World Neurosurg
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The present study described a modified technique of atlantoaxial arthrodesis in patients with atlantoaxial instability (AAI) along with the postoperative clinical and radiological results. ⋯ Modified atlantoaxial arthrodesis via intraarticular autografting using the structural iliac bone combined with posterior instrumentation appears to be an efficient alternative treatment method for AAI patients with concurrent pathologies, even when the C1-2 posterior arches are unavailable for the grafting bed.
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Case Reports
Biportal endoscopic paraspinal decompression for epidural cement leakage removal: A technical note.
We aimed to preliminarily explore the efficacy and safety of unilateral biportal endoscopy for the treatment of epidural cement leaks. We report a patient who underwent epidural cement leakage removal and achieved endoscopic spinal decompression. ⋯ A paraspinal approach that avoids a posterior approach reduces the need to remove stabilizing facet bone, is truly minimally invasive and does not involve an instrumented fusion, maybe a helpful addition in the minimally invasive spine surgeon's armamentarium.
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Case Reports
Long-term Progression of a Residual Cerebral Amyloidoma: An Illustrative Case and Systematic Review.
Cerebral amyloidomas (CA) are exceptionally rare tumor-like lesions composed of cerebral amyloid-beta, which is derived from the cleavage of the amyloid precursor protein. ⋯ This systematic review provides insights into the epidemiological, clinical, and neurosurgical characteristics, as well as the long-term prognosis of CA. This marks the first case in the reviewed literature with a 19-year period of follow-up where the patient had reoperation due to disease progression.
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Intracranial kissing aneurysms, arising either from the same artery or from 2 adjacent arteries at similar locations, are rare.1,2 The internal carotid artery is most frequently involved; kissing aneurysms rarely affect the distal anterior cerebral artery (DACA). By dint of the close proximity of the aneurysm fundus, these aneurysms can pose unique operative challenges.3,4 A highly fragile aneurysm dome with a high intraoperative rupture rate is a unique management challenge in DACA aneurysms.5 The stakes are higher when there is an aneurysm rupture in the setting of kissing DACA aneurysms requiring an anterior interhemispheric approach. The negotiation of a tight interhemispheric fissure in between the bridging veins and prevention of a premature aneurysm rupture at a narrow space become vital in these situations. ⋯ The patient in Video 1 presented with an acute subarachnoid hemorrhage with severe headache of sudden onset and nuchal rigidity (World Federation of Neurological Surgeons grade II). Both aneurysms were located at the A3-A4 junction and successfully clipped through a right-sided anterior interhemispheric approach. She made a satisfactory postoperative recovery (modified Rankin Scale score of 1 at 6-week follow-up and 0 at 6-month follow-up) with an excellent angiographic outcome.
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To establish a predictive model to evaluate the risk of adjacent vertebral refracture (VRF) after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF) based on perioperative imaging data. ⋯ The prediction model obtained in this study can predict refracture after PKP for OVCF early and effectively. It has an excellent predictive effect which is suitable for clinicians.