Thoracolumbar burst fractures requiring instrumented fusion: Should reducted bone fragments be removed? A retrospective study

Background Thoracolumbar burst fractures are common clinical entity encountered in neurosurgical practice, accounting for 10–20% of all spinal fractures. Clinical picture could be devastating due to severe neurological deficits which lead the patients dependent both socially and emotionally. Materials and methods This study compared two groups of patients who were operated because of thoracolumbar burst fracture secondary to spinal trauma in terms of neurologic deficits, degree of improvement, and radiologic measurements at one-year follow-up. The first group (group I) included the patients who underwent posterior total laminectomy, peroperative reduction of intracanal bone fragments, and posterior spinal instrumentation and the second group (group II) included the patients who underwent total laminectomy, and spinal instrumentation without reduction of free bone fragments. Results Neither group showed significant correlation with any measurement parameter. Radiological assessments and clinical improvements did not disclosed significant difference between the two groups at one-year follow-up. Conclusion Retropulsion of free bone fragments extend the time of surgery and causes complications. This study found that there is no need to retropulse the bone fragments in the spinal canal in patients with unstable burst fractures who underwent total laminectomy and posterior long segment stabilization

The denticulate ligament: anatomical properties, functional and clinical significance

DL histology and anatomy are strongly correlated with the function of this structure at different spinal levels. It is important to have accurate knowledge about DLs as these structures are relevant for clinical procedures that involve the spinal cord or craniovertebral junction

A Variation of the Cords of the Brachial Plexus on the Right and a Communication between the Musculocutaneous and Median Nerves on the Left Upper Limb: A Unique Case

During routine anatomical dissection of the upper extremity of a 64-year-old cadaver for educational purposes, we observed variations in the brachial plexus on each side. On the right an anomaly of cord formation was present and on the left there was a communication between the musculocutaneous nerve (MCN) and median nerve (MN). On the right side the brachial plexus showed two trunks, superior (C5 and C6) and inferior (C7, C8, and T1); the middle trunk was absent. The superior trunk bifurcated into anterior and posterior divisions, the anterior division continued as the lateral cord forming the MCN. The posterior division gave off the subscapular branch. The inferior trunk trifurcated into radial, median, and ulnar nerves. The radial nerve gave off the axillary and thoracodorsal nerves. The ulnar nerve gave off the median cutaneous nerves of the arm and forearm. The median nerve received a small ascending branch from the MCN. On the right side, there was a communicating branch from the MCN to the MN in the lower third of the arm region. This communicating branch also gave rise to a muscular branch to the brachialis muscle and the lateral cutaneous nerve of forearm. No additional heads of the biceps brachii muscle were observed in either upper limb. Knowledge of the variations of the brachial plexus in humans can be valuable for operations of the shoulder joint and its repair for providing an effective block or treatment for anesthetists and also for explaining otherwise incomprehensible clinical signs for neurologists

Falcine venous plexus within the falx cerebri: anatomical and scanning electron microscopic findings and clinical significance

The falcine venous plexus is a network of venous channels that exists within the connective tissue of the falx; the sizes and patterns of communication of these structures showed regional differences. Neurosurgeons should be aware of the regional differences when making an incision or puncturing the falx during a surgical approach

An Unusual Mechanism of Delayed Intracerebral Hemorrhage After Ventriculoperitoneal Shunting: Case Report

We present a case of delayed intracerebral hemorrhage that developed seven years after initial ventriculoperitoneal shunt surgery. A seven-year-old boy was admitted to emergency when he experienced sudden headache and vomiting. Computed tomography (CT) scanning showed an intracerebral hemorrhage around the ventricular catheter that cannot be explained by known predisposing factors such as head trauma, coexisting bleeding disorder, occult vascular malformation, and intratumoral hemorrhage. The presumed mechanism in this case is that the ventricular catheter caused contusion of cerebral tissue because the shunt tube at the neck had stretched during the growing up of the child

A Microsurgical Training Model For Anterior Cervical Discectomy in Fresh Sheep Spine

The main purpose of this study is to develop a practical microscopic training model of a fresh cadaveric sheep cervical spine that simulates the human anterior cervical discectomy under operating microscope. According the study results, it has been claim that this model simulates well standard anterior cervical discectomy of the human spine and is a useful method for trainees

Ensuring Corpectomy and Stabilization Effectiveness in Patients Who Underwent Single Posterior Approaches

Introduction: Today, approximately 2 million people worldwide suffer from spinal tuberculosis (STB). In endemic areas, classical STB is often accompanied by spondylodiscitis. Methods: This study retrospectively analyzed 15 patients diagnosed with STB who were followed up in our clinic from January 2010 to August 2021. The study included a total of 15 patients diagnosed with spondylodiscitis, 7 males and 8 females, with detection of STB bacillus (6 patients) and/or pathological diagnosis of caseous necrosis (15 patients). Results: Pre-operative neurological examinations of the patients revealed neurological deficits according to the Frankel scale, except in 2 patients. According to the Frankel scale, 8 patients showed improvement, 6 of them did not change, 1 worsened, and 13 had fusion documented on radiological imaging. Conclusion: Anterior corpectomy and posterior instrumentation may be a safe and effective technique compared with all other surgical interventions applicable in such patients

Malgaigne Fracture in Childhood A Case Report and Review of Literature

WOS: 000370525700001PubMed: 26825888Sacrum fractures are rare pathologies seen after spinal traumas. The incidence of a sacral fracture after trauma is 0.6% in childhood. A Malgaigne fracture is composed of fractures and dislocations of the anterior and posterior regions of the pelvis. This is the first reported case of Malgaigne fracture during childhood. A 12-year-old girl was admitted to our emergency room after having suffered a fall. Radiological tests revealed a zone 3 sacral fracture according to the Denis scoring, a subtype 2 sacral fracture according to the Roy-Camille classification, and a detachment in the symphysis pubis. Appropriate load distribution through a bilateral L5-S1-S2 transpedicular screw and a bilateral iliac wing screw, as well as neural decompression were performed together with an S1-S2 total laminectomy. It is very difficult to make a generalization for treatment of sacral fractures and Malgaigne fractures in childhood due to the small number of patients. Each patient should be individualized and lumbosacroiliac instability should be treated

Chronic Subdural Hematomas: Epidemiology, Radiology, Hematological Parameters and Surgical Results of Cases

Aim: Chronic Subdural hematomas (CDSH) first reported in 1656 by JJ Wepfer. In 1857 CSDH was defined as Pachimenengitis hemoragyca interna. Frequency of CSDH changes with age progression. İt’s reported in literature; CDSH coexists %60-80 with minor head trauma. We aimed to present our experience in follow-up and treatment of patients with CSDH which are frequently encountered in routine neurosurgical practice. Materials and Methods: Cases of CSDH which were operated between January 2016- December 2017 evaluated retrospectively from Clinical Files. The patients' clinical files were evaluated retrospectively according to age, gender, personal background, complaint, use of anticoagulant, presence of head trauma, radiologic images, hematologic parameters, type of anesthesia, surgical method and recurrence rates.Results: The study consists of total 67 cases which %20,9 (n=14) female and %79,1 (n=53) male. The ages of the cases ranged from 16 to 91 years with an average of 68,60 ± 16,45 years. The duration of hospitalization according to gender and age, the duration of hospitalization according to the presence of additional disease and the types of additional diseases seen, the duration of hospitalization according to drug use and anesthesia type (p> 0.05), between N / L and residence time (r: 0,222; p > 0.05) were not statistically significant.Conclusions: However, it may seem so basic; Choices about Surgical techniques and type of anesthesia are effective about mortality and morbidity. Because of duration of surgery is shorter; it is shown that Surgeries performed with Sedoanalgesia and local anesthesia can be used safely especially for patients with comorbidity