Journal of neurosurgery
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Journal of neurosurgery · Mar 2004
ReviewHigh cervical disc herniation presenting with C-2 radiculopathy. Case report and review of the literature.
The authors report the case of a 78-year-old man with a C2-3 disc herniation that had migrated rostrally, causing C-2 radiculopathy. The C-2 radiculopathy manifested immediately after the patient underwent placement of a ventriculoperitoneal shunt for normal-pressure hydrocephalus. ⋯ Postoperatively the patient's radiculopathy resolved completely. To the authors' knowledge, this is the first case of a C2-3 disc herniation manifesting as C-2 radiculopathy and treated via a posterior extradural approach.
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Journal of neurosurgery · Mar 2004
Clinical course of patients with ossification of the posterior longitudinal ligament: a minimum 10-year cohort study.
Ossification of the posterior longitudinal ligament (OPLL) may produce quadriplegia. The course of future neurological deterioration in patients with radiographic evidence of OPLL, however, is not known. The authors conducted a long-term follow-up cohort study of more than 10 years to clarify the clinical course of this disease progression. ⋯ Results of this long-term cohort study elucidated the clinical course of OPLL following conservative or surgical management. Surgery proved effective for the management of patients with Nurick Grades 3 and 4 myelopathy.
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Journal of neurosurgery · Mar 2004
Open reduction of pediatric atlantoaxial rotatory fixation: long-term outcome study with functional measurements.
Atlantoaxial rotatory fixation (AARF) is an uncommon disorder of childhood in which resolution usually occurs spontaneously or after traction therapy. In a minority of children irreducible or chronic fixation develop, and the natural history then usually involves restriction of head on neck movement, abnormal head position, and progressive facial asymmetry. The conventional management in these cases has been a posterior fusion. ⋯ In the authors' opinion, open reduction provides the best possibility of normal facial development and return of axial movement in cases of AARF.
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Vascular complications related to lumbar disc operations are rare but extremely fatal conditions. The authors analyzed data retrospectively obtained in 13 patients with vascular complications that occurred during lumbar disc operations performed between January 1990 and January 2002. ⋯ Despite its low incidence, iatrogenic vascular injury related to lumbar disc surgery is a possible complication. During lumbar disc operations early diagnosis of vascular injuries and urgent transperitoneal surgery can save patients' lives.
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Journal of neurosurgery · Mar 2004
Comparative StudyBiomechanical comparison of anterior and posterior stabilization methods in atlantoaxial instability.
The authors compared the biomechanical stability of two anterior fixation procedures--anterior C1-2 Harms plate/screw (AHPS) fixation and the anterior C1-2 transarticular screw (ATS) fixation; and two posterior fixation procedures--the posterior C-1 lateral mass combined with C-2 pedicle screw/rod (PLM/APSR) fixation and the posterior C1-2 transarticular screw (PTS) fixation after destabilization. ⋯ The PLM/APSR fixation method was found to have the highest biomechanical stiffness followed by PTS, ATS, and AHPS fixation. The PLM/APSR fixation and AATS methods can be considered good procedures for stabilizing the atlantoaxial joints, although specific fixation methods are determined by the proper clinical and radiological characteristics in each patient.