World Neurosurg
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The application of stand-alone anchored spacer (SAAS) in anterior cervical discectomy and fusion (ACDF) has been proven to be safe and effective to treat cervical spondylosis. Skip-level ACDF with SAAS, fusing only the involved levels without anterior plates, may be the optimal treatment. The aim of the study was to compare the clinical outcomes, radiologic results of SAAS, and plate-cage construct in the treatment of 2 noncontiguous levels of cervical spondylosis. ⋯ Skip-level ACDF with SAAS is a safe and effective treatment of 2 noncontiguous levels of cervical spondylosis without obvious contraindications, which can keep the IS intact, and have a low impact on the IS.
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To evaluate the incidence, clinical presentation, operative techniques, and long-term outcome of spinal cervical meningiomas after surgery. ⋯ Spinal meningiomas are benign tumors for which advances in imaging tools and microsurgical techniques have yielded better results. The goal of surgery should be the total resection, which significantly decreases the risk of recurrence with an acceptable morbidity. Cervical locations represent a challenge particularly for ventro and ventrolaterally located tumors. Despite the difficulty of performing a complete resection, the results obtained in this work advocate for the use of the far-lateral approach to manage meningiomas locate anterior to the neural axis.
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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.
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Delayed rupture of a previously coiled unruptured aneurysm is extremely rare, and no hemodynamic analysis of such aneurysms has been reported during the postprocedural course. ⋯ Heterogeneous hemodynamic characteristics were involved in the outcomes of intracranial aneurysm after endovascular treatment. High-flow impingement and WSS were associated with recanalization and regrowth, whereas low WSS was associated with aneurysm rupture.
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To analyze the relationship between clinical factors and spontaneous canal remodeling. ⋯ During posterior fixation, the degree of the reduction of the vertebral body by distraction can affect the degree of postoperative reduction and spontaneous bone remodeling. Therefore, close attention must be given to the indirect reduction technique through distraction during the operation. Because comminuted fracture fragments affect spontaneous canal remodeling, the degree of postoperative resorption can be estimated by preoperative computed tomography imaging.