World Neurosurg
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Most patients with microprolactinomas require lifetime treatment with a dopamine agonist. Many patients in our center have sought endoscopic transsphenoidal surgery as an alternative therapy. ⋯ According to our findings, endoscopic transsphenoidal surgery performed on patients with microprolactinomas at advanced pituitary tumor centers could be an option with high success rates and low complications. Moreover, improving magnetic resonance imaging techniques and/or multidisciplinary team discussion before surgery for microprolactinoma could improve tumor remission after surgery.
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The aim of this study is to evaluate the efficacy of cerebral revascularization for Moyamoya disease (MMD) with extracranial internal carotid artery occlusion (ICAO). ⋯ Cerebral revascularization can prevent recurrent ischemic and hemorrhagic stroke events for MMD patients with extracranial ICAO. There was no difference on long-term clinical outcomes after combined bypass, direct bypass, and indirect bypass surgery. The cerebral revascularization has similar effect on the MMD patients with extracranial ICAO and MMD patients without extracranial ICAO.
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This study aimed to evaluate preoperative and perioperative predictors associated with persistent low back pain (LBP) following lumbar fusion in patients aged >75 years. ⋯ This study showed that a relatively younger age, history of preoperative lumbar decompression, and greater preoperative VAS score for LBP were preoperative predictors of postoperative persistent LBP following lumbar fusion in elderly patients. In contrast, preoperative spinopelvic sagittal parameters were not associated with persistent postoperative LBP. Although lumbar fusion is expected to improve LBP, surgeons should pay attention to age, surgical history, and preoperative back pain intensity.
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Case Reports
Bilateral Multiple Orbital Metastases Successfully Treated with Standalone Stereotactic Radiosurgery: Clinical Image.
Bilateral orbital metastases are extremely rare, and no previous literature has reported bilateral multiple orbital metastases treated with stereotactic radiosurgery (SRS). We present the impressive images of a patient with history of metastatic leiomyosarcoma with newly diagnosed bilateral multiple orbital metastases. The pre-SRS magnetic resonance imaging (MRI) showed 1 right and 2 left orbital metastatic lesions. ⋯ The presenting symptoms were all improved after the treatment with no adverse effects from the SRS. Our interesting images show the presence of multiple lesions in the orbital spaces with excellent treatment response post SRS. This is the first report of a patient who has bilateral and multiple orbital metastases that were successfully treated with standalone SRS.
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has been rapid technological advancement in navigation-guided minimally invasive surgery over the past two decades, making these advancements an invaluable aid for surgeons by essentially providing real-time virtual reconstruction of patient anatomy. The objectives of these navigation- and robot-guided procedures are to reduce the likelihood of neural and vascular injury, minimize hospitalization time, decrease bleeding and postoperative pain, shorten healing time, and lower infection rates. ⋯ Comparing minimally invasive spine interventions with free-hand instrumentation and robotic instrumentation, a statistically significant difference was identified in radiation exposure per screw and surgical time. The literature on Cirq Robotic is limited; however, minimally invasive spine surgery with robotic assistance appears advantageous in terms of radiation exposure and surgical time.