World Neurosurg
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Biomechanical studies demonstrate that cortical bone trajectory pedicle screws (CBTPS) have greater pullout strength than traditional pedicle screws with a lateral-medial trajectory. CBTPS start on the pars and angulate in a mediolateral-caudocranial direction. To our knowledge, no large series exists evaluating the perioperative outcomes and safety of CBTPS. ⋯ As CBTPS becomes increasingly popular among spine surgeons performing lumbar fusion, this report provides an important evaluation of technique safety and acceptable perioperative outcomes.
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Aneurysmal subarachnoid hemorrhage management is hampered by our incomplete understanding of what variables promote aneurysm formation, growth, and rupture. Because hypovitaminosis D has been identified as a risk factor for other vascular diseases, we examined its association with cerebral aneurysms requiring treatment. ⋯ Patients with cerebral aneurysms requiring treatment have a significantly higher incidence of hypovitaminosis D compared with patients in a control group.
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Os odontoideum is a relatively rare but significant condition of the cervical spine that has potentially life-threatening complications, including vertebral artery dissection, leading to permanent neurologic disability and even death. Unfortunately, the literature is not clear as to the best management approach for os odontoideum. As such, clinicians and their patients are still left with difficult and uncertain treatment decisions in the absence of a clinical consensus. ⋯ This case illustrates that in the event an asymptomatic case of os odontoideum with radiological instability is managed conservatively, careful clinical and radiologic follow-up is essential as such cases can become symptomatic.
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Endovascular treatment using Onyx has been increasingly used to treat intracranial dural arteriovenous fistulas (DAVFs). This study evaluated predictive factors for favorable treatment outcome in patients with intracranial noncavernous DAVFs treated by transarterial Onyx embolization. ⋯ Transarterial Onyx embolization is a highly effective treatment method for non-sinus DAVFs. Careful consideration of angiographic features and multimodal embolization strategies are required for treatment of sinus DAVFs.
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The purpose of this study is to demonstrate the possible bony regrowth of the sella after transsphenoidal surgery without any intraoperative sellar reconstruction. ⋯ There is a natural bony regeneration of the sella after transsphenoidal pituitary surgery.