Acta neurochirurgica
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Acta neurochirurgica · Nov 2009
Dural suturing for repair of cerebrospinal fluid leak in transnasal transsphenoidal surgery.
Repair of a cerebrospinal fluid (CSF) leak after transsphenoidal surgery (TSS) is usually accomplished using various graft materials. These methods are effective in most, but not all, cases. ⋯ Direct suturing of the sellar dura is a simple, safe, and reliable surgical technique for repairing CSF leaks after TSS. Using this procedure, more than 70% of patients with an intraoperative CSF leak can avoid autologous tissue grafts.
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Acta neurochirurgica · Nov 2009
Long-term outcome and survival of surgically treated supratentorial low-grade glioma in adult patients.
The appropriate management of low-grade gliomas is still a matter of debate. So far, there are no randomized studies that analyze the impact of surgical resection on patient outcome. The value of the data obtained from the few retrospective reports available is often limited. ⋯ In summary, we could retrospectively evaluate a large case series of well-defined low-grade gliomas patients with a long follow-up period showing that extended surgery would be the most effective therapy for low-grade glioma patients even in recurrent diseases.
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Cervical spondylodiscitis is a quite rare finding regarding the number and the common location of spinal abscesses in the lumbar region. While in thoracic and lumbar discitis, single-step surgery with neural decompression, disc space evacuation, and subsequent fusion is well known, there is no such report in cervical discitis. Here the authors present their experience with ventral polyetherketone (PEEK) cage fusion in cervical spondylodiscitis in a single-step procedure. ⋯ In all, abscess drainage and ventral fusion with PEEK-cage disc replacement in one single setting was proven to be a successful treatment option in cervical discitis and spinal epidural abscess.
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Acta neurochirurgica · Nov 2009
Association of F18-fluoro-ethyl-tyrosin uptake and 5-aminolevulinic acid-induced fluorescence in gliomas.
Malignant gliomas are highly infiltrative tumours with a fatal prognosis. F18-fluoroethyl-tyrosine (FET)-positron emission tomography (PET) often reveals a broader extension of these tumours compared with contrast-enhanced magnetic resonance imaging (MRI). Complete resection of the contrast-enhancing lesion is aspired. Fluorescence-guided resection using 5-aminolevulinic acid (5-ALA) improved the extent of resection. In this study, we investigated whether the FET uptake correlates with the extent of resection using 5-ALA-induced fluorescence. ⋯ FET uptake predicts the 5-ALA-induced fluorescence in glioma patients. Thus, FET-PET provides useful information for planning glioma resection.
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Acta neurochirurgica · Nov 2009
Herniated nucleus pulposus in isthmic spondylolisthesis: higher incidence of foraminal and extraforaminal types.
The purpose of this study was to evaluate the pattern of disc herniation and to investigate the associated symptoms in cases of isthmic spondylolisthesis. It is well known that the pathogenesis of degenerative spondylolisthesis associates with disc degeneration, followed by facet laxity and ligamentum flavum hypertrophy, which result in severe spinal canal stenosis. But isthmic spondylolisthesis is known to have a different pathogenesis. In isthmic spondylolisthesis, pseudodisc bulging is easily identified, and canal stenosis is comparatively rare. Therefore, we propose that isthmic spondylolisthesis has a different pattern of disc herniation from degenerative spondylolisthesis. We studied the type, incidence of disc herniation and clinical symptoms related to isthmic spondylolisthesis. ⋯ As expected, pseudodisc bulging without disc herniation was the most common type in isthmic spondylolisthesis. However, in cases of disc herniation, extreme lateral disc herniation occasionally occurs; therefore, every isthmic spondylolisthesis patient should be examined carefully for extreme lateral disc herniation with thin-cut axial CT or MRI, especially when the patients complain of lateralizing symptom.