World Neurosurg
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Case Reports
Intra-arterial dantrolene for refractory cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage.
Dantrolene has a safe side-effect profile and a mechanism of action that makes it attractive as an option for treatment of cerebral vasospasm. The authors report 2 cases of refractory cerebral vasospasm secondary to aneurysmal subarachnoid hemorrhage that were successfully treated with intra-arterial (IA) dantrolene. ⋯ This evidence suggests IA dantrolene as a safe and effective novel alternative for the treatment of cerebral vasospasm.
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Metastasis from melanoma carries poor prognosis and survival. Average life expectancy is estimated 4 to 6 months after diagnosis of skeletal metastasis. Comprehensive treatment, along with newer immunotherapies, has shown promising results. ⋯ Our report emphasizes the importance of regular and critical surveillance of the disease and aggressive surgical and medical management in melanoma.
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Meta Analysis
Magnetically Controlled Growing Rod for Early Onset Scoliosis: A Systematic Review and Meta-Analysis.
The goal of the current systematic review and meta-analysis was to explore the utilization of a magnetically controlled growing rod (MCGR) for the treatment of early-onset scoliosis based on eligible studies demonstrating efficacy. ⋯ We demonstrated that MCGR significantly reduced the Cobb angle and thoracic kyphosis while markedly increasing T1-T12 and T1-S1 distances. However, a close comparison of MCGR with CGR reveals more high-quality randomized control trials with a larger sample size and long-term follow-ups are necessary to gather more robust evidence on the efficacy of MCGR for early-onset scoliosis.
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To retrospectively evaluate long-term efficacy and safety of dorsal root entry zone (DREZ) lesion for treatment of neuropathic pain within the lower extremities and perineal region after thoracolumbar spine fracture. ⋯ For patients with neuropathic pain of the lower extremities and/or the perineal region after thoracolumbar spine fracture, pain within the lower extremities was mostly because of nerve root injury. Pain in the perineal region caused by L1 fracture was attributed to spinal cord injury segmental pain. Nerve root injury pain had a good prognosis after DREZ lesion; the effect of DREZ lesion for spinal cord injury segmental pain may be uncertain.
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Ventral lesions of upper thoracic spinal cord due to degenerative diseases are rare and often have poor operative outcomes. Anterior decompression of the lesion is difficult because of the local anatomy. This retrospective study aimed to evaluate reproducible anatomic measurements for selecting the best surgical approach for anterior decompression of ventral lesions of upper thoracic spinal cord. ⋯ The SV line, a useful landmark for upper thoracic lesions, is not sufficiently reliable because it changes according to the patient's posture. By leaning in the direction of the surgical microscope, more caudal upper thoracic lesions can be reached than when using the SV line as a surgical landmark.