Notes

Naturally sourced hypothermia helps bring about tactical in extreme anaphylaxis.
To compare biomechanical results between different polymethylmethacrylate (PMMA) augmentation methods on failed lumbar pedicle screw models of animal vertebrae.

Thirty lumbar vertebrae were harvested from six calves, and their bone mineral density was measured. 60 Polyaxial pedicle screws were inserted to all vertebrae. Pull-out tests were performed to all specimens on an Instron machine. The specimens were randomly divided into four groups. The same screws used in primary screwing process were labeled and used in revision. Screws in the first group were augmented by injecting PMMA into the failed screw hole with a syringe; screws in the second group by inserting bone graft and roll-shaped PMMA, screws in the third group by inserting bone graft and injecting PMMA with a syringe; and the fourth group by inserting bone graft and injecting PMMA through a fenestrated pedicle screw. The pull-out strength (POS) results of all specimens were recorded and compared with statistical analyses.

The mean BMD of the vertebrae was 1.31 ± 0.225 g/cm < sup > 2 < /sup > and no significant difference was found between the groups (p > 0.05). The mean POS of the primary screws in the first, second, third, and fourth groups were 2166,5 N/m < sup > 2 < /sup > , 2183,5 N/m2, 2508,5 N/m < sup > 2 < /sup > , and 2005c N/m < sup > 2 < /sup > respectively. After the augmentation, the mean POS in the first, second, third and fourth groups were 3839 N/m < sup > 2 < /sup > , 2874 N/m < sup > 2 < /sup > , 2929 N/m < sup > 2 < /sup > and 3826 N/m < sup > 2 < /sup > respectively. No statistical difference was found between the groups in post-revision POS values (p > 0.05).

There was no significant statistical difference found in POS between the augmentation methods.
There was no significant statistical difference found in POS between the augmentation methods.
To investigate the effect of the number of open vertebral segments on the prognosis of newborns with midline closure defects (MCD), and the optimal timing for ventriculoperitoneal shunt (VPS) placement in those with MCD accompanied by hydrocephalus.

A total of 63 patients (35 girls and 28 boys) were admitted to the neonatal intensive care unit between April 2016 and January 2019. The patients? MCDs were examined in terms of type, localization, number of open vertebral segments, accompanying hydrocephalus (HC), surgical technique, and complications.

The mean follow-up period was 12 months (6-24 months). STA-4783 cost Ten cases of meningocele (M) (15.9%), 41 cases of myelomeningocele (MM) (65%), and 12 cases of encephalocele (E) (19.1%) were identified. A VPS was inserted in 44 (69.8%) patients (E, 8; MM, 34; and M, 2), performed in 33 patients during the same admission, while 11 were shunted after discharge during the follow-up period. Thirty-four of the 41 cases of MM and all cases of M and E were primarily closed, while the remaining MMs required skin flaps. The M and MM cases were categorized according to the number of open vertebral segments and examined in terms of neurological deficit, length of hospital stay, and complications.

In all pediatric cases, case-by-case evaluation, attention to hypothermia and meticulous hemostasis, protection of functional neural tissue, closing the defect as soon as possible, and treating accompanying HC during the same session, were considered. Additionally, the neural tissue density correlated with the number of open vertebral segments and it was considered prognostically more valuable.
In all pediatric cases, case-by-case evaluation, attention to hypothermia and meticulous hemostasis, protection of functional neural tissue, closing the defect as soon as possible, and treating accompanying HC during the same session, were considered. Additionally, the neural tissue density correlated with the number of open vertebral segments and it was considered prognostically more valuable.
To identify the characteristics of patients admitted to the emergency department with intracranial hemorrhages in the era of the COVID-19 pandemic.

Seventy-eight patients with spontaneous intracranial bleeding who were admitted to emergency departments and treated in neurosurgery clinics between March 11, 2020, and September 11, 2020, were included in the study.

The most frequent symptom was the loss of consciousness (32.1%), followed by headache (15.4%), syncope (10.3%), motor loss (9%), and seizures (9%). Antiaggregant and anticoagulant drug use were detected in 37.2% of the patients. Intraparenchymal hematoma was the most common type of intracranial hemorrhage (59%). Viral pneumonia was detected in 52.6% of the patients in thorax CTs. Surgical treatment was applied to 23.1% of the patients. There was no significant difference between patients with pneumonia and patients without pneumonia in the treatment modalities or 30-day mortality.

In this study, we found that low Glasgow Coma Scores affected mortality and that mechanical ventilation needs are higher in ICH patients with COVID-19. Nevertheless, the treatment differences may not have affected the outcomes.
In this study, we found that low Glasgow Coma Scores affected mortality and that mechanical ventilation needs are higher in ICH patients with COVID-19. Nevertheless, the treatment differences may not have affected the outcomes.
To compare the effect of ultrasound-guided modified thoracolumbar interfascial plane (TLIP) block versus local anesthetic infiltration on the wound site for post-operative analgesia in patients undergoing lumbar disc surgery with spinal anesthesia.

This prospective and observationally planned study included 42 patients from the ages of 18 to 75 years, American Society of Anesthesiologists classes I?III, who underwent lumbar disc surgery. In Group L, bupivacaine infiltration was performed on the surgical incision line. In Group T, TLIP block was performed with ultrasound. In the postoperative period, visual analogue scale (VAS) values were also investigated and recorded on the 10 < sup > th < /sup > day after discharge. Nausea, vomiting, and sedation score values and analgesic doses used by all patients in the postoperative period were recorded.

During any of the postoperative follow-up hours, the VAS score was ? 3 (mild pain), and those who did not need tramadol were 80.9% (n=17) in Group T scores.
The purpose of this study was to investigate the safety and efficacy of endoport-assisted endoscopic techniques when used to remove intraventricular lesions.

Data of patients with intraventricular lesions who were surgically treated by endoport-assisted endoscopic resection between January 2018 and February 2019 were retrospectively reviewed. The surgical procedures, complications and outcomes were analyzed.

A total of 11 patients, with a mean age of 33 years (5-70 years) were included in the study. The mean Karnofsky Performance Scale (KPS) score evaluated on admission was 50.0 ± 7.0. Lesions located in the unilateral ventricle, the third ventricle and multiple sites of ventricles were recorded in 7, 2 and 2 patients, respectively. The average lesion size was 3.4 ± 0.4 cm (2-6 cm). Gross-total removal of all lesions was achieved, and all patients experienced a stable recovery after operations except for one hemorrhage and one visual field defect occurring in two patients in the early postoperative period. With a follow-up of 6-19 months, dysfunctions and complications occurring pre- or postoperation gradually recovered to different degrees. The mean KPS score was 85.5 ± 4.3 at the last follow-up, and no tumor recurrence was observed in any of the patients.

Endoport-assisted endoscopic techniques could be a simple, minimally invasive surgical method in the resection of lesions located in the lateral ventricle, the third ventricle, or both with acceptable surgical complications occurring in patients.
Endoport-assisted endoscopic techniques could be a simple, minimally invasive surgical method in the resection of lesions located in the lateral ventricle, the third ventricle, or both with acceptable surgical complications occurring in patients.
To present the application of volume rendering technique (VRT) of computed tomography (CT) scan in cranio-vertebral junction (CVJ) surgeries.

The authors used VRT images of CT scan in patients of congenital CVJ anomalies who were subjected to various surgeries through midline posterior approach. The screw entry points and courses of vertebral arteries were identified in relation to various landmarks on the VRT images, preoperatively and intra-operatively.

A total of 15 patients of CVJ anomalies, who underwent surgeries through midline posterior approach, formed the study group. The screw entry points and courses of the vertebral arteries could be effectively identified in the surgical fields.

We conclude that VRT images are an inexpensive and user friendly tool to identify the screw insertion points in the surgeries of CVJ anomalies. They also help in identifying the course of the vertebral artery in the surgical field. On the whole, their use makes the surgery in this region, safer.
We conclude that VRT images are an inexpensive and user friendly tool to identify the screw insertion points in the surgeries of CVJ anomalies. They also help in identifying the course of the vertebral artery in the surgical field. On the whole, their use makes the surgery in this region, safer.
To evaluate the option of lumbar transpedicular fixation at the index level in patients who did not achieve adequate pain relief after lumbar total disc replacement (TDR) without evidence of device failure.

Four patients (mean age, 47 years) presented with persistent low back pain following lumbar TDR for 12-24 months (mean, 16.3). No device failures were observed. All patients underwent transpedicular fixation at the index level. Clinical outcome was assessed via the Oswestry disability index, a visual analog scale, and recording of the consumption of analgesics.

No postoperative complications were observed. The average follow-up after lumbar transpedicular fixation was 53.5 months (range, 43-80). Two patients considered the outcome as excellent, one as good, and one as poor. The mean visual analog scale pain score decreased from 7.8 (range, 7-8) to 4.3 (range, 2-8). The mean Oswestry disability index decreased from 43.5 (range, 39?47) to 27.5 (range, 14-47). At the last follow-up, one patient was without analgesic medication and substitution of opiates with non-opioid analgesics was possible in two patients.

In patients with persistent low back pain after TDR without device failure or adjacent segment pathologies, lumbar transpedicular fixation without removal of the disc prosthesis may be a useful therapeutic option.
In patients with persistent low back pain after TDR without device failure or adjacent segment pathologies, lumbar transpedicular fixation without removal of the disc prosthesis may be a useful therapeutic option.
The spinal cord is drained by three interconnected venous systems. Among them the extrinsic venous system of the dorsal thoracolumbar region with its radicular communications is liable to get injured due to its anatomical position. With increasing case reports of post puncture hematomas, revisiting the intrathecal extrinsic venous system of spinal cord has become a necessity.

In a tertiary teaching institution, 25 adult cadavers were dissected by standard dissection procedure and spinal cord was removed with meninges. The dorsal aspect was further dissected out and layers of meninges were removed carefully to expose the extrinsic venous system in the dorsal region. The specimens that showed engorged veins were further studied for their extent, pattern, presence of radicular veins, their level and route of exit.

Five specimens showed variant dorsal venous pattern of the extrinsic system of veins in the thoracolumbar region. The main dorsal spinal vein was seen to be engorged, tortuous and more than 2mm with engorged radicular veins.
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