World Neurosurg
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Comparative Study
Robot-Assisted Versus Fluoroscopy-Assisted Cortical Bone Trajectory Screw Instrumentation in Lumbar Spinal Surgery: A Matched-Cohort Comparison.
The aim of the present study was to compare the accuracy and safety of TiRobot system-assisted with those of fluoroscopy-assisted cortical bone trajectory screw placement in lumbar spinal surgery. ⋯ Robot-assisted screw placement is more accurate and safe compared with fluoroscopy-assisted placement for lumbar spinal cortical bone trajectory instrumentation.
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Spinal cord ischemia is a serious and catastrophic clinicopathologic condition. Despite studies reported over the last 20 years, alternative and efficient treatment options remain unclear. We examined the neuroprotective effects of vigabatrin on a spinal ischemia-reperfusion model. ⋯ Neuroprotective effects of vigabatrin are shown. For clinical use, further studies are needed.
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Case Reports
Post-Traumatic Pituitary Tumor Apoplexy after Closed Head Injury: Case Report and Review of the Literature.
Head trauma is a rare inciting factor of pituitary apoplexy (PA); however, there is a clear temporal relationship between trauma and apoplexy, and this is the first reported case of PA after an assault. ⋯ Early and accurate diagnosis is important to allow for timely neurosurgical intervention. Symptoms of fever, hypotension, and tachycardia in a patient with a known sellar mass should raise the suspicion of hypocortisolemia from pituitary tumor apoplexy.
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Postoperative C5 palsy is a well-known complication after cervical decompression with either a posterior or an anterior approach. Its cause has been discussed more regarding the posterior approach. The main hypothesis is that postoperative spinal cord shift causes root traction and palsy. However, the pathogenesis in anterior cases has not been fully described. Therefore, the purpose of this study was to clarify the risk factors for C5 palsy in the anterior approach through our C5 palsy cases. ⋯ Multiple corpectomy for patients with longer anterior lesions and locally developed kyphosis is related to a larger postoperative cord shift, which can cause the occurrence of C5 palsy. Moreover, C4-5 or C5-6 foraminal stenosis can accelerate tethering of the C5 or C6 nerve root. Older patients undergoing multiple corpectomy are susceptible to these risks of palsy. Appropriate patient selection and sufficient additional foraminotomy should be considered for extensive anterior lesions and locally developed kyphosis to avoid postoperative C5 palsy.
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Cerebral fat embolism (CFE) is a rare complication that usually occurs after trauma injury. The incidence of CFE due to aesthetic surgery is extremely rare and can lead to fatal outcome. Due to the rarity of this complication, there is still lack of knowledge and standardization of the treatment. ⋯ CFE is associated with high morbidity and mortality, and early surgical intervention can improve the prognosis.