World Neurosurg
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Review Case Reports
Styloidectomy and venous stenting for treatment of styloid induced internal jugular vein stenosis: a case report and literature review.
Internal jugular vein stenosis (IJVS) results in poor venous outflow and can result in intracranial hypertension. Venous stenting has become a debated topic for correction of this pathology. ⋯ The clinical practice in this case indicated that in patients with bilateral IJVS, a 2-side intervention may be necessary when unilateral correction fails. We advise a staged approach to correction of bilateral IJVS. Styloid compression-induced IJVS should be corrected by styloidectomy in combination with balloon and/or stenting, whereas IJVS induced by venous wall issues needs only stenting.
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Idiopathic scoliosis is the most common spinal disorder in the pediatric population. The goals of treatment for pediatric idiopathic scoliosis are to correct deformity, prevent curve progression, restore trunk symmetry and balance, and minimize pain and morbidity. Surgical treatment has advanced significantly, from the advent of segmental pedicle screw instrumentation several decades ago to the recent development of robotic-assisted surgery and growth-modulating fusionless surgery. The objective of the present study was to review the reported data on emerging techniques in the surgical treatment of idiopathic scoliosis in children and adolescents. ⋯ Various emerging techniques in the surgical treatment of idiopathic scoliosis in children and adolescents have demonstrated promising results in the reported data thus far. However, longer term prospective studies with larger cohorts are necessary to better evaluate their safety and efficacy.
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Multicenter Study
Significance of modified clivoaxial angles in the treatment of adult Chiari malformation type I.
To investigate the influence of modified clivoaxial angle (MCAA) on the surgical planning and outcome in adult patients with Chiari malformation type I. ⋯ MCAA may play a role in guiding the surgical treatment and predicting the prognosis in adult CMI patients. The larger the MCAA, the less invasive surgery is preferred with higher CCOS. PFDD should be the first choice in patients with mild or no VCMC (MCAA >138°) and RT in patients with moderate VCMC (127° < MCAA ≤ 138°). For patients with severe VCMC (MCAA ≤ 127°), RT could be considered as the primary surgery with awareness of the possible insufficiency of posterior decompression alone.
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Prolonged post-surgical drain retention increases risk for deep wound infection after spine surgery.
Surgical site infections (SSIs) complicate 1% to 9% of elective spine surgeries. Previously identified risk factors include diabetes mellitus type 2, obesity, and chronic kidney disease. We sought to determine whether the use of postoperative surgical site drains is associated with deep SSIs. ⋯ Prolonged surgical drain retention correlates with risk of deep SSI after surgery for degenerative spine disease independent of surgical invasiveness, diabetes mellitus type 2 status, and total drain output. Our data suggest early postoperative drain removal may potentially decrease the risk of SSI and shorten duration of hospital stay.
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Case Reports Randomized Controlled Trial
Preliminary Study on Obese Patients with Chronic Obstructive Pulmonary Disease Suffering from Painful Osteoporotic Vertebral Compression Fracture Treated by Percutaneous Vertebroplasty in Improved Prone Position and Right Lateral Position.
To assess outcomes in obese patients with chronic obstructive pulmonary disease (COPD) who sustained an osteoporotic vertebral compression fracture (OVCF) treated by percutaneous vertebroplasty (PVP) in the improved prone position and right lateral position. ⋯ Treatment of obese patients with COPD suffering from painful OVCF by PVP in both the improved prone position with a bilateral technique and the right lateral position with a unilateral technique was relatively safe and effective. However, unilateral PVP in the right lateral position was associated with a shorter operation time, limited fluoroscopic time, and minimal cement leakage.