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001). Upper adjacent SL, upper adjacent ROM, and lower adjacent ROM were stable after ACDF (P > 0.05). The maximal CMAPs of abductor digit minimi and the latency of the ulnar nerve F reaction improved bilaterally (P < 0.05), whereas there was no significance in the maximal CMAPs of abductor pollicis brevis (P > 0.05). Abnormal spontaneous action potentials reduced remarkably. selleck products The selected brief-Michigan Hand Questionnaire score increased after surgery (P < 0.001). The Odom scale showed a ratio of 79.1% (excellent and good ratio).

This study showed favorable radiologic, electrophysiologic, and clinical outcomes after ACDF among patients with HD.

This study showed favorable radiologic, electrophysiologic, and clinical outcomes after ACDF among patients with HD.

Posterior vertebral column resection (PVCR) is a versatile technique for correction of severe and rigid spinal deformities, but the high rate of neurological complications is a major disadvantage of this procedure. This study aimed to describe a modified PVCR technique for safe treatment of severe post-tuberculous kyphotic deformity.

Four consecutive patients with severe post-tuberculous kyphosis underwent modified PVCRs. Radical removal of the posterior elements was avoided by performing laminectomy in stages, and the posterior vertebral wall and the bases of the spinous processes were maintained throughout the procedure. Perioperative clinical presentation, imaging data, and operative variables were recorded.

Desirable efficacy and clinical outcomes were obtained, including satisfactory correction rates and low estimated blood loss. Neurological status improved in all patients with preoperative neurological deficits, and no postoperative neurological complications were reported.

Modified PVCRs could prevent excessive handling or overstretching of the spinal cord, reduce bleeding, and provide more security in the correction of severe spinal deformities. Our initial experience showed that this modified procedure might be an alternative to conventional Schwab grade 6 osteotomy for the correction of severe post-tuberculous kyphotic deformity.

Modified PVCRs could prevent excessive handling or overstretching of the spinal cord, reduce bleeding, and provide more security in the correction of severe spinal deformities. Our initial experience showed that this modified procedure might be an alternative to conventional Schwab grade 6 osteotomy for the correction of severe post-tuberculous kyphotic deformity.Spontaneous spinal cerebrospinal fluid (CSF) leak is a condition that commonly presents with debilitating positional headaches. Often, the cause of the leak is located in the spine. Although often cured with conservative management, including epidural blood patching, a subset of patients are refractory to this initial management. Determining the focal location of the spinal leak can, in some patients, require several imaging modalities. Treatment similarly involves multiple options, including targeted epidural blood and/or fibrin patching as well as surgical closure. In this article, we review the current literature regarding this challenging condition and present an algorithm for management.

The endoscopic endonasal approach (EEA) has been applied in the treatment of olfactory neuroblastoma (ONB). However, there is a lack of research examining the impact of EEA on locally advanced ONB. This study assessed the outcomes of EEA in patients with locally advanced ONB and its impact on the quality of life (QOL).

We retrospectively reviewed patients with Kadish stage C ONB who underwent EEA between December 2004 and October 2019 and assessed demographic data, histopathologic grade, the extent of resection, postoperative complications, and outcomes. Preoperative and postoperative QOL was assessed using the Sino-Nasal Outcome Test.

Twenty-six patients (18 men, 8 women; aged 26-79 years) were enrolled, with 12 cases of Hyams grade II and III and 1 case of grade I and IV each. In total, 25 patients received radiotherapy and 16 patients received chemotherapy, of whom 11 received preoperative neoadjuvant chemotherapy. Postoperative nasal bleeding was observed in 2 patients. The follow-up ranged from 8 to 124 months (median, 42.3 months). The 1-year and 5-year overall survival were 96.2% and 84.8%, respectively. The 1-year and 5-year disease-free survival were 76.9% each. The analysis of the postoperative Sino-Nasal Outcome Test scores showed significant improvement in certain psychological and sleep-associated domains, compared with the preoperative scores.

Our results showed that pure EEA followed by radiotherapy offered excellent outcomes in the management of selected patients with locally advanced ONB. The postoperative QOL was significantly improved. More research is required on neoadjuvant chemotherapy to establish its role.

Our results showed that pure EEA followed by radiotherapy offered excellent outcomes in the management of selected patients with locally advanced ONB. The postoperative QOL was significantly improved. More research is required on neoadjuvant chemotherapy to establish its role.Arachnoid web (AW) is a rare phenomenon that has only been described in small case reports and case series,1 most commonly presenting with upper motor neuron signs and subtle radiographic findings, such as the classically described "scalpel sign."2 In this report, we demonstrate the use of imaging and operative techniques that have not been previously shown in the literature as a video for AW. These include high-definition magnetic resonance imaging (MRI) sequences for preoperative diagnosis, use of intraoperative ultrasonography for identification of adhesions, and operative technique for AW fenestration (Video 1). The patient consented to this manuscript. A 64-year-old female patient developed progressive difficulty with balance and ambulation that particularly worsened over the last 4 months associated with tingling and numbness in the bilateral lower extremities. Physical examination revealed spastic gait and upper motor neuron signs in the lower extremities along with left foot drop. MRI revealed a chronic noncontrast-enhancing intramedullary lesion, along with a spinal cord indentation at the level T6 with an associated fiber between the cord and the posterior dura.