World Neurosurg
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Case Reports
"Spinous process splitting laminectomy for lumbar spinal stenosis: 2D operative video".
Degenerative lumbar spinal stenosis involves an acquired reduction in the spinal canal diameter due to osteoarthritic changes on the disk, facet joints, and ligaments and may result in spinal cord or cauda equina compression.1 This process may lead to pain radiating to the legs, neurogenic claudication, and neurologic deficit. First-line treatment includes conservative care such as physical therapy, spinal injections, and lifestyle changes. If this strategy is insufficient to achieve symptom relief, surgical management is recommended.1,2 Surgery generally encompasses a decompression procedure through a posterior approach. ⋯ The images showed multilevel degenerative lumbar spinal stenosis, with severe bilateral compression at L4-5, without signs of instability. Surgical alternatives were discussed with the patient, and it was decided to perform an L4-5 spinous process splitting laminectomy. The patient had a good evolution with an unremarkable postoperative course.
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This study aimed to compare the thickness and mechanical properties of the frontal; parietal; temporal; occipital human dura; autogenous grafts (facia lata, temporal fascia, galea aponeurotica); and artificial dura. ⋯ The thickness and mechanical properties of the regional cranial dura should be taken into consideration for a better cure and fewer complications. The mechanical properties of sagittal and transverse dura should be kept in mind for the preference of dura material. The present study's data can pave the way to produce artificial regional dura by mimicking the thickness and mechanical properties of the human dura.
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Increasing evidence indicates that pyroptosis is closely linked to the occurrence and progression of cancer. However, the expression and prognostic role of most pyroptosis-related genes in glioma have not been fully elucidated. ⋯ The risk signature based on 7 pyroptosis-related genes can effectively predict the clinical outcomes of patients with glioma. Our study provides novel insights for further understanding the association between pyroptosis-related genes and glioma prognosis.
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In current neurosurgical practice, treatment paradigms for posterior circulation aneurysms have shifted away from microsurgical clip ligation toward endovascular therapy. This is largely due to the results of the International Subarachnoid Aneurysm Trial and International Study of Unruptured Intracranial Aneurysms, which, in part, showed that outcomes in patients with ruptured aneurysms were better with coiling and that a location in the posterior circulation was an independent risk factor for poor outcome, respectively.1,2 Nevertheless, there exist certain anatomic features that highlight the importance of a microsurgical approach. ⋯ Endovascular options were deemed less favorable due to the small size of the aneurysm and the hemorrhagic complications associated with dual-antiplatelet therapy in the setting of an acute subarachnoid hemorrhage. A standard right-sided orbitozygomatic approach was performed.3 This video highlights the importance of performing microsurgical clipping for posterior circulation aneurysms in an era with increasing reliance on endovascular treatment.
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Expandable transforaminal lumbar interbody fusion (TLIF) cages capable of multidirectional in situ expansion have gained popularity as they increase axial surface area for fusion and may enhance lordotic correction through a traditional minimally invasive surgery (MIS) surgical corridor. We evaluated and compared the radiographic and clinical outcomes between a novel expandable versus static minimally invasive surgery TLIF cage for the treatment of degenerative disk disease. ⋯ Taken together, these radiographic and clinical findings suggest an expandable cage placed through an MIS corridor represents a safe, equitable, and efficacious alternative to a static TLIF in adults with degenerative lumbar pathology.