World Neurosurg
-
This study critically evaluates the long-term results of standalone anterior lumbar interbody fusion (ALIF), without use of rhBMP-2, as a therapeutic option for symptomatic patients with degenerative disc disease (DDD). Furthermore, this study intends to identify predictive parameters for anterior lumbar interbody fusion outcome. ⋯ The ALIF technique is a durable treatment option for patients with DDD. This study suggests different predictive parameters for treatment outcome.
-
Case Reports
Spontaneous Resolution of Cerebral Pial Arteriovenous Fistula following Angiography: Report of two cases.
Cerebral pial arteriovenous fistula (AVF) is a rare disorder, and its natural course is uncertain. The present article reports 2 rare cases of pial AVF that underwent spontaneous cure after diagnostic cerebral angiogram. ⋯ It is possible that pial AVF is a cause of headache and neurologic symptoms in association with focal hyperperfusion. Diagnostic cerebral angiography should be performed to make a definite diagnosis; after this, pial AVF sometimes disappears.
-
Localization of the arteriovenous fistula (AVF) is a crucial step in the diagnosis and treatment of spinal vascular malformations (VMs). Noninvasive angiographic techniques such as dynamic magnetic resonance angiography and three-dimensional computed tomography angiography (CTA) have been used as standard modalities to localize AVF. With the increasing prevalence of high-specification computed tomography scanners, four-dimensional (4D) CTA is being increasingly used in the evaluation of cerebrovascular disorders. However, application of 4D-CTA in spinal lesions has been limited. The position and role of 4D-CTA, among various modalities, in the evaluation of spinal VMs has not been elucidated. ⋯ In the diagnostic process of spinal VMs, the position of 4D-CTA is the third choice for noninvasive angiography, after dynamic MRA and three-dimensional CTA. However, the role of 4D-CTA might be decisive in difficult-to-find spinal dural AVFs. We believe that this novel imaging technique can be applied in spinal VMs.
-
Implantation of responsive neurostimulation (RNS) system has been previously discussed in the literature but there is a paucity of data on target accuracy and the use of intraoperative imaging. We describe our experience with 8 patients using intraoperative computed tomography (iCT) during implantation of the NeuroPace RNS system. ⋯ Frame-based stereotactic implantation of the NeuroPace RNS system using iCT is feasible and allows for intraoperative target accuracy confirmation and correction.
-
Lumbar cortical bone trajectory (CBT) screw constructs provide an alternative method of pedicle screw fixation in minimally invasive spine surgery. In this study, we explored the CBT technique in further anatomic detail. The primary aims were to evaluate variations in anatomy relevant to CBT screw placement and to determine optimal screw location, trajectory, and length using measures obtained from computed tomography (CT) scans. ⋯ Improved anatomic knowledge relevant to CBT screw placement for lumbar fixation offers the potential for improving outcomes and reducing complications. Moreover, detailed analysis of the anatomy of the pedicle-pars interarticularis junction via preoperative CT can aid in determining the ideal fixation method.