Neurosurgery practice最新文献

{"title":"Utilization of the Lateral Extracavitary Approach for the Resection of a Giant Extradural Paraspinal Schwannoma: A Case Report.","authors":"Khashayar Mozaffari, Max Fleisher, Peter Harris, Michael K Rosner","doi":"10.1227/neuprac.0000000000000108","DOIUrl":"10.1227/neuprac.0000000000000108","url":null,"abstract":"<p><strong>Background and importance: </strong>Spinal schwannomas are benign neoplasms originating from the spinal nerve sheath and account for around one-third of primary spine neoplasms. The most common treatment modality for these tumors is complete surgical resection. Compared with intradural tumors, the resection of an extradural spinal schwannoma is generally associated with a more complex approach, including longer incisions and increased lateral exposure. One useful surgical technique is the lateral extracavitary approach (LECA), which enables dorsal and ventrolateral access to the thoracolumbar spine with decreased rates of morbidity. Herein, the authors describe this approach for the resection of a giant extradural paraspinal schwannoma.</p><p><strong>Clinical presentation: </strong>A 74-year-old female patient presented with right flank pain and difficulty breathing during strenuous exercise. Imaging revealed a large 8.5 × 5.2 × 6.3 cm solid paraspinal lesion spanning from T11-L2 vertebral body levels, with mass effect on the right posterior diaphragm and lung. Before surgical resection, the lesion was confirmed to be a schwannoma by needle biopsy. A LECA approach was used, achieving gross total resection. At 1-month follow-up, the patient reported great symptomatic resolution.</p><p><strong>Conclusion: </strong>LECA proved to be an instrumental approach in a technically challenging resection of a giant extradural paraspinal schwannoma.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"5 4","pages":"e00108"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434522","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":"Bone Regrowth After Frontal Burr Hole Craniostomy: Natural History of 14-mm and 20-mm Burr Holes and Implications for Postoperative Trans-Burr Hole Ultrasound.","authors":"Albert Antar, Ryan P Lee, Shahab Aldin Sattari, Michael Meggyesy, Jheesoo Ahn, Carly Weber-Levine, Kelly Jiang, Judy Huang, Mark Luciano","doi":"10.1227/neuprac.0000000000000110","DOIUrl":"10.1227/neuprac.0000000000000110","url":null,"abstract":"<p><strong>Background and objective: </strong>Burr hole craniostomy is performed for ventriculoperitoneal shunt insertion and endoscopic third ventriculostomy in patients with cerebrospinal fluid disorders. These burr holes are increasingly being used as windows for postoperative ultrasound, an investigational alternative to computed tomography or MRI for follow-up imaging of ventricular caliber. However, bone regrowth reduces ultrasound visibility, and little is known about burr hole regrowth rates in adults. Our study evaluates burr hole regrowth patterns and implications for transcranial ultrasound imaging.</p><p><strong>Methods: </strong>We retrospectively analyzed 101 consecutive patients who had frontal burr hole craniostomy for new ventriculoperitoneal shunt insertion or endoscopic third ventriculostomy over a 3-year period. A mix of standard 14-mm burr holes and expanded 20-mm burr holes were used. Burr hole bone regrowth was assessed using serial follow-up computed tomography scans. Linear and logistic regression analyses examined if bone regrowth correlated with any clinical variables.</p><p><strong>Results: </strong>There was wide variability in rate and degree of burr hole regrowth. The average percentage closure was 25% at 6 months, with minimal additional closure over the following 18 months. The mean residual diameter for 14-mm and 20-mm burr holes stabilized around 9.4 mm and 15.4 mm, respectively. Bone regrowth was not associated with patient characteristics, including age, sex, skull thickness, or etiology of cerebrospinal fluid disorder. Rate of bone regrowth was similar between both cohorts.</p><p><strong>Conclusion: </strong>Bone regrowth after burr hole craniostomy is common, even in elderly patients, occurring rapidly within the first 6 to 12 months and subsequently stabilizing. It is frequently severe enough to restrict ultrasound visualization. Regrowth could not be predicted with any investigated variables, so uniform techniques are needed to block regrowth to allow for longitudinal ultrasound imaging, such as full-thickness cylindrical burr hole implants.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"5 4","pages":"e00110"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434482","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":"Durotomy During Outpatient Lumbar Discectomy Should Not Preclude Same-Day Discharge: A Case Series.","authors":"Joshua L Golubovsky, Michael Spadola, Connor Wathen, Neil R Malhotra, William C Welch, Paul Marcotte","doi":"10.1227/neuprac.0000000000000112","DOIUrl":"10.1227/neuprac.0000000000000112","url":null,"abstract":"<p><strong>Background and objectives: </strong>With advances in surgical techniques over the past 40 years, single-level lumbar hemilaminectomy and microdiscectomy (HLMD) has become a standard outpatient surgery. Incidental durotomy is a common complication of lumbar decompression surgeries and often precludes same-day discharge based on preexisting paradigms, involving bedrest that have no empirical support, but often lead to increased complications in available evidence-based studies. Limited data exist regarding the safety of same-day discharge after lumbar decompression involving an incidental durotomy. The objective of this study was to establish the safety of same-day discharge after repair of incidental durotomy after single-level lumbar HLMD.</p><p><strong>Methods: </strong>This study involved a retrospective review of the electronic medical record for all adult patients undergoing single-level lumbar hemilaminectomy and microdiscectomy by a single surgeon at our institution from 2013 through 2021. Descriptive statistics were used for data analysis.</p><p><strong>Results: </strong>346 lumbar single-level HLMD were performed during this time frame by a single surgeon. There were 17 incidental durotomies (4.9%), all primarily repaired. Of the 17 patients with incidental durotomy, all but 5 returned home on postoperative day 0, with the 5 who remained inpatient staying for reasons unrelated to the dural tear. Patients had no durotomy-associated complications, readmissions, or reoperations regardless of same-day discharge home.</p><p><strong>Conclusion: </strong>Same-day discharge after primary repair of incidental durotomy in single-level lumbar HLMD seems to be safe and may significantly improve health care costs associated with HLMD. This investigation should be expanded to other one-level to two-level lumbar decompression surgeries and minimally invasive and endoscopic approaches.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"5 4","pages":"e00112"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434532","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":"The Usefulness of Vascularized Flap Craniotomy for Open-Wound Depressed Skull Fractures.","authors":"Yoichiro Nakahara, Jin Kikuchi, Yoshikuni Kotaki, Yusuke Otsu, Keisuke Sugi, Hidenobu Yoshitake, Tetsuya Negoto, Motohiro Morioka","doi":"10.1227/neuprac.0000000000000111","DOIUrl":"10.1227/neuprac.0000000000000111","url":null,"abstract":"<p><strong>Background and importance: </strong>Free bone flap craniotomy for open-wound depressed skull fractures poses a high risk of infection due to free bone fragments. This risk escalates in the presence of compound fractures with accompanying dural injuries. The primary objectives in managing depressed skull fractures include infection prevention and the correction of cosmetic deformities. This report describes the efficacy of vascularized flap craniotomy, which preserves blood flow to bone fragments, in reducing infection risks.</p><p><strong>Clinical presentation: </strong>In this study, we present a 54-year-old man with a head injury and a Glasgow Coma Scale score of 8. He had an open wound in the left parietal temporal area and depressed skull fractures with compound bone fragments. The patient underwent vascularized flap craniotomy, focusing on maintaining blood supply to the bone fragments, resulting in successful wound healing without acute infections.</p><p><strong>Conclusion: </strong>Vascularized flap craniotomy is an effective surgical option for treating open-wound depressed skull fractures, potentially reducing the risk of infection by maintaining blood flow to bone fragments. Further studies are required to validate its efficacy in larger patient populations.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"5 4","pages":"e00111"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434598","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":"Delayed Deep White Matter Ischemia After Resection of Gliomas by Awake Surgery.","authors":"Takahiro Tsuchiya, Masamichi Takahashi, Makoto Ohno, Shunsuke Yanagisawa, Sho Osawa, Shohei Fujita, Yoshitaka Narita","doi":"10.1227/neuprac.0000000000000105","DOIUrl":"10.1227/neuprac.0000000000000105","url":null,"abstract":"<p><strong>Background and objectives: </strong>Deep white matter (DWM) is perfused by the medullary arteries from the cortex, and ischemia sometimes occurs after glioma resection. However, the clinical significance of postoperative medullary artery-related ischemia has not been well studied. We retrospectively reviewed cases of delayed DWM ischemia after awake craniotomy to elucidate the clinical characteristics, mechanisms, and management of delayed ischemia.</p><p><strong>Methods: </strong>We identified 4 cases of intra-axial brain tumors, mainly gliomas, that underwent tumor resection by awake craniotomy at our hospital and developed DWM ischemic symptoms after surgery, despite no worsening of neurological symptoms at the end of surgery.</p><p><strong>Results: </strong>Four patients (3 men and 1 woman) presented with glioblastoma, oligodendroglioma, astrocytoma, and brain metastasis. The median age at surgery was 47.5 years (41-73 years). The tumors were located in the watershed area in the frontal lobe (<i>n</i> = 2) and the parietal lobe (<i>n</i> = 2), all of which were left-sided (<i>n</i> = 4). DWM ischemic symptoms, such as motor dysfunction, aphasia, dysarthria, and dysgraphia, developed at an average of 24 hours (14-48 hours) after resection by awake craniotomy. All 4 patients showed symptom improvement within a week after surgery and completely recovered within a month.</p><p><strong>Conclusion: </strong>DWM ischemia is caused by sacrifice of the medullary artery, which feeds the tumor and adjacent brain tissue during tumor resection, and should be considered when delayed aphasia or paralysis occurs postoperatively. These symptoms are often transient and recovery usually occurs. Tumors located in the frontal or parietal lobes, particularly in the watershed area, should be carefully monitored for postoperative ischemia.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"5 4","pages":"e00105"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434516","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":"How to Avoid and Handle Problems in the Placement of Cement-Augmented Fenestrated Percutaneous Pedicle Screws?","authors":"Fernando Padilla-Lichtenberger, Federico Landriel, Alfredo Guiroy, Miguel Casimiro, Álvaro Silva, Santiago Hem","doi":"10.1227/neuprac.0000000000000106","DOIUrl":"10.1227/neuprac.0000000000000106","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pedicle screws with a central cannula and fenestrations allow cement augmentation, providing lower risk for screw loosening and pullout, especially in these patients with poor bone quality. This study aims to offer suggestions for resolving issues and reducing complications associated with the use of cement-augmented fenestrated pedicle screws.</p><p><strong>Methods: </strong>A retrospective study was conducted across multiple centers on patients who received fenestrated pedicle screws with cement augmentation (CAFPS). Using 2-dimensional fluoroscopy guidance, we placed over 800 screws in 137 patients. Based on our analysis of common challenges and complications, 10 tips were compiled, that we believe are crucial for successfully implementing this technique, regardless of the brand or instrument used.</p><p><strong>Results: </strong>The 10 tips included the following: (1) Indications of cement-augmented fenestrated pedicle screws; (2) use the K-wire blunt end in osteoporotic vertebrae; (3) know the longitude and diameter of the screw, by the measurement of the vertebrae to treat; (4) do not go bicortical; (5) clean the way of the screws fenestrae with saline; (6) protecting screw extensors with gauze; (7) measuring time and volume; (8) gently and smoothly introduce the cement; (9) do not panic. The presence of cement in the posterosuperior area adjacent to the pedicle does not necessarily indicate a leakage into the canal; and (10) fenestrated screw removal.</p><p><strong>Conclusion: </strong>The implementation of these tips could enhance technique performance and minimize complications in cement-augmented fenestrated pedicle screw placement.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"5 4","pages":"e00106"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434502","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":"Intraoperative Intermittent Pneumatic Compression Reduces Incidence of Venous Thromboembolism in Patients Undergoing Craniotomy: Study Protocol of a Randomized Multicenter, Single-Blind Trial.","authors":"Maximilian Scheer, Grit Schenk, Bettina Taute, Michael Richter, Michael Hlavac, Jens Gempt, Matthias Krammer, Ehab Shiban, Michael Sabel, Marco Stein, Andreas Wienke, Anke Höllig, Christian Strauss, Stefan Rampp, Julian Prell","doi":"10.1227/neuprac.0000000000000109","DOIUrl":"10.1227/neuprac.0000000000000109","url":null,"abstract":"<p><strong>Background and objective: </strong>Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complication in craniotomy patients. The duration of surgery has been identified as a risk factor for the development of VTE. In a pilot study, the use of intermittent pneumatic venous compression (IPC) dramatically reduced the incidence of VTE. Despite randomization, a significant difference in the duration of surgery between the groups limited the validity of this result. The study was underpowered to compensate for this problem. We now present the protocol of a multicenter trial.</p><p><strong>Methods: </strong>All patients receive medical compression stockings and low-molecular-weight heparin from the first postoperative day. The therapy group receives IPC stockings intraoperatively. Postoperatively, all patients receive lower-extremity duplex sonography to detect/exclude DVT within the first 7 postoperative days. Contrast-enhanced chest CT is the gold standard for the detection of PE and is performed in cases of clinical suspicion of PE.</p><p><strong>Expected outcomes: </strong>The incidence of VTE is the primary end point. The distinction between symptomatic and asymptomatic, etiologies, influence of lesion type, duration of surgery, and mortality will be evaluated as secondary end points. The pilot study showed a VTE incidence of 26% in the control group vs 7% in the treatment group. To avoid overly optimistic treatment effect assumptions, we assume VTE rates of 9% and 24% in the treatment and control groups, respectively, and thus calculated a number of 127 patients per treatment group.</p><p><strong>Discussion: </strong>If this trial shows that intraoperative IPC reduces the risk of VTE to the extent observed in our pilot study (number needed to treat: 5.24), the potential benefit to neurosurgical patients would be significant. The results would potentially influence treatment guidelines by providing the high-quality evidence needed to make robust recommendations.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"5 4","pages":"e00109"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434505","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":"A Scoping Review on Vestibulopathy After Microsurgical Resection of Vestibular Schwannoma-The Forgotten Symptom.","authors":"Evangeline Bambakidis, Sarah Mowry, Sepideh Amin-Hanjani","doi":"10.1227/neuprac.0000000000000107","DOIUrl":"10.1227/neuprac.0000000000000107","url":null,"abstract":"<p><strong>Background and objectives: </strong>Although half of patients with vestibular schwannoma (VS) experience some form of vestibular dysfunction, it is rarely the most prominent symptom. The effect of VS resection on preexisting vestibulopathy remains poorly understood. Our objective was to perform a scoping review to elucidate the incidence and role of postoperative vestibulopathy after microsurgery (MS) as it relates to long-term quality of life (QOL) and predictors of recovery and to identify optimal management of vestibulopathy as a presenting symptom.</p><p><strong>Methods: </strong>Studies were identified using the PubMed database published in the English language peer-reviewed recent literature (2000-2023) using MeSH and tiab terms, and additional studies identified from a secondary review of reference lists.</p><p><strong>Results: </strong>Thirty-one articles were selected and reviewed. The literature quotes a wide range for the incidence of postoperative vestibulopathy after MS (4%-100%). Persistent vertigo universally demonstrates a strong negative effect on long-term QOL. Potential predictors of poor vestibular compensation include sex, advanced age, and tumor size. Few studies examine postoperative vertigo compared with preoperative baseline. Studies are inconsistent and variable in their use of measurement tools to assess vestibulopathy and QOL. Improvement in baseline vestibulopathy can be seen in long-term post-MS, particularly in patients with severe or disabling vertigo, although outcomes relative to other treatment modalities are otherwise similar.</p><p><strong>Conclusion: </strong>Further understanding of predictors and comparative management strategies for vestibulopathy would be valuable in addressing an important negative influence on QOL in patients with VS. Prospective studies factoring preoperative baseline and using standardized measurement tools are needed.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"5 4","pages":"e00107"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434483","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":"Methodology for the Formulation of the Guidelines for the Management of Moderate to Severe Traumatic Brain Injury in Austere and Combat Environments.","authors":"Ross C Puffer, Andres M Rubiano, Simon Oczkowski, Gregory W J Hawryluk, Jamshid Ghajar, Halinder S Mangat, Randy Bell, Jeffrey V Rosenfeld, Lynne Lourdes N Lucena, William R Copeland, Grant Mallory, Scott Cota, Bradley A Dengler","doi":"10.1227/neuprac.0000000000000104","DOIUrl":"https://doi.org/10.1227/neuprac.0000000000000104","url":null,"abstract":"<p><p>Care for the patient with traumatic brain injury (TBI) in austere or combat environments is challenging because resources are substantially limited as compared with care for these patients in a tertiary medical facility. Significant research has been and will continue to be performed on TBI care in these settings. This includes high-quality, evidence-based guidelines that are routinely updated to help guide the treating team as to best practices for a wide range of TBI presentations, complications, and outcomes. Much less is known regarding best practices for TBI care in a resource-limited environment, such as a facility in an austere environment without advanced imaging, dedicated neurointensive care, or definitive neurosurgical capabilities. The aim of this study was to identify the methodology that will be used for an upcoming in-person guideline conference, focusing on the care of patients with TBI in resource-limited austere and/or combat zones.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"5 3","pages":"e00104"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442946","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":"Complete Surgical Resection of a C3 Neuroenteric Cyst With Concurrent Cervical Fusion Deformity Through Posterior Midline Approach in the Lateral Position: Case Report.","authors":"Jin Huang, Yuning Chen, Kefei Chen, Wei Ji, Junfei Shao, Jian Guan","doi":"10.1227/neuprac.0000000000000103","DOIUrl":"https://doi.org/10.1227/neuprac.0000000000000103","url":null,"abstract":"<p><strong>Background and importance: </strong>Enterogenic cysts often occur along the spinal axis and are frequently associated with congenital spinal malformations. The special location of the lesion can limit the surgical resection to achieve complete removal. In this report, the authors describe a successful case of complete resection of a ventral enterogenic cyst in the cervical spinal cord using a posterior midline approach in the lateral position.</p><p><strong>Clinical presentation: </strong>This report discusses a case of a 36-year-old young female patient who presented with relatively short-term discomfort and pain in the left shoulder and neck area. MRI examination revealed a cystic mass located ventrally in the C3 cervical spinal cord. We performed a posterior surgical approach and, under the lateral position, the lesion was completely resected. The surgical treatment alleviated the neurological dysfunction. During the follow-up periods of 3 and 6 months, the patient recovered well, and magnetic resonance imaging scans showed no residual lesion.</p><p><strong>Conclusion: </strong>Complete surgical resection of the cyst wall is the only effective treatment for enterogenic cysts because partial resection or subtotal resection may lead to recurrence. For patients with concomitant spinal malformations, a posterior midline approach in the lateral position is a viable surgical option.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"5 3","pages":"e00103"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442906","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}