Thoracoscopic debridement and stabilization of pyogenic vertebral osteomyelitis

Journal ArticleThe role of surgical debridement and internal fixation in treatment of vertebral osteomyelitis has been evolving. The standard surgical approach to thoracolumbar vertebral osteomyelitis requiring extensive thoracotomy or retroperitoneal exposure carries significant associated morbidity and postoperative pain. Minimally invasive thoracoscopic spine surgery is designed to improve postoperative morbidity associated with the traditional open surgery. We report a case of a 70-year-old man who developed T11-T12 pyogenic vertebral osteomyelitis 3 months after undergoing posterior laminectomy and microsurgical excision of a herniated thoracic disc. The patient underwent minimally invasive thoracoscopic radical debridement and anterior spinal reconstruction and fusion. Patients with vertebral osteomyelitis may benefit from the decreased postoperative morbidity that is associated with minimally invasive thoracoscopic spinal surgery

Photophobia in a blind patient: an alternate visual pathway

Journal ArticlePhotophobia is a common neurological and ophthalmological symptom that has been associated with a growing number of neurosurgical conditions, especially compressive lesions. The exact signaling pathways and neurophysiological features of the disorder are not well understood; however, data from multiple studies have shown the significance of the trigeminal system and the pretectal nuclei in its pathophysiology. The authors report on a rare case of a blind patient who presented with photophobia without evidence of light perception. They also review the literature and early experimental data in an effort to understand the possible neuronal pathways and structures involved in photophobia

Thoracoscopic spine surgery for decompression and stabilization of the anterolateral thoracolumbar spine

Journal ArticleThe anterior thoracolumbar spine can be exposed via a variety of approaches. Historically, open anterolateral or posterolateral approaches have been used to gain access to the anterior thoracolumbar spinal column. Although the exposure is excellent, open approaches are associated with significant pain and respiratory problems, substantial blood loss, poor cosmesis, and prolonged hospitalization. With the increasing use of the endoscope in surgical procedures and recent advances in video-assisted thoracoscopic surgery, minimally invasive thoracoscopic spine surgery has been developed to decrease the morbidity associated with open thoracotomy. The purpose of this article is to illustrate the surgical technique of a minimally invasive thoracoscopic approach to the anterolateral thoracolumbar spine and to discuss its potential indications and contraindications in patients with diseases involving the anterior thoracic and lumbar regions

Glioblastoma multiforme of the pineal region

ManuscriptGlioblastoma multiforme (GBMs) tumors are exceedingly rare tumors in the pineal region. We present three cases in which patients presented with a pineal/posterior third ventricular region mass and review all the previously reported cases in the literature. Pineal region GBM seems to be a very aggressive tumor with a high rate of leptomeningeal and ependymal metastatic disease. Patients usually present with signs and symptoms of hydrocephalus and Parinaud's syndrome. The clinical and radiological characteristics of pineal GBM do not differentiate it from other malignancies of this region, thus surgical biopsy is generally required for definitive diagnosis. Glioblastoma should be considered in the differential diagnosis of the pineal region tumors, especially when evidence of leptomeningeal or ependymal metastatic disease is present

Chylorrhea: a rare complication of thoracoscopic discectomy of the thoracolumbar junction

Journal ArticleThe thoracic duct along with the cisterna chyli is a major lymphatic pathway near the anterior thoracolumbar spine. Despite the fragile nature of the lymphatic system and its proximity to the spinal column, chylorrhea is rarely encountered by spine surgeons. The authors present a unique case of chylorrhea associated with a left thoracoscopic, transdiaphragmatic discectomy and fusion for a T12-L1 herniated disc. The anomalous location of the thoracic duct at the left lateral vertebral column contributes to this unusual complication

Syndrome of inappropriate secretion of antidiuretic hormone and hyponatremia after spinal surgery

Journal ArticleHyponatremia caused by an inappropriately high level of antidiuretic hormone secretion after spinal surgery is an uncommon and self-limiting phenomenon that resolves within 2 or 3 weeks. During the early postoperative period, the patient's urine output and serum level of sodium should be monitored closely to prevent possible serious complications of the syndrome of inappropriate secretion of antidiuretic hormone. Symptoms vary depending on the severity of the hyponatremia and can range from mild headache, muscle cramps, nausea, and vomiting to convulsions, coma, and death. Treatment options include fluid restriction, oral intake of salt, and hypertonic saline. It is important that spine surgeons recognize this phenomenon early and treat it appropriately and conservatively to prevent possible serious complications

The Dangers of Witchcraft in the View of Hadith: A Study of Takhrij and Hadith Syarah

This study aims to discuss the hadith about the dangers of magic. This study uses a qualitative approach by applying the descriptive-analytical method. The formal object of this research is the science of hadith, while the material object is the hadith about the dangers of magic in the history of Malik No. 1564. The results and discussion of this study indicate that the status of hadith is of authentic quality that meets the qualifications of maqbul ma'mul bih for the practice of Islam. This study concludes that the hadith narrated by Malik No. 1564 is relevant to be used as motivation, advice, and learning about the dangers of magic

Using 3D sensing and projecting technology to improve the mobility of Parkinson's disease patients

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonParkinson’s is a neurological condition in which parts of the brain responsible for movements becomes incapacitated over time due to the abnormal dopamine equilibrium. Freezing of Gait (FOG) is one of the main Parkinson’s Disease (PD) symptoms that affects patients not only physically but also psychologically as it prevents them from fulfilling simple tasks such as standing up or walking. Different auditory and visual cues have been proven to be very effective in improving the mobility of People with Parkinson’s (PwP). Nonetheless, many of the available methods require user intervention or devices to be worn, charged, etc. to activate the cues. This research suggests a system that can provide an unobtrusive facility to detect FOG and falling in PwP as well as monitoring and improving their mobility using laser-based visual cues casted by an automated laser system. It proposes a new indoor method for casting a set of two parallel laser lines as a dynamic visual cue in front of a subject’s feet based on the subject’s head direction and 3D location in a room. The proposed system controls the movement of a set of pan/tilt servo motors and laser pointers using a microcontroller based on the real-time skeletal information acquired from a Kinect v2 sensor. A Graphical User Interface (GUI) is created that enables users to control and adjust the settings based on the user preferences. The system was tested and trained by 12 healthy participants and reviewed by 15 PwP who suffer from frequent FOG episodes. The results showed the possibility of employing the system as an indoor and on-demand visual cue system for PwP that does not rely on the subject’s input or introduce any additional complexities to operate. Despite limitations regarding its outdoor use, feedback was very positive in terms of domestic usability and convenience, where 12/15 PwP showed interest in installing and using the system at their homes