World Neurosurg
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Patients with far lateral disc herniation (FLDH) experience more severe pain and sensory symptoms compared with those with paracentral disc herniation. In addition, surgical intervention has both been more challenging and resulted in poorer outcomes. ⋯ These results from a small group of patients suggest this is a safe approach with the potential for improved outcomes in the surgical treatment of FLDH.
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Observational Study
Intraspinal Inclusion Tumor After Myelomeningocele Repair: A Long-Term Single-Center Experience.
Given the lack of significant responses to many queries regarding behavior, treatment options, and possible prevention of iatrogenic intraspinal inclusion tumors (IITs), we think that further clinical, radiologic, and follow-up data are mandatory to better characterize this entity. We retrospectively reviewed a series of 14 consecutive patients with IIT occurring after myelomeningocele repair. The long follow-up is a mainstay of this series and may help a better understanding of the history of this slow-growing disease. To date, this is the largest series of IITs after myelomeningocele repair reported in the literature. ⋯ It is well established that IITs may be discovered in patients who have previously undergone myelomeningocele repair. In our series, with a long follow-up time, we describe the possible range of behavior of such lesions and the utility of surgical treatment of primary therapy. Our series confirms that residual IITs showed marked stability during our long follow-up.
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To describe and compare surgical exposure through microsurgical cadaveric dissection of the intercollicular region afforded by the median, paramedian, and extreme-lateral supracerebellar infratentorial (SCIT) approaches. ⋯ All the SCIT approaches warrant a safe route to the quadrigeminal plate. Among the different variants, the median approach had the smallest median surgical area exposure but presented superior results to access the intercollicular safe entry zone.
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A 65-year-old man presented with a giant recurrent sacral chordoma after undergoing 7 surgical resections. Neurologic examination revealed urinary incontinence. Magnetic resonance imaging showed a huge mass lesion in the bilateral gluteal regions and multiple metastatic chordomas. ⋯ In addition, multiple metastatic chordomas localized to the pelvic cavity and the subcutaneous layer of the gluteal region showed significant enlargement. The metastatic chordomas were resected in May 2018. At his last follow-up, the patient presented with an indwelling catheter and a colostomy bag, and the recurrent chordoma showed no visible enlargement.
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Postoperative ileus is not uncommon after spinal surgery. Although previous research has focused on the frequency of ileus formation, little has been done to investigate the clinical sequelae after development. We investigated the effect of postoperative ileus on patients' length of stay and rates of deep vein thrombosis (DVT) formation, myocardial infarction (MI), aspiration pneumonia, sepsis, and death. ⋯ This study demonstrates that patients with postoperative ileus are significantly more likely to have DVT, experience MI, acquire aspiration pneumonia, develop sepsis, and die.