World Neurosurg
-
Transforaminal lumbar interbody fusion (TLIF) augmented with pedicle screw instrumentation has become a favored surgical treatment for management of lumbar degenerative disease and spondylolisthesis. Iliac crest bone graft has traditionally been used for interbody arthrodesis. Many substitutes for autograft have been suggested to reduce iliac crest graft morbidity. The present study was aimed to determine fusion rate and clinical outcome with local bone autograft drill shavings harvested during minimally invasive (MI) TLIF. ⋯ Use of a cage filled with local bone shavings harvested using a specimen trap during MI-TLIF is simple and can result in up to a 70% fusion rate with good clinical outcome in 92% of patients. This is the first study assessing fusion rate with local bone shavings, and the results may help spine surgeons in choosing the best graft option for patients undergoing posterior lumbar fusion surgery.
-
Historical Article
Neurosurgery in Tanzania: a discussion of culture, socioeconomics, and humanitarians.
To elucidate the progress of neurosurgical practices in Tanzania, taking into account humanitarian, socioeconomic, and geographic influences. ⋯ Neurosurgery in Tanzania and Africa more generally has a long history; however, it was not until more recent efforts of certain local pioneers and educational advisors abroad that modernization occurred. The progress of the past 50 years is substantial and with continued efforts advances will continue to be made.
-
Randomized Controlled Trial Comparative Study
A randomized outcome study of enteral versus intravenous nimodipine in 171 patients after acute aneurysmal subarachnoid hemorrhage.
Delayed ischemic neurologic deficit (DIND) is a serious complication of acute aneurysmal subarachnoid hemorrhage (aSAH). Although oral nimodipine is accepted as standard care for the prevention of DIND, the intravenous route is preferred by several centers. In the present study we compared the clinical efficacy between enteral and intravenous nimodipine after aSAH. ⋯ Our pilot study suggested no differences in the clinical efficacy of enteral and intravenous nimodipine after aSAH. However, a much larger phase III clinical trial would be needed to show or exclude meaningful clinical differences.