World Neurosurg
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Cervical stenosis with myelopathy caused by ossification of the ligamentum flavum is relatively rare. Surgical treatment is the preferred option. Previous surgical procedures usually require assisted internal fixation, and some problems may occur, such as large trauma, intraoperative bleeding, wound infection, and internal fixation failure. The aim of this paper is to introduce a new minimally invasive surgical procedure for the treatment of upper cervical spinal stenosis complicated with myelopathy. ⋯ PECLD is an effective method for treating cervical stenosis associated with myelopathy because of ossification of the ligamentum flavum. It has the advantages of smaller trauma, less bleeding, shorter postoperative hospital stay, and faster recovery. Taken together, this minimally technique can be considered as a good alternative to traditional open surgery.
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To determine outcomes of spinal anesthesia (SA) in high-risk patients undergoing lumbar spine surgery in whom general anesthesia (GA) was contraindicated. ⋯ SA is a safe, reliable, and satisfactory alternative to general anesthesia in high-risk lumbar spine surgeries. Postoperative morbidity and mortality can be reduced by SA and spinal analgesia techniques. SA allows good perioperative hemodynamic stability. It is also more cost-effective.
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Learning surgical anatomy of the petrous pyramid can be a challenge, especially in the beginning of the training process. Providing an easier, holistic approach can be of help to everyone with interest in learning and teaching skull base anatomy. We present the complex organization of petrous pyramid anatomy using a new compartmental approach that is simple to understand and remember. ⋯ This new compartmental approach allows a comprehensive understanding of the distribution of petrous pyramid contents. Dividing it into anatomic compartments, and then navigating this mental map along specific reference points, lines, spaces, and segments, could create a useful tool to teach or learn its complex tridimensional anatomy.
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We investigated pediatric patients presenting with isolated head trauma to emergency service. Where abnormal findings were detected on brain computed tomography (CT) scan, we evaluated the follow-up scan rate and whether follow-up scans affected the treatment protocol. ⋯ Follow-up CT scan for patients with abnormal findings on the initial CT scan after head trauma does not influence the decision to choose clinical observation or surgery except in patients with neurologic deterioration.
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To assess the relationship between the ratio of C2-C7 Cobb angle to T1 slope (CL/T1S) and cervical alignment changes after laminoplasty. ⋯ The cervical alignment was kept well in the mid-range CL/T1S ratio group after laminoplasty. Patients with a high CL/T1S ratio were more likely to present with kyphotic alignment changes. Patients with a low CL/T1S ratio were more likely to have postoperative kyphosis.