World Neurosurg
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Kyphoplasty is a minimally invasive spine surgical procedure performed to stabilize and treat the pain caused by a spine compression fracture. Complications are rare with kyphoplasty and include cement extrusion into the vertebral canal leading to spinal cord or nerve root compression. Herein, the authors present a case of a 72-year-old woman who presented with symptoms of a right L2 radiculopathy after a kyphoplasty procedure. ⋯ A transforaminal endoscopic surgical approach was used to remove the cement and decompress the L2 nerve. The patient's postoperative clinical course was uneventful. Clinicians should be aware that for the treatment of complications to vertebroplasty and kyphoplasty procedures, minimally invasive transforaminal endoscopic surgery is one option to avoid the destabilizing effects of laminectomy and facetectomy.
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The mid-arm structure named arcade of Struthers has been shrouded in controversy since it was identified. Most specimens in previous studies were European. The occurrence, component, extent, and position of this structure in the xanthoderm are not clear. Moreover, research into the arcade of Struthers has been at the anatomic level and there has been no ultrasonic research. The aim of this study was to elucidate and measure this anatomy by both anatomic dissection and ultrasonic observation to provide clear and definite criteria to classify the arcade of Struthers, as well as operation guidelines for identifying the arcade of Struthers in ultrasonic imaging and surgical decompression. ⋯ We believed that an arcade of Struthers described by multiple investigators did exist in Chinese people, and based on our study, it was classified into 2 types: TAS and MAS. Caution should be used to preserve the superior ulnar collateral artery when incising the arcade of Struthers. Ultrasonography can detect the existence ratio, dimension, and location of the arcade of Struthers.
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Retroperitoneal dumbbell lumbar spinal schwannomas (RDLSSs) classified as the Eden type 4 are composed of small intervertebral foramen components and large paravertebral components extending into the retroperitoneal cavity. The surgical management of RDLSSs s remains a great challenge for all neurosurgeons because of the features of tumor. ⋯ The operative plan should be tailored to the features of the RDLSS. Retroperitoneal laparoscopy surgery by the anterior approach can produce safe and effective resection of RDLSSs with minimal postoperative complications. This procedure may be preferred for RDLSSs mainly located in the retroperitoneum without spinal canal extension.
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To investigate the usefulness of 3-dimensional computerized tomography angiography (3D-CTA) in the microsurgical management of anterior communicating artery (AcomA) aneurysms. ⋯ Rotation of the AcomA complex and dome projection are important angioanatomic elements in determining the surgical exposure and side of the approach. This study illustrates the role of 3D-CTA in the management of these difficult lesions by individualizing the surgical approach.
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Acute subdural hematoma (ASDH) is the most important cause of severe head injuries occurring during judo practice in Japan. Repeated head injuries have been reported as a cause of fatal ASDH, although the mechanism remains unknown. ⋯ It is important to be aware of the possibility of a small ASDH in concussed judo players after an initial impact, which may lead to subsequent fatal ASDH after another impact incident.