Microsurgical Resection of Calcified C2 Cavernous Malformation: 2-Dimensional Operative Video.

Autor:	Motiwala M; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA., Gimenez P; Department of Neurosurgery, Bristol Institute of Clinical Neurosciences, Southmead Hospital, Bristol, UK., Baqai MWS; Department of Neurosurgery, Bristol Institute of Clinical Neurosciences, Southmead Hospital, Bristol, UK., Cernei C; Department of Neurosurgery, Bristol Institute of Clinical Neurosciences, Southmead Hospital, Bristol, UK., Sajjad J; Department of Neurosurgery, Bristol Institute of Clinical Neurosciences, Southmead Hospital, Bristol, UK., Patel NK; Department of Neurosurgery, Bristol Institute of Clinical Neurosciences, Southmead Hospital, Bristol, UK., Teo M; Department of Neurosurgery, Bristol Institute of Clinical Neurosciences, Southmead Hospital, Bristol, UK., Nelson R; Department of Neurosurgery, Bristol Institute of Clinical Neurosciences, Southmead Hospital, Bristol, UK., Abhinav K; Department of Neurosurgery, Bristol Institute of Clinical Neurosciences, Southmead Hospital, Bristol, UK.
Jazyk:	angličtina
Zdroj:	Operative neurosurgery (Hagerstown, Md.) [Oper Neurosurg (Hagerstown)] 2024 Jul 05. Date of Electronic Publication: 2024 Jul 05.
DOI:	10.1227/ons.0000000000001260
Abstrakt:	We present the case of a 58-year-old woman presenting with left upper limb paresthesia and bilateral lower limb spasm who was found to have a likely radiation-induced calcified intramedullary cavernous malformation at the level of C2.1-4 Owing to the symptomatic nature of the lesion with progressive increase in size and associated cord edema on serial imaging, through a lateral approach, the patient underwent a microsurgical left C2-3 hemilaminectomy and medial facetectomy to access the ventral exophytic calcified component.5-7 Debulking and piecemeal resection were performed with the aid of an ultrasonic bone aspirator with "claw" attachment while minimizing any manipulation of neural parenchyma.8-13 Ultimately, near total resection was achieved as a rim of capsule was left densely adherent to the spinal cord. Postoperatively, no new neurologic deficits were noted, and imaging as early as 1 week postoperatively showed significant reduction of cord signal abnormality. The technical considerations for the ultrasonic bone claw and the literature on treatment outcomes for calcified intramedullary spinal cavernous malformations are reviewed. The patient consented to the procedure and to the publication of her images. Institutional review board approval was deemed not necessary because of the retrospective, case report nature of this work. (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)
Databáze:	MEDLINE
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