Successful treatment of a brain-metastasized renal cell carcinoma.

Renal cell carcinoma is an uncommon type of cancer that rarely metastasizes to the brain. The prognosis after discovering brain metastasis has traditionally been dismal. We are presenting a case of renal cell carcinoma with multiple brain metastases that was successfully treated with multimodal therapy including a new type of medication.

Quantitative estimation of the recurrent laryngeal nerve irritation by employing spontaneous intraoperative electromyographic monitoring during anterior cervical discectomy and fusion.

Study Design: Prospective, clinical study.

Objective: The objective of our study was to evaluate the role of laryngeal intraoperative electromyography (IEMG) in predicting the development of postoperative recurrent laryngeal nerve (RLN) palsy in patients undergoing anterior cervical discectomy and fusion (ACDF). We also attempted to develop a method to quantify the total IEMG irritation of the RLN.

Upper-limb somatosensory evoked potential monitoring in lumbosacral spine surgery: a prognostic marker for position-related ulnar nerve injury.

Background Context: Somatosensory evoked potential (SSEP) is used to monitor integrity of the brain, spinal cord, and nerve roots during spinal surgery. It records the electrical potentials from the scalp after electrical stimulation of the peripheral nerves of the upper or lower limbs. The standard monitoring modality in lumbosacral spine surgery includes lower-limb SSEP and electromyography (EMG).

Cauda equina syndrome-think of cancer.

Leptomeningeal carcinomatosis (LC) is a serious complication found in approximately 1% to 8% of patients with solid cancer and carries substantial rates of morbidity and mortality. Up to 48% of patients may present with LC before the presence of systemic cancer is known. We present the case of a patient who presented with symptoms of cauda equina syndrome and for whom subsequent investigations revealed intrathecal metastases and locally advanced lung cancer without respiratory symptoms or brain or bone metastases.

Anterior cervical discectomy and fusion associated complications.

Study Design: Retrospective review study with literature review.

Objective: The goal of our current study is to raise awareness on complications associated with anterior cervical discectomy and fusion (ACDF) and their early detection and proper management.

Summary Of Background Data: It is known that ACDF constitutes one of the most commonly performed spinal procedures.

Pain outcome and vertebral body height restoration in patients undergoing kyphoplasty.

Introduction: Kyphoplasty, a minimally invasive technique, has recently been developed to provide immediate pain relief, biomechanical stabilization, prevention of fracture progression, vertebral height restoration, and prevention or reversal of kyphosis to patients with osteoporotic vertebral compression fractures (VCF).

Materials And Methods: We retrospectively reviewed 24 patients treated with kyphoplasty. A total of 37 vertebral levels were augmented.

Surgical treatment of acute type II and rostral type III odontoid fractures managed by anterior screw fixation.

Objectives: In the present study, the authors comment on their experience with anterior odontoid screw fixation in the management of odontoid fractures, in an attempt to further assess the safety and the efficacy of this procedure.

Materials And Methods: A retrospective analysis of 50 consecutive patients with reducible type II or rostral type III odontoid fractures, operated at our hospital with anterior odontoid screw fixation. Radiographic bony fusion, complications, and clinical outcome were evaluated.

Intracranial temperature: is it different throughout the brain?

Introduction: Accurate knowledge of cerebral temperature is assuming increasing importance, because its manipulation is employed more frequently for cerebral protection.

Purpose: This prospective clinical study was performed to examine how well intraventricular temperature reflects global cerebral temperature.

Methods: The intraventricular temperature was monitored in 61 patients who were admitted to the neurointensive care unit for various intracranial pathological entities.

Cerebrospinal fluid fistula secondary to dural tear in anterior cervical discectomy and fusion: case report.

Study Design: A case of cerebrospinal fistula secondary to a dural tear during anterior cervical discectomy and fusion.

Objectives: To report a quite rare complication associated with anterior cervical discectomy and remind the spinal surgeons that this infrequent complication can easily become a very serious one.

Summary Of Background Data: Anterior cervical discectomy represents one of the most commonly performed spinal procedures.

Immediate and early postoperative pain relief after kyphoplasty without significant restoration of vertebral body height in acute osteoporotic vertebral fractures.

Object: Painful osteoporotic vertebral compression fractures (VCFs) are a significant cause of disability in the elderly population. Kyphoplasty, a recently developed minimally invasive procedure, has been advocated for the successful management of these fractures in terms of immediate pain relief, and also for restoration of the premorbid level of daily activities. In this retrospective study the authors report on their experience with the early management of VCFs with kyphoplasty.

Correlation of the amount of disc removed in a lumbar microdiscectomy with long-term outcome.

Study Design: The authors conducted a prospective clinical study.

Objectives: The objectives of this study were to investigate the relationship, if any, of the amount of removed disc in a standard first-time lumbar microdiscectomy and long-term outcome as well as recurrence and postoperative instability rates.

Summary Of Background Data: There is lack of data on the amount of disc that needs to be removed during a lumbar microdiscectomy.

Does intraoperative electromyographic monitoring in lumbar microdiscectomy correlate with postoperative pain?

Objectives: Our objective was to correlate the findings of intraoperative electromyographic (EMG) monitoring with immediate postoperative pain in patients undergoing lumbar microdiscectomy.

Methods: A total of 112 patients undergoing de novo lumbar microdiscectomy were prospectively randomized into a control group (n = 45) and a study group (n = 67) in which intraoperative EMG monitoring was used. Postoperative pain and postoperative narcotic consumption were recorded for each patient.

Epidural intracranial abscess as a complication of frontal sinusitis: case report and review of the literature.

Two cases of epidural abscess as a complication of frontal sinusitis are presented. The diagnoses were suspected on the basis of history and were confirmed by magnetic resonance imaging and computed tomography. Both patients were treated successfully by means of surgery and intravenous antibiotics.