Retrospective Analysis of Expansile Duraplasty as Surgical Adjunct After Acute Traumatic Spinal Cord Injury.

Study DesignRetrospective single-center review.ObjectivesAssess whether expansile duraplasty was associated with greater motor recovery in patients with acute traumatic spinal cord injury (tSCI) compared with bony decompression alone.MethodsRetrospective chart review was conducted for patients who underwent surgical stabilization and decompression for tSCI at a level-1 trauma center.

External Ventricular Drain Versus Intraparenchymal Pressure Monitor in Severe Traumatic Brain Injury: A TRACK-TBI Study.

Background And Objectives: The 2 most common intracranial pressure (ICP)-monitoring devices in traumatic brain injury (TBI) are external ventricular drains (EVDs) and intraparenchymal monitors (IPMs). EVDs and IPMs differ in functionality and debate remains as to whether device selection affects patient outcomes. We aimed to determine whether the use of EVDs or IPMs for ICP monitoring was associated with better outcomes using data from severe TBI patients prospectively enrolled in the 18-center US Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study.

Early Prognostication in Pediatric Severe Traumatic Brain Injury in South America: Development of a Local Pediatric-Specific Model and Validation of Established Models.

Prognostication in severe traumatic brain injury (sTBI) is important, but few models are pediatric-specific and from low- and middle-income countries where head computed tomography (CT) scans may not be routinely available. We assessed intensive care unit admission risk factors for early mortality and unfavorable outcome in a secondary analysis of 115 children (mean 7.0 years, standard deviation [sd] 5.

Limitations of current robot-assisted pedicle screw insertion systems.

Objective: As robot systems for spine surgery have been developed, they have demonstrated a high degree of accuracy in screw placement without sacrificing safety or surgical efficiency. These robotic systems offer preoperative planning and real-time feedback to enhance surgical precision and mitigate human error. Nevertheless, limitations to their optimal performance remain.

Incidence and management of dural tears in full-endoscopic unilateral laminotomies for bilateral lumbar decompression.

Purpose: To report incidence of dural lacerations in lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD) and to describe patient outcomes following a novel full-endoscopic bimanual durotomy repair.

Methods: Retrospective review of prospectively collected database including 5.5 years of single surgeon experience with LE-ULBD.

Full-endoscopic technique mitigates obesity-related perioperative morbidity of minimally invasive lumbar decompression.

Purpose: Obesity is associated with increased surgical complexity and postoperative complications in spine surgery. Minimally invasive procedures have been shown to lessen some of the increased risk in obese patients. This study investigated whether utilization of a working channel endoscope can further mitigate obesity-associated challenges in spinal surgery.

Fixed, Dilated, and Conversing-Unreactive Pupil With Preserved Consciousness Indicating Acutely Rising Intracranial Pressure due to Traumatic Intraparenchymal Contusions: Case Report and Review of the Literature.

Patients with fixed and dilated pupils (FDPs) due to rising intracranial pressure (ICP) typically experience a deterioration in consciousness. We describe an exceptional case of a patient with bifrontal contusions who developed worsening edema and a unilaterally FDP while maintaining consciousness and the ability to communicate. A 58-year-old man with history of hypertension and diabetes mellitus type II presented after being assaulted, with bifrontal contusions and right frontal intraparenchymal hemorrhage.

Complications associated with early cranioplasty for patients with traumatic brain injury: a 25-year single-center analysis.

Objective: Cranioplasty is a technically simple procedure, although one with potentially high rates of complications. The ideal timing of cranioplasty should minimize the risk of complications, but research investigating cranioplasty timing and risk of complications has generated diverse findings. Previous studies have included mixed populations of patients undergoing cranioplasty following decompression for traumatic, vascular, and other cerebral insults, making results challenging to interpret.

Cellular allograft for multilevel stand-alone anterior cervical discectomy and fusion.

Objective: Anterior cervical discectomy and fusion (ACDF) is the most common treatment for degenerative disease of the cervical spine. Given the high rate of pseudarthrosis in multilevel stand-alone ACDF, there is a need to explore the utility of novel grafting materials. In this study, the authors present a single-institution retrospective study of patients with multilevel degenerative spine disease who underwent multilevel stand-alone ACDF surgery with or without cellular allograft supplementation.

Re-examining decompressive craniectomy medial margin distance from midline as a metric for calculating the risk of post-traumatic hydrocephalus.

Decompressive craniectomy (DC) is a life-saving procedure in severe traumatic brain injury, but is associated with higher rates of post-traumatic hydrocephalus (PTH). The relationship between the medial craniectomy margin's proximity to midline and frequency of developing PTH is controversial. The primary study objective was to determine whether average medial craniectomy margin distance from midline was closer to midline in patients who developed PTH after DC for severe TBI compared to patients that did not.

Pseudoaneurysm of the Superficial Temporal Artery After Intracranial Pressure Monitoring Device Placement: Case Report of a Rare Complication.

Background And Importance: Pseudoaneurysms involving the superficial temporal artery (STA), either iatrogenic or caused by direct trauma, are rare. The STA is prone to injury due to its long course throughout the scalp. Injuries can cause cosmetic defects and/or skin breakdown leading to further complications.

Resection of Temporal Neocortex During Multiple Hippocampal Transections for Mesial Temporal Lobe Epilepsy Does not Affect Seizure or Memory Outcome.

Background: Multiple hippocampal transection (MHT) is a surgical treatment for mesial temporal lobe epilepsy associated with improved postoperative neuropsychological outcomes compared with lobectomy.

Objective: To determine whether resection of the amygdala and anterior temporal neocortex during MHT affects postoperative seizure/memory outcome.

Methods: Seventeen patients with normal magnetic resonance imaging and stereo-electroencephalogram-proven drug-resistant dominant mesial temporal lobe epilepsy were treated with MHT.