World Neurosurg
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Spinal arachnoid webs are abnormal formations of arachnoid membranes that reside in the arachnoid space. Clinically, they may present as an incidental finding or in patients with progressively worsening myelopathy. Early detection and surgical intervention are recommended in patients with progressive symptoms. ⋯ Our patient was symptomatic for 12 months with rapid progression of myelopathic symptoms in the 3 months before presentation. Following surgery, she remained asymptomatic at 4-year follow-up with no reoccurrence at 24-month magnetic resonance imaging. Intraoperative ultrasound is a useful adjunct to successfully performing dorsal arachnoid web surgery and ensuring improved surgical outcomes through complete web resection and decompression of the spinal cord.
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To analyze the current research trends and potential mechanisms related to the role of autophagy in intervertebral disc degeneration (IVDD) and to provide new ideas for future research in this field. ⋯ This study provided a scientific perspective on autophagy in IVDD and elucidated the current research status and hot spots in this field. The mechanism of autophagy and the application of regulating autophagy in the treatment of IVDD deserve further research.
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Ultrahigh-definition 3-dimensional exoscopes represent an excellent technologic innovation in contemporary neurosurgery. They combine the advantages of operating microscopes and endoscopes, offering excellent magnification and lighting, maintaining a relatively small footprint and optimal ergonomic features.1-5 One of the most interesting employments of exoscopes in neurosurgery is represented by intracranial vascular surgery. ⋯ Postoperative course was uneventful, and follow-up examinations demonstrated the complete occlusion of the aneurysm. This report highlights the feasibility of exoscopic-based ICG-VA in vascular neurosurgery, given its ease of use, ergonomics, and excellent quality of vision provided to both surgeons and operating staff.
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Observational Study
Posterior Fossa Volume and Dimensions: Relation to Pathophysiology and Surgical Outcomes in Classical Trigeminal Neuralgia.
A small posterior fossa (PF) has been hypothesized to explain the increased incidence of trigeminal neuralgia (TN) in females and could make microvascular decompression (MVD) more challenging. The aim of this study was to investigate the association between the PF volume and dimensions in relation to biological sex, type of neurovascular conflict (NVC), and outcome after MVD in classic TN. ⋯ PF anatomy was related to the NVC type but did not differ between patients with TN and controls and was not related to the surgical outcome after MVD.
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Pedicle subtraction osteotomy (PSO) is a surgical technique to restore lumbar lordosis in patients with rigid sagittal deformity. Herein, we report on outcomes of a surgical technique utilizing a 4-rod PSO with satellite rods. ⋯ Rod failure rate after PSO with the 4-rod satellite configuration was low. SVA, PI-LL mismatch, and PT significantly improved for these previously-fused patients. Mean GAP score also improved, but was still considered severely disproportioned, likely due to the inability of PSO to correct low LL or PT in previously-fused spines.