World Neurosurg
-
This study aimed to evaluate the risk factors for adjacent vertebral compression fractures after lumbar spinal fusion with instrumentation. ⋯ A greater Loss of LL, osteoporosis, and advanced age may be risk factors for fractures in the adjacent vertebral body of the fixed segment after lumbar fusion fixation.
-
Case Reports
Tension pneumoventricle after endoscopic transsphenoidal surgery for Rathke cleft cyst.
Tension pneumoventricle is an extremely rare, but treatable, neurosurgical emergency. The prompt and accurate diagnosis of tension pneumoventricle requires vigilance for the detection of clinical signs, which should also be corroborated by the imaging findings. We have reported on the pathophysiology of tension pneumoventricle and its management. ⋯ Tension pneumoventricle is an extremely rare, but life-threatening, complication of TSS. The development of tension pneumoventricle should be kept in mind even when the surgery has proceeded very smoothly. Sellar reconstruction will, theoretically, prevent this extremely rare complication but might increase the recurrence rate of Rathke cleft cysts. The related symptoms and signs should be recognized. Prompt recognition and treatment of this condition can be life-saving, and the long-term outcomes have generally been favorable if the condition has been recognized early.
-
Observational Study
Utility of Immediate Postprocedural Cone Beam Computed Tomography in the Detection of Ischemic and Hemorrhagic Complications in Pediatric Neurointerventional Surgery.
Cone beam computed tomography (CBCT) imaging is used commonly in neurointerventional surgery for rapid intraprocedural assessment and planning of intracranial interventions. Our goal was to evaluate the ability of immediate postprocedural CBCT scan in assessing potential complications in pediatric patients. ⋯ Immediate postprocedural CBCT images were adequate to detect ventricular size/subarachnoid spaces changes and large volume hemorrhage compared with cCT scan in pediatric patients. However, there are limitations using immediate CBCT images to detect small volume hemorrhage and ischemic changes.
-
In ventriculoperitoneal shunt (VPS) placement, distal placement of the peritoneal catheter will typically be performed by a neurosurgeon. More recently, laparoscopic-assisted (LA) placement of the distal peritoneal catheter by general surgeons has become common. The present study examined whether LA placement of a VPS (LAVPS) is associated with a reduced operative time, lower hospital costs, and fewer distal revisions. ⋯ Compared with non-LAVPS, LAVPS was associated with significantly shorter operative times and fewer distal shunt revisions within 30 days. The findings from a subset analysis supported a decrease in total hospital charges. Additional studies are needed; however, these data suggest that LAVPS is a safer, less-expensive alternative to non-LAVPS.
-
Cylindrical expandable cages are commonly used as interbody grafts after cervical, thoracic, or lumbar corpectomy in patients with osteomyelitis. Unfortunately, there is a high incidence of hardware subsidence due to small-diameter footplates. Newer expandable intervertebral cages with large rectangular endcaps use the anatomic strength of the vertebral epiphyseal ring to prevent subsidence. ⋯ Expandable intervertebral cages with rectangular endcaps can be used to prevent and/or correct preexisting cage subsidence in patients in need of anterior column instrumentation, especially in those with bone-weakening pathologies. Prospective studies should be entertained to evaluate subsidence rates in cages with cylindrical versus rectangular endcaps.