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ce may support increased segmental stabilization compared with static ISPF.

Tuberculum sellae meningiomas are challenging tumors often compressing the optic apparatus and involving the optic canals. Traditional approaches provide wide exposure, but optic canal access can remain difficult. Endonasal approaches offer a less invasive option that allows access to the medial optic canals, but larger tumors can still be challenging along with a higher risk of postoperative spinal fluid leak. KG-501 Epigenetic Reader Do inhibitor We present the use of a keyhole superior interhemispheric approach for tuberculum sellae meningioma resection.

Five patients with tuberculum sellae meningioma who underwent a keyhole superior interhemispheric approach were retrospectively reviewed. Preoperative tumor volumes, visual outcomes, extent of resection, pathologic grading, perioperative complications, recurrence rates, operative times, and hospital length of stays were analyzed.

The average age of the patients was 68.6 ± 7.7 years old (range 57-78). Average tumor volume was 8 ±1.8 cm

. All patients had a gross total resection. Three out of 5 patients had World Health Organization grade 1 meningioma, and the other 2 had World Health Organization grade 2 meningioma. There were no recurrences over an average follow-up of 18.6 months (range 1-44). On preoperative visual assessment, 9 out of 10 eyes (90%) had a deficit. Postoperative visual assessment found 9 out of 9 eyes with preoperative deficits had improvement (100%).There were no perioperative or postoperative complications.

The keyhole superior interhemispheric approach provides a transcranial alternative that allows excellent exposure of the vasculature and both optic canals, resulting in good extents of resection and recovery of vision.

The keyhole superior interhemispheric approach provides a transcranial alternative that allows excellent exposure of the vasculature and both optic canals, resulting in good extents of resection and recovery of vision.

Diabetes mellitus and aneurysmal compression are well-known causes of oculomotor nerve palsy (ONP), but nonaneurysmal vascular compression of the oculomotor nerve has rarely been reported.

A 70-year-old nondiabetic man presented with left ONP for the past 2 days. Magnetic resonance imaging revealed the left posterior communicating artery to be compressing the left oculomotor nerve. Microvascular decompression of the offending artery from the nerve via a left frontotemporal craniotomy was performed; the nerve showed a color change suggestive of degenerative alteration. ONP was fully resolved within 1 month of surgery.

Whether nonaneurysmal vascular compression of the oculomotor nerve is a true cause of ONP is sometimes controversial. However, recent developments in magnetic resonance imaging can clearly demonstrate the spatial relationship between the oculomotor nerve and vessels. Detailed magnetic resonance imaging should be used to diagnose compression of the oculomotor nerve by blood vessels. Microvascular decompression is the treatment of choice in this situation.

Whether nonaneurysmal vascular compression of the oculomotor nerve is a true cause of ONP is sometimes controversial. However, recent developments in magnetic resonance imaging can clearly demonstrate the spatial relationship between the oculomotor nerve and vessels. Detailed magnetic resonance imaging should be used to diagnose compression of the oculomotor nerve by blood vessels. Microvascular decompression is the treatment of choice in this situation.

Spinal arthrodesis is a commonly performed spinal operation. Spinal arthrodesis can be complicated by pseudoarthrosis and resultant hardware failure. Static magnetic fields (SMF) have the ability to improve bone fusion. We seek to assess the feasibility of the construction and implantation of a lumbar interbody cage equipped with a SMF in a caprine model.

Six skeletally mature female Boer goats underwent a lateral approach for placement of an interbody graft at lumbar (L) 1-2 and 3-4. The goats were divided into 2 groups of 3 animals. The interbody graft contained a neodymium iron boron magnet in the experimental group and a nonmagnetic titanium sham in the control group. Both groups contained a synthetic bone graft. Blinded radiographic and histologic evaluation was performed at predetermined timepoints to assess degree of bony fusion and osseointegration.

All 6 goats underwent successful placement of lumbar interbody grafts. At the 1-month postoperative computed tomography, 1 goat in the experimental group and 1 goat in the control group were noted to have dislodged their intervertebral cage. Qualitative radiographic and histologic evaluation identified enhanced bone formation, bone density, and osteointegration of the graft in the experimental group.

A spinal interbody cage containing a neodymium iron boron magnet for the production of a local SMF is feasible. Preliminary data suggests enhanced bone formation, bone density, and osseointegration of the graft.

A spinal interbody cage containing a neodymium iron boron magnet for the production of a local SMF is feasible. Preliminary data suggests enhanced bone formation, bone density, and osseointegration of the graft.

Our study aimed to assess whether elective posterior lumbar fusions (PLFs) performed in states with Certificate-of-Need (CON) laws versus states without CON laws had lower utilization rates, lower costs, and better quality of care.

The 2005-2014 100% Medicare Standard Analytical File was queried to identify patients undergoing elective 1- to 3-level PLF. Differences in per-capita utilization, 90-day reimbursements, and proportion of high-volume between CON and No-CON states were reported. Multivariate analyses were used to analyze 90-day complications and readmissions.

A total of 188,687 patients underwent an elective 1- to 3-level PLF in a CON state and 167,642 patients in a No-CON state during 2005-2014. The average per capita utilization of PLFs was lower in CON states as compared with No-CON states (14.5 vs. 15.4 per 10,000 population; P < 0.001). Average 90-day reimbursements between CON and No-CON states differed by a small amount ($22,115 vs. $21,802). CON states had a higher proportion of high-volume facilities (CON vs.

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