence. ⋯ The natural history of the lesion, risk of future hemorrhage, and potential for symptom resolution should be carefully considered when planning to resect brainstem CMs. Nuanced microsurgical techniques with minimal disruption of normal tissues provide the best chance of satisfactory outcomes.
-
Minimally invasive surgery (MIS) techniques have advanced the treatment of metastatic diseases to the spine. The objective of this review is to describe clinical outcomes, benefits, and complications of these techniques. ⋯ MIS for the treatment of spine metastasis has significant potential benefits in reducing surgical site infections, hospital stay, and blood loss without compromising instrument accuracy or overall outcomes. Overall, MIS and its adjuncts have the potential to reduce the risks involved in the treatment of patients with metastatic disease to the spinal column without compromising the benefits of decompression and stabilization of the spine.
-
The decision-making process surrounding resection of arteriovenous malformations (AVMs) in proximity to vital brainstem structures is a complex topic. Intricate vasculature in the setting of exquisite brainstem eloquence creates a high-risk operative landscape with the potential for devastating complications. Effective resections are driven by mastery of the relevant operative anatomy, preservation of pertinent vasculature, and technical experience and acumen. ⋯ Careful consideration of the patient's clinical background, the natural history of the lesion, and expertise of the treating surgeon are paramount for improving the natural course of brainstem AVMs.