World Neurosurg
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The aim of this study was to assess nasal morbidity of endoscopic transsphenoidal approaches (ETAs) for treatment of sellar and parasellar diseases through evaluation of quality of life (QoL) and nasal function. The impact of different ETAs, according to extent and reconstruction technique, was also studied. ⋯ The modular ETA technique is associated with minimal morbidity and preserves nasal patency, airflow, and olfactory function. Quality of life is not affected and although small septal perforations and synechiae can be observed, nasal physiology is not compromised. Nonetheless, careful manipulation of sinonasal structures is recommended to minimize postoperative sequelae.
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Pituitary adenomas are uncommon in the pediatric population. Although medical treatment can be effective in treating prolactinomas and some growth hormone-secreting tumors, resection is indicated in the setting of pituitary apoplexy, large or giant pituitary adenomas causing mass effect or visual loss, or when medical therapy becomes ineffective or intolerable. Modern microsurgical transsphenoidal approaches are potential avenues for resection in pediatric patients. We evaluated the outcomes and safety of this approach. ⋯ A modern transsphenoidal microsurgical approach proved to be a safe, well-tolerated, and effective modality in the setting of pediatric pituitary adenomas.
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Comparative Study
The n-HA/PA66 Cage Versus the PEEK Cage in Anterior Cervical Fusion with Single-Level Discectomy During 7 Years of Follow-Up.
The nano-hydroxyapatite/polyamide66 (n-HA/PA66) cage is a novel biomimetic nonmetal cage, whereas the polyetheretherketone (PEEK) cage has been widely used for decades with excellent clinical outcomes. However, there has been no long-term comparison of these 2 cages in anterior cervical reconstruction. ⋯ After single-level ACDF, the n-HA/PA66 cage showed similar radiographic fusion, subsidence rate, and clinical results compared with the PEEK cage during 7 years of follow-up. These results suggest that the n-HA/PA66 cage could be comparable with the PEEK cage for ACDF.
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Minimally invasive transformational lumbar interbody fusion (MI-TLIF) with unilateral pedicle screw (UPS) fixation was controversial. The aim of this study was to compare the stability between UPS and bilateral pedicle screw (BPS) fixation before and after graft fusion. ⋯ Fusion of graft improved the fixation effect of posterior instrumentation system. Unilateral pedicle screw fixation could provide similar biomechanical stability to bilateral pedicle screw fixation in 1-level MI-TLIF after fusion.
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Case Reports
Intraspinal Dissemination and Local Recurrence of an Intracranial Hemangiopericytoma: Case Report.
Hemangiopericytomas (HPCs) are rare vascular tumors that resemble meningiomas on imaging and have a high rate of local recurrence and metastases. There remains a paucity of data to guide management decisions of intraspinal dissemination of HPCs in the literature, and none specifically related to anaplastic HPCs. ⋯ This case report discusses the role genetics, adjuvant RT, SRS, magnetic resonance imaging, and PET scan played in this unique clinical scenario of anaplastic HPC.