Journal of neurosurgery. Spine
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Extensive muscle dissection associated with conventional dorsal approaches to the cervical spine frequently results in local pain, muscle wasting, and temporarily painful and restricted neck movement. The utility of a percutaneous muscle-sparing access technique and specifically modified instrumentation for multilevel posterior cervical decompression and fusion were evaluated. ⋯ Muscle sparing posterior decompression and instrumented fusion constitutes a safe and effective surgical option in a selected subgroup of patients with multilevel cervical spondylotic radiculomyelopathy. Specific modifications in surgical technique, instrumentation, and implants are mandatory for effective achievement of the surgical goals. The use of refined image guidance technology and intraoperative imaging can further improve surgical safety and efficacy.
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Perhaps the single greatest error that a surgeon hopes to avoid is operating at the wrong site. In this report, the authors describe the incidence and possible determinants of incorrect-site surgery (ICSS) among neurosurgeons. ⋯ Neurosurgical ICSSs do occur, but are rare events. Although there are significant limitations to the survey-based methodology, the data suggest that the prevention of such errors will require neurosurgeons to recognize risk factors and increase the use of intraoperative imaging.
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In this report, the authors present the case of patient with a lymphocele in the retroperitoneal area following anterior lumbar interbody fusion at L4-5. A lymphocele is a rare complication of spinal operations, especially lower lumbar spinal surgeries. The authors discuss this complicating factor and describe its features and treatments.
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A spinal epidural hematoma is an extremely rare complication of cervical spine manipulation therapy (CSMT). The authors present the case of an adult woman, otherwise in good health, who developed Brown-Séquard syndrome after CSMT. ⋯ The unique feature of this case was the magnetic resonance image showing increased signal intensity in the paraspinal musculature consistent with a contusion, which probably formed after SMT. The pertinent literature is also reviewed.
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The aim of this study was to analyze the endovascular treatment results of using the Onyx liquid embolic system for spinal intramedullary arteriovenous malformations (AVMs). ⋯ Embolization using the Onyx system is a promising treatment method for spinal vascular malformations, even for challenging intramedullary AVMs. Larger studies with longer follow-up durations will further enhance our knowledge on the safety and efficacy of this relatively new liquid embolic agent.