World Neurosurg
-
Sphenoid wing meningiomas with cavernous sinus invasion (SWMCSI) are challenging tumors. The preservation of quality of life and cranial nerve function is one of the most relevant aspects of treating patients with SWMCSI. ⋯ The surgical treatment of symptomatic SWMCSI is an effective treatment modality with low morbimortality and good long-term control of the disease. Visual impairment is the most common abnormality, affecting preoperative and postoperative quality of life of patients with SWMCSI. Training in the microsurgical laboratory is essential for safe surgical approaches in this area.
-
Investigations showed that low back pain of occupational drivers might be closely related to the whole-body vibration. Restricted by ethical concerns, the finite element method had become a viable alternative to invasive human experiments. Many mechanical behaviors of the human spine inside of the human body were unclear; therefore, a human whole-body finite element model might be required to better understand the lumbar behavior under whole-body vibration. ⋯ The model developed in this study could reflect the biomechanical response of the human lumbar spine under vibration and could be used in further vibration analysis and offer proposals for protecting human body under whole-body vibration environment.
-
Sacral cysts are classically divided into Tarlov cysts and meningeal diverticula. However, the pathogenesis of sacral cysts remains unclear. This study aimed to clarify a novel type of sacral extradural spinal meningeal cyst with a specific arachnoidal structure. ⋯ The clinical findings of this study illustrate a special subtype and may help explain the mechanism of sacral cyst formation.
-
Internal carotid artery (ICA) injury during transsphenoidal surgery is a rare but serious complication. We analyzed a series of ICA injuries that occurred during a transsphenoidal approach to suggest an optimal management strategy. ⋯ Prompt control of bleeding, endovascular management of injured ICA, and consideration of revascularization surgery based on collateral flow may prevent catastrophic neurological sequelae.
-
A significant portion of health care spending is driven by a small percentage of the overall population. Understanding risk factors predisposing patients to disproportionate use of health care resources is critical. Our objective was to identify risk factors leading to a prolonged length of stay (LOS) after cervical spine surgery. ⋯ After adjusting for potential cofounders, patients most disadvantaged on Area of Deprivation Index were more likely to have an extended LOS.