World Neurosurg
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Superior cluneal nerve (SCN) entrapment neuropathy can result in low back pain and thus be confused with other pathologies (e.g., lumbar disk disease). Therefore we performed cadaveric dissection of the SCN to better understand its anatomy and segmental origin. ⋯ The origin of the SCN, which has been described in the textbook and literature for a long time, should be reconsidered on the basis of our study results.
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Synovial cysts are most commonly found in the lumbar spine and are associated with low back pain and radiculopathy. Frequent use of imaging modalities has led to an increase in intraspinal synovial cyst identification. Treatment typically ranges from conservative measures to surgical decompression, but spontaneous resolution has previously been reported. Here, we present the first report of symptomatic lumbar synovial cyst resolution after a traumatic fall. ⋯ The diagnosis of synovial cysts are increasing in frequency due to their ease of identification with computed tomography and MRI. For cases of refractory pain and/or neurologic deficits, surgical decompression is usually necessary. In rare instances, synovial cysts may spontaneously regress or resolve secondary to other events. This is the first description of resolution after a traumatic fall. Due to limited data on this topic, this report may provide additional insight into the pathophysiology of synovial cyst formation and resolution.
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To provide anatomic evidence of preoperative assessment of oblique lumbar interbody fusion (OLIF) for Chinese patients. ⋯ OLIF can be a good choice for lumbar intervertebral fusion, including L5-S1 segment, in most Chinese patients. Older women are likely to have more scope of OLIF surgery. As a routine preoperative examination, lumbar magnetic resonance imaging is of great importance to OLIF surgery preoperative assessment.
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One third of patients with epilepsy fail to gain optimal control using antiepileptic drugs. New advances in epilepsy surgery have reshaped some diagnostic and therapeutic modalities into less invasive approaches. To understand the cortical epileptogenic networks, stereoelectroencephalography uses depth electrodes as a tool for invasive intracranial monitoring. These electrodes are now being placed using a robot instead of the traditional Talairach stereotactic grid and frame with comparable accuracy and the advantage of shortened surgical time. Whereas accuracy is important for correct cortical sampling and surgical morbidity, the factors that play a role in the deviation of the electrode's trajectory are not yet understood. The aim of this study was to determine if the angle the planned trajectory makes with the skull impacts the final accuracy of placement. ⋯ The ROSA robotic system is a powerful tool that increases the speed and efficiency of stereotactic neurosurgery. Care should be taken when planning trajectories to avoid high skew angles. If a high skew angle is unavoidable, care should be taken to ensure a larger margin of safety.
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In this study, we present our experience using resting-state functional magnetic resonance imaging (rs-fMRI) in preoperative planning. We performed group analysis to demonstrate the effects of brain tumor on resting-state networks (RSNs). ⋯ rs-fMRI is a feasible method for extended brain mapping. Diverse RSNs could be detected in patients with brain tumors and could be applied in preoperative planning. SCA was a robust and direct approach for data analysis and could answer specific clinically relevant questions. However, further studies are needed to validate the technique and its clinical impact.