World Neurosurg
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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.
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Inflammatory lesions of the pituitary gland including hypophysitis are poorly understood, and it is difficult to make a correct diagnosis on the basis of only clinical and radiologic findings. ⋯ To the best of our knowledge, this is the first case report of hypophysitis with radiologic signal changes over a short period. Vigilant attention regarding the clinical diagnosis of such rare entity is paramount.
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Case Reports
Postarachnoiditis Anterior Spinal Arachnoid Cyst Formation with Compressive Myelopathy: Report of 2 Cases.
Spinal cystic arachnoiditis is a rare complication of a subarachnoid haemorrhage or infectious meningitis. The inflammatory process leads to fibrosis, adhesions, and in severe cases cyst formation. Large arachnoid cysts are an uncommon cause of compressive myelopathy. The majority are located posterior of the spinal cord at the thoracic level. Anterior cyst formation is exceptional, especially at the cervical region. ⋯ Spinal cystic arachnoiditis with anterior cyst formation is an extremely rare complication of subarachnoid haemorrhage and infectious meningitis but can cause severe neurologic deficits. Clinicians should be aware of this rare complication. Due to the risk of irreversible spinal cord injury, rapid surgical intervention is recommended in most cases.
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To correlate interpedicular distance (IPD) with radiographic parameters, neurologic deficit, and posterior structures injury in patients with thoracolumbar burst fractures. ⋯ Our results indicate that IPD is correlated with LK, SCS, neurologic status, facet joint injury, and lamina fracture. Our data demonstrate that IPD measured from plain radiographs is a reliable indicator for assessment of thoracolumbar burst fractures.
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To evaluate safety and efficacy of pedicle screw with polymethyl methacrylate (PMMA) augmentation in unilateral transforaminal lumbar interbody fusion (uTLIF) in osteoporotic patients. ⋯ Pedicle screw with PMMA augmentation can increase fixation stability and reduce DSH loss in uTLIF. Moreover, PMMA in the vertebral body did not impede the interbody fusion ability in uTLIF.