World Neurosurg
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Case Reports
Bone but not Bone: Systemic Calcinosis presenting as Lumbar Facet Pseudohypertrophy with Neurogenic Claudication.
Systemic sclerosis affects 14-21 per million persons annually and can present with calcinosis-deposition in the skin and subcutaneous tissues. In rare circumstances, paraspinal depositions are also seen, which can cause neural element compression requiring surgical intervention. ⋯ Such pseudohypertrophy is often refractory to medical therapy, necessitating surgical intervention. Last, owing to the fluid nature of the calcinotic fluid, decompression is often easier than would be expected based on preoperative imaging alone.
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The coexistence of perisellar tumors and intracranial aneurysms was previously considered a rare phenomenon. In this study, we introduce our experience with surgical strategies for the treatment of such coexisting pathologies. ⋯ Staged surgery or conservative treatment for aneurysms can be considered a safe and effective strategy for the treatment of coexisting pathologies. However, in very selected cases, the single-stage EEA can be used as part of a comprehensive treatment for such coexisting pathologies.
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The aim of this study was to compare the biomechanical performance of 6 pedicle screw internal fixation strategies for the treatment of burst fractures of the thoracolumbar spine using finite element (FE) analysis. ⋯ The P1-BF-D1 model exhibited better stability and less von Mises stress on the pedicle screws and rods, thereby reducing the risk of screw loosening and fracture. The P2-D1 internal fixation approach is recommended when the fractured vertebrae are not nailed bilaterally.
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This study aimed to determine the incidence and potential risk factors of superior mesenteric artery syndrome (SMAS) after corrective spinal surgery in patients with adult spinal deformity (ASD). ⋯ The incidence of SMAS after corrective spinal surgery in patients with ASD was 2.0%. Postoperative smaller TLK and greater ULL can be risk factors for developing SMAS. Spine surgeons should avoid overcorrection of the upper lumbar spine in the sagittal plane to prevent SMAS.
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Although tractography-guided surgery is used by many surgeons, there is controversy in the published literature as it relates to its clinical utility. Here we adopted a survey-based approach with the goal of attaining a broader view of how tractography influence preoperative planning in a sampling of practicing neurosurgeons. ⋯ The clinical utility of tractography in preoperative planning varies as a function of surgeon and the tumor anatomy, with >80% of the participating surgeons believing that tractography added value in preoperative surgical planning.