World Neurosurg
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Anterior cervical diskectomy and fusion (ACDF) is a standard surgical procedure used widely in the treatment of degenerative cervical spine conditions. Although the safety and effectiveness of single-level ACDF is well supported in the literature, reports of multilevel ACDF are sparse and present mixed results. There is concern for greater complications with increasing levels of fusion given the increased complexity, procedure duration, and invasiveness of multilevel ACDF. ⋯ This study suggests that 4-level ACDF is not necessarily associated with a greater number of or more severe complications than 3-level ACDF.
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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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Overlapping surgery, performed by the same primary attending surgeon asynchronously, has gained significant attention from the government and media as potentially harmful to patients. Therefore, the goal of this study was to evaluate the outcomes and safety of overlapping versus nonoverlapping microvascular decompression (MVD) operations. ⋯ Overlapping MVD operations may be performed safely at our institution. Further prospective studies are needed to understand the association of overlapping surgery among MVD operations.
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Case Reports
Intramedullary cavernous hemangioma with calcification of the spinal cord: Case report.
A 61-year-old man was admitted complaining of myelopathy and back pain for 3 months. ⋯ Hemangioma calcificans, a variant of cavernous hemangioma with full calcification and ossification, is an extremely rare disease in the spine and brain. Here we report a rare case of intramedullary cavernous hemangioma with calcification of the spinal cord.
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Glossopharyngeal neuralgia (GPN) and trigeminal neuralgia (TN) can result from mechanical stimulation of the glossopharyngeal nerve (GPNv) and trigeminal nerve (TNv) by blood vessels. TN can cause severe pain in the orofacial region, whereas GPN manifests as pain in the tongue, throat, tonsil, and ear. Although these 2 neuralgias can occur concurrently, concurrence of recurrent TN and GPN that develops postoperatively has not been previously described. ⋯ GPN can result from adhesions between the GPNv and arachnoid membrane following previous MVD.