Journal of neurosurgery
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Journal of neurosurgery · Mar 2004
Case ReportsCervical peridural calcification in patients undergoing long-term hemodialysis. Report of two cases.
The authors report on two patients undergoing long-term hemodialysis in whom cervical myelopathy was caused by calcification related to the cervical dural sac. The lesions were demonstrated on plain computerized tomography (CT) scans as dotted curvilinear bands outlining the dural sacs in almost the whole of their cervical spines. ⋯ In each case, the spinal cord could not be decompressed by merely enlarging the osseous spinal canal; rather, it required removal of the calcified membrane from the posterior surface of the dura. Based on the operative findings, the lesion should be described as cervical peridural calcification.
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Journal of neurosurgery · Mar 2004
Stereotactic radiosurgery for brainstem arteriovenous malformations: factors affecting outcome.
Management options for arteriovenous malformations (AVMs) of the brainstem are limited. The long-term results of stereotactic radiosurgery for these disease entities are poorly understood. In this report the authors reviewed both neurological and radiological outcomes following stereotactic radiosurgery for brainstem AVMs over 15 years of experience. ⋯ Stereotactic radiosurgery provided complete obliteration of AVMs in two thirds of the patients with a low risk of latency-interval hemorrhage. Better three-dimensional imaging studies and conformal dose planning reduced the risk of adverse radiation effects. Younger patients harboring more spherical AVMs that did not involve the tectal plate had the best outcomes.
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Journal of neurosurgery · Mar 2004
Retrospective study of surgery-related outcomes in patients with syringomyelia associated with Chiari I malformation: clinical significance of changes in the size and localization of syrinx on pain relief.
Pain is one of the major symptoms in patients with syringomyelia; however, its origin is not fully understood, and postoperative improvement of pain is difficult to predict. The objectives of this study were to assess the surgery-related results obtained in patients who underwent treatment for syringomyelia associated with Chiari I malformation, particularly related to pain status, and to identify factors that may influence improvement in postoperative pain by comparing pre- and postoperative magnetic resonance (MR) imaging findings. ⋯ Neurons in the dorsal horn were thought to be involved in the development of pain as a result of the deafferentiation mechanism in cases of syringomyelia.
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Journal of neurosurgery · Mar 2004
Comparative StudyBiomechanical evaluation of cervical lateral mass fixation: a comparison of the Roy-Camille and Magerl screw techniques.
The purpose of this study was to assess human cervical spine pullout force after lateral mass fixation involving two different techniques: the Roy-Camille and the Magerl techniques. Although such comparisons have been conducted previously, because of the heterogeneity of results and the importance of this procedure in clinical practice, it is essential to have data derived from a prospective and randomized biomechanical study involving a sufficient sample of human cervical spines. The authors also evaluated the influence of the sex, the vertebral level, the bone mineral density (BMD), the length of bone purchase, and the thickness of the anterior cortical purchase. ⋯ The difference between pullout forces associated with the Roy-Camille and the Magerl techniques was not as significant as has been previously suggested in the literature. It was interesting to note the influence of the vertebral level: Roy-Camille screws demonstrated greater pullout strength (23%) at the C34 vertebral level than Magerl screws but no significant difference between the techniques was observed at C5-6.
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Journal of neurosurgery · Mar 2004
Case ReportsSciatic nerve entrapment in the upper thigh caused by an injury sustained during World War II at the battle of Anzio. Case report.
The authors present an unusual case of sciatic nerve entrapment due to a World War II shrapnel injury to the left thigh suffered during the battle of Anzio in 1943. The patient presented for evaluation of left lower-extremity pain in the sciatic nerve distribution. Magnetic resonance imaging of the lumbosacral spine revealed a disc bulge at L5-S1 that would not explain severe sciatica. ⋯ The patient underwent exploratory external neurolysis of the area, and the sciatic nerve was released from fibrous adhesive entrapment. The patient improved dramatically following surgery. During a 3-year follow-up period, no recurrence of symptoms was noted.