World Neurosurg
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Meta Analysis
How Center of Rotation Changes and What Affects These After Cervical Arthroplasty: A Systematic Review and Meta-analysis.
To determine how center of rotation (COR) changes and what affects changes in COR after cervical arthroplasty. ⋯ Prosthesis design affects changes in COR after cervical arthroplasty. If a constrained or semiconstrained prosthesis is chosen (2-piece implant, ball-and-socket, or ball-in-trough design), the COR location tends to shift anteriorly and/or superiorly, whereas if a nonconstrained prosthesis is chosen (3-piece implant, mobile nucleus design), the COR tends to keep the same location as preoperation. In addition, the position of the prosthesis in the intervertebral space also can affect changes in COR after cervical arthroplasty.
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Just like Raymond M. Peardon Donaghy and Gazi Yasargil changed modern neurosurgery by introducing the surgical microscope into the operating room, so did Leonardo Gigli by developing and using for the first time a tool that allowed faster, easier, and safer opening of the skull. ⋯ Gigli (1863-1908) was an Italian surgeon and obstetrician remembered among others for describing his operation-the lateralized version of Severin Pineau's pubiotomy for safe delivery in cases of maternal pelvic deformity-and for designing the Gigli saw, a simple yet brilliant wire saw, versatile enough to be used as both a tool of war and a surgical instrument in the fields of gynecology, orthopedics, surgery, and neurosurgery. The authors pay tribute to Gigli and his contribution at 125 years since the first written mention of his innovative instrument.
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Iatrogenic ureteral injury associated with lumbar spine surgery is an uncommon but devastating complication with associated medicolegal implications. ⋯ Ureteral injury associated with lumbar spine surgery is overreported in developed or developing countries. It should be considered in the differential diagnosis of any patient who presents with symptoms of acute abdomen after lumbar spine surgery, and patients who underwent restorative surgery had a good prognosis.
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Over the last decades, significant advancements have been achieved in the treatment of pediatric brain tumors as a result of radiation therapy (RT). With the increasing diffusion of this treatment, iatrogenic damage to cerebrovascular tissues contouring the radiation target volume has become the subject of debate, especially radiation-induced moyamoya syndrome (RIMS). ⋯ Pediatric patients receiving involved field RT for the treatment of brain tumors have an increased risk of developing RIMS. Prompt diagnosis and early surgical revascularization play a pivotal role in decreasing the clinical impact of this complication. The use of new techniques, such as the intensity-modulated RT, and the increasing dose saving for the organs at risk, are essential to prevent iatrogenic vasculopathy. The combination of appropriate medical therapy and surgery will improve patient management and clinical outcome.
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Review Historical Article
Right versus Left Approach to Anterior Cervical Discectomy and Fusion: An Anatomic versus Historic Debate.
The debate over the influence approach sidedness has on the risk of recurrent laryngeal nerve palsy (RLNP) following anterior cervical discectomy and fusion (ACDF) has its origins with the introduction of the procedure for radicular pain in the 1950s. The recurrent laryngeal nerves follow disparate courses in the lower neck secondary to differences in embryogenesis. ⋯ However, modern surgical series have not shown a clear risk of RLNP with a right- versus left-sided approach. By looking at the historical context surrounding the introduction of ACDF, we propose the dogmatic view of an increased risk of RLNP with a right-sided approach likely arose from a combination of theoretical anatomic risk and the early surgical experience of a pioneer of the procedure.