Richard Menger, Paul J. Park, Elise C. Bixby, Gerard Marciano, Meghan Cerpa, David Roye, Benjamin D. Roye, Michael Vitale, and Lawrence Lenke
The overwhelming majority of literature on instrumentation to the pelvis in children focuses on nonambulatory cohorts. The objective of this study was to address the minimal literature on early complications following fusion to the sacrum with instrumentation to the pelvis in the era of sacral-alar-iliac instrumentation in ambulatory pediatric patients. Instrumentation to the pelvis in this patient population allows for powerful deformity correction with a 36.0% (9/25) complication rate within a mean follow-up period of 24.3 months.
Armin Mortazavi, Ross-Jordon S. Elliott, Tiffany N. Phan, John Schreiber, William D. Gaillard, and Chima O. Oluigbo
The authors present their experience with responsive neurostimulation in pediatric patients at a single institution and review the indications, strategies, outcomes, and technical considerations for RNS System implantation in this population. They emphasize the compassionate-use indication for this device in pediatric patients. All 5 patients in the study experienced medium-term improvements in seizure control after RNS System implantation, with decreases in seizure frequency greater than 50% from the baseline preoperative seizure frequency. No adverse events were seen.
In this study, the authors proposed a novel indicator, gROM (representing the gap between flexion and extension ranges of motion), for predicting the loss of cervical lordosis after laminoplasty in patients with cervical spondylotic myelopathy and examined its clinical performance. The study results demonstrated that gROM could be a highly useful indicator and that one exceeding 30° was a risk factor for a marked loss of cervical lordosis postoperatively.
Srujan Kopparapu, Daniel Lubelski, Zach Pennington, Majid Khan, Nicholas Theodore, and Daniel Sciubba
The authors investigated whether radiation exposure during percutaneous vertebroplasty (PV) or balloon kyphoplasty (BK) exceeds safety limits for patients and operators. Exposures were lower for PV than BK for both operators and patients, but both procedures were unlikely to exceed safety limits when standard radiation protection equipment was used. However, radiation to the hand may limit the number of procedures an operator can safely perform. Additional high-quality data are necessary to definitively establish exposure differences between procedures and evaluate impacts of newer techniques, such as CT-guided procedures.
Simon G. Ammanuel, Caleb S. Edwards, Andrew K. Chan, Praveen V. Mummaneni, Joseph Kidane, Enrique Vargas, Sarah D’Souza, Amy D. Nichols, Sujatha Sankaran, Adib A. Abla, Manish K. Aghi, Edward F. Chang, Shawn L. Hervey-Jumper, Sandeep Kunwar, Paul S. Larson, Michael T. Lawton, Philip A. Starr, Philip V. Theodosopoulos, Mitchel S. Berger, and Michael W. McDermott
The authors aimed to assess the efficacy of preoperative chlorhexidine gluconate (CHG) showering on surgical site infection (SSI) following cranial surgery. In an analysis of 3126 cranial surgeries, implementation of a preoperative CHG showering protocol was not associated with decreased SSI. These findings do not support the use of preoperative CHG showering prior to cranial surgery and suggest that alternative preventative measures for SSI should be investigated.
Kathrin Machetanz, Florian Grimm, Thomas V. Wuttke, Josua Kegele, Holger Lerche, Marcos Tatagiba, Sabine Rona, Alireza Gharabaghi, Jürgen Honegger, and Georgios Naros
Researchers evaluated the implantation accuracy of oblique stereo-electroencephalography (SEEG) trajectories and the detection of epilepsy-related SEEG activity in insular epilepsy. The authors found that the oblique approach is safe and efficient, covering the complete functional organization of the insula with few electrodes. There was no decrease in accuracy due to the longer trajectory of insular SEEG, and there was no difference between frame-based and robot-assisted implantations.
In this conversation, Dr. Amanda Gosman (UC San Diego) and Dr. Mark Proctor (Boston Children’s) discuss Dr. Gosman and colleagues' video, "Rotation flap distraction osteogenesis for unicoronal synostosis” published in the April 2021 issue of Neurosurgical Focus: Video. Moderated by Dr. Cormac Maher (University of Michigan). With Drs. Aaron Cohen-Gadol (Associate Editor, Neurosurgical Focus: Video) and William Couldwell (EIC, Neurosurgical Focus).