Efficacy of Spinal Cord Stimulation for Failed Back Surgery Syndrome in Elderly Patients: A Retrospective Study.

Objectives: Failed back surgery syndrome (FBSS) refers to a condition where symptoms such as low back pain, leg pain, and numbness persist or recur after lumbar surgery; it has been reported to occur in 10%-40% of patients who have undergone lumbar surgery. Spinal cord stimulation (SCS) has been reported useful for low back and leg pain due to FBSS. In this study, we studied the efficacy and safety of SCS for FBSS in older adults.

Novel wrapping surgery for symptomatic sacral perineural cysts.

Objective: Perineural cysts, also called Tarlov cysts, are dilatations of the nerve root sleeves commonly found in the sacrum. The majority of the cysts are asymptomatic and found incidentally on routine spine imaging. Symptomatic sacral perineural cysts (SPCs) that induce intractable low-back pain, radicular symptoms, and bladder/bowel dysfunction require surgery.

Sacral plexus disorder caused by a wooden toothpick in the rectum.

A 67-year-old man presented with a 2-month history of pain in his right buttock and lower limb. MRI depicted right L5/S1 lateral recess stenosis requiring surgical treatment; however, preoperative CT showed an approximately 7 cm long, thin, rod-shaped structure in the rectum, which was ultimately determined to be an accidentally ingested toothpick. It was removed surgically 6 days after diagnosis, because right leg pain worsened rapidly.

Cervical myelopathy due to neurovascular compression syndrome caused by persistent first intersegmental artery: a case report.

Background: Persistent first intersegmental artery (PFIA) is a rare anatomical variation of vertebral arteries and is an asymptomatic finding in most cases. Here we report a rare case of cervical myelopathy caused by spinal cord compression by the PFIA.

Case Presentation: The patient was a 52-year-old man who complained of numbness and burning sensation around the neck and left shoulder area, partial weakness in the left deltoid muscle, right side thermal hypoalgesia, and disturbance of deep sensation since the past 1 year, and the symptoms had gradually worsened.

Prospective Multicenter Study of a Multistep Screw Insertion Technique Using Patient-Specific Screw Guide Templates for the Cervical and Thoracic Spine.

Study Design: A prospective clinical study of a multistep screw insertion method using a patient-specific screw guide template system (SGTS) for the cervical and thoracic spine.

Objective: To evaluate the efficacy of SGTS for inserting screws into the cervical and thoracic spine.

Summary Of Background Data: Posterior screw fixation is a standard procedure for spinal instrumentation; however, screw insertion carries the risk of injury to neuronal and vascular structures.

Accurate and Simple Screw Insertion Procedure With Patient-Specific Screw Guide Templates for Posterior C1-C2 Fixation.

Study Design: Prospective clinical trial of the screw insertion method for posterior C1-C2 fixation utilizing the patient-specific screw guide template technique.

Objective: To evaluate the efficacy of this method for insertion of C1 lateral mass screws (LMS), C2 pedicle screws (PS), and C2 laminar screws (LS).

Summary Of Background Data: Posterior C1LMS and C2PS fixation, also known as the Goel-Harms method, can achieve immediate rigid fixation and high fusion rate, but the screw insertion carries the risk of injury to neuronal and vascular structures.

A novel screw guiding method with a screw guide template system for posterior C-2 fixation: clinical article.

Object: Accurate insertion of C-2 cervical screws is imperative; however, the procedures for C-2 screw insertion are technically demanding and challenging, especially in cases of C-2 vertebral abnormality. The purpose of this study is to report the effectiveness of the tailor-made screw guide template (SGT) system for placement of C-2 screws, including in cases with abnormalities.

Methods: Twenty-three patients who underwent posterior spinal fusion surgery with C-2 cervical screw insertion using the SGT system were included.

Multistep pedicle screw insertion procedure with patient-specific lamina fit-and-lock templates for the thoracic spine: clinical article.

Object: Pedicle screw fixation is a standard procedure of spinal instrumentation, but accurate screw placement is essential to avoid injury to the adjacent structures, such as the vessels, nerves, and viscera. The authors recently developed an intraoperative screw guiding method in which patient-specific laminar templates were used, and verified the accuracy of the multistep procedure in the thoracic spine.

Methods: Preoperative bone images of the CT scans were analyzed using 3D/multiplanar imaging software and the trajectories of the screws were planned.

β-Tricalcium phosphate promotes bony fusion after anterior cervical discectomy and fusion using titanium cages.

Study Design: Retrospective consecutive cohort study.

Objective: To study the effectiveness of β-tricalcium phosphate (β-TCP) granules as a packing material in the titanium cages for anterior cervical discectomy and fusion (ACDF), compared with the conventional hydroxyapatite (HA) granules.

Summary Of Background Data: ACDF using titanium cages is a standard procedure for the treatment of cervical spinal degenerative diseases.

Limaprost alfadex improves myelopathy symptoms in patients with cervical spinal canal stenosis.

Study Design: Myelopathy symptoms were prospectively studied in patients with cervical spinal canal stenosis (CSCS), using objective grading systems and stabilometry, to examine the effect of administration of prostaglandin E1 derivative limaprost alfadex (limaprost).

Objective: Myelopathy scores/grades and stabilometry parameters were evaluated before, and 1 and 3 months after starting the limaprost treatment.

Summary And Background Data: Limaprost is a potent vasodilator and antiplatelet agent and has been used to treat the symptoms of lumbar spinal canal stenosis.

Long term outcome and adjacent disc degeneration after anterior cervical discectomy and fusion with titanium cylindrical cages.

Background: Anterior cervical discectomy and fusion (ACDF) is widely performed for the treatment of cervical spinal degenerative disease. Autogenic or allogenic bone grafts are used for interbody fusion with satisfactory long term outcomes. However, harvest of the autograft causes donor site complications and allograft is associated with low fusion rate.

Novel dural closure technique using polyglactin acid sheet prevents cerebrospinal fluid leakage after spinal surgery.

Objective: Extradural or subcutaneous cerebrospinal fluid (CSF) leakage is a common complication after spinal surgery and is associated with the risks of poor wound healing, meningitis, and pseudomeningocele. Numerous methods to prevent postoperative CSF leakage are available, but pressure-tight dural closure remains difficult, especially with synthetic surgical membranes. The efficacy of a novel dural closure technique was assessed by detecting extradural or subcutaneous CSF leakage on magnetic resonance imaging.

[Four cases of spontaneous spinal epidural hematoma].

Spontaneous spinal epidural hematoma (SSEH) is a rare clinical entity. Although approximately 500 cases have been reported, controversy exists concerning timing of the treatment and the validity of decompression surgery. We recently encountered four cases of SSEH.

[Unusual MR appearance of intracranial dissemination from cervical glioblastoma].

We reported a rare case of cervical glioblastoma with intracranial dissemination at an early stage of clinical course and reviewed the literature. An 8-year-old girl presented with failure of vision 3 months prior to admission to our hospital. Neurological examination on admission disclosed no definitive abnormalities except for bilateral visual disturbance and optic atrophy.

[Supratentorial primitive neuroectodermal tumor: report of a surgical case].

We reported a rare case of supratentorial primitive neuroectodermal tumors (sPNET) and reviewed the literature. A 15-year-old girl presented with a one-month history of headache and vomiting. CT scans showed a huge, solid and cystic tumor with calcification, occupying the left anterior cranial fossa.

Direct repair of a blisterlike aneurysm on the internal carotid artery with vascular closure staple clips. Technical note.

Vascular closure staple clips made of titanium were originally developed for microvascular anastomosis. Clinical applications for these clips include arteriotomy closure for carotid endarterectomy, extracranial-intracranial bypass, and dural closure. This is the first report in which vascular closure staple clips have been used successfully for direct repair of a tear on the internal carotid artery (ICA).

[Primary intracerebral malignant fibrous histiocytoma: case report].

We report a rare case of a primary intracerebral malignant fibrous histiocytoma (MFH) with malignant progression from a premalignant stage. A 73-year-old male presented with mild hemiparesis on the right side of his body 4 months prior to admission. MR images showed a homogenously enhanced mass in the left parietal lobe.

Endoscope-assisted clipping of a superior hypophyseal artery aneurysm without removal of the anterior clinoid process. Case report.

A 47-year-old man presented with a superior hypophyseal artery aneurysm and an ipsilateral posterior communicating artery aneurysm. Both lesions were successfully clipped without removal of the anterior clinoid process or retraction of the optic nerve by using endoscopic guidance. The endoscope was introduced into the prechiasmatic cistern and provided a clear visual field around the aneurysm that could not be seen via the operating microscope.