World Neurosurg
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We aimed to evaluate neuroprotective effects of tocilizumab on spinal cord ischemia-reperfusion (I/R) injury. Our study design was an experimental rabbit spinal cord I/R injury model, and the setting was at the Animal Research Laboratory, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey. ⋯ This study shows significant neuroprotective effects of tocilizumab on rabbit spinal cord I/R injury.
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Hemifacial spasm (HFS) is caused by vascular compression of the facial nerve. The definitive mechanism of offending vessel formation remains unclear. The aim of this study was to explore whether the anatomic and hemodynamic characteristics of the vertebrobasilar artery play a role in problematic vessel formation in HFS. ⋯ Anatomic variations and hemodynamics of the vertebrobasilar arterial system are likely to contribute to vascular compression formation in HFS.
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Dura of the anterior clinoid process (ACP) is presumably supplied by the ophthalmic and external carotid artery branches. There is a less recognized artery described by Yasargil that arises directly from the supraclinoid internal carotid artery (ICA) and supplies the ACP dura. We studied the origin and course of this direct branch in patients in whom the carotid cistern was dissected for lesions not involving the carotid cistern and ACP dura. The management implications of this arterial twig have been described. ⋯ The knowledge of this arterial twig to the clinoidal dura is important as this supply may be responsible for feeding the tumor arising from the dura arising from the anterior clinoid, making preoperative embolization impossible. In addition, the tumor may grow along with this vessel and infiltrate the adventitia of the ICA at the origin of this vessel.
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The use of postoperative cervical collars following cervical fusions is common practice. Its use has been purported to improve fusion rates and outcomes. There is a paucity in the strength of evidence to support its clinical benefit. Our objective is to critically evaluate the published literature to determine the strength of evidence supporting the use of postoperative cervical collar use following cervical fusions. ⋯ We found no strong evidence to support the use of cervical collars after 1- and 2-level anterior cervical discectomy and fusion procedures, and no studies comparing collar use and no collar use after posterior cervical fusions. Given the cost and likely impact of collar use on driving and the return to work, our study shows that currently there is no proven benefit to routine use of postoperative cervical collar in patients undergoing 1- and 2-level anterior cervical discectomy and fusion for degenerative cervical pathologies.
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The present study assessed the most common types of lead failures, identified the causes, and discussed the potential procedures for revision surgery after vagus nerve stimulator implantation in patients with epilepsy. ⋯ The method of measuring the RC ratio developed in the present study is feasible for identifying lead disengagement at the generator level. Lead revision was an effective and safe procedure for patients experiencing lead failure.