World Neurosurg
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The craniovertebral junction (CVJ) involves the atlas, axis, and occiput along with the atlanto-occipital and atlantoaxial joints. The anatomy and neural and vascular anatomy of the junction render the CVJ unique. Specialists treating disorders that affect the CVJ must appreciate its intricate anatomy and should be well versed in its biomechanics. This first article in a three-article series provides an overview of the functional anatomy and biomechanics of the CVJ.
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The trend of practice pattern and impact on health care utilization for surgery and radiation therapy (RT) in patients with glomus jugulare tumors (GJTs) is not well defined. ⋯ RT plays an increasingly important role in the treatment for patients with GJTs, with fewer complications and a comparable health care utilization at 1 year.
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For carotid endarterectomy (CEA) patients with renal dysfunction and allergies to contrast media, we developed a preoperative novel method of noncontrast 3-dimensional magnetic resonance fusion imaging (NC-3DMRFI) which could describe well blood vessels, plaques, and bony structures even in surgical position. In this study, we examined the usefulness of this method. ⋯ This pilot study showed our novel NC-3DMRFI method is useful for preoperative simulation in CEA, especially in patients with renal dysfunction and allergies to contrast media.
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To evaluate the learning curve of minimally invasive scoliosis surgery (MISS) in patients with adolescent idiopathic scoliosis (AIS). ⋯ A mild learning curve was demonstrated in MISS for AIS with significant improvement in operative times and EBL over time. Experience of more than 46 cases of MISS was required to obtain proficient surgical skills for a trained surgeon of conventional open scoliosis surgery.
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Carotid artery stenting (CAS) is the established treatment strategy of the cervical internal carotid artery (cICA) stenosis, but its use for acute tandem lesions remains controversial. We investigated the clinical and procedural outcomes of management of cICA lesions and evaluated the risk factors for complications. ⋯ Acute CAS is effective for the management for cICA tandem lesions during mechanical thrombectomy, but care not to overextend may be important to reduce the risk of sICH. Severe calcification of the cICA may increase the risk of postoperative thromboembolic complications using non-CAS treatment.