Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2014
Treatment of thoracic or lumbar spinal tuberculosis complicated by resultant listhesis at the involved segment.
The purpose of this study was to present a singular pathological process of thoracic or lumbar spinal tuberculosis contributing to listhesis at the involved site, with special focus on clinical features and management of this disorder. ⋯ Treatment of this rare pathology aims to restore good spinal alignment, radical debridement, and permanent stability. A reasonable surgical strategy may be the combination of posterior reduction, anterior debridement, and supportive graft fusion. This strategy can safely and effectively achieve all of the therapeutic goals in one step.
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Clin Neurol Neurosurg · Oct 2014
Accuracy of C2 pedicle screw placement using the anatomic freehand technique.
The objective of this study is to evaluate the incidence and prognostic factors of breach rates following the placement of C2 pedicle screws using the anatomic, freehand technique. ⋯ In this cohort study on the anatomic freehand placement of C2 pedicle screws, the breach rate was 17.3%. Lateral breaches were more common than medial breaches. Screw length was not statistically correlated with cortical violation or severity of breach. Therefore, screw length is not a prognostic factor for C2 pedicle screw misplacement.
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Clin Neurol Neurosurg · Oct 2014
Being a neighbor to Syria: a retrospective analysis of patients brought to our clinic for cranial gunshot wounds in the Syrian civil war.
Toward the end of 2010, the Arab spring, the waves of revolutionary demonstrations and protests influenced also Syria, where violent clashes turned into a civil war. Hundreds of thousands of people became refugees. The use of excessive force unfortunately culminated in numerous deaths and injuries in many cities. Being the closest city to Aleppo, Damascus and Homs, the biggest cities of Syria, Antioch/Hatay has been the city where initial emergency treatments were performed. For this reason, we examined and retrospectively analyzed the medical records of the patients treated in the clinics of our hospital due to cranial gunshot wounds during the war. ⋯ The authors recommend that the patients with cranial gunshot wounds who has GCS of 4-7 should be aggressively treated including surgery as well. We do not recommend surgical treatment for patients with GCS of 3. All our experiences show that treatment of gunshot wounds will continue to be a matter of debate, about which there is more to learn. The data presented in this study will once again demonstrate the seriousness of the event, and will, perhaps, contribute to the peace negotiations to end the war.
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Clin Neurol Neurosurg · Oct 2014
Octyl-cyanoacrylate skin adhesive is effective for wound closure in posterior spinal surgery without increased risk of wound complications.
Few published studies have examined the complication profile after posterior spinal surgery wherein absorbable, subcuticular suture and cyanoacrylate skin adhesives (CSA) were used for incision closure. The purpose of this report is to compare the rate and profile of wound complications in a large number of patients who underwent posterior spinal surgery with CSA skin closure to rates of similar complications with standard nylon closure techniques. ⋯ CSA is a safe method to achieve ultimate skin closure in patients who undergo posterior spinal surgery without increased risk of wound-related complications, even in those patients undergoing intradural procedures.
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Clin Neurol Neurosurg · Oct 2014
Nasal MRSA colonization: impact on surgical site infection following spine surgery.
Prior studies published in the cardiothoracic, orthopedic and gastrointestinal surgery have identified the importance of nasal (methicillin-resistant Staphylococcus aureus) MRSA screening and subsequent decolonization to reduce MRSA surgical site infection (SSI). This is the first study to date correlating nasal MRSA colonization with postoperative spinal MRSA SSI. ⋯ Preoperative nasal MRSA colonization is associated with postoperative spinal MRSA SSI. Preoperative screening and subsequent decolonization using topical antibiotics may help in decreasing the incidence of MRSA SSI after spine surgery. Nasal MRSA+ patients undergoing spinal surgery should be informed regarding their increased risk of developing surgical site infection.