Basilar invagination is one of the most frequently observed abnormalities at the craniovertebral junction, in which the odontoid process of C2 prolapses into the foramen magnum.
The current study ...included 27 patients who underwent surgery for basilar invagination between October 2013 and January 2023. The study group was divided into 2 groups according to basilar invagination types; type I (the presence of type A atlantoaxial instability and instability is the main pathology) and type II (the presence of type B and C atlantoaxial instability and skull base dysgenesis is the main pathology). Craniometric parameters included in the study were atlantodental interval, posterior atlantodental interval, Chamberlain's line violation, clivus-canal angle, Welcher's basal angle, and Boogaard angle.
The mean age of the patients was 24.30 ± 14.36 years (5–57 years). Fourteen patients (51.9%) were female, and 13 patients (48.1%) were male. Ten patients (37%) had type I basilar invagination, and 17 patients (63%) had type II basilar invagination. Preoperative and postoperative atlantodental interval and Boogaard angle were significantly higher in type I basilar invagination, as preoperative and postoperative posterior atlantodental interval and clivus-canal angle were significantly higher in type II basilar invagination. There was a positive strong correlation between Chamberlain's line violation and Boogaard angle. Postoperative Chamberlain's line violation was significantly higher in occipitocervical fixation (P = 0.035). C1 lateral mass screw fixation was found more successful in Chamberlain's line violation correction than occipital plates. Occipitocervical fixation was found to be associated with higher postoperative Nurick scores (P = 0.015) and complication rates (P = 0.020). Cages applied to the C1-C2 joint space were found to be associated with higher fusion rates (P = 0.023) and lower complication rates (P = 0.024).
In the present study, it was found that C1–C2 fixation was more successful in correcting craniometric parameters and had lower complication rates than occipitocervical fixation. In appropriate patients, it was determined that cage application increased the success rates of the operations.
{Figure 1}{Figure 2} The most common symptoms of SSEH are acute-onset severe neck or back pain and motor, sensory, and/or sphincteric deficits, depending on the level of the hematoma. Due to the ...presence of sudden severe headache with backache, these patients may be erroneously diagnosed to be suffering from a cerebrovascular disease such as subarachnoid hemorrhage. 2 In the absence of cerebral symptoms such as deterioration in consciousness and cranial nerve deficits, SSEH should be kept in mind by the treating physician because the medications administered for treating cerebrovascular diseases may often be contraindicated in the presence of SSEH.
Background
Two different techniques of short-segment instrumentation, with and without a pedicle screw at the fracture level, were compared in thoracolumbar burst fractures in neurologically intact ...(ASIA-E) patients. The sagittal index, kyphosis angle (Cobb), canal compromise ratio, and compression ratio of the anterior vertebral height were analyzed.
Methods
Seventy patients who underwent short-segment stabilization for thoracolumbar (T11-L2) burst fractures in our clinic between 2008 and 2012 were included in this retrospective study. In 35 patients (group 1), a pedicle screw was placed only one level down and one level up from the fracture level. In another 35 patients (group 2), a screw was placed at the fracture level in addition to the short segment. Only neurologically intact patients with burst fractures according to the Denis classification were included. The patients were evaluated according to their age/gender, trauma etiology, and fracture level. Their preoperative and most recent postoperative follow-up radiographs and CTs were evaluated in terms of the sagittal index, kyphosis angle (Cobb), ratio of canal compromise, and anterior vertebral height.
Results
The two groups were similar in their ages, follow-up periods, and severity of the deformity and fracture. When the pedicle screw was placed at the fracture level in addition to short-segment stabilization, statistically significant improvements in the sagittal index (
p
< 0.001), local kyphosis (Cobb) angle (
p
= 0.006), and compression ratio of the anterior vertebral height (
p
= 0.002) were observed. Concerning the ratio of canal compromise according to the CT findings (
p
= 0.189), moderate differences were found.
Conclusions
Short-segment stabilization in thoracolumbar burst fractures with additional screws at the level of the fracture results in an improved kyphosis correction, sagittal index, and compression ratio of the anterior vertebral height. However, long-term follow-up is needed to determine the clinical significance of these findings.
ABSTRACT
Teratoma is a tumor that derivatives from all three primitive germ layers and spinal intramedullary teratomas are very rare lesions. The primary treatment modality for these tumors is ...surgical resection, and total resection should be the aim. However, subtotal resection is a valid alternative to prevent traumatizing adjacent functional neural tissue. In this report, we presented a case of a 12-year-old male patient with spinal teratoma of the conus medullaris. We describe the presentation, evaluation, and treatment of this rare disease.
This paper presents a novel low-complexity full-duplex radio design, which only uses a single patch antenna without any duplexer or circulator for passive suppression of self-interference, and a ...computationally efficient technique for linear digital cancellation. The proposed full-duplex design is tested for IEEE 802.11g Wireless Standard on the WARP (v3) software-defined radio implementation platform. It is shown that this design provides a total suppression of 88 dB, which is sufficient for low-power or short-range full-duplex communication. The dual polarized slot coupled patch antenna used in our design provides an interport isolation as high as 60 dB in 2.4 GHz band. Additionally, the digital domain cancellation utilizes a frequency domain-based estimation and reconstruction approach, which not only offers up to <inline-formula><tex-math notation="LaTeX">61\%</tex-math></inline-formula> reduction in the computational complexity but also provides a <inline-formula><tex-math notation="LaTeX">5-7 </tex-math></inline-formula> dB better digital cancellation performance in highly selective channel conditions, as compared to the time-domain-based techniques. The proposed full-duplex implementation can be easily applied in OFDM-based wireless systems, such as IEEE 802.11, which is the considered air interface in this paper.
The aim of this retrospective study was to evaluate the follow-up results of patients who received late-term surgical treatment for peripheral nerve lesions caused by penetrating injuries.
The study ...included 25 patients who underwent surgery for peripheral nerve injuries in our clinic between 2007 and 2013. The patients were evaluated with respect to age, gender, etiology of the trauma, the affected nerve, clinical examinations, electrophysiological findings, surgical techniques and functional outcomes.
The study included 30 nerves of 25 patients (19 male, 6 female; mean age 30.1 years). The mean time between the initial injury and admission to our clinic was 11.5 months (range, 3 to 30 months). Cuts caused by glass were the most common cause of injury (68.5%). The most commonly injured nerves in our patients were the median nerve (43.4%) and ulnar nerve (26.6%). External neurolysis and decompression were performed in eleven patients, epineurotomy and internal neurolysis were performed in eight patients, epineural repair was performed in fourteen patients, fascicular repair was performed in three patients, and interfascicular anastomosis using sural nerve grafting was performed in five patients. Postoperative motor strength and electrophysiological analyses showed significant improvements. Better outcomes were obtained in cases with median nerve injuries rather than other nerve injuries. Additionally, patients undergoing external neurolysis and decompression exhibited better outcomes than those undergoing other surgical approaches.
Although surgical treatment is recommended as early as possible for peripheral nerve injuries, late-term surgical treatments may provide positive outcomes.
Objective: It was aimed to evaluate the patients who underwent laminoplasty for the various pathologies that were located in the spinal canal. Materials and Methods: The records of the patients who ...underwent osteoplastic laminoplasty for various pathologies between 2014 and 2019 were analyzed retrospectively. Patient data including age, gender, preoperative and postoperative neurological conditions, type and radiographic localization of their pathologies, preoperative and postoperative deformities, involved segments, hospitalization periods and postoperative complications were gathered. Results: Sixty-two patients were included in the study. The mean age of the patients was 44.3 years (9-80 years). Fifty-two patients had tumoral and 10 patients had non-tumoral pathologies. Grade 3 and 4 patients were predominant in the preoperative period, while grade 1 and 2 patients were predominant in the postoperative period according to Modified McCormick Scale classification of the patients. Twenty-three patients had preoperative deformity. A total of 138 laminae were reconstructed. One patient had cerebrospinal fluid leak in the long-term period and 1 patient had quadriplegia and respiratory deficiency in the postoperative period. In only 1 patient, a new-onset deformity developed and in 1 patient, progression of previous deformity was seen. However, the deformities of these patients did not require corrective surgery. Conclusion: Laminoplasty technique has recently gained popularity and begun to replace traditional laminectomy technique. Laminoplasty is a preferred technique with the low complication rates and high patient-comfort in the postoperative period. Keywords: Laminoplasty, spinal tumor, spinal deformity, cerebrospinal fluid leak
Introduction
Central nervous system xanthogranulomas are uncommon clinical entities, and symptomatic bilateral choroid plexus xanthogranulomas are rare.
Case presentation
We present the case of a ...15-year-old male patient with bilateral choroid plexus xanthogranulomas with symptoms of increased intracranial pressure. Gross total resection of the tumor in the left lateral ventricle was performed. The patient improved, and asymptomatic right-sided tumor was monitored at follow-up.
Conclusion
The main treatment objective in these tumors is gross total resection. Asymptomatic tumors can be followed without intervention. However, surgery should be performed for symptomatic tumors that cause hydrocephalus or symptoms of increased intracranial pressure.
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