World Neurosurg
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The psoas muscle (PS), 1 of the paravertebral core muscles, is associated with sarcopenia. It also has clinical relevance in lateral-access spinal surgery (LASS) as a determinant structure affecting the operative window. We aimed to identify age-related patterns of PS degeneration, and we propose that our results be used to evaluate the operative window in LASS. ⋯ In patients without sagittal imbalance, the PS showed significant imaging characteristics. Our detailed data may aid the identification of degeneration patterns and specific preoperative planning regarding the operative window for LASS.
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Case Reports
Tentorial Venous Anatomy: Cadaveric and Radiographic Study with Discussion of Origin and Surgical Significance.
Described variations of tentorial venous anatomy impact surgical sectioning of the tentorium in skull base approaches; however, described configurations do not consistently explain postoperative complications. To understand the outcomes of 2 clinical cases we studied the tentorial venous anatomy of 2 cadavers. ⋯ Herein, we elaborate on transtentorial venous anatomy. These veins, previously reported to obliterate in completed development of the tentorium, remain patent with consistent observed configuration. The same transtentorial venous system was observed in both cases and provided insight to their outcomes. These findings emphasize the importance of the transtentorial venous system physiologically and in surgical approaches.
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Distal catheterization in the ophthalmic artery beyond the origin of the central retinal artery has been attempted to avoid visual complications in cases of transarterial embolization (TAE). Although avoiding visual complications is important, extraocular complications have been rarely reported and discussed. Here, we report a case of an intraorbital arteriovenous fistula (AVF) presenting with impaired extraocular movement after a provocation test and discuss the potential risks associated with TAE at the third segment of the ophthalmic artery. ⋯ In intraorbital hypervascular lesions, occlusion of the third segment of the ophthalmic artery is associated with a potential risk of extraocular complications.
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Early decompression after acute spinal cord injury (SCI) is recommended. Acute care is crucial, but optimal management is unclear. The aim of this study was to investigate the role of preoperative magnetic resonance imaging (MRI) in addition to computed tomography (CT) in surgical decision making for acute cervical SCI. ⋯ Preoperative MRI influenced surgical decision making substantially in our cohort and has become a new standard for patients with cervical SCI in our institution if medically possible.
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The benefit of adjuvant radiotherapy (RT) is uncertain in elderly patients diagnosed with World Health Organization (WHO) grade III meningiomas. ⋯ Adjuvant external beam RT may not provide any survival benefit for elderly patients with WHO grade III meningioma after gross total resection.