Neurosurgery
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To evaluate the role of stereotactic radiosurgery (SRS) in the management of recurrent or residual intracranial hemangioblastomas, we assessed tumor control, survival, and complications in 32 consecutive patients. ⋯ SRS is an important tool in the management of hemangioblastomas and is associated with a high tumor control rate and a low risk of adverse radiation effects.
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Scoliosis is a three-dimensional spinal deformity for which surgery may be indicated when patients experience severe pain, curve progression, or progressive disability. Operative treatment has conventionally involved extensive posterior stabilization, either alone or in combination with anterior release procedures. Anterior-only approaches have a more limited role, but they should be considered in the appropriate setting when addressing this disease. ⋯ Technological advances, including minimally invasive thoracic access as well as evolving instrumentation, may minimize the stated disadvantages and expand the scope of scoliosis cases that may be treated by anterior-only approaches. Hence, the enhanced corrective ability and biomechanical advantages of the anterior column can be used in the treatment of these patients. Although the indications for anterior-only strategies in scoliosis remain limited, such operations should be considered in the appropriate setting when addressing spinal deformity.
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Congenital thoracolumbar spinal deformities are a common and frequent reason for referral to spine surgeons. Neurosurgeons also treat many neurological diagnoses which may result in a progressive spinal deformity, such as scoliosis. ⋯ Advances in the field of spinal deformity correction now allow us to better treat individuals with these types of deformities. It is important for the practicing neurosurgeon to be knowledgeable of surgical and nonsurgical treatments of patients with congenital thoracolumbar spinal deformities in order to better understand which patients will ultimately progress and necessitate surgical treatment.
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To describe the technique and indications of a Smith-Petersen osteotomy in spinal deformity surgery. ⋯ A Smith-Petersen osteotomy is a safe and effective surgical technique to obtain correction of spinal deformity in both the sagittal and coronal planes.
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Comparative Study
Predictors of peritumoral edema after stereotactic radiosurgery of supratentorial meningiomas.
Anecdotal evidence suggests that radiosurgical ablation of parasagittal meningiomas may be associated with increased risk of subsequent edema. Potential predictors of postradiosurgical peritumoral edema, including parasagittal tumor location, tumor size, and treatment dose, were evaluated. ⋯ Patients with parasagittal meningiomas are at greater risk of developing peritumoral symptomatic edema after SRS. Close follow-up after SRS may be particularly important in such patients. These results highlight the need to pursue strategies that could decrease the incidence of postradiosurgical edema in patients with parasagittal meningioma.