World Neurosurg
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Mesial temporal lobe epilepsy is the most frequent type of focal epilepsy in young adults and the most commonly reported in surgical series worldwide.1,2 When seizures become refractory to drug therapy, they are unlikely to remit spontaneously, and for the 30% of patients with epilepsy that is refractory to antiepileptic drugs, resection of the mesial temporal lobe structures provides seizure control rates of 70%-80%.3,4 The transsylvian route for amygdalohippocampectomy has been used at our institution for many years, evolving from the first description of Yasargil through the inferior circular sulcus of insula to the most recent one through the amygdala trying to preserve the temporal stem.5,6 Despite good outcomes according to the Engel classification, analysis of late postoperative magnetic resonance imaging scans of our patients showed a high incidence of temporal pole atrophy and potential gliosis.7,8 Therefore, we decided to keep the transsylvian route, but we removed a portion of the temporal pole anterior to the limen insula, resulting in a temporopolar amygdalohippocampectomy.4,9 Temporopolar amygdalohippocampectomy demonstrated good temporal stem preservation, good visual outcomes, and good memory results.4 We also advocate that the transsylvian route has the potential to provide a superior view and resection of the piriform cortex, that is associated with seizure outcome after surgery.10 We present a case of a 42-year-old woman who had refractory seizures secondary to mesial temporal lobe epilepsy and underwent temporopolar amygdalohippocampectomy with a good outcome, remaining seizure-free (Engel IA) (Video 1). The patient provided consent for surgery and video publication.
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Anterior controllable antedisplacement and fusion (ACAF) surgery for cervical OPLL is commonly used in clinical practice and has shown promising results. Nonetheless, precise slotting and lifting are the most critical procedures in ACAF surgery to avoid several unique and dangerous problems, such as residual ossification and incomplete lifting. C-arm intraoperative imaging can help with traditional cervical surgery but not with the precise slotting and lifting operation in ACAF surgery. ⋯ O-arm assisted ACAF can achieve accurate slotting and lifting, which might effectively reduce the occurrence of complications and is worthy of clinical application.
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Solitary plasmacytoma of bone of the spine (SPBS) was rarely detected in the past. However, its incidence has gradually increased with improvements in the diagnosis and understanding of the disease. We aimed to conduct a population-based cohort study to characterize the prevalence and factors associated with SPBS and develop a prognostic nomogram for predicting the overall survival of SPBS patients with a real-world analysis based on the surveillance, epidemiology, and end results database. ⋯ Our model effectively demonstrated the clinicopathological features of SPBS patients. The results indicated that the nomogram had a favorable discriminatory ability, good consistency, and yielded clinical benefits for SPBS patients.
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Although significant advancements have been made in the detection, surveillance, and treatment of intracranial aneurysms, research and care can differ vastly based on location. Currently, there is lack of knowledge regarding the trends in literature and how the field is evolving with new technology. Here, we use bibliometric analysis to visualize the knowledge structure of the field and identify global research trends in intracranial aneurysm treatment. ⋯ Evaluating the safety of flow diversion treatment remains a pressing area of research. Chinese and Korean organizations may be of interest for global collaborations.
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There are several landmarks to safely identify the limits of the retrosigmoid approach and its intradural variations; however, there has been little discussion about how those landmarks may vary among patients. ⋯ The retrosigmoid approach is the workhorse of posterior skull base surgery. By recognizing patient-specific variations in known landmarks, the approach may be tailored prevent complications.