World Neurosurg
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The rationale of only fixation without any kind of bone, ligament, disc, or osteophyte decompression as a treatment for single- or multiple-level cervical spinal degeneration was analyzed. The concept was based on the understanding that muscle weakness-related spinal instability is the cause of spinal degeneration, and spinal stabilization is the treatment. ⋯ Instability of spinal segments forms the basis of spinal degeneration. Stabilization forms the basis of surgical treatment. The role of decompression needs to be re-evaluated.
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Case Reports
Intraoperative use of a cone beam CT in the treatment of atlanto-axial rotatory subluxation: a case report.
Atlantoaxial rotatory subluxation (AARS) is a rare pathological condition of the upper cervical spine. It can be caused by multiple mechanisms, including minor neck manipulations. Children are more prone owing to the weaker periarticular soft tissue and a steeper slant of the C1 facet plane against the vertical axis of the dens. If AARS does not resolve spontaneously, a normal position of the atlantoaxial joint must be achieved by reduction and stabilization. ⋯ Complete reduction of the AARS was achieved with closed intraoral reduction. We used intraoperative cone-beam CT to confirm complete reduction. We found cone-beam CT to be a very useful tool.
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Posterior synostotic plagiocephaly represents a rare challenging type of craniosynostosis, often misdiagnosed as a simple posterior positional plagiocephaly. Underdiagnosed forms may result in delayed diagnosis and neurosurgical management, with potential ophthalmologic, cognitive, and aesthetic sequelae in children. ⋯ Interesting findings in our series were male gender predominance and predilection of the right-side synostotic lambdoid suture. We think that early correct diagnosis and appropriate neurosurgical treatment may prevent potential complications such as neurocognitive and aesthetic sequelae in children with posterior synostotic plagiocephaly.
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To investigate the effect of the application of a microsurgical space restrictor in microsurgical simulation training. ⋯ Microsurgical space restrictor use can improve the effect of microsurgical simulation training and help trainees better master microsurgical operation skills.