World Neurosurg
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Randomized Controlled Trial Comparative Study
Eleven-year follow-up of two cohorts of patients comparing stand-alone porous-tantalum cage versus autologous bone graft and plating in anterior cervical fusions.
Anterior cervical discectomy and fusion with a porous tantalum cage is an accepted method to treat degenerated cervical discs, with good results, similar to those with autologous bone graft and plating at short- and mid-term follow-up. However, to date, long-term follow-up studies have been performed. ⋯ These results show that the clinical and radiological outcomes achieved at mid-term follow-up using a tantalum cage for single-level anterior cervical discectomy and fusion will be maintained for 11 years postoperatively, similar to the results with autologous bone graft and plating.
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Cerebrospinal fluid rhinorrhea from a lateral skull base defect refractory to spontaneous healing and/or conservative management is most commonly managed via open surgery. Approach for repair is dictated by location of the defect, which may require surgical exploration. The final common pathway is the eustachian tube (ET). Endoscopic ET obliteration via endonasal and lateral approaches is under development. Whereas ET anatomy has been studied, surgical landmarks have not been previously described or quantified. We aimed to define surgical parameters of specific utility to endoscopic ET obliteration. ⋯ Although membranous and petrous components of the ET are important to its function, the genu may be a more useful surgical landmark. Basic surgical parameters for endoscopic ET obliteration are defined.
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Review Case Reports
Spinal Cord Stimulation in Adult Tethered Cord Syndrome: Case Report and Review of the Literature.
Spinal cord stimulation (SCS) is an evidence-based treatment for chronic neuropathic pain; however, there is a dearth of evidence investigating this modality in patients with tethered cord syndrome. ⋯ The literature review identified 2 other case reports of SCS in tethered cord syndrome with similar improvement in pain alleviation.
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Around 7%-33% of cases of neurocysticercosis (NCC) have intraventricular involvement, and the fourth ventricle is the most frequent site. Medical management and various surgical approaches have been described for treating this disease. The objective of this study was to describe technical modification for endoscopic fourth ventricular NCC removal in a series of 5 cases. ⋯ We conclude that our endoscopic approach is safe, simple, cost-effective, and allows minimally invasive removal of the fourth ventricle cyst and treatment of hydrocephalus without any morbidity.
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Review Case Reports
Management of Chyloretroperitoneum After Lumbar Surgery by Anterior Approach.
Anterior lumbar approach, routinely used in spinal surgery, provides many advantages, specifically avoidance of manipulation and potential injury to nervous system structures; it also provides indirect central and foraminal decompression, with a complication rate of 1%-3%. Chyloretroperitoneum is a rare complication of spinal procedures using anterior lumbar approach. The aim of this study was to discuss diagnosis, treatment, and management of chyloretroperitoneum based on review of the international literature through 2017. ⋯ Computed tomography was the most useful imaging modality for diagnosis and assessment of associated complications. If puncture alone is not sufficient and should be avoided, percutaneous computed tomography-guided drainage with sclerosing agent administration appears to be a safe and efficient first-line treatment. Laparoscopic fenestration should be used in cases of complicated or recurrent lymphoceles.