Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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We report a patient with McCune Albright syndrome with acromegaly and features predictive of difficult airway except a class I upper lip bite (ULB) test. Our patient, a 33-year-old woman, had a history of polyostotic fibrous dysplasia. ⋯ Our report suggests that the ULB test in people with acromegaly may act as an indicator of easy intubation in spite of other poor predictive signs. However, this finding needs further corroboration by a large study to evaluate the role of the ULB test in people with acromegaly.
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Patients with sickle cell disease (SCD) who have deformities and vertebral fractures due to osteoporosis may require surgery. Spinal surgeons must become familiar with the vertebral morphometry of patients with SCD and to that aim we have examined the morphometry of the thoracolumbar spine in these patients. A cohort of 100 patients with SCD was examined using plain thoraco lumbar anteroposterior/lateral radiographs and dual energy X-ray absorptiometry (DEXA). ⋯ Our data highlight the differences in vertebral bone mineral density, anatomy and deformities in patients with SCD compared to healthy individuals. When considering surgical intervention for patients with SCD, it is important that pre-operative radiography and planning is undertaken, and that the surgeon is familiar with the geometry of the pedicles of the thoracolumbar vertebrae necessary for the safe insertion of pedicle screws. Osteoporosis must be considered when planning surgical interventions in these patients.
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Phrenic nerve stimulation is a technique whereby a nerve stimulator provides electrical stimulation of the phrenic nerve to cause diaphragmatic contraction. The most common indications for this procedure are central alveolar hypoventilation and high quadriplegia. This paper reviews the available data on the 19 patients treated with phrenic nerve stimulation in Australia to date. ⋯ Three patients had revisions due to mechanical failure. The remaining patients' notes were incomplete. These data suggest that phrenic nerve stimulation can be used instead of mechanical ventilators for long-term ongoing respiratory support.
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Kyphoplasty is a minimally invasive procedure that is used to augment vertebral body strength. This technique has been commonly used to treat osteoporotic, vertebral body compression fractures. The technique was also used to augment painful metastatic vertebral fractures. ⋯ It can restore VBH and correct the kyphosis angle. While the increased amount of the injected PMMA led to its leakage, it did not contribute to restoration of the VBH or kyphosis correction. Therefore, one should avoid injection of excessive amounts of PMMA.
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Seeding metastases of a benign intraventricular meningioma along the surgical track is rare. We report a patient with a benign fibroblastic intraventricular meningioma that had spread along the path of previous surgery; the recurrences as well as the primary tumor were benign.