World Neurosurg
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To describe a novel technique, posterior thoracic antidisplacement and fusion (PTAF), for a special type of ossification of the posterior longitudinal ligament in the thoracic spine (T-OPLL), and to evaluate its safety and efficacy. ⋯ The preliminary clinical outcomes indicate that PTAF is a safe and effective method for the treatment of beak-type T-OPLL, which has its apex located at the vertebral body level and has a high spinal canal occupation ratio.
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Meningiomas involving the dural venous sinuses present unique therapeutic challenges. While gross total resection remains the mainstay of treatment for meningiomas, involvement of critical vascular structures may limit extent of resection and increase the risk of recurrence. Optimal management of meningiomas with venous sinus involvement has been discussed in the literature, with some advocating for subtotal resection with postoperative surveillance and radiation, if necessary, while others recommend total resection with reconstruction of resection of the involved sinus. ⋯ Maximal safe resection, including resection and reconstruction of involved sinuses, may be a safe and effective treatment for many patients. Careful preoperative assessment of venous anatomy and planning extent of resection and reconstruction are essential for safe and successful surgery in these patients.
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Cavernous sinus (CS) dural arteriovenous fistulas (DAVFs) are commonly treated by transvenous embolization, but the details of treatment need to be more clearly defined. We propose a classification of CS-DAVF that can contribute to formulating endovascular treatment process. ⋯ Our proposed classification system based on cumulative CS range and drainage patterns can assist in formulating treatment strategies for transvenous embolization.
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To put forward a new index of cervical curvature evaluation - relative cervical curvature area, and a new classification of cervical spine was proposed according to the relative cervical curvature area. ⋯ The relative cervical curvature area uses the area parameter instead of the original angle parameter and distance parameter to incorporate the change of segmental curvature, which makes up for the shortcomings of the Cobb angle method that only evaluates the curvature of 2 vertebrae, and better reflects the cervical curvature. Studies have shown that relative cervical curvature area has good repeatability and diagnostic value, and found that it has a good correlation with common cervical sagittal parameters. The new classification of cervical spine makes up for the disadvantage that the angle classification method cannot distinguish between S-type and RS-type, and initially proposes to use the number of intersections and the relative absolute value area to reflect the severity of S-type.
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Colloid cysts are nonneoplastic epithelial lesions arising from the roof of the third ventricle near the foramen of Monro. They comprise approximately 0.5% to 2% of all brain lesions.1-3 Surgical resection is the definitive treatment when indicated. The microsurgical approach is generally considered the "gold standard," but the endoscopic approach has been gaining popularity.4-6 The choice is usually based on a surgeon's preference and key image findings such as the presence of hydrocephalus. ⋯ The major drawback of the endoscopic approach was previously reported as a higher recurrence rate due to incomplete removal of the cyst capsule. However, it has been shown that the rate of capsule excision may be similar to that of microsurgery, ranging from 80 to 100%.7-14 The authors demonstrate an endoscopic resection of a recurrent colloid cyst with bimanual technique through parallel channels in a ventriculoscope. Video 1 highlights the critical steps involved in preserving both vascular and neural structures during the procedure.