World Neurosurg
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Over the past 2 decades, management of idiopathic normal pressure hydrocephalus (iNPH) has evolved significantly. In the current study, we sought to evaluate the national prevalence and management trends of iNPH in the United States using a national database. ⋯ We have summarized the national prevalence of iNPH, trends in its management over the previous decade and trends by region and hospital type.
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The purpose of this study was to test the application of diffusion tensor imaging (DTI) in patients with hemifacial spasm (HFS), to make more accurate diagnoses before surgery and to judge the degree of recovery more accurately after surgical microvascular decompression. To our knowledge, this is the first study to test the validity of DTI for diagnosis and postsurgical evaluation of HFS. ⋯ The use of DTI improves diagnosis and treatment of HFS.
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Case Reports
Intramedullary Spinal Cord Metastasis from Primary Lung Neuroendocrine Carcinoma: A Case Report and Operative Video.
Intramedullary spinal cord metastasis (ISCM) account for a minority of all spinal cord tumors. Rarely, symptoms from ISCM may be the initial presentation of an unknown primary carcinoma. Intramedullary metastasis from a second malignancy or from an unknown neuroendocrine malignancy is extremely rare and has never been reported in the literature. Because of the rarity of these tumors and the low volume of cases, well-defined treatment guidelines do not exist for the management of ISCM. Here we present a rare and one of the first reports of an intramedullary metastatic neuroendocrine tumor. ⋯ Neuroendocrine ISCM are rare and lack well-defined treatment guidelines. Care should be individualized in these cases. Whenever feasible, surgical resection should be considered. Despite multidisciplinary care, the prognosis is dismal with limited life expectancy. Larger, multiinstitutional, or national database studies are needed that compare treatment modalities in the management of ISCM to identify the therapy with the best outcomes.
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To identify the impact of different surgical approaches for lumbar degenerative disc disease (DDD) on complications, reoperations/readmissions, and health care utilization. ⋯ mAP procedures are associated with higher cumulative complications and health care utilization compared with other procedures and the difference in health care utilization tends to decrease over 12 and 24 months.
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Three-dimensional (3D) printing has emerged as a visualization tool for clinicians and patients. We sought to use patient-specific 3D-printed anatomic modeling for preoperative planning and live intraoperative guidance in a series of complex primary spine tumors. ⋯ We present the largest case series of 3D-printed spine tumor models reported to date. 3D-printed models are broadly useful for operative planning and intraoperative guidance in spinal oncology surgery.