Juan C. Fernandez-Miranda September 5, 2017

Journal of Neurosurgery, Ahead of Print. OBJECTIVETumors with cavernous sinus (CS) invasion represent a neurosurgical challenge. Increasing application of the endoscopic endonasal approach (EEA) requires a thorough understanding of the CS anatomy from an endonasal perspective. In this study, the authors aimed to develop a surgical anatomy–based classification of the CS and establish its utility for preoperative surgical planning and intraoperative guidance in adenoma surgery.METHODSTwenty-five colored silicon–injected human head specimens were used for endonasal and transcranial dissections of the CS.… Read More...

Darryl Lau September 5, 2017

Journal of Neurosurgery: Spine, Ahead of Print. OBJECTIVECervical curvature is an important factor when deciding between laminoplasty and laminectomy with posterior spinal fusion (LPSF) for cervical spondylotic myelopathy (CSM). This study compares outcomes following laminoplasty and LPSF in patients with matched postoperative cervical lordosis.METHODSAdults undergoing laminoplasty or LPSF for cervical CSM from 2011 to 2014 were identified.… Read More...

Jian Guan September 5, 2017

Journal of Neurosurgery: Spine, Ahead of Print. OBJECTIVEBlood loss during surgery for thoracolumbar scoliosis often requires blood product transfusion. Rotational thromboelastometry (ROTEM) has enabled the more targeted treatment of coagulopathy, but its use in deformity surgery has received limited study. The authors investigated whether the use of ROTEM reduces transfusion requirements in this case-control study of thoracolumbar deformity surgery.METHODSData were prospectively collected on all patients who received ROTEM-guided blood product management during long-segment (≥ 7 levels) posterior thoracolumbar fusion procedures at a single institution from April 2015 to February 2016.… Read More...

Hyeoncheol Hwang September 5, 2017

Journal of Neurosurgery: Pediatrics, Ahead of Print. OBJECTIVEThe aim of this study was to establish optimal electric stimulation parameters for intraoperatively monitoring the bulbocavernosus reflexes (BCRs) in infants.METHODSThe authors retrospectively reviewed the medical records of all infants (age < 24 months) who had undergone an untethering operation for tethered cord syndrome between May 2013 and February 2014 at a single institution and whose baseline BCR had been elicited during surgery. Using different combinations of stimulation parameters—number of stimulation pulses: 4 or 8 pulses, interpulse interval: 1, 2, or 5 msec, and polarity of stimulation: biphasic or monophasic—the authors compared the relative mean amplitude of 10 BCR responses (rmaBCRs) to each combination of parameters.RESULTSThe rmaBCRs were larger with the 8-pulse stimulations than with the 4-pulse stimulations (p < 0.0001). There was a tendency, though not statistically significant, for larger rmaBCRs to be obtained with the longer interpulse interval in the 8-pulse stimulation (p = 0.1289). The biphasic stimulation produced larger rmaBCRs than the monophasic stimulation (p = 0.0005).CONCLUSIONSBiphasic 8-pulse stimulations with 5-msec or 2-msec intervals yield the largest BCR responses. Considering that an 8-pulse stimulation with 5-msec intervals may overlap the onset of the BCR, a biphasic 8-pulse stimulation with 2-msec intervals is recommended as the optimal stimulation paradigm to monitor intraoperative BCRs in infants.

http://thejns.org/doi/abs/10.3171/2017.6.PEDS16664?mi=67t04w&af=RRead More...

Ryuichi Hirayama September 5, 2017

Journal of Neurosurgery, Ahead of Print. OBJECTIVEIn the present study the authors aimed to determine preferred locations of meningiomas by avoiding descriptive analysis and instead using voxel-based lesion mapping and 3D image-rendering techniques.METHODSMagnetic resonance images obtained in 248 treatment-naïve meningioma patients with 260 lesions were retrospectively and consecutively collected.… Read More...

Masafumi Hiramatsu September 5, 2017

Journal of Neurosurgery, Ahead of Print. OBJECTIVEThe aim of this retrospective multicenter cohort study was to assess the details of the angioarchitecture of arteriovenous fistulas (AVFs) at the craniocervical junction (CCJ) and to determine the associations between the angiographic characteristics and the clinical presentations and outcomes.METHODSThe authors analyzed angiographic and clinical data for patients with CCJ AVFs from 20 participating centers that are members of the Japanese Society for Neuroendovascular Therapy (JSNET).… Read More...

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