World Neurosurg
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Review Meta Analysis
Radiosurgery for benign vertebral body hemangiomas of the spine: a systematic review and meta-analysis.
Spinal vertebral hemangiomas (SVHs) are the most common benign tumors of the spine. We performed a systematic review and meta-analysis of radiosurgery (RS) for SVHs. ⋯ Radiosurgery is safe and effective for SVHs. Pain relief after RS in symptomatic patients was extremely high, while no progressive disease was reported. Damage to surrounding tissues was reported in only 1 series and included osteitis, osteonecrosis, or soft tissue injury after higher radiation doses.
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Review
Spinal tractography as a potential prognostic tool in spinal cord injury. A systematic review.
Magnetic resonance imaging is considered the most accurate examination to study the spinal cord. Nevertheless, the use of diffusion tensor imaging (DTI) can demonstrate additional key details about spinal cord lesions. We examined the literature to investigate and discuss the role, limitations, and possible evolution as a prognostic tool of DTI in spinal cord injury (SCI). ⋯ The main spinal cord tract involved and studied in SCIs was the cervical tract (57.5%), followed by conus terminalis (15.4%) and dorsal tract (13.7%). In all studies based on American Spine Injury Association impairment scale score for neurological assessment, a correlation was found between FA values and American Spine Injury Association impairment scale: patients with complete SCI had a statistically significative lower FA value at the injured site compared with patients with incomplete SCI. Published clinical studies showed promising results for the utility of DTI parameters as noninvasive biomarkers in SCI grade evaluation, remaining an evolving area of further investigation.
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Both transarticular screw fixation (TAS) and segmental screw-rod fixation (SF) have been widely performed for C1-2 fusion; however, just only small clinical studies and a few meta-analyses comparing the 2 surgical techniques for C1-2 posterior fusion have been reported. ⋯ SF showed a greater fusion rate and lower risk of vertebral artery injury than TAS did, but TAS showed less blood loss and lower operation times than SF.
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Intraoperative neuromonitoring of motor functions experienced a dramatical revolution in the last years thanks to significant advances in anesthesiology procedures and both preoperative and intraoperative mapping techniques. Asleep, awake, and combined intraoperative mapping techniques were responsible for an improvement in the functional outcomes in neurosurgery, providing reliable and reproducible mapping of both projection and association fibers involved in motor control. ⋯ Here, we provide evidence of intraoperative mapping of commissural fibres involved in motor control in a patient with asleep technique as well as a review of the potential tracts involved in the connectivity underlying the motor function.
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Optic nerve sheath meningiomas (ONMs) are often managed with radiotherapy (RT) with the goal of achieving radiographic local control (LC) and preventing deterioration of visual acuity (VA). We aimed to perform a systematic review and meta-analysis of outcomes for patients with ONM treated with RT. ⋯ RT was well tolerated, with excellent LC achieved. Nearly 90% of patients noted either stability or improvement in VA and VF. Larger ONMs were associated with poorer VA.