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Background: The spinal intrathecal space, characterized by a complex three-dimensional (3D) fluid-filled geometry with varying levels of anatomic intricacy, plays a pivotal role in drug administration strategies targeting the central nervous system (CNS). Lumbar injections into this space represent a clinically used approach for delivering therapeutics directly to the brain, bypassing critical barriers such as the blood-brain and blood-cerebrospinal fluid barriers. A nuanced understanding of CSF dynamics is vital for comprehending physiological states of the CNS for drug delivery.
View Article and Find Full Text PDFRisk of Surgical Site Infection in Posterior Spine Surgery Using Different Closing Techniques: A Retrospective Study of Two Neurosurgical Centers.
J Clin Med
December 2024
Division of Neurosurgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.
To determine whether a closed dressing protocol reduces the surgical site infections (SSI) rate compared to conventional closing techniques. Patients who underwent lumbar spine surgery at two neurosurgical centers were retrospectively included from June 2015 to December 2019. Data on patients, general risk factors, and surgical risk factors for SSI were collected.
View Article and Find Full Text PDFCerebrospinal Fluid Leak Prevention in Intradural Spine Surgery: A Long Series Analysis of Closure with Non-Penetrating Titanium Clips.
Brain Sci
December 2024
Department of Neurosurgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy.
: Postoperative cerebrospinal fluid (CSF) fistulas remain a significant concern in spinal neurosurgery, particularly following dural closure. The incidence of dural tears during spinal surgery is estimated between 1.6% and 10%.
View Article and Find Full Text PDFProximal Junctional Failure Development Despite Achieving Ideal Sagittal Correction According to Age-Adjusted Alignment Target in Patients With Adult Spinal Deformity: Risk Factor Analysis of 196 Cases Undergoing Low Thoracic to Pelvic Fusion.
Neurospine
December 2024
Department of Orthopedic Surgery, Haeundae Bumin Hospital, Busan, Korea.
Objective: To identify the risk factors for proximal junctional failure (PJF) after adult spinal deformity (ASD) surgery despite ideal sagittal correction according to age-adjusted alignment target.
Methods: The study included patients who underwent low thoracic to pelvic fusion for ASD and obtained ideal correction according to age-adjusted pelvic incidence minus lumbar lordosis. PJF was defined either radiographically as a proximal junctional angle (PJA) of >28° plus a difference in PJA of >22° or clinically as revision surgery for proximal junctional complications.
Is Transforaminal Endoscopic Discectomy the Best Option for Recurrent Lumbar Disc Herniation? A Systematic Review.
Int J Spine Surg
January 2025
Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, Italy
Introduction: Recurrent lumbar disc herniation (rLDH) remains a challenge in spinal surgery. This systematic review analyzes the use of transforaminal endoscopic discectomy (TFED) for the treatment of rLDH.
Methods: A comprehensive search of 4 electronic databases, including PubMed, Google Scholar, Science Direct, and Cochrane, was conducted.
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