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https://www.readbyqxmd.com/read/29732426/significance-and-pitfalls-of-percutaneous-endoscopic-lumbar-discectomy-for-large-central-lumbar-disc-herniation
#1
Mikihito Kondo, Yasushi Oshima, Hirokazu Inoue, Yuichi Takano, Hirohiko Inanami, Hisashi Koga
Background: Percutaneous endoscopic lumbar discectomy (PELD) is a relatively less invasive treatment for lumbar disc herniation (LDH). The present study focused on the transforaminal approach (TFA) and investigated the significance of PELD via this approach for large central LDH. Methods: LDH that did not show cerebrospinal fluid (CSF) on axial T2-weighted magnetic resonance images was defined as large central LDH. PELD via the TFA was performed in 11 patients with large central LDH...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29682014/neurosurgical-interventions-for-occipital-encephalocele
#2
Lal Rehman, Ghulam Farooq, Irum Bukhari
Aims and Objectives: The aim of this study is to find the outcome of repair and resection of the occipital encephalocele. Study Design: Case series. Materials and Methods: The clinical data of fifty consecutive occipital encephalocele patients were retrieved from medical records including operative notes, postoperative follow-up visits, and postsurgical complications were noted for analysis from November 2009 to November 2013 at the Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29618073/anterolateral-approach-for-central-thoracic-disc-prolapse-surgical-strategies-used-to-tackle-differing-operative-findings-3-dimensional-operative-video
#3
Krunal Patel, Karol P Budohoski, Olivia R P Kenyon, Damiano G Barone, Thomas Santarius, Ramez W Kirollos, Richard J Mannion, Rikin A Trivedi
Thoracic disc prolapses causing cord compression can be challenging. For compressive central disc protrusions, a posterior approach is not suitable due to an unacceptable level of cord manipulation. An anterolateral transthoracic approach provides direct access to the disc prolapse allowing for decompression without disturbing the spinal cord. In this video, we describe 2 cases of thoracic myelopathy from a compressive central thoracic disc prolapse. In both cases, informed consent was obtained. Despite similar radiological appearances of heavy calcification, intraoperatively significant differences can be encountered...
April 2, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29535901/mri-vessel-wall-imaging-and-treatment-of-an-aneurysm-at-the-atlanto-axial-segment-of-an-aberrant-vertebral-artery
#4
Tsang Chun On Anderson, Yeung Wan Lung Ryo, Mak Ka Fung, Lui Wai Man
We report a case of unique location of an aneurysm at the atlanto-axial extradural segment of a unilateral aberrant vertebral artery. The MRI vessel wall imaging findings and possible mechanism of aneurysm formation were discussed. A 5 mm extracranial vertebral artery aneurysm located at the interlaminar space between C1 and C2 was diagnosed in a woman presenting with occipital headache. The index vertebral artery ran an aberrant course at the V3 segment, where it entered the dura between C1 and C2 instead of the usual atlanto-occipital space...
March 2018: Neurointervention
https://www.readbyqxmd.com/read/29516348/three-dimensional-visualization-of-internal-vertebral-venous-plexuses-relative-to-dural-sac-and-spinal-nerve-root-of-spinal-canal-stenosis-using-mri
#5
Junji Kamogawa, Osamu Kato, Tatsunori Morizane
PURPOSE: The aim of this study was to introduce a new method of producing three-dimensional (3D) images of vertebral venous plexuses (VVPs) by 3D-MRI with and without contrast media, to identify pathoanatomical features that might accelerate or modify spinal canal stenosis. METHODS: We used a 1.5-T MRI unit with two different 3D sequences with and without contrast media. Multi planar reconstruction (MPR) images of VVPs could be obtained by volume image subtraction methods with a workstation for dural sac from whole 3D volume MPR without contrast media, using images before and after gadoteridol injection...
May 2018: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29191390/efficacy-of-intraoperative-lumbar-subarachnoid-drainage-for-prevention-of-cerebrospinal-fluid-leak-after-spinal-cord-tumor-resection
#6
Kazuyoshi Kobayashi, Kei Ando, Kenyu Ito, Mikito Tsushima, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Naoki Ishiguro, Shiro Imagama
BACKGROUND: Postoperative cerebrospinal fluid (CSF) leakage is a major clinical problem, and prevention of CSF leakage at the surgical site is an important issue. The goal of the study was to evaluate the efficacy of intraoperative lumbar subarachnoid drainage (LSAD) for prevention of CSF leakage after spinal cord tumor resection. METHODS: The subjects were 97 patients with a cervical or thoracic primary intradural spinal cord tumor who underwent surgery at our hospital...
November 27, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29119040/giant-mucopyocele-associated-with-intracranial-hypertension-case-report-and-literature-review
#7
Maick Willen Fernandes Neves, Luis Otavio Carneiro Pontelli, Luiz Gustavo de Abreu Mattos, Mariana Mazzuia Guimarães, Telmo Augusto Barba Belsuzarri, Tiago Fernandes Gonçales, Wolnei Marques Zeviani, Paulo Henrique Pires de Aguiar, João Flavio Mattos Araújo
Background: Mucoceles are epithelial lined sacs that contain mucous. Eventually, they can be infected and so called mucopyoceles, which are usually slow growing lesions with common bone destruction located in the facial sinus. Mucoceles show multivariate etiology and occur between the fourth and seventh decade of life. Case Description: Patient, 55-year-old, female, was referred unconscious with Cushing's triad to our department; she had fever since four days. The findings of skull computer tomography highlighted a large bifrontal lesion with an invasion of the rear wall of the frontal sinus, compression of the frontal lobes, and midline deviation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29116395/correlations-between-sedimentation-sign-dural-sac-cross-sectional-area-and-clinical-symptoms-of-degenerative-lumbar-spinal-stenosis
#8
Sangbong Ko
PURPOSE: In this study, we addressed the correlation between the cross-sectional area (CSA) of the dural sac and the nerve root sedimentation sign (SedSign) and the correlation between the distance of claudication and the CSA of the dural sac or SedSign in patients with lumbar spinal stenosis. We also evaluated the reliability of clinical symptom prediction. METHODS: We checked claudication distance using a questionnaire, and we gauged low back pain when standing, referred pain, and radiating pain using visual analog scale scores...
November 7, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29089672/radiological-requirements-for-surgical-planning-in-cochlear-implant-candidates
#9
Mohamad Hasan Alam-Eldeen, Usama Mohamed Rashad, Al Hussein Awad Ali
OBJECTIVE: This study is concerned with clarification of radiological findings that should be addressed and reported in patients listed for cochlear implant (CI) operation. These findings may force a surgeon to consider modifications of the surgical approach by a CI surgeon. MATERIALS AND METHODS: The study was performed from January 2015 to January 2016. It included 50 patients with severe-to-profound sensorineural hearing loss who fulfilled the criteria for CI...
July 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29050895/minimal-invasive-lumbar-spine-revision-surgery-at-distance-from-the-dura-and-postsurgical-scar-tissue-extraforaminal-lumbar-interbody-fusion-elif
#10
Arthur R Kurzbuch, Didier Recoules-Arche
Lumbar spine revision surgery is considered as challenging and related to longer operation time and complications because of the loss of anatomical landmarks and the formation of postoperative epidural fibrosis. Minimal invasive lumbar spinal surgery techniques have been refined over the last 5 years but the reexposure of the dura, the formation of postsurgical scar tissue and related dural tears remain a source of complications. For lumbar spinal revision surgery we advocate the minimal invasive Extraforaminal Lumbar Interbody Fusion (ELIF) technique...
January 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28781916/nursing-review-section-of-surgical-neurology-international-part-2-lumbar-spinal-stenosis
#11
REVIEW
Nancy E Epstein, Renee D Hollingsworth
BACKGROUND: The lumbar spine includes 5 lumbar vertebral bodies, L1, L2, L3, L4, and L5. At each level, there is a disc space defined by the two bones (vertebral bodies) in the back; for example, there is a disc space at the L5-S1 level etc. The normal front to back (anterior to posterior or AP diameter) measurement of the spinal canal is typically 18-20 mm, but some patients have narrowing called spinal stenosis. METHODS: Lumbar stenosis is defined by two major types...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28770547/analysis-of-dural-sac-thickness-in-the-human-cervical-spine
#12
Soonwook Kwon, Seung-Woo Suh, Dasom Kim, Im Joo Rhyu, Hyunung Yu, Seung Woo Han, Jae-Young Hong
The thickness of the dura mater in the human cervical spine can vary between individuals and by vertebral level; these differences can result in various clinical outcomes. The purpose was to measure and analyze cervical dura mater thickness. Microscopic measurements were made of tissue from human cadavers. The subjects were nine human cadavers with no previous history of spinal deformity or surgery. Fourteen segments of both anterior and posterior dura mater from the C1 to C7 cervical vertebrae were obtained...
March 2018: Anatomical Science International
https://www.readbyqxmd.com/read/28736354/novel-technique-of-percutaneous-fat-graft-for-repair-of-persistent-large-pseudomeningocele
#13
Gabrielle Santangelo, Tyler Schmidt, Mithra Gonzalez, Per-Lennart Westesson, Howard Silberstein
BACKGROUND: Pseudomeningocele is an uncommon but problematic complication in lumbar spine surgery. Initial conservative measures frequently are successful, but persistence requires additional management. The current surgical approach can involve a range of techniques, including blood patches, hydrogel/fibrin sealants, drains, open surgical repair of the dura, or a combination of the all techniques if symptoms persist. This report demonstrates a novel technique for repair via a percutaneous approach to deliver an autologous fat graft into the pseudomeningocele...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28602497/anatomical-localization-of-the-cavernous-sinus-dural-fistula-by-3d-rotational-angiography-with-emphasis-on-clinical-and-therapeutic-implications
#14
Santhosh Kumar Kannath, Jayadevan Enakshy Rajan, Sankara P Sarma
BACKGROUND AND PURPOSE: Carotid cavernous sinus dural arteriovenous fistulas (CSDAVFs) are presumed to be located within the walls of the cavernous sinus, however the exact fistulous site has not yet been studied by angiographic or anatomical methods. The present study aimed to localize CSDAVFs with the help of 3D rotational angiography (RA) and correlated the observations with clinical and angiographic findings. MATERIALS AND METHODS: The CSDAVFs were categorized as dural, extradural or osseous based on the site of convergence of feeders into the venous sac...
September 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28524124/-endoscopic-endonasal-diagnosis-and-treatment-of-skull-base-meningoencephalocele
#15
D N Kapitanov, E V Shelesko, A A Potapov, A D Kravchuk, D N Zinkevich, M V Nersesyan, L A Satanin, A V Sakharov, G V Danilov
PURPOSE: The study purpose was to determine the successful outcome rate of endoscopic endonasal reconstruction of skull base CSF fistulas with removal of meningocele as well as analyze disease relapses. The second purpose of the study was to describe the treatment outcomes, depending on the type, location, and size of meningocele as well as on a technique used to reconstruct the skull base defect. MATERIAL AND METHODS: Three hundred and eleven patients diagnosed with cerebrospinal fluid (CSF) rhinorrhea who underwent surgery at the Burdenko Neurosurgical Institute in the period between 2007 and 2014 were retrospectively analyzed...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28458825/a-locally-destructive-completely-asymptomatic-c1-root-schwannoma-with-base-of-skull-invasion-a-case-report
#16
David Pisani, Christian Camenzuli, Josephine Psaila, Snežana Božanić, Jean Calleja-Agius
Patients with C1 nerve root schwannomas usually present with signs relating to nerve root compression. However, asymptomatic presentations have never been reported. A healthy, 37-year-old female was referred in view of a slow-growing lump in the left posterosuperior aspect of the neck. The lump was asymptomatic and neurological examination was normal. Magnetic resonance imaging revealed a left C1 nerve root tumour, extending around the C1 vertebra and compressing the thecal sac. The tumour had invaded the basiocciput and was impinging on the left cerebellar hemispheric dura...
February 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28414692/neuronal-fibers-and-neurotransmitter-receptor-expression-in-the-human-endolymphatic-sac
#17
Martin Nue Møller, Svend Kirkeby, Jonas Vikeså, Finn Cilius Nielsen, Per Cayé-Thomasen
INTRODUCTION: Recent studies suggest that the human endolymphatic sac (ES) may have multiple functions, including an ion-transport capacity comparable to the kidney, an immunological capacity and a possible natriuretic capacity. Further, there have been speculations of a yet undefined role in intracranial pressure homeostasis. The anatomical location towards the sigmoid sinus would suggest a possible endo- and/or paracrine signaling. However, neuronal connections may also apply, but it remains very scarcely explored in the human ES...
June 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28327939/a-new-classification-for-pathologies-of-spinal-meninges-part-1-dural-cysts-dissections-and-ectasias
#18
Jörg Klekamp
BACKGROUND: The clinical significance of pathologies of the spinal dura is often unclear and their management controversial. OBJECTIVE: To classify spinal dural pathologies analogous to vascular aneurysms, present their symptoms and surgical results. METHODS: Among 1519 patients with spinal space-occupying lesions, 66 patients demonstrated dural pathologies. Neuroradiological and surgical features were reviewed and clinical data analyzed. RESULTS: Saccular dural diverticula (type I, n = 28) caused by defects of both dural layers, dissections between dural layers (type II, n = 29) due to defects of the inner layer, and dural ectasias (type III, n = 9) related to structural changes of the dura were distinguished...
July 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28115269/stretching-of-roots-contributes-to-the-pathophysiology-of-radiculopathies
#19
Jean-Marie Berthelot, Jean-Denis Laredo, Christelle Darrieutort-Laffite, Yves Maugars
PURPOSE: To perform a synthesis of articles addressing the role of stretching on roots in the pathophysiology of radiculopathy. METHODS: Review of relevant articles on this topic available in the PubMed database. RESULTS: An intraoperative microscopy study of patients with sciatica showed that in all patients the hernia was adherent to the dura mater of nerve roots. During the SLR (Lasègue's) test, the limitation of nerve root movement occurs by periradicular adhesive tissue, and temporary ischemic changes in the nerve root induced by the root stretching cause transient conduction disturbances...
January 2018: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28024891/transdural-herniated-lumbar-disc-disease-with-muscle-patch-for-closure-of-durotomy-a-brief-review-of-literature
#20
REVIEW
Harsha A Huliyappa, Rakesh Kumar Singh, Sunil Kumar Singh, Manish Jaiswal, Somil Jaiswal, Chhitij Srivastava, Balkrishna Ojha, Anil Chandra, Satnam Chhabra
PURPOSE: Intradural migration of disc (IDMD) is a rare clinical entity accounting for 0.27-0.33% of all herniated disc diseases. Flimsy or dense adhesion between the ventral dural surface and the opposing posterior longitudinal ligament (PLL) is the principal pathology for intradural migrated disc. The most commonly affected lumbar segments are L4-5 (55%), L3-4 (16%), L5-S1 (10%) and less commonly L2L3 and L1L2. No imaging feature is characteristic and the management protocol of durotomy via an endoscopic method is unclear...
March 2017: Neurologia i Neurochirurgia Polska
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