World Neurosurg
-
Patients with cervical instability and intramedullary signal intensity changes on preoperative magnetic resonance imaging scans may benefit from not only cervical decompression but also from fusion surgery. Transarticular screw (TAS) fixation is a useful technique for posterior fixation. We first report treating a patient with cervical spondylosis and instability by cervical laminoplasty with TAS fixation using a bioabsorptive screw. ⋯ Our method has advantages over metal instrumentation. The treated area can be evaluated with the use of magnetic resonance imaging, and the space left after screw absorption is filled by newly formed bone. Because our screw contains hydroxyapatite, it is osteoconductive. This may increase the fusion rate and induce substitution with new bone. To our knowledge this is the first patient treated by cervical posterior TAS fixation via the use of a bioabsorptive screw. Our method is safe and economical and free of the complications elicited by the use of metal parts. TAS fixation with a bioabsorptive screw may be appropriate for one fixation in patients without severe instability.
-
Schwannomas originating from the oculomotor nerve are extremely rare. We report our experience in the management of oculomotor schwannomas and other lesions mimicking them, and discuss operative strategy for these rare tumors emphasizing oculomotor nerve preservation. ⋯ The microsurgical resection of oculomotor schwannomas carries a risk of worsening preoperative oculomotor nerve function; however, this is often transient. Considerable technical training and microanatomical knowledge of the region is required to optimize outcome.