World Neurosurg
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Observational Study
Long-term Multicolumn-Lead Spinal Cord Stimulation Efficacy in Patients Suffering from a Failed Back Surgery Syndrome: A Six-Year Prospective Follow-up Study.
The use of multicolumn-lead spinal cord stimulation (SCS) to control back pain (BP) and leg pain (LP) in patients with failed back surgery syndrome (FBSS) in the short term and mid-term has been well documented. Our study investigated whether SCS remained efficient after 72 months. ⋯ The SCS device provides sustained beneficial effects on BP, LP, DAL, sleep, and medication consumption in patients with FBSS still using it at 72 months postoperatively. Further studies are needed to identify the factors of adherence to the technique and the chances of success compared with the natural evolution of FBSS.
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Visual dysfunction and headache are major symptoms in patients with idiopathic intracranial hypertension (IIH). We aimed to evaluate the improvement of these symptoms in patients who underwent ventriculoperitoneal (VPS) and lumboperitoneal (LPS) shunting. ⋯ VPS and LPS are effective in improving visual symptoms and headache in patients with IIH.
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Case Reports
Ventral Thoracic Spinal Cord Herniation: Clinical Image and Video Illustration of Microsurgical Treatment.
Idiopathic spinal cord herniation is a rare cause of progressive myelopathy that can result in severe disability. In the following report, an illustrative case and associated video in the surgical management of ventral thoracic spinal cord herniation is presented and discussed. Spinal cord herniation is most commonly observed in the thoracic spine and is characterized by ventral displacement of the spinal cord through a defect in the dura. ⋯ The etiology is unclear, but suspected to be either acquired or congenital. Multiple surgical techniques have been reported with the goal of detethering the cord and taking adjunctive measures in reducing the risk for re-herniation. Surgical management of thoracic spinal cord herniation carries great risks, although neurological outcomes are generally favorable with improvements reported in the majority of cases.
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Review Case Reports
Tension pneumoventricle secondary to cutaneous-ventricular fistula. Case report and literature review.
Tension pneumoventricle (TPV) is a subtype of tension pneumocephalus in which the air is trapped inside the ventricles through a one-way osteodural defect, causing an increase in intracranial pressure. TPV secondary to cutaneous-ventricular fistula has been reported only twice in the literature. ⋯ This case report highlights the importance of suspecting and treating cutaneous-ventricular fistulas in TPV urgently in patients without skull base defects or those who showed no improvements with external ventricular drainage.
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Every year, there are an estimated 22.6 million new neurosurgical consultative cases worldwide, of which 13.8 million require surgery. In 2016, the global neurosurgical workforce was estimated and mapped as open-access information to guide neurosurgeons, affiliates, and policy makers. We present a subsequent investigation for mapping the global neurosurgical workforce for 2018 to show the replicability of previous data collection methods as well as to show any changes in workforce density. ⋯ Overall, the density of the neurosurgical workforce has increased from 2016 to 2018. However, at the current rate, 80 LMICs (58.0%) will not meet the neurosurgical workforce density target by 2030.