World Neurosurg
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Extended fusion can be performed in patients with Lenke 5C adolescent idiopathic scoliosis (AIS) with a large and relatively rigid thoracic curve. Progression of the thoracic curve is related to coronal imbalance. We aimed to determine the correlation between the upper instrumented vertebra choice and coronal balance in patients with Lenke 5C AIS. ⋯ In patients with Lenke 5C AIS, thoracic curve fusion results in better correction of the thoracic curve but no improvement in coronal balance. With TL/L fusion, a postoperative UEV tilt >5° leads to better coronal balance.
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Review Case Reports
Recurrent secondary trigeminal neuralgia caused by an obliterated tentorial dural arteriovenous fistula cured with surgical resection: A case report and literature review.
Trigeminal neuralgia (TN) caused by a tentorial dural arteriovenous fistula (TDAVF) is quite rare. To date, only 10 cases and 2 small case series have been reported in this regard, and most were treated with either embolization or surgery. Here, we report a unique case of a TDAVF presented as TN, which was embolized with Onyx first and resected later. ⋯ Even complete obliteration of fistula could cause the recurrence of neuralgia, and resection of embolized dilated veins might be effective for the treatment of TN in such recurrent cases.
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Review Case Reports
Re-recurrence of intracranial aneurysm with proximal vascular stenosis after primary clipping and secondary endovascular embolization: A case report and literature review.
It was known that a small number of patients could have intracranial aneurysm recurrences after either surgical clipping or endovascular embolization treatment. However, early recurrence within 1 month after the treatment and re-recurrence has rarely been reported before. ⋯ Re-recurrence of intracranial aneurysm could happen after initial successful treatment with surgical clipping and endovascular embolization. In addition to the patient's medical history and characteristics of the aneurysm, local vascular stenosis might also contribute to its recurrence. Close postoperative follow-up is required for these patients.
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Traditional open approaches to correct lumbar spine deformities include 3-column osteotomies, such as a pedicle subtraction osteotomy (PSO). Minimally invasive surgical (MIS) techniques have been developed for lateral transpsoas anterior column realignment (ACR). These 2 techniques have not previously been combined. Our objective was to investigate the cadaveric feasibility of a combined hybrid MIS ACR-PSO technique for deformity correction and to review early clinical experience. ⋯ Our early experience suggests that a combined ACR-PSO with posterior fixation allows for significant correction of segmental lordosis and global imbalance. This combined approach may maximize results attainable with hybrid MIS-open surgical techniques and represents a complementary option to PSO and other posterior approaches.
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Review Case Reports
A rare and symptomatic Cavernous Donut-shaped Aneurysm treated by Flow Diverter Deployment.
We describe the case of a 62-year-old woman who was admitted to our center for acute diplopia secondary to a left III cranial nerve palsy, left eyelid swelling and ptosis, and mild ipsilateral retroorbital pain. No other motor or sensitive deficits were observed. ⋯ Twelve months after the procedure the aneurysm was completely occluded, and the patient had totally recovered the cavernous syndrome. A careful literature review has been performed, and the different endovascular approaches have been analyzed.