World Neurosurg
-
Idiopathic normal pressure hydrocephalus (iNPH) refers to a complex brain disorder characterized by ventricular enlargement and the classic Hakim's triad of gait and balance difficulties, urinary incontinence, and cognitive impairment. It predominantly affects older patients in the absence of an identified cause. ⋯ In this article, we highlighted the challenges of current practice and identify key points for an optimal structuration of care for iNPH. Adopting a global approach to iNPH could facilitate a progressive shift in mindset, moving away from solely aiming to cure an isolated neurological disease with uncertain outcomes to providing comprehensive care that focuses on improving the daily life of frail patients with complex neurodegenerative burdens, using tailored goals.
-
Full-endoscopic (FE) lumbar interbody fusion (LIF) is now a widely used type of minimally invasive surgery (MIS). Although FE-LIF includes LIF with foraminoplasty via a Kambin's triangle approach (FE-KLIF) and LIF with foraminotomy via an interlaminar approach, these techniques are rarely discussed separately. This review evaluates the outcomes and complications of FE-KLIF reported in the literature. ⋯ In terms of complications, although there were no reports of hematoma, dural tear and surgical site infection were reported in 1 paper each, with transient nerve disorders reported in 5 studies (frequency, 1.8%-23.5%). This review indicates that FE-KLIF is a feasible and viable surgical option for lumbar degenerative disease. However, the amount and level of evidence is low for the studies included in this review, and the data on long-term outcomes remain limited.
-
This paper aims to bring back to life an underrated, even forgotten surgeon of the late first century B. C. E., Meges of Sidon. ⋯ Celsus, a Roman encyclopedist of the first century, would later erroneously receive credit for ancient surgical innovations, such as the nonslipping cranial drill and the treatment of depressed skull fractures, even though he was not a surgeon. However, as Celsus was going over the history of surgery, he described Meges as the "most learned" of its prominent figures. Meges' neurosurgic techniques and teachings are deduced from Celsus, who shortly succeeded him, did not practice surgery, and acknowledged him as his primary source on surgical topics.
-
Neuroendoscopy has progressed remarkably in the past few decades. Ventriculoscopy, skull base endoscopy, and spinal endoscopy are now part of routine practice in the neurosurgical treatment of numerous pathologies. Like other developing fields, however, it faces numerous challenges and obstacles that must be overcome for the field to continue to evolve and expand. This brief review of new and exciting developments in neuroendoscopy describes some of the most interesting directions the field is starting to steer towards.
-
Multicenter Study
Predictive factors for dysphagia after anterior cervical spine surgery: A prospective multicentre study.
To identify the incidence and predictors of postoperative dysphagia in patients who undergo anterior cervical spine surgery (ACSS) by utilizing the Eating Assessment Tool (EAT-10). ⋯ Dysphagia is common after ACSS, affecting more than 67.5% of patients at 7 days postoperatively, but over time, the incidence of dysphagia gradually decreases. Involvement of the vertebral bodies at C4 and above is a risk factor for dysphagia after ACSS, and intraoperative neurophysiological monitoring is a protective factor.