World Neurosurg
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Hirayama disease (HD), characterized by insidiously progressive muscular atrophy of forearms and hands, is a self-limited cervical myelopathy that predominantly affects male adolescents, with female patients, especially middle-aged women, rarely affected. We present a rare case of HD with severe spinal cord injury in a 34-year-old woman. ⋯ The present case clarified the potential involvement of cervical kyphosis and cervical loading-related exercise in the onset and progression of HD. Anterior cervical corpectomy and fusion could serve as a promising treatment of HD with severe spinal cord injury.
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Oligodendrogliomas, the third most common primary gliomas, have a strict molecular definition, characterized by the combined presence of isocitrate dehydrogenase mutation and 1p19q codeletion. Herein, we describe an extremely unusual case of molecularly defined anaplastic oligodendroglioma with transdural extension into the frontal and ethmoid sinuses, without prior neurosurgical intervention or radiotherapy. The molecular profile of the tumor is also provided. ⋯ Most of the previously reported glial tumors with transdural extension were cases of histologically proven glioblastomas and gliosarcomas, typically seen in the context of prior neurosurgical intervention and/or radiotherapy. This case adds to the limited literature on oligodendrogliomas with transdural extension. Further studies are necessary to elucidate the relationship between the incidence of transdural extension and molecular subtypes of oligodendrogliomas.
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Observational Study
Symptomatic Pneumocephalus after Spinal Intradural-Extramedullary Tumor Surgery.
Durotomy is a necessary procedure for resection of spinal intradural-extramedullary (IDEM) tumor. The purpose of this study was to investigate the prevalence and clinical implications of pneumocephalus after spinal IDEM tumor surgery and also the association between pneumocephalus and postoperative headache. ⋯ Pneumocephalus is a common complication after spinal IDEM tumor surgery. This report is the first study to investigate the prevalence of pneumocephalus and analyze its association with headache after spine surgery. The severity of pneumocephalus was significantly related to postoperative headache.
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Comparative Study
Partial hemi-vertebra resection (Grade 4 osteotomy) for congenital scoliosis: a comparison with radical hemi-vertebra resection.
To compare radiological and clinical outcomes between partial and radical hemivertebra (HV) resection in congenital scoliosis (CS) patients with single nonincarcerated HV. ⋯ Partial HV resection is a safe, effective, and less invasive procedure and achieved comparable correction with radical HV resection in the treatment of CS patients with single nonincarcerated HV.
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Case Reports
3D, HD exoscopic Anterior Cervical Discectomy and Fusion: a valid alternative to microscope-assisted surgery.
Anterior cervical discectomy and fusion (ACDF) remains one of the most commonly taught procedures during residency and one of the most frequently performed by neurosurgeons. Neurosurgeons use microscopes to perform surgery and to train other surgeons. Although the microscope provides excellent illumination and magnification, its use will be limited to 2 people: the surgeon and the assistant. Consequently, the scrub nurse and residents watching 2-dimensional images on monitors will have a reduced perception of the surgical field depth and anatomical details. The exoscope has been introduced as an alternative to microscopes and endoscopes. We used a 3-dimensional (3D), high-definition exoscope (3D Vitom [Karl Storz, Tuttlingen, Germany]) in 2 patients undergoing 2-level ACDF for cervical myeloradiculopathy. ⋯ We believe that exoscope-assisted surgery could become a safe and effective alternative to microscope-assisted surgery in ACDF.