World Neurosurg
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Falcine meningioma is usually approached ipsilaterally, and the technique for tumor removal has traditionally been performed under microscopy. We report a surgical procedure for large falcine meningioma by an endoscopic contralateral interhemispheric transfalcine keyhole approach. ⋯ In the case of falcine meningioma, the endoscopic keyhole contralateral technique allows detachment of the tumor from the falx and safe manipulation in a minor field of view. In addition, because the craniotomy is smaller and the operation time is shorter, this procedure offers a less-invasive approach for the patient. This technique is thus, in our opinion, quite advantageous.
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Dorsal instrumentation and decompression are the mainstays of spinal tumor treatment. Replacing titanium screws with carbon fiber-reinforced polyetheretherketone (CFRP) screws can reduce imaging artifacts on neural structures and perturbations of radiation dose. Further reduction of metal content in such screws might enhance the benefit. The aim of this study was to assess the artifacts produced by all-titanium screws (Ti-Ti), CFRP thread-titanium screw heads (C-Ti), and all-CFRP screws (C-C). ⋯ CFRP pedicle screws reduced the artifact intensity in spinal structures compared with titanium screws, and may be beneficial for planning radiotherapy and for follow-up imaging. C-C demonstrated an enhanced effect on dorsal structures.
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Selective tibial neurotomy (STN) has been indicated for spastic equinus foot (SEF); however, the impact of this procedure on quality of life and activities of daily living has not been evaluated in detail. This study aimed to evaluate the surgical outcomes of STN and its effect on SEF accompanied by pain. ⋯ Our study showed significant improvements in spasticity and its associated symptoms, and STN effectively addressed spastic pain and motor weakness. Among various treatment modalities, STN may be positively indicated for patients with spastic pain in the lower leg.
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Pedicle screw loosening and fractures of instrumented vertebrae are not uncommon and require reoperations, which are an immense burden on the patient and health care system. We aimed to describe a novel, simple percutaneous technique on instrumented vertebrae for treating pedicle screw loosening and demonstrate that corpus with osteoporotic vertebral compression fractures can be managed with this simple technique. ⋯ Our preliminary results imply that transforaminal vertebroplasty is a safe and easy percutaneous technique in symptomatic pedicle screw loosening and osteoporotic vertebral compression fractures in the instrumented vertebrae. Further trials on larger series are necessary to validate our data.
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Patients with nmoyamoya disease (MMD) who present primarily with ischemic stroke are known to have greater rates of perioperative strokes as compared with those who present with nonstroke symptoms. The optimal timing for revascularization for these patients remains unclear. ⋯ Patients with MMD who present with ischemic stroke are more likely to have perioperative strokes, overall perioperative complications, worse long-term mortality rates, and lower rates of stroke-free survival if revascularization surgery occurred within 90 days of last stroke.