World Neurosurg
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Controllable factors associated with surgical site infections (SSIs) have focused on reducing contamination of the surgical field with potential pathogens. The aim of this prospective study is to determine the incidence of glove contamination in a series of elective neurosurgical operations and determine the relationship of such glove contamination to subsequent SSI. We hypothesize that contamination of surgical gloves is associated with subsequent SSI. ⋯ Surgical glove contamination identified at the time of wound closure does not correlate with the development of subsequent SSI in elective neurosurgical operations.
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Hemorrhage following glioma resection usually happens in tissues that were surgically manipulated. Remote bleeding is a rare and serious complication that is still poorly understood. Distant wounded glioma syndrome is a special type of this complication, where bleeding happens in a glioma lesion that was not surgically manipulated. ⋯ Remote bleeding, including distant wounded glioma syndrome, is a rare complication that should be considered in cases of postoperative deterioration, especially in cases of symptoms not congruent with the operated site.
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Unilateral laminotomy for bilateral decompression (ULBD) is a minimally invasive surgical technique widely used in patients with lumbar spinal stenosis and low-grade spondylolisthesis. However, few studies have investigated the long-term effects of the unilateral approach of ULBD on postoperative coronal imbalance, and the effect of additional discectomy on ULBD has not yet been evaluated in detail. ⋯ ULBD preserved lumbar lordosis and motion with or without discectomy during the 2-year follow-up period. Improvement in coronal balance was observed after ULBD regardless of discectomy, without significant negative effects on sagittal and coronal spine stability.
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To evaluate outcomes of sagittal reconstruction of the atlantoaxial lateral mass complex using a modified intra-articular cage fusion technique for treating degenerative atlantoaxial instability. ⋯ Posterior reduction and intra-articular cage fusion with a C2 nerve root preservation technique is effective in treatment of degenerative atlantoaxial instability. Satisfactory reconstruction of the sagittal alignment and the height of atlantoaxial complex can be achieved.
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The combined petrosectomy is one of the workhorse skull base approaches to the petroclival region. Traditionally, this approach starts with a temporosuboccipital craniotomy, followed by the mastoidectomy/anterior petrosectomy, and completed with the dural opening/tumor resection. This sequence of events (neurosurgery-neuro-otology-neurosurgery) involves at least 2 handoffs and change of surgical teams and instrumentation. This report describes a resequencing of events and a modification of the technique used to craft the temporosuboccipital craniotomy, with aims to reducing handoffs between surgical teams and improving operating room workflow. ⋯ Combined petrosectomy, although often performed in a 3-step manner with the neurosurgeon starting the craniotomy, can be performed as described here in a 2-step manner, with similar outcomes and reasonable operating time.