World Neurosurg
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Microvascular decompression (MVD) is the most effective treatment for hemifacial spasm (HFS). However, surgical difficulties due to complex anatomy or revision surgery can endanger the functional integrity of the brainstem. We describe surgically challenging cases and provide operative guidance that may be helpful for neurosurgeons who perform MVDs. ⋯ Complex or unusual HFS types carry higher surgical risks in MVD. Neurosurgeons performing MVDs need to be prepared to manage complex HFS cases in order to achieve favorable clinical outcomes.
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To evaluate prevalence and prognosis of postoperative coronal imbalance (CIB) and factors related to its onset and spontaneous improvement in patients with Lenke 5C adolescent idiopathic scoliosis who underwent selective thoracolumbar-lumbar fusion. ⋯ Although CIB was frequently detected in the early postoperative period after selective thoracolumbar-lumbar fusion, it mostly corrected spontaneously. Relatively younger age at surgery and less flexible lumbosacral curve may be related to postoperative CIB, and greater changes of LIV disc angle may be associated with spontaneous improvement of CIB.
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The current study seeks to examine the association between chronic opioid use and postoperative outcomes for patients undergoing anterior cervical discectomy and fusion (ACDF) and posterior lumbar fusion (PLF). ⋯ Our analysis using a national administrative database showed that opioid dependence may be associated with worse economic outcomes for patients undergoing ACDF and PLF.
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Surgical techniques to achieve complete resection of mesial-basal temporal tumors should be pursued by neurosurgical oncologists. We describe the anatomical subpial amygdalohippocampectomy (SpAH) technique for tumor resection. ⋯ The SpAH technique permits complete resection of mesial-basal temporal tumors with an acceptable morbidity profile. An in-depth understanding of temporal lobe anatomy combined with a refined microsurgical technique allows for reproducible resection of tumor in the amygdalohippocampal region while protecting critical neurovascular structures.
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The incorporation of perspective into art and science revolutionized the study of the brain. Beginning in about 1504, Leonardo da Vinci began to model the ventricles of the brain in three dimensions. A few years later, Andreus Vesalius illustrated radically novel brain dissections. ⋯ We analyzed 414 of 508 works authored by Rhoton; these studies were analyzed according to subjects discussed, including anatomic region, surgical approaches, subjects covered, anatomic methods used, forms of multimedia, and subspecialty. Rhoton taught detailed neuroanatomy from a surgical perspective using meticulous techniques that evolved as the technical demands of neurosurgery advanced, inspiring students and contemporaries. His work aligns him with renowned figures in neuroanatomy, arguably establishing him historically as the most influential anatomist of the neurosurgical era.