World Neurosurg
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Although cervical disc arthroplasty (CDA) has reportedly been associated with similarly low incidences of complications to anterior cervical discectomy and fusion, the phenomenon of anterior bone loss (ABL) is unique to CDA and has only recently gained notice. This study thus aimed to investigate the incidence of ABL and its correlation with cervical alignment post-operation. ⋯ During the mean follow-up of 2 years, ABL was a common radiologic finding. More than half of the patients (26 of 41, 63.4%) in the series gained cervical lordosis (ΔCobb >0) after CDA. These patients with increased cervical lordosis (ΔCobb >0) after CDA had higher grades of ABL.
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At our institution, patients undergoing neurosurgical procedures in the posterior cranial fossa are placed either in the semisitting or in the supine position. The major risk of the semisitting positioning is a venous air embolism (VAE), which may, however, also occur in the supine position. ⋯ The semisitting position with TEE monitoring and a standardized protocol is a safe and advantageous technique, taking account of a significant rate of VAEs. VAEs also occur in the supine position, but less frequently.
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We sought to develop screening criteria predicting the lack of poor neurologic outcomes in patients presenting with traumatic subarachnoid hemorrhage (tSAH) and to evaluate their potential to improve resource allocation in these cases. ⋯ In our study, we found multiple risk factors inversely associated with good neurologic outcome, namely low GCS score, midline shift, emergent medical intervention, and INR ≥1.4. Our findings may aid clinicians in determining which tSAH patients are candidates for safe early discharge.
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Distance learning has become increasingly important to expand access to neurosurgical spine education. However, emerging online spine education initiatives have largely focused on residents, fellows, and surgeons in practice. We aimed to assess the utility of online neurosurgical spine education for medical students regarding career interests, knowledge, and technical skills. ⋯ Virtual distance learning for neurosurgical spine education is beneficial for students by enabling career exploration and learning content and clinical skills. Although the overall benefit was lowest for clinical skills, virtual programming could serve as an adjunct to traditional in-person exposure. Distance learning could also provide an avenue to reduce disparities in medical student neurosurgical spine education locally and globally.
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Direct pars repair with cannulated screws in adults: A case series and systematic literature review.
Lumbar spondylolysis occurs in 5%-8% of adults. This study aimed to report clinical and radiographic outcomes of direct pars repair in adults with lumbar spondylolysis. ⋯ Lumbar spondylolysis treatment with open fracture reduction and direct pars repair with cannulated screws in adults is safe and may result in mechanical back/radicular pain relief, even in the absence of radiographic fusion.