World Neurosurg
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The Meckel's cave (MC) is commonly affected by neoplastic lesions that often require neurosurgical treatment. We simulated the posterior petrous apicectomy (PPA) on fresh cadavers to verify the in vivo feasibility of the approach. We proposed a new classification system of MC meningioma based on the extent of middle cranial fossa (MCF) involvement. ⋯ Preliminary results obtained with the PPA in 2C type I meningiomas are encouraging. The new classification system proposed can be useful in clinical practice, especially in the choice of the most suitable surgical approach for dumbbell meningiomas.
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To compare the clinical and radiographic outcomes on the sagittal plane between anterior and posterior selective fusion (ASF and PSF) in patients with Lenke 5 adolescent idiopathic scoliosis (AIS) for a minimum of 5 years of follow-up. ⋯ A significant and continuous loss of lordosis in ISA was observed after ASF in patients with Lenke 5 AIS. A larger LL was obtained with a higher incidence of proximal junctional kyphosis at long-term follow-up after PSF.
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We report a case of a ruptured fusiform aneurysm of the distal internal carotid artery (ICA) involving the anterior choroidal artery and posterior communicating artery, treated with selective coil embolization. ⋯ Mostly, surgical clipping (vascular reconstruction, proximal occlusion, or trapping) with bypass surgery is necessary for this lesion. However, in our case, selective coiling was successfully performed only at the suspected rupture point. This technique can be a good alternative treatment modality.
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Endothelial cell coverage along the Pipeline embolization device (PED) is 1 of 2 primary proposed mechanisms of action of the device, along with induction of intra-aneurysmal thrombosis. The temporal course of endothelialization following device deployment is poorly understood in human patients. ⋯ Aneurysm healing via endothelialization following flow diverter treatment may occur subacutely and not chronically as previously stipulated.
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We sought to describe a novel modified guidewire technique used in the placement of percutaneous pedicle screws (PPSs), which enables safe and precise control of the depth of screw placement and prevents excessive advancement of the guidewire with low radiation exposure. PPSs have been widely used and have many advantages. However, inadvertent advancement of the guidewire may damage peripheral tissue or viscera, and repeated confirmation of the depth of screw and guidewire leads to extensive radiation exposure. ⋯ The modified guidewire with markers is an effective device to precisely control the depth of PPSs and prevent complications of the guidewire in the placement of pedicle screws.