World Neurosurg
-
Distal anterior cerebral artery (DACA) aneurysms are rare, and their treatment by either surgical clipping or endovascular treatment poses technical difficulties. Earlier studies have reported higher complication rates in DACA aneurysms compared with other aneurysms in the circle of Willis. Therefore, endovascular management of DACA aneurysms still remains a challenge. The aim of this report is to review clinical presentation, angiographic presentation of DACA aneurysms, complications, and outcome of their endovascular treatment in our institutional experience. ⋯ Our experience with 11 patients showed that endovascular management of small DACA aneurysms, though associated with higher intraprocedural events, is associated with good outcome.
-
Nonfunctioning pituitary adenomas (NFPA) often shrink after transsphenoidal surgery. However, little is known about the predictors of spontaneous NFPA regression. The aim of this study was to determine whether the blood supply pattern of remnant NFPA lesions was associated with the likelihood of such lesions shrinking. ⋯ Evaluations of the blood supplies of remnant NFPA via preoperative dynamic MRI and the locations of the remnant tumors could be useful for predicting postoperative tumor shrinkage.
-
Cervical spondylotic myelopathy (CSM) is a disorder that can cause neurologic deterioration. Studies on paraspinal muscular atrophy (PMA) in the lumbar spine have shown that these changes are caused by several perioperative factors. It is possible that PMA in the cervical spine could behave similarly. In this retrospective study, we compared the degree of PMA after laminoplasty versus laminectomy and fusion (LF) using a standard posterior approach to the cervical spine. ⋯ PMA should be part of the decision making process when a posterior approach is considered, inasmuch as this study demonstrates that cervical laminoplasty was associated with significantly lower rates of PMA compared with cervical laminectomy and fusion. Additionally, these results suggest that minimizing PMA may help preserve cervical lordosis.
-
Although not life threatening, hemifacial spasm (HFS) can be disabling and significantly affect quality of life (QOL). The aim of this study was to assess the major factors affecting the QOL and further to investigate the impact of microvascular decompression (MVD) on QOL in patients with HFS. ⋯ HFS affects QOL both physically and mentally. Patients with severe HFS symptoms or a higher educational level are at higher risk of worse QOL. MVD not only provides high spasm-relief rate but also leads to significantly higher QOL after surgery.
-
Observational Study
Influence of obesity on complications, clinical outcome and subsidence following anterior lumbar interbody fusion (ALIF): prospective observational study.
The complications associated with obesity have been well described for posterior lumbar spinal surgery. However, the influence of obesity on anterior lumbar interbody fusion (ALIF) is not well established. We aimed to compare complication risks, functional outcomes, and subsidence rates in normal-weight, overweight, and obese patients who underwent ALIF. ⋯ There were no differences in functional outcomes or complications in patients with elevated BMI compared with normal-weight patients. Fusion rates were lower for patients were obese. Obesity should not be considered a contraindication to surgery in patients with appropriate indication to undergo ALIF.