World Neurosurg
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Cervical spinal stenosis most commonly occurs at the subaxial spine. C1-C2 stenosis is relatively unusual but can be present in certain congenital or syndromic conditions such as rheumatoid arthritis. ⋯ Decompression and stabilization of the segment were performed. This case is unique as this pathology occurred at an uncommon location, leading to an unusual degree of compression and resulting in surgical intervention.
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Concomitant diffuse idiopathic skeletal hyperostosis (DISH) and cervical ossification of the posterior longitudinal ligament (cOPLL) are primarily investigated in radiographic studies of East Asian populations. This study aimed to determine clinical prevalence of concomitant DISH/cOPLL in a large U.S. sample and to compare characteristics and complications in cOPLL patients with and without concomitant DISH who were surgically treated. ⋯ Clinical prevalence of DISH in patients with cOPLL in the United States is low; however, cOPLL patients with concomitant DISH underwent surgery more frequently than those without. Despite higher comorbidity burden, cOPLL patients with DISH may have similar short-term postsurgical risk to cOPLL patients without DISH. However, higher nonprocedural neurologic injury in cOPLL patients with DISH may indicate insidious or delayed disease sequelae.
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The impact of statin pretreatment on outcomes for patients undergoing endovascular treatment of intracranial aneurysms remains uncertain. We aimed to conduct a systematic review and meta-analysis evaluating the efficacy and safety of statins in this population. ⋯ Statin pretreatment may decrease the risk of hemorrhagic complications and in-stent stenosis after endovascular aneurysm therapy but does not improve angiographic occlusion. An increased hazard of ischemic events was found. Further data are needed to validate these findings and clarify the role of statins in patients with aneurysms undergoing endovascular procedures.
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To investigate the effect of intravertebral cleft sclerosis on the efficacy of percutaneous vertebroplasty (PVP) in osteoporotic vertebral compression fractures (OVCFs). ⋯ IVCs affect cement distribution and recovery outcomes, with IVCns achieving better results. Early treatment is advised for OVCF with intravertebral clefts.
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In general, the superior cerebellar artery is the most prevalent vessel that compresses the trigeminal nerve root exit zone (TGNREZ) and is responsible for trigeminal neuralgia (TGN). Nevertheless, the surgical outcome is less efficacious when the offending vessel is a dolichoectatic vertebrobasilar vessel (DVB). In addition, the potential for postprocedural adhesion and fibrosis renders recurrent TGN after prior surgery, an extremely challenging operation. ⋯ A combined transpetrosal approach with microneurovascular transposition technique was selected to achieve all objectives. A case illustration with a surgical video is demonstrated.