Use of Subfascial Passive Bile Bag Drainage for the Management of Durotomies in Spine Surgery.

Introduction: Historically, the use of subfascial drains for the management of durotomies was avoided due to concerns about the creation of cerebrospinal fluid (CSF) fistulas. Currently, there are limited series utilizing subfascial drainage for CSF leak management, many of which utilize suction drainage. We report our experience with the use of subfascial passive drainage in the management of such leaks.

Accounting for repeat intervention costs in the economic comparison of laser interstitial thermal therapy and anterior temporal lobectomy for treatment of refractory temporal lobe epilepsy.

Objective: Laser interstitial thermal therapy (LITT) is an alternative to anterior temporal lobectomy (ATL) for the treatment of temporal lobe epilepsy that has been found by some to have a lower procedure cost but is generally regarded as less effective and sometimes results in a subsequent procedure. The goal of this study is to incorporate subsequent procedures into the cost and outcome comparison between ATL and LITT.

Methods: This single-center, retrospective cohort study includes 85 patients undergoing ATL or LITT for temporal lobe epilepsy during the period September 2015 to December 2022.

Vasospasm secondary to responsive neurostimulator placement: a previously unreported complication. Illustrative case.

Background: The Responsive Neurostimulation (RNS) system is an implantable device for patients with drug-resistant epilepsy who are not candidates for resection of a seizure focus. As a relatively new therapeutic, the full spectrum of adverse effects has yet to be determined. A literature review revealed no previous reports of cerebral vasospasm following RNS implantation.

Rib fixation for flail chest physiology and the facilitation of safe prone spinal surgery: illustrative case.

Background: Spine fractures are frequently associated with additional injuries in the trauma setting, with chest wall trauma being particularly common. Limited literature exists on the management of flail chest physiology with concurrent unstable spinal injury. The authors present a case in which flail chest physiology precluded safe prone surgery and after rib fixation the patient tolerated spinal fixation without further issue.

Sacroiliac Joint Fusion-A Shift Toward Variant Anatomy and Clinical Implications.

Objective: To investigate impact of patient factors and sacroiliac joint (SIJ) anatomical structure on SIJ fusion outcomes.

Methods: This single-center, retrospective, observational study evaluated patients diagnosed with SIJ dysfunction refractory to conservative measures who had available preoperative imaging of the sacrum and underwent SIJ fusion surgery. The impact of patient sociodemographics on pain improvement was assessed by Mann-Whitney U test.

3-Dimensional Exoscope for Far Lateral Approach to Pontomedullary Cavernous Malformation.

Brainstem cavernous malformations account for 15%-18% of all central nervous system cavernomas and are histologically characterized by thin-walled, low-pressure capillaries, classically without intervening brain tissue. Cavernomas may be sporadic, typically characterized by a single lesion, or inherited. The inherited form is most often autosomal dominant with incomplete penetrance and variable expression.

Microsurgical Management of a Primary Neuroendocrine Tumor of the Filum Terminale: A Surgical Technique.

Neuroendocrine tumors (NETs) are benign tumors of the autonomic nervous system that rarely occur in the spinal canal. The gold standard treatment is gross total resection while preserving the patient's neurologic functioning as complete surgical resection is curative. The surgical management of NETs could pose a challenge given their friable consistency, hypervascular nature, and proclivity to adhere to the cauda equina nerve roots.

Venous Thromboprophylaxis in Spine Surgery.

Study Design: Review article.

Objective: A review of the literature on postoperative initiation of thrombophylactic agents following spine surgery.

Methods: A review of the literature and synthesis of the data to provide an update on venous thromboprophylaxis following spine surgery.

Anticoagulation and Spine Surgery.

Study Design: Literature review.

Objective: Preoperative management of therapeutic anticoagulation in spine surgery is critical to minimize risk of thromboembolic events yet prevent postsurgical complications. Limited research is available, and most guidelines are based on drug half-lives.

Fast-track incorporation of the transradial approach in endovascular neurointervention.

Background: The transradial approach as a frontline approach is a novel technique in neuroendovascular procedures. In this study we aim to present our early experience with full transition to transradial access as the first-line approach for neuroendovascular procedures.

Methods: We prospectively collected data on the first 100 consecutive patients who underwent a diagnostic or interventional neuroendovascular procedure using the transradial approach at our institution between March 22 and April 30, 2019.