World Neurosurg
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Case Reports
Spinal cοrd compression secondary to a brοwn tumοr as a first manifestation of primary hyperparathyroidism.
Brown tumors (BTs) represent the typical nonmalignant lesions of hyperparathyroidism. Mandibles, ribs, and large bones are the most usual localization of BT. The diagnosis of these tumors requires biological and radiologic assessments. Their treatment is essentially based on parathyroidectomy. ⋯ The brown tumor, when localized at the level of the spine, can be life-threatening and must be managed as soon as possible.
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Knowledge of the anatomy of the foramen transversarium (FT) is essential for performing surgical procedures on the cervical spine. The aim of the present study was to analyze the characteristics of the FT anatomy of the lower cervical spine and its anatomic variations using computed tomography (CT) in a Brazilian population. ⋯ We determined the morphometric features of the FT using CT images. Anatomic variations were observed that justify their study before performing cervical surgical procedures.
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Anterior cervical diskectomy and fusion (ACDF) is the main surgical treatment of cervical radiculopathy. Controversy exists about the need to resect the posterior longitudinal ligament (PLL) to directly decompress the nerve roots, or if it is sufficient to indirectly decompress with diskectomy and graft placement. The objective of this study was to determine the effect of PLL resection after ACDF. ⋯ ACDF leads to a high rate of success in improvement of preoperative radiculopathy. Excision of PLL during surgery leads to 3.8 times greater odds of improvement in this symptom, with no significant difference in the complication rate.
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This is a surgical video that showcases the surgical repair of a young male patient with idiopathic scoliosis in a hybrid operating room with the utilization of a new imaging modality Advanced Radar Target Identification System (ARTIS) PHENO (Siemens Medical Solutions, Pennsylvania, USA) and augmented reality (Video 1). A 17-year-old male patient with idiopathic scoliosis underwent scoliosis repair in a hybrid operating room with segment reality surgical planning. The use of augmented reality helped in visualization of proper screw trajectory, and the use of ARTIS PHENO helped in identification of correct screw placement and rod fixation. Intraoperative use of new imaging modalities as augmented reality imaging and ARTIS PHENO can decrease surgical complication and time.
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Odontoid fractures are the most common lesions of the upper cervical spine in patients >70 years old. These fractures are associated with frequent comorbidities, and minimally invasive techniques might have the potential to reduce postoperative complications while ensuring better precision. The aim of this study was to report an innovative technique and preliminary results of minimally invasive atlantoaxial fixation using a three-dimensional intraoperative navigation system and percutaneous approach. ⋯ Minimally invasive atlantoaxial fixation using an intraoperative three-dimensional navigation system is a safe and effective alternative to the conventional approach that reduces postoperative morbidity.