World Neurosurg
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Retrospective cohort study. ⋯ The results of this study confirm that APCD aids surgical outcomes of ALIF in patients with suspected lumbar discogenic pain. We recommend performing APCD before ALIF to confirm lumbar discogenic pain.
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Intraoperative ultrasonography is widely used in neurosurgery for the management of intracerebral hematoma and brain tumor. However, the clinical value of this method in the surgery of cerebral arteriovenous malformations (AVMs) has not been reported. In this study, the application of intraoperative ultrasonography for AVM surgery was evaluated prospectively. ⋯ Microneurosurgery with intraoperative ultrasonographic image guidance was a safe, effective, and reliable method for identifying the afferent and efferent vessels and for confirming the complete resection of AVMs. These benefits of image-guided microsurgery were mostly apparent for deep-seated AVMs that were not visible on the surface of the brain.
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Case Reports
Intraoperative loss of tibialis anterior tceMEP predicted postoperative foot drop: A case report.
Footdrop secondary to L5 root injury is a rare complication associated with lumbar surgery. It is unclear whether intraoperative neuromonitoring can detect such an injury. ⋯ Intraoperative TA tceMEPs could detect L5 root iatrogenic injury.
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A 72-year-old man with bilateral chronic subdural hematomas was admitted to our department and treated using a YL-1 type hematoma aspiration needle. The treatment was complicated by hemorrhage of the basal ganglia and brainstem. This patient had no history of hypertension. We evaluated the relevant literature to analyze the causes of cerebral hemorrhage in similar patients. ⋯ This case report illustrates that the stability of the intracranial pressure should be closely monitored during the surgical treatment of chronic subdural hematomas, and large fluctuations in the cerebral perfusion pressure should be avoided during the operation. We also propose improvements in the technical details of the operative treatment of chronic subdural hematomas.
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To analyze the clinical outcomes of our experience with the unilateral C2 translaminar screw technique and evaluate its feasibility as an alternative or salvage of the pedicle screw. ⋯ Patients with variant vertebral artery or osseous anomaly are good candidates for the hybrid translaminar screw technique as an alternative to or salvage of C2 pedicle screw.