Safety and Validity of Anterior Cervical Disc Replacement for Single-level Cervical Disc Disease: Initial Two-year Follow-up of the Prospective Observational Post-marketing Surveillance Study for Japanese Patients.

Anterior cervical disc replacement (ACDR) using cervical artificial disc (CAD) has the advantage of maintaining the range of motion (ROM) at the surgical level, subsequently reducing the postoperative risk of adjacent disc disease. Following the approval for the clinical use in Japan, a post-marketing surveillance (PMS) study was conducted for two different types of CAD, namely, Mobi-C (metal-on-plastic design) and Prestige LP (metal-on-metal design). The objective of this prospective observational multicenter study was to analyze the first 2-year surgical results of the PMS study of 1-level ACDR in Japan.

Pathophysiology and surgical treatment of spinal adhesive arachnoid pathology: patient series.

Background: Spinal adhesive arachnoid pathology is a rare cause of myelopathy. Because of rarity and variability, mechanisms of myelopathy are unknown. The authors retrospectively analyzed patients to understand pathophysiology and provide implications for surgical treatment.

Ischemic complications in the neurosurgical and endovascular treatments of craniocervical junction arteriovenous fistulas: a multicenter study.

Objective: A recent comparative analysis between neurosurgical and endovascular treatments for craniocervical junction (CCJ) arteriovenous fistulas (AVFs) revealed better treatment outcomes in the neurosurgery group than in the endovascular group. This finding was attributed to the higher than expected rate of ischemic complications in the endovascular group than in the neurosurgery group (26% vs 7.7%, p = 0.

Neurosurgical versus endovascular treatment of craniocervical junction arteriovenous fistulas: a multicenter cohort study of 97 patients.

Objective: Craniocervical junction (CCJ) arteriovenous fistulas (AVFs) are treated using neurosurgical or endovascular options; however, there is still no consensus on the safest and most effective treatment. The present study compared the treatment results of neurosurgical and endovascular procedures for CCJ AVFs, specifically regarding retreatment, complications, and outcomes.

Methods: This was a multicenter cohort study authorized by the Neurospinal Society of Japan.

Secondary Chiari malformation due to enlarged spinal arachnoid villi-like structure: illustrative case.

Background: Secondary Chiari malformation can be caused by various disorders associated with cerebrospinal fluid (CSF) leakage at the spinal level. In this report, the authors describe a rare case of secondary Chiari malformation caused by excessive CSF absorption through the enlarged spinal arachnoid villi-like structure.

Observations: A 20-year-old woman presented with progressive severe headache and posterior neck pain.

Options of Management of the Patient with Mild Degenerative Cervical Myelopathy.

Surgical management of patients with mild degenerative cervical myelopathy (DCM) is controversial. This article reviews 84 subjects with cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) who underwent surgical treatment. Nine had mild myelopathy: 6 CSM and 3 OPLL.

Double Crush of L5 Spinal Nerve Root due to L4/5 Lateral Recess Stenosis and Bony Spur Formation of Lumbosacral Transitional Vertebra Pseudoarticulation: A Case Report and Review.

We present a case of double-crushed L5 nerve root symptoms caused by inside and outside of the spinal canal with spur formation of the lumbosacral transitional vertebra (LSTV). A 78-year-old man presented with 7-year history of moderate paresis of his toe and left leg pain when walking. Magnetic resonance imaging (MRI) revealed spinal stenosis at the L3/4 and 4/5 spinal levels and he underwent wide fenestration of both levels.

Chronic Spinal Subdural Hematoma Associated with Antiplatelet Therapy.

Background: Spinal subdural hematoma is a rare clinical entity marked by the onset of pain and paralysis, which is usually associated with hemorrhagic disorders, trauma, and iatrogenic causes such as lumbar puncture or epidural anesthesia.

Case Description: A 71-year-old man was admitted to our hospital with 2 weeks' history of bilateral lower leg pain, dysesthesia, paraparesis, and urinary disturbance. Magnetic resonance imaging showed characteristic findings at the thoracolumbar spine, and surgical evacuation successfully treated this condition.

Surgical Outcome of Children and Adolescents with Tethered Cord Syndrome.

Study Design: Retrospective cohort study.

Purpose: To compare long-term results of surgery with the outcomes of symptomatic and asymptomatic tethered cord syndrome (TCS) in children and adolescents and to assess the surgery duration for those with TCS.

Overview Of Literature: Pediatric patients with TCS continue to pose significant diagnostic and management challenges.

Clinical Factors for Prognosis and Treatment Guidance of Spinal Cord Astrocytoma.

Study Design: Retrospective study.

Purpose: To obtain information useful in establishing treatment guidelines by evaluating baseline clinical features and treatment outcomes of patients with spinal cord astrocytoma (SCA).

Overview Of Literature: The optimal management of SCA remains controversial, and there are no standard guidelines.

Surgical Outcomes of High-Grade Spinal Cord Gliomas.

Study Design: A retrospective study.

Purpose: The purpose of this study was to obtain useful information for establishing the guidelines for treating high-grade spinal cord gliomas.

Overview Of Literature: The optimal management of high-grade spinal cord gliomas remains controversial.

Cervical spinal cord injuries associated with resuscitation from fatal circulatory collapse.

Introduction: Fatal cervical spinal cord injury (SCI) associated with collapse of the circulatory and/or respiratory system usually consists of high cervical SCI caused by high-energy trauma. As the elderly population grows, however, the etiology of fatal SCI may be changing. The aim of the present study was to understand the current clinical features of fatal SCI.

Intramedullary spinal cord ganglioglioma presenting as hyperhidrosis: unique symptoms and magnetic resonance imaging findings: case report.

Hyperhidrosis is caused by a sympathetic dysfunction of the central or peripheral nervous system. Intramedullary spinal cord lesions can be a cause of hyperhidrosis. The authors report a rare case of intramedullary thoracic spinal cord ganglioglioma presenting as hyperhidrosis.

Dissection aneurysm of the radiculomedullary branch of the artery of Adamkiewicz with subarachnoid hemorrhage.

A 60-year-old female presented with sudden onset of severe headache and back pain, followed by nausea. The initial head computed tomography (CT) scan revealed posterior fossa subarachnoid hemorrhage (SAH). Spinal T(2)-weighted magnetic resonance imaging demonstrated SAH, and a homogeneous and slightly low signal intensity mass at T11.

[Threshold levels of intracranial pressure as determinants of survival from diffuse brain injury. An observational study].

Objective: Intracranial pressure (ICP) is frequently monitored in patients with severe head injuries. In this study of a series of diffuse brain injury patients, we investigated whether there are significant threshold levels that determine the outcome.

Method: Data were obtained from 17 patients with severe head injuries (adults aged ≥ 15-years-old).

Remote cerebellar hemorrhage after foramen magnum decompression surgery for Chiari I malformation--case report.

A 47-year-old woman underwent decompressive suboccipital craniectomy and C1 laminectomy with duroplasty in the prone position for Chiari malformation type I and syringomyelia. The arachnoid membrane was not injured. Intraoperative echography showed good enlargement of the subarachnoid space.

Intraoperative indocyanine green videoangiography for spinal vascular lesions: case report.

Background And Importance: In surgery of spinal vascular lesions such as spinal arteriovenous fistula or vascular tumors, assessment of feeding arteries and draining veins is important. Intraoperative digital subtraction angiography is useful but is invasive and sometimes technically demanding. Near-infrared indocyanine green (ICG) videoangiography is less invasive and has been reported as an intraoperative diagnosis of arterial patency during clipping surgery of cerebral aneurysms or bypass surgeries.

[Fracture of the cervical spine in ankylosing spondylitis. A case report].

We report a case of a 61-year-old man with ankylosing spondylitis who showed cervical spine fracture. The patient had fallen down on the floor and presented with severe neck pain. He was treated conservatively with a hard neck collar in an emergency hospital because of C7 body fracture without dislocation.

Pathogenesis of syringomyelia associated with Chiari type 1 malformation: review of evidences and proposal of a new hypothesis.

The exact pathogenesis of syringomyelia associated with Chiari type 1 malformation is unknown, although a number of authors have reported their theories of syrinx formation. The purpose of this review is to understand evidences based on the known theories and to create a new hypothesis of the pathogenesis. We critically review the literatures on clinicopathological, radiological, and clinical features of this disorder.

Pulsatile wall movement of spinal arachnoid cyst deteriorates spinal cord symptoms: report of three cases.

Introduction: Symptomatic spinal arachnoid cyst is a rare disease and the pathophysiology causing spinal cord symptoms has not been well clarified.

Patients And Methods: The authors report three symptomatic cases of spinal arachnoid cyst at the thoracic level. These patients, aged from 70 to 73 years, showed progressive gait disturbance for a few months before admission.

Quantitative analysis of adverse events in neurosurgery.

Objective: : It is well recognized that the occurrence rate of adverse events related to surgical procedures is considerably high in neurosurgery compared with other specialties. The purpose of this study was to quantitatively determine the occurrence rate of adverse events related to surgery and endovascular intervention in neurosurgery.

Methods: A conference on adverse events related to treatments (morbidity and mortality conference) has been held every month for the past 2 years in our department.

[Cerebral ischemia originating from rotational vertebral artery occlusion caused by C5/6 spondylotic changes: a case report].

A 68-year-old man presented with sudden onset of left hemiparesis, diplopia and numbness of the left side of the body and was admitted to our hospital. MRI of the brain revealed no abnormality. However, neurological examination on admission strongly suggested ischemia of the brainstem.