World Neurosurg
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Microendoscopic discectomy (MED) has been widely accepted for its advantage of minimal injury in the treatment of lumbar disc herniation. Recurrence after successful MED has been reported; however, the risk factors responsible for the MED recurrence were still unclear. ⋯ Age (≥50 years old) was the most robust risk factor for MED recurrence. Obesity (BMI ≥25) and modic change were also highly involved in the recurrent herniation after successful MED. Taking these risk factors into consideration before surgery may be instrumental in pursuing a personalized operative method, which may lead to a more satisfactory operative outcome and a relatively lower recurrence rate.
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Spinal syphilitic gumma is an unusual presentation of neurosyphilis, with a limited number of cases reported in the literature. Owing to its extreme rarity, the diagnosis and treatment of spinal syphilitic gumma and the relevant prognosis have not been outlined. ⋯ Spinal syphilitic gumma can occur in the intramedullary region, and clinicians should be aware of this extremely rare entity, as it can be easily mistaken for more common neoplasms occurring at this site. The magnetic resonance imaging appearance of this entity has some suggestive characteristics, and a confident diagnosis depends on the pathology. Surgical resection can help to relieve acute spinal cord compression, and systemic antibiotic treatment for syphilis should be emphasized for long-term control.
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The DERIVO embolization device (DED) is a new nitinol flow diverter stent manufactured for the treatment of intracranial aneurysms. In this study, we evaluated the safety and efficacy of the DED in the treatment of intracranial aneurysms and present the short- and midterm results. ⋯ The DED seems effective and safe in the treatment of different kinds of intracranial aneurysms.
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Large schwannomas with intradural and extradural extensions are often challenging surgical lesions. A variety of approaches, usually requiring large exposures, removal of facets and pars interarticularis, and spinal stabilization, have been described. The aim of this study is to describe the "dual approach," a less invasive technique for the excision of these lesions. ⋯ The dual approach is a novel and unique technique that allows complete and safe removal of large intradural and extradural dumbbell tumors through a less invasive approach and no need for instrumentation.
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To evaluate the obliteration rate and clinical outcome following linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) for intracranial arteriovenous malformation (AVM) in pediatric patients (age ≤18 years). ⋯ A modest median marginal dose of 15 Gy (16 Gy in the obliterated AVM group vs. 12 Gy in the nonobliterated group) resulted in an obliteration rate of 66.7% after LINAC-based SRS for intracranial AVM, with low rate.