World Neurosurg
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We report a rare case of unruptured middle cerebral artery aneurysm associated with moyamoya disease. ⋯ Understanding the complexity of such process may be valuable in proper decision-making in the management of moyamoya disease patients.
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Transforaminal lumbar interbody fusion (TLIF) via a fusion cage is widely carried out to treat degenerative lumbar spinal disease, and cage implantation plays a pivotal role in buttressing the vertebrae and promoting fusion. Clinically, the cage implantation is commonly placed in 2 different orientations: oblique and traverse. Therefore, this study aimed to explore the effects of different orientations of cage implantation on lumbar interbody fusion. ⋯ The traverse cage implantation in TLIF had the same clinical effect as oblique cage implantation, but is superior in improving sagittal alignment. Therefore, we advise that the cage should be placed in traverse orientation in TLIF.
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To identify the prognostic factors affecting the outcome of acute traumatic spinal cord injury (tSCI) and to provide updated recommendations on improving outcomes. ⋯ Prognostic data in tSCI are fundamental to assess the value of new therapies and to undertake clinical trials. The increasing knowledge of new and emerging prognostic factors may assist us to direct our efforts toward focused therapeutic interventions, which may present a promising result.
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Atlanto-occipital transarticular screw fixation (AOTSF) has rarely been reported for fixation of the craniovertebral junction (CVJ). ⋯ AOTSF was feasible in half of pediatric patients suffering from traumatic CVJ instability. Therefore, intraoperative salvage options and strategies should be on hand readily. In the pediatric population, where bony anatomy may pose challenges to fixation, this technique may offer a viable first-line option in selected cases, despite the overall modest success rate.
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Conventional surgical treatment of multilevel cervical disc disease is based on anterior cervical discectomy and fusion (ACDF). However, fusion alters the biomechanics of the spine, potentially resulting in accelerated adjacent segment degeneration. To improve clinical outcomes, hybrid surgery, combining cervical disc arthroplasty with fusion, has been developed. Cervical total disc replacement (TDR) has been shown to keep the motion of adjacent segment, and a dynamic cervical implant (DCI) was shown to provide cervical dynamic stability under nonfusion. However, curative and unwanted side effects of the new therapy options TDR and DCI for treating multilevel cervical degenerative disc disease are still unknown. ⋯ These results indicate that both TDR hybrid and DCI hybrid are effective and safe procedures for the treatment of multilevel degenerative disc disease. However, there is no definitive evidence that DCI or TDR arthroplasty lead to better intermediate-term results than ACDF over an average observation time of 19.5 months.