Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
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Volume 50, Issue 1
Displaying 1-21 of 21 articles from this issue
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Original Articles
  • Efficacy of Keishibukuryogan, a Traditional Japanese Herbal Medicine, in Treating Cold Sensation and Numbness After Stroke: Clinical Improvement and Skin Temperature Normalization in 22 Stroke Patients
    Keishi FUJITA, Tetsuya YAMAMOTO, Takao KAMEZAKI, Akira MATSUMURA
    2010 Volume 50 Issue 1 Pages 1-6
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.1
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    Cold sensation and numbness have been reported as post-stroke sensory sequelae attributable to distal axonopathy, which is caused by chronic ischemia of diseased limbs resulting from dysfunction of vasomotor regulatory systems. Keishibukuryogan is a traditional herbal medicine used to treat symptoms of peripheral ischemia such as cold extremities. This study investigated clinical improvement and skin temperature in peripheral ischemia patients to determine the efficacy of keishibukuryogan in alleviating post-stroke cold sensation and numbness. Twenty-two stroke patients with cold sensation and/or numbness were enrolled in this study. Subjective cold sensation and numbness, evaluated using the visual analogue scale, were found in 21 and 31 limbs, respectively. The skin temperature of diseased and healthy limbs was recorded. We observed all patients for 4 weeks and 17 patients for 8 weeks after administration of keishibukuryogan. The skin temperature of diseased limbs was significantly higher than baseline at 4 weeks and 8 weeks, whereas that of healthy limbs did not change significantly. Cold sensation and numbness were significantly improved at 4 weeks and 8 weeks compared to baseline. Keishibukuryogan administration resulted in warming of diseased limbs and improved cold sensation and numbness, probably by increasing peripheral blood flow.
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  • Convulsion During Intra-arterial Infusion of Fasudil Hydrochloride for the Treatment of Cerebral Vasospasm Following Subarachnoid Hemorrhage
    Yukiko ENOMOTO, Shinichi YOSHIMURA, Kiyofumi YAMADA, Toru IWAMA
    2010 Volume 50 Issue 1 Pages 7-12
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.7
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    The incidence of convulsion and associated factors were retrospectively analyzed in 23 patients with symptomatic cerebral vasospasm following subarachnoid hemorrhage (SAH) who underwent a total of 31 intra-arterial infusion of fasudil hydrochloride (IAFH) procedures in 49 vessels. Fasudil hydrochloride was administered by superselective infusion via a microcatheter positioned at the proximal portion of the affected artery. Thirteen procedures were performed by manually controlled infusion of 30-75 mg fasudil hydrochloride (1.2-3.75 mg/ml) for approximately 10 minutes. Eighteen procedures were performed by continuous infusion of 60 mg fasudil hydrochloride (1.2 mg/ml) by infusion pump at a constant rate of 3 mg/min. Neurological improvement was observed after 18 of 22 procedures in patients with neurological deterioration due to vasospasm. Convulsion during IAFH developed in 4 patients, all treated by manual infusion (p < 0.05). The manual infusion method (p < 0.05) and infusion rate greater than 3 mg/min (p < 0.01) were significantly associated with the incidence of convulsion during IAFH. IAFH was effective for treating cerebral vasospasm following aneurysmal SAH. IAFH at a constant rate of 3 mg/min delivered by infusion pump improved the symptoms of cerebral vasospasm and prevented convulsions during IAFH.
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  • Long-Term Follow Up of Patients With Good Outcome After Intra-arterial Thrombolysis for Major Arterial Occlusion in the Carotid Territory: Clinical and Magnetic Resonance Imaging Evaluation
    Takatoshi SORIMACHI, Yasushi ITO, Kenichi MORITA, Yukihiko FUJII
    2010 Volume 50 Issue 1 Pages 13-19
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.13
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    Long-term clinical symptoms, including extrapyramidal signs, and magnetic resonance (MR) imaging studies were retrospectively analyzed in 21 patients with good outcome (modified Rankin scale scores 0-2) after successful recanalization of occluded major arteries by intra-arterial thrombolysis with mechanical disruption. Changes in high intensity areas (HIAs) and cerebral atrophy in the ischemic hemisphere were evaluated on follow-up fluid-attenuated inversion recovery MR images. Extrapyramidal signs, short-stepped gait and/or masked face, were observed in 12 of 21 patients during the follow-up period (11 to 68 months, mean 42 months). Enlargement of HIA was demonstrated in 10 of 18 patients undergoing follow-up MR imaging. Cerebral atrophy in the ischemic hemisphere was revealed on the follow-up MR images in all 18 patients. In nine patients with small infarctions, 20 ml or less on computed tomography scans, cerebral atrophy progressed more rapidly in four patients with extrapyramidal signs compared to the other five patients without extrapyramidal signs (p < 0.05). More than half of the patients with good outcome showed extrapyramidal signs. Extrapyramidal signs in patients with small infarction may indicate rapid progression of cerebral atrophy. The occurrence of extrapyramidal signs might be related to delayed neuronal death in atrophic areas.
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  • Operative Management of Skull Base Malignant Tumors Arising From the Nasal Cavity and Paranasal Sinus: Recent Strategies Used in 25 Cases
    Hiroyuki JIMBO, Shinetsu KAMATA, Kouki MIURA, Shunji ASAMOTO, Shinichi ...
    2010 Volume 50 Issue 1 Pages 20-26
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.20
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    Cancers of the paranasal sinuses and nasal cavity are the most common malignant tumors of the anterior and anterolateral skull base. The treatment of these tumors affecting the skull base is complex due to the significant anatomical features. We examined 25 patients, 17 males and 8 females with mean age 61 ± 2 years. En bloc resections using anterior skull base resection, orbital resection, middle fossa resection, and combined procedures of these three resections were performed. Using a combination of adjuvant radiation and chemotherapy, we have achieved a 2-year disease-free survival rate of 90% in these cases. However, potential complications include cerebrospinal fluid leakage, meningitis, abscess formation, pneumocephalus, frontal brain contusion, trismus, and dysphagia as a functional complication. We believe that the optimal management of such malignant tumors involves a multimodal and multidisciplinary team approach. Here we present our recent institutional experience and treatment policy employed during the past 3 years.
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  • Fluorescent In Situ Hybridization 1p/19q Deletion/Imbalance Analysis of Low-Grade and Atypical Meningiomas
    Toru NAGASAKA, Masaharu GUNJI, Noboru HOSOKAI, Kumiko HAYASHI, Masahik ...
    2010 Volume 50 Issue 1 Pages 27-32
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.27
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    The chromosomal 1p/19q state was analyzed in 16 low-grade meningiomas and 7 atypical meningiomas using fluorescent in situ hybridization (FISH) analysis. Chromosome 1p aberrations were observed in all atypical meningiomas, but in only one low-grade meningioma. Atypical meningiomas showed 19q deletion or imbalance, suggesting chromosomal instability of 19q. A small group of low-grade meningioma showed 19q aberrations. FISH 1p/19q deletion/imbalance analysis is a sensitive method for detecting chromosome aberrations of meningiomas and provides useful information for grading of meningiomas. Patients with low-grade meningioma with chromosomal instability of 1p/19q should be followed up carefully. Assessment of the chromosomal state by FISH might be of crucial importance in the clinical management of meningiomas.
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Case Reports
  • Proptosis Caused by Partially Thrombosed Orbital Varix of the Superior Orbital Vein Associated With Traumatic Carotid-Cavernous Sinus Fistula
    —Case Report—
    Seisuke ISEKI, Yoshitaka ITO, Yasuaki NAKAO, Takuji YAMAMOTO, Kentaro ...
    2010 Volume 50 Issue 1 Pages 33-36
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.33
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    A 49-year-old female presented with proptosis and slight chemosis with diplopia on the right. The patient had a past history of skull base fracture occurring one year before the onset of the symptoms. Magnetic resonance imaging showed a partially thrombosed varicose aneurysm (varix) of the superior ophthalmic vein (SOV). Carotid angiography showed a pseudoaneurysm in the right cavernous sinus, associated with slow flow carotid-cavernous sinus fistula via the SOV. Proptosis was due to the direct mass effect of the thrombosed varix of the SOV. The thrombosed varix was removed after right carotid artery trapping with external carotid artery-middle cerebral artery (M2) high flow bypass. The symptoms subsided after the surgery.
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  • Anomia for People's Names After Left Anterior Temporal Lobe Resection
    —Case Report—
    Masanori KURIMOTO, Akiko TAKAIWA, Shoichi NAGAI, Nakamasa HAYASHI, Shu ...
    2010 Volume 50 Issue 1 Pages 36-40
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.36
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    A 47-year-old man was admitted to our hospital with an intrinsic brain tumor in the left anterior temporal lobe. Preoperative sodium thiopental test demonstrated left hemispheric dominance. Awake craniotomy was performed for dominant-hemispheric tumor resection using language mapping to identify the stimulation-induced positive language area. The tasks of object naming and repetition were used, along with specific tests for famous people's names. The language area was detected on the superior temporal gyrus and preserved. Following surgery, this patient was unable to retrieve the names of famous individuals (i.e. anomia for people's name) despite preservation of semantic knowledge for those individuals. This anomia for people's names showed no improvement at all for a period of 15 months. This case report and other sporadic cases with this type of deficit reveal the left anterior temporal lobe is an important brain area for retrieving people's names.
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  • Subarachnoid Hemorrhage Caused by Ruptured Dissecting Aneurysm Arising From the Extracranial Distal Posterior Inferior Cerebellar Artery
    —Case Report—
    Homare NAKAMURA, Toshihide TANAKA, Takami HIYAMA, Shinji OKUBO, Tadash ...
    2010 Volume 50 Issue 1 Pages 41-44
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.41
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    A 50-year-old man presented with a dissecting aneurysm arising from the extracranial portion of the right posterior inferior cerebellar artery (PICA) causing subarachnoid hemorrhage (SAH) and manifesting as sudden onset of disturbed consciousness. Computed tomography showed SAH with ventricular reflux predominantly in the posterior fossa. Angiography revealed a fusiform aneurysm of the right PICA originating extracranially from the right vertebral artery. The aneurysm was isolated and excised. Histological examination showed dissection of the aneurysm wall. Dissecting aneurysm arising from the extracranial portion of the PICA is extremely rare.
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  • Vernet's Syndrome Caused by Large Mycotic Aneurysm of the Extracranial Internal Carotid Artery After Acute Otitis Media
    —Case Report—
    Mizuki AMANO, Eiichi ISHIKAWA, Yuji KUJIRAOKA, Shunji WATANABE, Kei AS ...
    2010 Volume 50 Issue 1 Pages 45-48
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.45
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    An 85-year-old man presented with a rare large aneurysm of the extracranial internal carotid artery (ICA) due to acute otitis media manifesting as Vernet's syndrome 2 weeks after the diagnosis of right acute otitis media. Angiography of the right extracranial ICA demonstrated an irregularly shaped large aneurysm with partial thrombosis. The aneurysm was treated by proximal ICA occlusion using endovascular coils. The ICA mycotic aneurysm was triggered by acute otitis media, and induced Vernet's syndrome as a result of direct compression to the jugular foramen. Extracranial ICA aneurysms due to focal infection should be considered in the differential diagnosis of lower cranial nerve palsy, although the incidence is thought to be very low.
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  • Revascularization for Anterior Cerebral Artery Dissecting Aneurysms
    —Three Case Reports—
    Yoichi UOZUMI, Hiroshi KATOH, Nobusuke TSUZUKI, Terushige TOYOOKA, Tak ...
    2010 Volume 50 Issue 1 Pages 49-53
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.49
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    We describe three rare cases of dissecting aneurysms in the anterior cerebral artery (ACA) treated by surgical reconstruction, and reviewed 79 previously reported cases with the ACA dissecting aneurysm. We found that 35 (77.8%) of 45 patients with ischemic event and 15 (40.5%) of 37 patients with hemorrhagic event were treated conservatively, with 11.4% (4/35 cases) and 13.3% (2/15) risk of bleeding and rebleeding, respectively. Furthermore, half of these patients died. The other 32 patients were treated surgically, and their outcome was favorable, especially after surgical reconstruction. Simultaneous treatment of both hemorrhagic and ischemic events is essential. We recommend early treatment with revascularization for patients with ACA dissection that has hemorrhaged and for patients presenting with signs of clinical deterioration with ischemic event.
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  • De Novo Basilar Head Aneurysms
    —Two Case Reports—
    Ichiro KAWAHARA, Morito NAKAMOTO, Yoshitaka MATSUO, Yoshiharu TOKUNAGA
    2010 Volume 50 Issue 1 Pages 54-56
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.54
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    We describe two rare cases of de novo basilar head aneurysms. The first patient presented with a ruptured basilar tip aneurysm, which developed de novo 5 years after the clipping of a left middle cerebral artery aneurysm. The second patient presented with a right basilar artery-superior cerebellar artery aneurysm, which developed de novo 3 years after the clipping of a right A1 aneurysm. The formation of de novo aneurysm in the posterior circulation has significant implications for screening. Patients must be carefully examined not only at the sites of the initial aneurysm, but also at separate sites, including the posterior circulation, to evaluate the possibility of de novo appearance of another aneurysm.
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  • Splitting of the Oculomotor Nerve by the Posterior Communicating Artery
    —Case Report—
    Sung-Pil JOO, Tae-Sun KIM, Bo-Ra SEO
    2010 Volume 50 Issue 1 Pages 57-58
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.57
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    A 62-year-old woman presented with subarachnoid hemorrhage manifesting as sudden onset of headache, but without visual symptoms or extraocular movement disturbances. Computed tomography angiography showed a 7-mm size aneurysm originating from the internal carotid-posterior communicating artery (PcomA). After the neck of the aneurysm was clipped, the PcomA was confirmed to have split the oculomotor nerve. Splitting of the oculomotor nerve by the PcomA was probably caused by arterial blood pulsation in the tortuous PcomA.
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  • Dural Sinus Thrombosis With Marked Enlargement of the Venous Sinus
    —Case Report—
    Toshiaki KODERA, Satoshi HIROSE, Hiroaki TAKEUCHI, Ken-ichiro KIKUTA
    2010 Volume 50 Issue 1 Pages 59-61
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.59
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    A 36-year-old female presented with dural sinus thrombosis manifesting as marked enlargement of the venous sinus, which could not be differentiated from epidural hematoma on computed tomography during the acute phase. Magnetic resonance imaging showed characteristic serial changes of the thrombus in the healing process. We believe this condition developed from use of oral contraceptives. Systemic anticoagulant therapy was effective without hemorrhagic complication.
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  • Delayed Radiation Necrosis 7 Years After Gamma Knife Surgery for Arteriovenous Malformation
    —Two Case Reports—
    Tatsuki OYOSHI, Kazuho HIRAHARA, Koichi UETSUHARA, Kazutaka YATSUSHIRO ...
    2010 Volume 50 Issue 1 Pages 62-66
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.62
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    A 44-year-old woman and a 55-year-old woman were treated with gamma knife surgery (GKS) for occipital arteriovenous malformation (AVM). Angiography confirmed complete nidus obliterations 2 years after GKS. However, both patients complained of chronic headache and visual symptoms from around 7 years after GKS. Magnetic resonance imaging showed round masses with or without cystic change surrounded by large areas of brain edema. Angiography also showed complete obliteration of AVM at this time. Extended corticosteroid treatment failed to control the edema. Both patients underwent total surgical removal of the mass. Visual disturbance and chronic headache improved postoperatively and the brain edema rapidly subsided. The histological diagnosis was radiation necrosis in both cases, attributed to the low conformity index and large 12-Gy volume due to usage of a large collimator for GKS. These cases of delayed radiation necrosis after GKS suggest that surgical removal of necrotic lesions is necessary for radiation necrosis intractable to medical treatment.
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  • Intracranial Hemorrhage Associated With Convexity Meningioma After Cerebral Angiography
    —Case Report—
    Yoshiteru MIYAJIMA, Hidehiro OKA, Satoshi UTSUKI, Satoru SHIMIZU, Sach ...
    2010 Volume 50 Issue 1 Pages 67-70
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.67
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    A 63-year-old female developed left hemiparesis caused by intracranial intratumoral and peritumoral hemorrhage with cerebral herniation 4 days after cerebral angiography to evaluate right convexity and petrosal meningiomas. The cerebral angiography procedure may have caused the tumoral edema and intracranial hemorrhage because computed tomography on admission revealed the right convexity meningioma as slightly low density compared to before the hemorrhage. Administration of contrast medium is known to cause complications involving microcirculatory collapse and blood-brain barrier dysfunction associated with brain tumors. Therefore, the contrast medium may have affected the meningioma after cerebral angiography.
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  • Iatrogenic Drop Metastasis of Recurrent Meningioma in a Vascularized Free Omental Flap
    —Case Report—
    Masahiro ICHIKAWA, Kiyoshi SAITO, Eiji ITO, Kumi KAWAI, Yasushi FUJIMO ...
    2010 Volume 50 Issue 1 Pages 70-73
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.70
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    A 62-year-old woman presented with drop metastasis of recurrent meningioma located in a vascularized free omental flap. She had undergone three resections of right sphenoid ridge meningioma in another hospital beginning in 1979. Invasive recurrent tumor in the infratemporal fossa was grossly totally removed and the defect was reconstructed with a vascularized free omental flap in our institute in 1999. Magnetic resonance imaging revealed a well-demarcated tumor in the omental flap in 2003. Histological examination showed meningothelial meningioma with Ki-67 labeling index of 2.5%. Surgeons should be aware of the possibility of drop metastasis if the tumor type has a tendency to local recurrence.
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  • Hypertrophic Synovial Mass Resulting in C8 Radiculopathy
    —Case Report—
    Toru SASAMORI, Toyohiko ISU, Daijiro MORIMOTO, Ryoji MATSUMOTO, Masano ...
    2010 Volume 50 Issue 1 Pages 73-76
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.73
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    A 58-year-old man presented with a hypertrophic synovial mass manifesting as left C8 radiculopathy. Computed tomography revealed hypertrophic changes in the left C7-T1 facet joint and widening of the interarticular space. Magnetic resonance imaging showed left C7-T1 foraminal stenosis attributable to a periarticular mass enhanced with gadolinium. Decompression surgery of the left C8 nerve root was performed. During left C7-T1 facetectomy we detected inflamed soft tissue occupying the interarticular space with extension toward the intervertebral foramen. The mass markedly compressed the left C8 nerve root and was gross totally removed. The histological diagnosis was proliferated fibrous connective tissue compatible with hypertrophic synovial tissue. Postoperatively, his neurological condition improved remarkably. The surgical and pathological findings in our patient indicate that this clinical condition is important in the differential diagnosis in adult patients presenting with cervical radiculopathy.
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  • Intracerebral Hemorrhage Secondary to Ventriculoperitoneal Shunt Insertion
    —Four Case Reports—
    Kouichi MISAKI, Naoyuki UCHIYAMA, Yutaka HAYASHI, Jun-ichiro HAMADA
    2010 Volume 50 Issue 1 Pages 76-79
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.76
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    Four patients presented with intracerebral hemorrhage secondary to ventriculoperitoneal (VP) shunt insertion. VP shunt insertion was performed for idiopathic normal-pressure hydrocephalus (Case 1), hydrocephalus after cerebellar hemorrhage (Case 2), and subarachnoid hemorrhage followed by meningitis (Cases 3 and 4). Cerebral hemorrhage was confirmed 4 hours (Case 1), 2 days (Case 2), 7 days (Case 3), and 13 days (Case 4) after the operation. Cases 1 and 2 required intraoperative hemostasis for bleeding from the cortical vein. The 7 previous and our 4 patients were divided according to early (within 2 days after shunt placement, n = 6, Group 1) and delayed (5-13 days post-shunting, n = 5, Group 2) hemorrhage. Bleeding was attributable to venous occlusion due to intraoperative manipulation in Group 1, and to the vulnerability of brain tissue induced by a primary brain disease in Group 2.
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  • Subcutaneous Migration of Distal Ventriculoperitoneal Shunt Catheter Caused by Abdominal Fat Pad Shift
    —Three Case Reports—
    Toru NAGASAKA, Suguru INAO, Hiroshi IKEDA, Masanori TSUGENO, Takeshi O ...
    2010 Volume 50 Issue 1 Pages 80-82
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.80
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    Aberrant migration of a ventriculoperitoneal shunt catheter is an infrequent complication and the mechanism is unclear. We report three cases of subcutaneous migration of the distal catheter. The relationship between thick abdominal fat and catheter migration was suggested in all three cases. Abdominal radiography showed that the subcutaneous fat pad had slid down in the standing position, pulling the catheter out of the peritoneal cavity. We suggest the following mechanisms: Changing from the supine position to the standing position caused subcutaneous fat pad to slide down, the shifted fat pad pulled out the catheter from the peritoneal cavity, and anchoring prevents the catheter returning into the peritoneal cavity. Subcutaneous fat pad shift might act as a “windlass,” resulting in coiling of the catheter in the subcutaneous tissue. During daily life, the peritoneal catheter was pulled out repeatedly and finally was coiled within the subcutaneous fat tissue. Placement of the catheter between the subcutaneous fat pad and the abdominal muscle wall will help to avoid this rare complication. This preventive measure is especially recommended for obese patients with a high risk of subcutaneous migration of the peritoneal catheter.
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Technical Note
  • New Surgical Technique to Secure the Bone Strut During Anterior Cervical Corpectomy and Fusion: Kusabi Fixation Technique
    —Technical Note—
    Satoshi TANI, Takao HOMMA, Hisaaki UCHIKADO, Hiroyasu NAGASHIMA, Akira ...
    2010 Volume 50 Issue 1 Pages 83-86
    Published: 2010
    Released on J-STAGE: January 25, 2010
    DOIhttps://doi.org/10.2176/nmc.50.83
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    Fixation using an anterior cervical plate is frequently used in anterior cervical discectomy or corpectomy and fusion procedures because of the higher fusion rate than without instrumentation. The surgical outcomes with the anterior plate technique are acceptable, but various hardware-related complications have been reported. The authors describe a new surgical technique, called the kusabi fixation technique, for securing the bone strut during anterior cervical corpectomy using cylindrical cages. Following corpectomy, the trimmed bone strut was placed into the space drilled-out. Two small holes of 5-6-mm diameter and 5-mm depth were drilled out at the interface of two bones at the top and bottom of the bone strut in a diagonal orientation. Two cylindrical cages filled with autologous bone tips were tapped into the interface. Eight patients with myelopathy were treated by this method. All procedures were uneventfully performed as a single level surgery (two vertebral bodies and one disk level). Solid bone union was obtained in all patients at 6 months after the operation. Apparent alignment change in the cervical spine was observed in only one patient, who developed asymptomatic kyphosis. No instrumentation failure or significant complications related to the surgery occurred. Precise biomechanical aspects and long-term radiographic analysis compared with the plate fixation technique should be established, but this new method provides another way to secure the bone strut in anterior cervical corpectomy and fusion.
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Editorial Committee
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