Journal of neurosurgery. Spine
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Multicenter Study
Dynamically evoked, discrete-threshold electromyography in the extreme lateral interbody fusion approach.
because the psoas muscle, which contains nerves of the lumbar plexus, is traversed during the extreme lateral interbody fusion (XLIF) approach, appropriate nerve monitoring is needed to avoid nerve injury during surgery and prevent approach-related neural deficit. This study was performed to assess the effectiveness of dynamically evoked electromyography (EMG) to detect and prevent neural injury during the XLIF approach. ⋯ the ability to identify and report a discrete, real-time EMG threshold during the transpsoas approach helps to avoid nerve injury and is required for the safe performance of the XLIF procedure. Additionally, nerve location is variable, thus reinforcing the need for real-time directional and proximity information.
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no published evidence indicates when patients can resume golfing after spine surgery. The objective of this study is to provide data from surveys sent to spine surgeons. ⋯ the return to golf after spine surgery depends on many variables, including the general well-being of patients in terms of pain control and comfort when golfing. This survey serves as a guide that can assist medical practitioners in telling patients the average times recommended by surgeons across North America regarding return to golf after spine surgery.
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the object of this study was to determine the safe screw placement technique for cervical transarticular screw fixation. ⋯ this study establishes anatomical guidelines to allow for safe cervical transarticular screw insertion. The starting point of transarticular screws should be 1 mm medial to the midpoint of the lateral mass. The "ideal" drilling angle is approximately 37° in the inferior direction and 16° in the lateral direction for the C2-3 through the C5-6 levels. The screw should be directed as laterally as possible in the axial plane without causing the lateral mass to fracture and as caudally as the occipital bone permits in the sagittal plane. The ideal screw size would be 3.5 mm in diameter and 18 mm in length.
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in this paper, the authors' goal was to evaluate the feasibility, safety, and efficacy of apical segment resection osteotomy with dual axial rotation correction for severe focal kyphosis by examining outcomes. ⋯ apical segmental resection osteotomy with dual axial rotation correction and instrumented fusion is an effective and safe way to treat severe focal kyphosis of the thoracolumbar spine.
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Review Case Reports
Multifocal intradural extramedullary ependymoma. Case report.
In this paper, the authors present the case of a patient with multifocal intradural extramedullary ependymoma, and they review 18 previously reported cases. A 32-year-old man presented to the authors' institution with a 1-month history of partial medullary syndrome. Magnetic resonance imaging of the neuraxis revealed multifocal intradural extramedullary lesions at the bulbomedullary junction and C2-3, T5-11, L-2, L-4, L-5, and sacrum. ⋯ Intradural extramedullary ependymomas are rare, they predominate in women in the 5th decade of life, and pain is the most frequent initial symptom. The extent of resection and the presence of meningeal infiltration seem to be key determinants of prognosis. The present case is the first intradural extramedullary ependymoma (with the exception of those occurring at the conus medullaris and terminal filum) with multiple lesions at presentation.