Neurosurgery
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Randomized Controlled Trial
Ruptured status discrimination performance of aspect ratio, height/width, and bottleneck factor is highly dependent on aneurysm sizing methodology.
Numerous size and shape parameters have historically been used to describe cerebral aneurysms and to correlate rupture status. These parameters are often inconsistently defined. ⋯ Alternative aneurysm size definitions have a significant impact on prediction performance and optimal threshold values. Adoption of standard methodology and sizing nomenclature appears critical to ensure rupture detection performance and reproducibility across studies.
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Multicenter Study
Motion preservation and clinical outcome of porous coated motion cervical disk arthroplasty.
Artificial cervical disk replacements are commonly used to treat radiculomyelopathy caused by degenerative disk disease. However, long-term disk mobility and an effect on adjacent segment disease have yet to be demonstrated. We report improvements in clinical outcome after disk replacement but also demonstrate potential limitations. ⋯ Clinical improvement was seen after PCM disk replacement, but adequate range of movement was sustained in only 21% of disk replacements over time. Unclear long-term results of this and other disk replacements suggest caution in adopting these new devices as the gold standard.
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Review Case Reports
Thoracic myelopathy due to an intramedullary herniated nucleus pulposus: first case report and review of the literature.
Herniation of intervertebral discs is relatively common. Migration usually occurs in the ventral epidural space; very rarely discs migrate in the subdural space. No cases of intradural intramedullary disc have been reported in humans. ⋯ Intradural intramedullary migration of a herniated intervertebral disc is extremely rare but should be considered in the differential. It may present in a variety of clinical scenarios, including thoracic myelopathy, and mimic intramedullary spinal cord tumor.
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Review Case Reports
Intracerebral abscess associated with the Camino intracranial pressure monitor: case report and review of the literature.
Intracranial pressure (ICP) monitoring is a mainstay in the management of traumatic brain injury. Large investigations have validated the safety and efficacy of ICP monitors in comatose patients. Clinically relevant infections are extremely rare and cerebral abscess has never been reported with the Camino device. We describe an exceptional case of a life-threatening intracerebral abscess from an intraparenchymal ICP monitor. ⋯ To the best of our knowledge, this is the first report describing an intracerebral abscess as a complication from an intraparenchymal pressure monitor. Corticosteroid therapy may have constituted an independent risk factor for the ICP monitor--associated infection, as well as reinsertion of the ICP monitoring device at the same site. That this is the first reported parenchymal infectious complication underscores the safety of this device with respect to infection. When reinsertion of a parenchymal monitor is considered, a new site should be chosen.
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Although it is generally agreed upon that surgery for high-grade spondylolisthesis (HGS) is associated with more complications than low-grade spondylolisthesis, its description is primarily based on case reports and relatively small case series. ⋯ This study provides short-term complication rates associated with surgical treatment for HGS in adult and pediatric patients and may prove valuable for patient counseling, surgical planning, and in efforts to improve the safety of patient care.