World Neurosurg
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High-grade L5-S1 spondylolisthesis is challenging to treat, and there is no standard recommended operative technique. The authors performed a systematic review of the literature evaluating the efficacy and safety of modern transsacral instrumentation techniques for high-grade L5-S1 spondylolisthesis. ⋯ Operative techniques for managing high-grade L5-S1 spondylolisthesis are evolving. In our systematic review, modern transsacral instrumentation resulted in good clinical outcome and fusion rates, and acceptable complication rates. Risks and benefits should be individualized for each patient. Transsacral instrumentation is a viable and effective treatment option for this pathology.
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Review Case Reports
Non-calcified, hypertrophic ligamentum flavum causing severe cervical stenosis and myelopathy - A case report and review of literature.
Calcified hypertrophic ligamentum flavum is a known entity that causes myeloradiculopathy of the cervical, thoracic, and lumbar spine and is seen more commonly in Asian populations. Noncalcified hypertrophic changes are less common and may mimic other epidural space-occupying lesions. ⋯ To our knowledge, noncalcified hypertrophic ligamentum flavum causing progressive cervical myelopathy has never been reported in the English literature. This entity should be considered in cases with epidural masses causing progressive myelopathy.
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Multicenter Study
Incidence and characteristics of remote intracerebral hemorrhage after endovascular treatment of unruptured intracranial aneurysms.
The purpose of this study was to investigate the incidence and characteristics of remote intracerebral hemorrhage (ICH) after endovascular treatment (EVT) of unruptured intracranial aneurysms (UIAs). ⋯ The incidence of remote ICH after EVT of UIAs was 0.46%. This event occurred mostly in patients with stents, hypertension, and UIAs on the ICA. It presented mostly as an ipsilateral lobar-type hemorrhage within 1 week after the procedure. This complication should not be neglected because of its poor clinical outcomes.
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A variety of biomaterials have been developed for cranial reconstruction after craniectomy, including polyethylene titanium mesh and calcium phosphate cement. This study sought to compare complication rates of calcium phosphate cement and titanium mesh cranioplasty in patients undergoing retromastoid craniectomy. ⋯ Calcium phosphate cement cranioplasty offers an alternative to titanium cranioplasty and may reduce the risk of surgical site complication. Randomized, prospective comparisons of cement cranioplasty to traditional techniques are warranted.
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Pleomorphic xanthoastrocytoma (PXA) is a unique meningocerebral glioma with a relatively favorable prognosis. PXA also possesses a variant with anaplastic features (aPXA), which is associated with poor outcomes. To date, few studies have examined the clinicopathologic importance of these anaplastic features. ⋯ aPXA is associated with poorer clinical outcomes compared with PXA. Gross total resection should be the goal of initial treatment. It remains unclear whether adjuvant radiation and chemotherapy are able to prevent progression or dissemination. Long-term monitoring of all patients is a critical step in management due to the potential for tumors to transform into higher-grade lesions.