World Neurosurg
-
Surgical management of hemifacial spasm associated with chiari I malformation: analysis of 28 cases.
Hemifacial spasm (HFS) associated with Chiari I malformation (CIM) is rare. This study aimed to analyze the frequency of HFS associated with CIM in our department and further to investigate the clinical characteristics, treatment strategies, and outcomes of these cases. ⋯ The results suggest that MVD can still be an effective treatment for HFS when it coexists with CIM. Furthermore, posterior fossa crowdedness may be a common risk factor for the 2 diseases, and foramen magnum decompression should be considered as the primary procedure in patients with HFS and symptomatic CIM.
-
Neurosurgical patients are aging as the general population is becoming older. ⋯ This study identifies factors that predict perioperative complications for elderly patients undergoing elective craniotomies, particularly congestive heart failure, smoking history, chronic steroid use, anesthesia time, and estimated blood loss. Age alone should not preclude elective craniotomy.
-
Comparative Study
Comparison of the Total and Hidden Blood Loss in Patients Undergoing Open and Minimally Invasive Transforaminal Lumbar Interbody Fusion.
This study examined the volume of hidden blood loss (HBL) and compared perioperative blood loss between minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and open transforaminal lumbar interbody fusion (O-TLIF). ⋯ HBL is seriously underestimated and accounts for a large percentage of TBL in both MI-TLIF and O-TLIF. A correct understanding of HBL can ensure patient safety and improve postoperative rehabilitation.
-
Sacroiliac joint pain can be disabling and recalcitrant to medical therapy. The innervation of this joint is poorly understood, especially its anterior aspect. Therefore, the present cadaveric study was performed to better elucidate this anatomy. ⋯ An improved knowledge of the innervation of the anterior sacroiliac joint might decrease suffering in patients with chronic sacroiliac joint pain.
-
Preoperative visualization of the facial nerve could help neurosurgeons to prevent facial nerve injury during vestibular schwannoma surgery. Some studies have addressed diffusion tensor tractography (DTT) for preoperative identification of the facial nerve. However, few studies have focused on tractography-integrated neuronavigation for DTT verification. This study aimed to explore the appropriate DTT tracing parameters and evaluate the effect of intraoperative facial nerve tractography-integrated neuronavigation for verifying the DTT accuracy. ⋯ We consider preoperative DTT with intraoperative tractography-integrated neuronavigation to be a useful method for identifying the location of the facial nerve. This method might improve facial nerve preservation.