Surgical neurology international
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The purpose of this study was to assess the feasibility of using dual expandable cages plus short segment posterior fixation for reconstruction of vertebral bodies following a mini-open transpedicular approach. ⋯ In select patients requiring circumferential decompression of the lumbar spine, dual cage reconstruction decreases the technical difficulty of the operation and facilitates a mini-open approach. The durability of this construct will need biomechanical assessment and long-term clinical follow-up.
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Dural metastases have been found in about 8-9% of patients who died of cancer, in most autopsy series. Dural metastases presenting with chronic subdural hematoma are rare, with only about 55 cases reported in the literature. ⋯ On reviewing the literature, 25 cases of dural metastases with chronic subdural hematoma and coagulopathy were found. These cases were characterized by the fact that they had a very poor clinical outcome in spite of surgical drainage. This combination could be a distinct entity and its recognition is important to guide management of this rare condition.
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Cervical foraminotomy is an operation designed to decompress a single or multiple cervical nerve roots from a posterior approach. This type of surgery is an alternative to operations designed to accomplish the same goal from an anterior approach. We describe our experience in patients treated with posterior cervical foraminotomy. ⋯ The posterior cervical foraminotomy is a good option for the treatment of a radicular pain caused by a foraminal conflict.
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To evaluate the usefulness and limitations of the intraoperative near-infrared (NIR) indocyanine green videoangiography (ICG-VA) and analysis of fluorescence intensity in cerebrovascular surgery. ⋯ ICG-VA provides high resolution images allowing real-time assessment of the blood flow in surgical field. The intensity analysis function, in addition, is a useful adjunct to improve the accuracy of the clipping and decrease the complication rates in cerebral aneurysm cases. In cerebral AVM cases, with the help of color map and intensity diagram function, the superficial feeders, drainers, and nidus can be identified easily.
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Although a relatively simple procedure, cranioplasties have been associated with high complication rates. Keeping this in perspective, we aimed to determine the factors associated with immediate and long-term complications of cranioplasties at our institution. ⋯ We have found a higher risk of complications of cranioplasty in patients who had EVD placement and removal prior to their constructive surgery. We however did not find any association between risks of complications in any other studied variable. We also did not find any association between intraoperative placement of subgaleal drains and postoperative risk of subgaleal fluid collections. Overall, our results are comparable with other reported series on cranioplasties.