Repair of isthmic pars interarticularis fractures: a literature review of conventional and minimally invasive techniques.

Introduction: The repair of symptomatic isthmic pars interarticularis fractures can result in excellent outcomes. A variety of operative interventions exist with conventional techniques requiring larger exposures. Recently described, less invasive techniques tend to minimize disruption of adjacent soft tissues, decrease postoperative pain, increase patient satisfaction, and improve return to work status and/or competitive sports.

Use of a contoured bioresorbable plate with a hemostatic plug to control life-threatening bleeding from the superior sagittal sinus during hemispherotomy: technical note.

Profuse bleeding originating from an injured cerebral sinus can be a harrowing experience for any surgeon, particularly during an operation on a young child. Common surgical remedies include sinus ligation, primary repair, placement of a hemostatic plug, and patch or venous grafting that may require temporary stenting. In this paper the authors describe the use of a contoured bioresorbable plate to hold a hemostatic plug in place along a tear in the inferomedial portion of a relatively inaccessible part of the posterior segment of the superior sagittal sinus in an 11-kg infant undergoing hemispherotomy for epilepsy.

Lead revision surgery for vagus nerve stimulation in epilepsy: outcomes and efficacy.

We present, to our knowledge, the first published analysis of vagus nerve stimulation (VNS) lead revisions to incorporate quality of life, clinical response, and antiepileptic drug (AED) burden in postrevision clinical outcomes. Ten patients were followed and had no postoperative complications. Seven patients had improvement in quality of life, and three experienced no change.

A calpain inhibitor enhances the survival of Schwann cells in vitro and after transplantation into the injured spinal cord.

Despite the diversity of cells available for transplantation into sites of spinal cord injury (SCI), and the known ability of transplanted cells to integrate into host tissue, functional improvement associated with cellular transplantation has been limited. One factor potentially limiting the efficacy of transplanted cells is poor cell survival. Recently we demonstrated rapid and early death of Schwann cells (SCs) within the first 24 h after transplantation, by both necrosis and apoptosis, which results in fewer than 20% of the cells surviving beyond 1 week.

Validation of the radiosurgery-based arteriovenous malformation score in a large linear accelerator radiosurgery experience.

Object: The radiosurgery-based arteriovenous malformation (AVM) score (RBAS) is a grading system designed to predict patient outcomes after Gamma Knife surgery for AVMs. This study seeks to validate independently the predictive nature of the RBAS, not only after single treatment but for retreatment, and to assess the overall outcome regardless of number of radiosurgeries.

Methods: The authors analyzed 403 patients treated with linear accelerator (LINAC) radiosurgery for AVMs between May 1988 and June 2008.

Treatment of a persistent iatrogenic cerebrospinal fluid-pleural fistula with a cadaveric dural-pleural graft.

Background Context: A cerebrospinal fluid (CSF)-pleural fistula is a unique condition with which all spine surgeons need to be familiar, particularly those who use anterolateral approaches to the thoracic region. When direct suturing of the dural defect is not possible, techniques for indirect repair must be considered.

Purpose: To report a novel technique for repair of a thoracic CSF-pleural fistula with a cadaveric dural-pleural graft after failure of initial treatment with Duragen (Integra, Plainsboro, NJ) and fibrin glue.