World Neurosurg
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The aim of this study was to assess rates of adjacent segment degeneration (ASDeg), adjacent segment disease (ASDis), and reoperation rates as a result of adjacent segment pathology in patients who have undergone anterior cervical discectomy and fusion (ACDF) versus cervical disc arthroplasty (CDA). ⋯ Our study shows CDA results in significantly lower ASDeg, ASDis, and reoperation rates. Although CDA may be a viable alternative to ACDF, further long-term studies are warranted to ensure consistency and establish longevity of our findings.
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There has been a paradigm shift in the management of hypothalamic hamartoma (HH) from traditional microsurgical techniques to less invasive alternatives. However, large and extensive HH may fail to respond to these therapies, necessitating craniotomies. ⋯ For large HH with interpeduncular extension, microsurgery via the frontotemporal orbitozygomatic approach is a safe and highly effective treatment modality.
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Review
Holocordic Spinal Subdural Hematoma: A Challenging Management In Emergency. Literature Review.
Spinal subdural hematoma (SSH) is a rare entity and the etiology has yet to be elucidated. Holocordic spinal hematomas represent an exception. The management of these patients remains controversial, due to their rarity and their extremely poor prognosis. ⋯ The correct treatment of holocordic hematomas is not yet well standardized. Complete evacuation is not amenable, but surgical evacuation based on magnetic resonance imaging has shown to be the most effective therapeutic option, crucial in terms of prognosis, even if performed with some delay.
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To consolidate the current literature related to atlantoaxial osteoarthritis (AAOA) and improve systematic understanding of this clinical syndrome among spine surgeons. ⋯ AAOA is a clinically common but often overlooked syndrome characterized by persistent occipitocervical pain. The most common cause of AAOA is joint degeneration, which is closely related to age and occupation. AAOA is initially managed with conservative treatment. Atlantoaxial fusion is an option for patients with severe pain who are unresponsive to conservative treatment.
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The risks and benefits of coagulating intradural venous elements during a retrosigmoid approach for trigeminal neurovascular decompression has not been accurately established. The objectives of this study were to identify the veins that drain into the superior petrosal sinus, classify them in relation to the suprameatal tubercle, and determine the implication of their coagulation. ⋯ The venous elements identified in trigeminal neurovascular decompressive surgery are variable. We propose classifying them into retromeatal, meatal, and premeatal groups. Retromeatal and meatal veins can be safely sacrificed for appropriate visualization of the neurovascular conflict. The premeatal venous elements should be coagulated only in justified cases.