World Neurosurg
-
Review
Navigating Challenges and Embracing Opportunities: The Outlook of Functional Neurosurgery in Africa.
This narrative review explores the current landscape of functional neurosurgery in Africa, focusing on the challenges and opportunities facing the field. Drawing upon existing literature and expert insights, the review highlights the scarcity of resources, including trained personnel, infrastructure, and specialized equipment, as major hurdles impeding the widespread adoption of advanced neurosurgical techniques. ⋯ Moreover, the review underscores the significance of addressing cultural beliefs and stigmas surrounding neurological conditions to ensure equitable access to care and promote acceptance of neurosurgical interventions. By navigating these challenges and embracing emerging opportunities, functional neurosurgery in Africa holds the potential to significantly impact neurological health outcomes and enhance overall well-being.
-
Review Case Reports
Cervical Intradural Fungal Infection Masquerading as a Meningioma in an Immunocompetent Patient: A Case report and Systematic Review.
Intradural spinal fungal infection is a rare phenomenon that can carry a significant increase in morbidity and mortality. This systematic review and case report provides a presentation of a 75-year-old male patient with an intradural cervical mass that was diagnosed as a fungal infection intraoperatively. We analyze and report on intradural spinal fungal infections in immunocompetent patients. ⋯ Intradural fungal infections are rare, with only 10 total cases reported in the past 25 years. Nonetheless, they can be associated with significant mortality and morbidity. Thus, the timeline from presentation to intervention should be evaluated and determined carefully.
-
Review
Beyond Surgery: Navigating Postoperative Care for Cauda Equina Syndrome Through a Scoping Review.
Cauda equina syndrome (CES) is a serious neurological injury that can result in permanent disability. Our objective was to review the evidence for rehabilitation strategies for CES in a scoping review. ⋯ Despite the risk of devastating injury and a recent Getting It Right First Time pathway recommending rehabilitation post CES surgery, there is very limited literature on rehabilitation for CES. Future high-quality rehabilitation trials following CES surgery are needed to guide treatment decisions and optimize postsurgical outcomes.
-
To observe the short-term to medium-term therapeutic effects and radiological outcomes of adjacent 2-level cervical spondylosis treated with artificial cervical disc replacement (ACDR) using Mobi-C and Bryan discs. To observe changes and discrepancies in the flexion-extension centers of rotation (FE-COR) of different ACDR segments. ⋯ In continuous 2-level cervical ACDR surgery, both Mobi-C and Bryan artificial cervical discs achieved satisfactory clinical outcomes in the short to medium term postoperatively. The FE-COR exhibited different trends of change. In the Mobi-C group, the FE-COR for both upper and lower segments shifted anteriorly and inferiorly, whereas in the Bryan group, whether upper or lower, the FE-COR remained closer to the preoperative state. The changes in FE-COR did not significantly affect the short-term to medium-term clinical outcomes postoperatively.
-
Thoracic ossification of the posterior longitudinal ligament (T-OPLL) causes myelopathy. Although posterior decompression for T-OPLL has shown positive results, patients with kyphotic curvatures often endure poor outcomes. Posterior decompression with fusion (PDF) has demonstrated better results compared to posterior decompression alone. This study aims to evaluate the effects of the posterior procedures for T-OPLL. ⋯ Effective management of intervertebral mobility and the appropriate length of decompression are crucial for addressing the thickness and mobility of T-OPLL.