China
Africa
Explore chapters and articles related to this topic
Myeloma
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
The spinal lesion is poorly visualised on X-ray. The MRI scan shows a large T2/3 paraspinal mass with thecal sac compression. (Note: Additional smaller lesions were seen at T12 and within the left clavicle.) Osseous lysis is seen in the T3 vertebral body, pedicle, left transverse process, lamina and posterior rib. There is intraspinal extension into the epidural space with compression of the thecal sac.
Pediatric Spinal Tumors
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Rajiv R. Iyer, Nir Shimony, Mohammad Hassan A. Noureldine, Eric Bouffet, George I. Jallo
Once tumor resection is completed, meticulous hemostasis should be obtained with a variety of hemostatic agents and, if needed, low-intensity bipolar cautery. The dura should be closed in a watertight fashion to decrease the likelihood of postoperative CSF leak. Use of a fibrin sealant may add additional protective effect against this complication following dural closure. We recommend waiting to remove the epidural D-wave electrodes until after dural closure is complete. If utilized, the laminoplasty should be re-affixed with mini-plates, with special care taken to avoid epidural compression of the thecal sac. The muscular fascia is closed in a watertight fashion and a layered superficial closure is preferred.
Bone metastases
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Rupert Berkeley, Muaaze Ahmad, Rikin Hargunani
The same imaging principles apply in cases of cauda equina compression. It should be borne in mind that compression of the thecal sac can cause neurological symptoms even in the absence of overt neural compression—this is attributed to vascular compromise.
Management of myxopapillary ependymoma: a retrospective study from three institutions
Published in Neurological Research, 2022
Anas Abdallah, Gökhan Baloğlu, Betül Güler Abdallah, Meliha Gündağ Papaker, Usame Rakip
In the prone-wise position, under general anesthesia and using intraoperative neurophysiological monitoring (IONM) (n = 38), the appropriate paramedian vertical midline incision was performed. The surgical technique (hemilaminectomy, laminectomy, or laminotomy) employed depended on the preference of the main neurosurgeon. Bilateral laminotomy was performed using Kerrison rongeurs or high-speed drills. The operative microscope was used by opening thecal sac in the midline and the thecal sac was tacked up bilaterally using strong sutures. The tumoral mass was resected as IONM allowed after checking all nerve roots, spinal cord/terminal filum, and arachnoid bands. After performing hemostasis, duraplasty was performed using 5.0 absorbable sutures. To avoid cerebrospinal fluid (CSF) fistula after tight closure of the thecal sac, Fibrin Sealant Products were used particularly, in the last 12 years. In laminotomy cases, the laminae were placed and fixed using miniplate screws or strong non-absorbable sutures. The multilayer closure was performed appropriately following usual anatomy.
Efficiency of topical rifampin on infection in open neural tube defects: a randomized controlled trial
Published in International Journal of Neuroscience, 2021
Ibrahim Deger, Murat Başaranoğlu, Nihat Demir, Abdurrahman Aycan, Oğuz Tuncer
Before the surgical procedure was initiated, the topical Rifampin infusion of the case group and the local normal saline infusion of the control group were stopped. Skin preparation was made using povidone-iodine solution [10% povidone-iodine solution (Batticon, ADEKA, Istanbul, Turkey)]. The repair was done under magnification. An incision was made between the arachnoid and the skin, isolating the neural sac. Then, the edges of the neural sac were pulled close to each other and the pial surfaces were sutured. Afterward, the intact dura mater was exposed and stitched across to form the thecal sac. The lumbar fascia was dissected and joined over the thecal sac. Finally, the subcutaneous tissue and the skin were sewn separately. The operation lasted from 1 to 5 h (case group: 2.3 h; control group: 2.4 h), depending on the size of the wound, tissue integrity in the surgical area, and flap transposition. The sutures were removed on postoperative days 10 and 14.
Primary intraspinal benign tumors treated surgically: an analysis from China
Published in British Journal of Neurosurgery, 2021
Lin-Lin Xia, Jian Tang, Sheng-Li Huang
The type of lesion, age of patient, and involvement of spinal cord are critical in determining the treatment algorithm. Both tumor resection and decompression can be approached anteriorly or posteriorly, depending on the location of the tumor and mechanical disorders caused by it. The most common primary spinal benign tumors occur at the dorsal or lateral spinal canal. Spine lesion requires posterior decompression in nearly all instances. When the lesion is situated dorsal or lateral to the spinal cord, it can be easily resected via a posterior approach without facetectomy. When a lesion locates ventral to the thecal sac in the cervical or thoracic spine, unilateral facetectomy may be the optimal choice, because the thecal sac cannot be mobilized freely to avoid iatrogenic spinal cord injury. In rare cases, large lesions, such as dumbbell-shaped lesions, require unilateral total facetectomy, pedicle resection, or even transversectomy. Bone removal maximizes the angle of visualization and reduces the risk of spinal cord retraction. Therefore, the posterior approach is appropriate to all the cases. In our cases, the posterior approach was more commonly used than the anterior approach; this is consistent with existing literature.8 Of note, total resection of such benign lesions is the key to avoiding relatively early recurrences.