Neurocirugia (English Edition)最新文献

{"title":"Effective method of pedicle screw fixation in patients with neurologically intact thoracolumbar burst fractures: a systematic review of studies published over the last 20 years","authors":"Andrey Grin,&nbsp;Vasiliy Karanadze,&nbsp;Ivan Lvov,&nbsp;Anton Kordonskiy,&nbsp;Aleksandr Talypov,&nbsp;Vladimir Smirnov,&nbsp;Petr Zakharov","doi":"10.1016/j.neucie.2024.07.009","DOIUrl":"10.1016/j.neucie.2024.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>To conduct a systematic review of studies on various posterior pedicle screw fixation (PSF) methods used for treating neurologically intact thoracolumbar burst fractures and to identify the most effective and safe approaches.</div></div><div><h3>Methods</h3><div>We conducted a systematic review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with the study registered in PROSPERO (CRD42024531093). The inclusion criteria were: (1) publication dates from January 1, 2004, to December 31, 2023; (2) availability of full-text articles in English; (3) thoracolumbar burst fractures without neurological deficits; (4) patients aged over 18; (5) reports on treatment outcomes or complications; (6) a mean follow-up period of at least 12 months.</div></div><div><h3>Results</h3><div>A total of 69 articles covering 116 patient groups were included. Our analysis highlighted the advantages of short-segment fixation without fusion over monosegmental, short-segment and long-segment fusion in terms of shorter operation times and reduced intraoperative blood loss (p = 0.001 and p &lt; 0.001, respectively). Extensive fusion was associated with a significantly higher frequency of deep surgical site infections compared to other PSF methods (p = 0.043). Percutaneous pedicle screw fixation, applied to patients with lower body compression rates and kyphotic deformities, led to less potential for correction (p = 0.004), yet significantly decreased blood loss (p = 0.011), operation duration (p &lt; 0.0001), and hospitalization duration (p &lt; 0.0001). No significant benefits were observed with the use of additional intermediate screws in short-segment PSF.</div></div><div><h3>Conclusions</h3><div>Short-segment pedicle screw fixation could be the optimal surgical treatment method for neurologically intact thoracolumbar burst fractures. The use of posterior lateral fusion in this context may increase the deep surgical site infection rate without reducing the frequency of implant-related complications or improving long-term treatment outcomes. The percutaneous approach remains the preferred technique; however, its limited reduction capabilities should be carefully considered during surgical planning for patients with severe kyphotic deformities. The application of intermediate screws in such patients has not demonstrated significant advantages. Removing the fixation system has not led to a significant decrease in implant-related complications or improvement in quality of life. The data obtained from the systematic review may assist surgeons in selecting the most appropriate surgical treatment method for patients with neurologically intact thoracolumbar burst fractures, thereby avoiding ineffective procedures and improving both short-term and long-term outcomes.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"35 6","pages":"Pages 299-310"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological aspects of syringomyelia in a 19-year old cohort of spinal cord injury patients","authors":"Vitor Viana Bonan de Aguiar ,&nbsp;Giovani Batista ,&nbsp;Ricardo Gepp ,&nbsp;Asdrubal Falavigna","doi":"10.1016/j.neucie.2024.09.004","DOIUrl":"10.1016/j.neucie.2024.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the prevalence, clinical and radiological risk factors, and surgical management of post-traumatic syringomyelia (PTS) in a 19-year cohort study of Spinal Cord Injury (SCI) patients treated at a SCI rehabilitation center.</div></div><div><h3>Methods</h3><div>Retrospective study of SCI patients in whom PTS was radiologically confirmed between January 2000 and December 2018. Protocols for assessing signs and symptoms of PTS were applied prior to PTS diagnosis and treatment and later at neurosurgical and rehabilitation reviews. The variables analyzed were prevalence, demographic data, trauma event, clinical and radiological risk factors, location and size of the syrinx, and effectiveness of the surgical procedures.</div></div><div><h3>Results</h3><div>Over the 19-year period, review of 920 SCI patients revealed 85 patients who met the clinical and neuroradiological criteria for the diagnosis of PTS and who were prospectively followed. Road traffic accidents were the leading cause of injury (n = 58; 68.2%), syringomyelia was most commonly observed in the thoracic spine (n = 56; 65.9%), and upper extremity paresis was the most common indication for surgical treatment (n = 27; 45%). Surgical treatment was indicated in 48 patients and the operative procedures included 29 syringopleural shunts (60.4%), 17 adhesiolysis (35.4%), and two syringosubarachnoid shunts (4.1%). The prevalence of PTS was 9% and was higher in patients with ASIA impairment scale grade A injuries. Most patients with PTS (63/85, 74.1%) were treated surgically at the time of injury. There was a significant reduction both in the extent (p = 0.05) and largest area (p = 0.001) of the syrinx after surgical treatment. Reoperation rates were 47% and 37.9% for adhesiolysis and syringopleural shunting, respectively.</div></div><div><h3>Conclusion</h3><div>Follow-up and routine clinical examination of SCI patients is critical for the diagnosis of PTS in patients with late neurological deterioration. Surgical treatment has a positive impact in reducing the size of the syrinx as seen on postoperative MRI.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"35 6","pages":"Pages 311-318"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant solitary fibrous tumor of the olfactory groove. An unusual simulator in an unusual location","authors":"Fernando García Pérez ,&nbsp;Ascensión Contreras Jiménez ,&nbsp;Beatriz Agredano Ávila ,&nbsp;José Masegosa González","doi":"10.1016/j.neucie.2024.07.005","DOIUrl":"10.1016/j.neucie.2024.07.005","url":null,"abstract":"<div><div>Solitary fibrous tumors are rare mesenchymal neoplasms that can develop in any part of the body, with those that settle intracranially being confused with meningiomas as a general rule. We present the case of a 57-year-old man referred to our hospital due to bifrontal headache, anosmia, and behavioral alterations of 6 months' duration. Radiological studies revealed the existence of a large tumor mass with an extra-axial appearance and location in the anterior cranial fossa, initially compatible with a giant meningioma of the olfactory groove. Gross total resection of the mass was carried out. The pathological diagnosis was unexpected: a solitary fibrous tumor (WHO grade 1, 2021). Given the aggressive nature of these lesions, with a tendency to recurrence, malignant transformation and even metastasis, surgery with macroscopically complete resection intention should constitute the first therapeutic option. Close clinical-radiological follow-up after the procedure is justified.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"35 6","pages":"Pages 323-328"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating endovascular techniques into established open neurosurgery practice: a temporal analysis of treatment evolution in a dual-trained neurosurgical unit","authors":"","doi":"10.1016/j.neucie.2024.06.003","DOIUrl":"10.1016/j.neucie.2024.06.003","url":null,"abstract":"<div><h3>Objetive</h3><div>In Europe, units with Dual-trained Neurovascular Surgeons (DTNS) skilled in both open neurosurgery<span> (ON) and endovascular neurosurgery<span> (EN) are scarce. For instance, in Spain, our unit is unique within the public health<span> system, where all neurovascular procedures are carried out by DTNS. Our study aims to evaluate the evolution in treating ruptured intracranial aneurysms (rICAs) and assess the impact of this evolution on clinical outcomes.</span></span></span></div></div><div><h3>Methods</h3><div>A retrospective cohort study was performed on rICAs treated in our unit from October 2012 to June 2023. We reviewed clinical and radiological data to analyze the evolution of ON and EN over time, as well as their impact on patient outcomes. Univariate, multivariate, and mixed-effects models were utilized to discern temporal changes.</div></div><div><h3>Results</h3><div>The modified Fisher Scale (mFS) and the modified World Federation of Neurological Surgeons scale (mWFNS) showed strong correlation with the outcome at 6 months outcomes, both with p &lt; 0.00001. However, the surgical intervention method, ON versus EN, did not significantly affect outcomes (p &gt; 0.85). In adjusted multivariate logistic regression<span><span>, mFS (−1.579, p: 0.011) and mWFNS (−0.872, p &lt; 0.001) maintained their significance. rICAs location was significant when comparing ON to EN p = 0.0001. A significant temporal trend favored the selection of EN p = 0.0058). Mixed-effects time series modeling indicated that while </span>patient characteristics and rICA specifics did not predict treatment choice, the year of treatment was significantly correlated (0.161, p = 0.002). Logistic regression with interaction terms for time and treatment type did not produce significant results.</span></div></div><div><h3>Conclusion</h3><div>Our findings suggest that despite an increased adoption of EN techniques, there has been no change in patient outcomes. Even with the rise of EN, our unit continues to perform ON for a higher proportion of rICAs than most national hospitals. We propose that a “dual approach” offers advantages in a patient individualized treatment decision protocol in the European context.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"35 6","pages":"Pages 281-288"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chiari malformation presenting with subarachnoid hemorrhage: a case report","authors":"","doi":"10.1016/j.neucie.2024.06.002","DOIUrl":"10.1016/j.neucie.2024.06.002","url":null,"abstract":"<div><div><span>Chiari malformations<span> (CM) are often diagnosed in childhood and younger adults, with an incidence of only 0.77% in adult populations. Patients with CM may develop syringomyelia<span> and increased intracranial pressure (ICP) due to </span></span></span>cerebrospinal fluid<span><span> (CSF) obstruction and altered fluid dynamics at the cervicomedullary junction. We describe the case of a 65-year-old female presenting with an angionegative subarachnoid hemorrhage<span> (SAH) with concomitant new diagnosis of CM type I with syringomyelia. After ruling out any aneurysm or </span></span>vascular malformations<span><span>, she underwent a suboccipital craniectomy for a Chiari decompression with a C1 </span>laminectomy. There were no complications with the surgery and her symptoms improved. This case report highlights the unusual presentation of a CM.</span></span></div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"35 6","pages":"Pages 319-322"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical spine spondylodiscitis due to neglected esophageal perforation after a dilation procedure 30 years after a laringectomy and radiotherapy. Report of a case and review of literature","authors":"Caribay Vargas-Reverón ,&nbsp;Ernesto Muñoz-Mahamud ,&nbsp;Alex Soriano ,&nbsp;Andrés Combalia","doi":"10.1016/j.neucie.2024.09.001","DOIUrl":"10.1016/j.neucie.2024.09.001","url":null,"abstract":"<div><div>Current treatment of cervical spine spondylodiscitis generally involves a radical surgical debridement and stable reconstruction together with antibiotic therapy until complete healing. But this classical approach could be difficult for patients who have been treated previously for an esophageal carcinoma and received radiotherapy.</div><div>We present a case of a 75-year-old male who underwent an esophageal dilation procedure and developed afterward a spondylodiscitis with epidural abscess due to a neglected esophageal perforation. Blood cultures were positive for Peptostreptococcus. Cervical spondylodiscitis and epidural abscess are extremely rare complications of esophageal dilations. Successful treatment without debridement was achieved by performing a posterior fixation without decompression associated with antibiotic therapy for 8 weeks. The present case highlights that spondylodiscitis and epidural abscess may be treated in selected cases where the anterior neck is unapproachable and with a recognized pathogen by a posterior approach fixation without debridement, in association to specific antibiotic therapy.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"35 6","pages":"Pages 334-339"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial sensory rhizotomy in recurrent trigeminal neuralgia. Our experience and literature review","authors":"","doi":"10.1016/j.neucie.2024.07.003","DOIUrl":"10.1016/j.neucie.2024.07.003","url":null,"abstract":"<div><h3>Background and objective</h3><p><span>Trigeminal Neuralgia (NT) is a common pathology in </span>Neurosurgery<span>. It can be classified as idiopathic or secondary to other pathologies, such as Multiple Sclerosis<span><span> (MS). Several surgical treatments have been described, some of them being replaced by more modern techniques. Partial sensory rhizotomy (PSR), described by Dandy is a technique replaced by other techniques due to its permanent side effects. We present our experience with this technique in patients with recurrent </span>NT.</span></span></p></div><div><h3>Methods and materials</h3><p>A retrospective review is carried out on five patients who underwent surgery at our center from 2018 to 2023 using the PSR technique.</p></div><div><h3>Results</h3><p>All the patients intervened showed significant clinical improvement, except one patient who required reintervention due to uncontrolled pain. According to the Barrow Neurological Institute (BNI) scale, 80% (4/5) of patients showed improvement from grade V to grades I/II except for one of them. This patient suffered from MS. Additionally, one patient presented a corneal ulcer<span> after surgery due to impairment of the corneal reflex.</span></p></div><div><h3>Conclusion</h3><p>In our experience, PSR is a valid treatment option in selected patients with recurrent TN. It has a low incidence of complications with an adequate surgical technique and anatomical knowledge of the region. To the best of our knowledge, we are one of the few centers in Spain to publish our results with PSR in the last ten years. We report good results in pain control withdrawing medication in 80% (4/5) of the operated patients.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"35 5","pages":"Pages 247-252"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma Knife radiosurgery for the treatment of trigeminal neuralgia: A single center-experience","authors":"","doi":"10.1016/j.neucie.2024.04.001","DOIUrl":"10.1016/j.neucie.2024.04.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>We aimed to assess the outcomes of patients with trigeminal neuralgia<span> (TGN) who underwent Gamma Knife radiosurgery (GKRS).</span></p></div><div><h3>Materials and methods</h3><p>Fifty-three patients with typical TGN underwent GKRS from May 2012 until December 2022. Among these patients, 45 patients who were follow-up for at least 12 months were included in the study. A mean dose of 87.5 Gy (range, 80–90) was administered to the trigeminal nerve. Postoperatively, outcome was considered excellent if the patient was pain- and medication-free.</p></div><div><h3>Results</h3><p>The mean symtpom duration was 9.53 years, and the mean patient age was 59.8 years (range, 34–85). The mean follow-up period was 46.8 months (range, 12–127 months). 46.7% of patients had a history of previous surgical interventions. A single nerve division was affected in 14 patients (31.1%), and multiple divisions were affected in 31 patients (68.9%). The rate of initial pain relief was 80%. Hypoesthesia in the area of trigeminal nerve developed in 30 (66.7%). Twenty patients (44.4%) exhibited excellent results within 72.4 months. Recurrence occurred in 11 patients (24.4%) with 27.6 months.</p></div><div><h3>Conclusions</h3><p>Our results suggest that GKRS is a safe and effective procedure. Thus, it is an attractive first- and second-line treatment choice for TGN.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"35 5","pages":"Pages 225-232"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial hypertension secondary to unruptured pial arteriovenous malformation. Suitability of isolated endovascular treatment with ethylene vinyl alcohol/dimethyl sulfoxide (Onyx®). Case report and literature review","authors":"","doi":"10.1016/j.neucie.2024.07.001","DOIUrl":"10.1016/j.neucie.2024.07.001","url":null,"abstract":"<div><p><span>A 36-year-old male presented to the Emergency Department<span> with clinical symptoms of blurred vision of progressive onset of two years of evolution. The ophthalmological examination revealed the existence of bilateral papilledema<span>. Using cranial computed tomography<span><span> and magnetic resonance imaging, the presence of a right occipital pial arteriovenous malformation<span> was certified. Arteriographically, pial arterial contributions dependent on the right middle cerebral artery and the right </span></span>posterior cerebral artery<span><span> were identified. Venous drainage was located at the level of the superior sagittal sinus<span>. An associated right transverse sinus stenosis was also identified. The existence of secondary </span></span>intracranial hypertension was corroborated by monitoring with an </span></span></span></span></span>intracranial pressure<span><span> sensor. An interventional procedure was carried out consisting of embolization of the </span>arterial supplies<span> of the lesion using Onyx®. The clinical-radiological findings after the procedure were favorable: the papilledema disappeared and complete exclusion of the malformation was achieved. A new intracranial pressure measurement showed resolution of intracranial hypertension. Subsequent regulated radiological controls showed complete exclusion of the malformation up to 5 years later.</span></span></p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"35 5","pages":"Pages 272-280"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term and long-term results of odontoid screw fixation in patients with Type II and rostral Type III dens fractures","authors":"","doi":"10.1016/j.neucie.2024.05.003","DOIUrl":"10.1016/j.neucie.2024.05.003","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate both the short-term and long-term outcomes of odontoid screw fixation (OSF), identifying potential risk factors<span> for implant-related complications in patients with odontoid fractures.</span></p></div><div><h3>Methods</h3><p>This is a retrospective observational cohort study<span><span>. Inclusion criteria were as follows: 1) Type II fractures and rostral Type III fractures, according to the Anderson and D’Alonzo classification; 2) patients older than 15 years. Exclusion criteria were: 1) other Type III injuries<span><span>; 2) osteoporosis confirmed by </span>densitometry<span> or a CT bone density score below 100 Hounsfield units; 3) odontoid fractures related to tumors or </span></span></span>aneurysmal bone cysts.</span></p></div><div><h3>Results</h3><p>In total, 56 patients were considered for the analysis of short-term results, and 26 patients were evaluated for long-term outcomes. No significant differences were observed in the preoperative imaging data and intraoperative features of OSF between patients with Type II and rostral Type III fractures. The mean operative duration was 63.9 ± 20.9 min, and the mean intraoperative blood loss was 22.1 ± 22.9 ml.</p><p>Screw cut-out was identified in four patients with rostral Type III fractures (p = 0.04). The rate of screw cut-out was found to correlate with the degree of dens fragment displacement. The bone fusion rate was 95.7%. CT scans identified stable pseudarthrosis<span> in two cases. We observed C2–C3 ankylosis<span> in all cases following partial disc resection. One third of patients with screws placed through the anterior lip of C2 showed no C2–C3 ankylosis. A strong trend towards lateral joint ankylosis formation in patients with a median lateral mass dislocation of 11.9 mm was observed. Most SF-36 scores either matched or exceeded the corresponding normal median values in the published reference database.</span></span></p></div><div><h3>Conclusions</h3><p>OSF is a reliable treatment method of Type II and rostral Type III odontoid fractures with fragment displacement of 4 mm or less. The minimally invasive OSF through the anterior-inferior lip of C2, using monocortical screw placement and cannulated instruments, without rigid intraoperative head immobilization, is sufficient to achieve favorable clinical and fusion results. This technique reduces the risk of ankylosis in the C2–C3 segment. OSF restore the quality of life for patients with odontoid fractures to levels comparable to those of the general population norm.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"35 5","pages":"Pages 233-240"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}