World Neurosurg
-
Ineffective closure of complex skull base approaches leads to wound complications and cerebrospinal fluid (CSF) leak. This can result in protracted hospital stays, additional procedures, delayed postoperative recovery, and increased cost of care. Removal of large middle fossa-infratemporal fossa tumors are particularly problematic as they result in a large dead space with gravity-facilitated CSF leakage into the cavity. In this report we describe the use of a novel technique, the "inverted gull wing" titanium mesh reconstruction. ⋯ The inverted gull wing technique represents a simple, fast, and effective closure for complex transzygomatic infratemporal fossa approaches.
-
Case Reports
Intraoperative supratentorial extradural haematoma complicating excision of a giant vestibular schwannoma.
A man developed a rare and unexpected contralateral intraoperative complication during a translabyrinthine resection of a large cystic vestibular schwannoma. ⋯ Although the development of postoperative extradural hematomas resulting from cerebrospinal fluid overdrainage is reported in the literature, this case is unique in that infratentorial surgery led to the development of a supratentorial hematoma.
-
Several trials from the U.S. Food and Drug Administration have demonstrated the success of cervical disc arthroplasty (CDA) in patients with degenerative disc disease causing radiculopathy, myelopathy, or both. For patients who had increased intramedullary signal intensity (IISI) on magnetic resonance image (MRI), however, the effectiveness and safety of CDA was unclear. This study aimed to evaluate the outcomes of CDA for patients with IISI on preoperative MRI. ⋯ Both clinical and radiological outcomes improved (the average length of IISI in the cervical spinal cord became shorter) after CDA. Therefore, CDA is a safe and effective option for patients even when there is IISI on the preoperative T2-weighted MRI.
-
Comparative Study
The Fate of Adjacent Segments after Anterior Cervical Discectomy and Fusion: The Influence of an Anterior Plate System.
The purpose of this study was to compare anterior cervical discectomy and fusion with cage alone (ACDF-CA) and anterior cervical discectomy and fusion with cage and plate (ACDF-CP) with regard to adjacent segment degeneration (ASD) diagnosed by the use of CT and MRI with retrospective matched cohort design. ⋯ The anterior plate system in ACDF tends to increase adjacent segmental motion and decrease adjacent segmental disc height. In addition, irrespective of clinical symptoms, ACDF-CP has a greater tendency to result in ASD than ACDF-CA after 24 months after surgery.