A 59-year-old man presented with epileptic seizures interpreted as episodic syncope in the past 3 years and the patient had a history of head trauma about 4 years ago. Computed tomography revealed an ossified chronic subdural hematoma involving the right frontotemporoparietal region, which was totally resected using microsurgical technique. Postoperatively, weakness developed in right arm and magnetic resonance imaging revealed a bilateral tension pneumocephalus, which was immediately treated by a left frontal burr hole trepanation, and the patient was discharged uneventfully.
Lumbar listhesis, is defined as a disorder that causes a vertebral body to slip over the one below it. Several surgical decompression and augmented fusion techniques are available for treatment. Transforaminal lumbar interbody fusion (TLIF) is a commonly used surgical technique for degenerative lumbar spondylolisthesis in cases in which conservative care fails to achieve satisfactory spinal fusion. Although TLIF is widely accepted because it is easy to perform and is very safe, cage migration is an important complication, and posterior migration is a serious one. Cage migration can be classified as posterior, anterior, or sagittal forms according to migration direction. An increasing number of the surgeons have encountered cage migration; however, consensus on its cause is lacking. In this report, a case of intradural cage migration with left leg pain is presented, and this complication is discussed in light of related studies.
Aim: Epidural fibrosis, which develops after spinal surgery, is one of the factors which reduce the chances of successful surgery in the medium and long term by tightly surrounding the dura and spinal roots. In this experimental study, the aim was to compare the effects of local and systemic administration of dexpanthenol on epidural fibrosis formation in rats. Methods: Twenty-eight rats were randomly divided into 4 equal groups (control, Spongostan, local dexpanthenol and systemic dexpanthenol) and laminectomy was performed at the T11 level. Local dexpanthenol (500mg/kg) was administered with Spongostan, and systemic dexpanthenol (500 mg/kg) was administered once a day for three weeks. Epidural fibrosis, arachnoidal involvement, fibroblast cell count, vascular endothelial growth factor, and hydroxyproline levels were evaluated. Results: The grade of epidural fibrosis, fibroblast cell counts, and hydroxyproline levels were significantly lower in the systemic dexpanthenol groups (P=0.025). Conclusion: Dexpanthenol may be used as potential agent for reducing epidural fibrosis. However, it should be administered more than once for it to take effect.
Retained surgical sponge and consequent foreign body reaction is a well-documented complication. In the current literature, the phenomenon has many names such as textiloma, gossypiboma, gauzoma, and muslinoma. While it is one of the widely reported topics, only a few cases are reported by neurosurgeons. Herewith we present a case of textiloma in Turkey who had repeated surgical interventions at various hospitals during the COVID-19 pandemic, possibly due to breakdown of preventive measures against retention of surgical sponge.
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