World Neurosurg
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Results of C4-C6 laminoplasty with C3 laminectomy and C3-C6 laminoplasty were compared retrospectively. ⋯ If the C2 interspinous angle is wide and intraoperative semispinalis capitis damage can be minimized, it is worth trying C3 laminoplasty, but if the C2 inter-spinous angle is narrow, C3 laminectomy is recommended from the beginning.
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Spinal epidural abscesses (SEA) require prompt diagnosis to avoid devastating consequences. Here, we discuss the case of a healthy 20-year-old college student-with a recent diagnosis of strep pharyngitis-who presented with neck pain, fever, and a neurologic deficit-the most common symptoms of SEA. Magnetic resonance imaging revealed a T1-postcontrast, peripherally enhancing epidural collection from C3-T5 with associated cord compression and T3 osteomyelitis. ⋯ We treated the patient with ceftriaxone for 6 weeks. The patient had a full neurologic recovery and remains without recurrence of infection 11 months postoperatively. Healthy patients without obvious risk factors may present with SEA, highlighting the need for atypical cases such as these to be brought to clinicians' attention.
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Despite advances in the surgical management of peripheral nerve pathologies over the past several decades, it is unknown how public awareness of these procedures has changed. We hypothesize that Google searches for peripheral nerve surgery have increased over time. ⋯ The increase in Google searches related to nerve injury and pain between 2010 and 2022 may reflect increasing public recognition of these clinical entities and surgical techniques addressing them. Technical terms relating to nerve pain are infrequently searched, surgeons should use plain English terms for online discovery. Interest in spasticity and myoelectric prosthetics remains stable, indicating an opportunity for better public outreach.
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Cervical stability may deteriorate and kyphotic spinal deformities may develop in cervical spondylotic myelopathy (CSM) after laminectomy or laminoplasty. This study aimed to investigate the therapeutic efficacy of the "bilateral osteoligamentous decompression via unilateral hemilaminectomy approach (UHBOLD)" technique in CSM patients. ⋯ The UHBOLD technique performed in multilevel CSM patients did not cause any change in cervical lordosis angle in long-term follow-up, did not cause cervical kyphotic deformity or cervical instability, and significantly improved Nurick grade values, and VAS and mJOA scores.
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Preoperative management requires the identification and optimization of modifiable medical comorbidities, though few studies isolate comorbid status from related patient-level variables. This study evaluates Charlson Comorbidity Index (CCI)-an easily derived measure of aggregate medical comorbidity-to predict outcomes from spinal fusion surgery. Coarsened exact matching is employed to control for key patient characteristics and isolate CCI. ⋯ Comorbidity, measured by CCI, did not increase the risk of readmission, reoperation, or mortality. Single-level, posterior lumbar fusions may be safe in appropriately selected patients regardless of comorbid status. Future studies should determine whether CCI can guide discharge planning and postoperative optimization.