World Neurosurg
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Radiosurgery has emerged as an important primary treatment means of typical trigeminal neuralgia. Despite its high safety and efficacy, the likelihood of recurrence is significant, potentially requiring salvage treatment. Posterior fossa exploration and microvascular decompression is an option for salvage treatment. Results are presented regarding a single-surgeon experience, and a grading scale is proposed for postirradiation surgical findings. ⋯ Microvascular decompression can be performed in the postradiosurgery setting safely with high efficacy. Dissection typically was not significantly more difficult in comparison to procedures performed without prior history of radiosurgery intervention.
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Transforaminal lumbar interbody fusion (TLIF) augmented with pedicle screw instrumentation has become a favored surgical treatment for management of lumbar degenerative disease and spondylolisthesis. Iliac crest bone graft has traditionally been used for interbody arthrodesis. Many substitutes for autograft have been suggested to reduce iliac crest graft morbidity. The present study was aimed to determine fusion rate and clinical outcome with local bone autograft drill shavings harvested during minimally invasive (MI) TLIF. ⋯ Use of a cage filled with local bone shavings harvested using a specimen trap during MI-TLIF is simple and can result in up to a 70% fusion rate with good clinical outcome in 92% of patients. This is the first study assessing fusion rate with local bone shavings, and the results may help spine surgeons in choosing the best graft option for patients undergoing posterior lumbar fusion surgery.