World Neurosurg
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Dilatation of the superficial temporal artery (STA) and middle meningeal artery (MMA) were occasionally observed after bypass surgery for moyamoya angiopathy. The purpose of this study was to examine the correlation between angiographic outcomes and magnetic resonance imaging (MRI), specifically focusing on the postoperative dilatation ratio of the STA (rSTA) and MMA (rMMA). ⋯ MRA may be an alternative to angiography. Both rSTA and rMMA estimated the development of collaterals after bypass surgery for moyamoya angiopathy.
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Giant cell tumors (GCTs) are benign tumors with a predilection for the epimetaphyseal region of the long bones. GCTs involving the skull base are rare, and only a few available cases have been reported. Surgical gross total resection is the recommended method of treatment for GCTs. In the case of skull base tumors, it is very difficult to achieve such a result by direct surgical resection alone without any morbidities. Denosumab is a fully humanized monoclonal anti-receptor activator of nuclear factor-κB ligand antibody that has been recently approved by the Food and Drug Administration for the treatment of GCTs that are surgically unresectable, metastatic, and have a high risk of progression and recurrence. Denosumab has been used in many cases involving the long bones. However, in cases of skull base GCTs, only a limited number of cases have been reported. In addition, in such cases, it was used as postoperative chemotherapy owing to subtotal resection. ⋯ Our findings emphasize the use of denosumab as a neoadjuvant treatment routinely for all cases of skull base GCTs to achieve safe and complete excision of the tumor.
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The present study introduced ultrasound volume navigation (UVN) to reduce the radiation exposure and puncture time of percutaneous transpedicular puncture in percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). ⋯ UVN could obviously reduce the radiation exposure and puncture time of percutaneous transpedicular puncture in PVP and PKP.
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Selecting optimal strategies for improving fixation in osteoporotic lumbar spine is an important issue in clinical research. Cortical bone trajectory (CBT) screws have been proven to enhance screw pullout strength, but biomechanical efficacy of these screws remains understudied. The aim of this study was to evaluate biomechanical efficacy of CBT screws in osteoporotic lumbar spine. ⋯ CBT screws had better biomechanical fixation in osteoporotic lumbar spine compared with standard pedicle screws.
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To introduce a modified percutaneous endoscopic lumbar diskectomy (PELD) technique to remove extraforaminal disk herniation at the L5-S1 segment, including the technical essentials and preliminary results. ⋯ We introduced a modified PELD technique to remove extraforaminal disk herniation at the L5-S1 segment. This technique was less invasive, effective, and safe. We also summarized a detailed protocol to identify and remove the herniated disk for nerve protection.