World Neurosurg
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A paucity of randomized trials have compared prophylactic dose of unfractionated heparin (UFH) versus low-molecular-weight heparin (LMWH) for the prevention of venous thromboembolic events in spinal surgery. Our objective was to determine the most prevalent chemoprophylactic techniques in spine surgery. ⋯ Prophylactic UFH was statistically more common than LMWH in neoplastic spinal surgery, but not in the degenerative/deformity and trauma groups (cohorts). Further trials are warranted.
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The middle fossa craniotomy for tegmen defect repair provides wide access. This approach often requires temporal lobe manipulation, lumbar drain placement, and longer recovery. We describe a keyhole middle fossa approach with a simple titanium skull base repair that allows for wide access with no temporal lobe manipulation and does not require lumbar drain placement, which results in a dramatic reduction in hospital length of stay. ⋯ A minimally invasive keyhole middle fossa approach with a multilayer dural reconstruction including titanium mesh "gull wing" skull base repair provides a quick, effective treatment for a broad spectrum of tegmen defects and meningoencephaloceles. This exposure and reconstruction technique do not require the use of a lumbar drain and result in minimal hospitalization.
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Cerebrospinal fluid (CSF) drainage reduces the risk of paraplegia in thoracoabdominal aortic aneurysm (TAAA) repair. Intracranial hemorrhage after TAAA repair has been reported as a rare complication of CSF drainage; however, spinal subarachnoid hematoma has never been reported. Here, we present a case of lumbosacral subarachnoid hematoma after CSF drainage in TAAA repair. ⋯ We present a rare case of lumbosacral subarachnoid hematoma after CSF drainage in TAAA repair. We should consider spinal subarachnoid hematoma when paralysis in the lower limbs occurs after CSF drainage.