World Neurosurg
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Case Reports
NECROTIZING FASCIITIS INVOLVING THE SPINE: An unusual medical emergency for the spine surgeon.
Necrotizing fasciitis (NF) is a surgical diagnosis characterized by a rapidly progressive soft tissue infection, widespread tissue necrosis, and associated systemic illness. Friability of the superficial fascia, dishwater-gray exudate, and absence of pus are surgical characteristics of this diagnosis. Due to rapid progression of the infection, early recognition and aggressive surgical debridement are crucial to reduce mortality. Despite being commonly seen by general, plastic, and orthopedic surgeons, NF is an extremely rare spine surgery emergency. Our objective is to report on a case of NF involving the spine and highlight this unusual surgical emergency for the spine surgeon. ⋯ To the best of our knowledge, the literature presents only 1 previous case reported involving the spine. Necrotizing fasciitis is an unusual surgical spine surgery emergency. Spine surgeons should be aware of this diagnosis in order to provide timely aggressive surgical debridement.
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The purpose of this study was to determine reference values for the sagittal plane alignment of the thoracolumbar junction (TLJ) in a young adult Korean population. ⋯ This study provides reference values with a wide physiologic range for the sagittal alignment of the TLJ of the spine in a young adult Korean population.
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The effect of marital status and living arrangements on health through modified health behaviors and social networks has been well-established in reported studies, with many experts claiming a "protective" effect from married life for individuals. We sought to study the effect of marital and socioeconomic status (SES) on the outcomes of patients with spinal cord tumors. ⋯ Unmarried and widowed status, lower SES, and male sex resulted in a greater risk of mortality. These factors should be considered when tailoring the treatment plan for such patients.
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Apparently similar intra-axial pontine lesions may demand distinct surgical approaches. Selecting the optimal approach reduces unnecessary manipulation of tracts and nuclei. This study aims to reveal a quantitative analysis of main surgical corridors dealing with intrinsic pontine pathology. ⋯ In addition to producing similar areas and angles of attack, the retrolabyrinthine yields a more orthogonal trajectory to lateral pons than the retrosigmoid approach. Adding a tentorial cut and anterior petrosectomy significantly increased areas and lengths of exposure of a regular subtemporal approach. The combined approach significantly increased angles of attack to both the supratrigeminal and lateral pontine safe zones.
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An academic genealogy describes mentoring relationships in an academic discipline. In this study, we outline an academic genealogy of neurosurgery department chairs in the United States beginning with the founding members of the field. ⋯ The academic genealogy in this study allows for any neurosurgeon trained in the United States to put his or her training into historical context. It also provides a reference for bibliographic research to quantitatively describe the influence of individuals and institutions on the field.