Disc Height and Angle Changes on Radiographs and Magnetic Resonance Imaging after Anterior or Posterior Percutaneous Endoscopic Cervical Discectomy.

Objectives: Cervical disc herniation (CDH) leads to pain, numbness, and potential disability. Percutaneous endoscopic cervical discectomy (PECD) offers an anterior or posterior approach. This study aims to compare postoperative disc height and angle changes one year after PECD, considering both approaches. Methods: We retrospectively reviewed the data from patients with CDH who underwent PECD from October 2017 to July 2022. Cervical disc height was measured using the preoperative and one-year postoperative magnetic resonance imaging (MRI) examinations. Lordotic angle (LA), global alignment angle (GAA), segmental alignment angle (SAA), and slippage distance (SD) at the surgical level were measured on radiographs in the neutral, flexion, and extension positions. Results: Thirty-eight patients who underwent posterior PECD (PPECD) and five patients who underwent anterior PECD (APECD) were included in the evaluation. The mean age of the patients was 47.4 years (range: 29-69 years). There was a significant difference in the preoperative and one-year postoperative GAA and SAA in extension in the PPECD group (p = 0.003 and 0.031, respectively). The mean decreased disc height one-year postoperative was 1.30 mm in the APECD group and 0.3 mm in the PPECD group by MRI. A significant disc height decrease was observed in the APECD group (p < 0.001). Conclusions: Treating CDH with PPECD or APECD is feasible, as it can relieve symptoms and reduce disability. Stability remained unaffected during the first year after surgery, even though there was an increase in angulation during extension. Despite a significant decrease in disc space following APECD, patients reported significant symptom improvement and no new symptoms.

Cervical Conjoined Nerve Root During Posterior Percutaneous Endoscopic Cervical Diskectomy.

Cervical conjoined nerve root is rare, and medical imaging, such as magnetic resonance imaging and computed tomography, cannot give an accurate preoperative diagnosis.1 Treatment of cervical radiculopathy with root anomaly can be challenging. We report here a case of cervical conjoined nerve root with a 2-dimensional video. A 41-year-old woman without systemic disease presented with a 2-month history of neck and bilateral shoulder pain, upper back tightness, and left upper limb painful numbness, especially of the first to third fingers. The visual analog scale scores of the neck and left upper limb were 4 and 8, respectively. The Neck Disability Index was 26. The diagnosis of retrolisthesis at C5-C6 and cervical disk herniation with severe neuroforaminal narrowing at the left C5-C6 and C6-C7 levels were made with radiographs and magnetic resonance imaging. Posterior percutaneous endoscopic cervical diskectomy at the left C5-C6 and C6-C7 levels via an interlaminar shoulder approach was performed. During operation, a left-sided conjoined nerve root at the C6-C7 level was found (Video 1). Upon removal of a calcified disk and osteophytes at the C6-C7 level, the dura was torn slightly with traction without nerve root exposure or cerebrospinal fluid leakage. The 3-month postoperative follow-up visual analog scale scores of the neck and left upper limb were 0 and 0, respectively. The 3-month postoperative follow-up Neck Disability Index was 1. Posterior percutaneous endoscopic cervical diskectomy has become a favored treatment for cervical disk herniation because it offers sufficient decompression, smaller incisions, minimal blood loss, shorter hospital stay, and less postoperative pain.2,3 Nonetheless, if unexpected variation of the nerve root is noted during decompressive procedures, iatrogenic nerve root injury is a risk. Seven cases of cervical nerve root anomalies have been reported; all were found during posterior cervical surgery, which may indicate that the posterior approach provides better visualization of nerve root variants, especially in endoscopic surgery.4.

Dumbbell-shaped meningioma of Meckel's cave mimicking trigeminal schwannoma: A case report.

INTRODUCTION AND IMPORTANCE: Several meningioma cases arising through Meckel's cave (MC) at the middle and posterior fossa have been reported. However, few relevant meningiomas have been observed with a dumbbell shape. PRESENTATION OF CASE: We report a rare case of a 36-year-old woman with a meningioma of MC with a typical dumbbell-shaped, schwannoma-like presentation on magnetic resonance imaging (MRI), resulting in a misleading differential diagnosis. CLINICAL DISCUSSION: In this case report, we discuss the characteristics of meningioma of MC observed on MRI and our surgical approach to this condition. CONCLUSION: This tumor was able to mimic a trigeminal schwannoma both clinically and radiographically. This case report has been reported in line with the SCARE 2020 criteria [1].

Odors from proximal species reverse the stress-decreased neurogenesis via main olfactory processing.

Unconditioned foot shock followed by restraint in water was used as a stress regimen to induce decreases in neurogenesis in mouse dentate gyrus (DG). Presence of conspecific odors has been known to reverse the stress-induced decrease in DG neurogenesis. In this study, we found that the conspecific odors did not produce these protective effects in mice whose MOE was impaired by nasal zinc sulfate lavage. Moreover, we observed that the presence of odors from rats, hamsters, and guinea pigs throughout the stress procedure reversed the stress-induced decrease in cell proliferation and neurogenesis in mouse dentate gyrus, while these odors alone did not affect mouse dentate cell proliferation or neurogenesis. In contrast, the presence of rabbit, sugar glider, hedgehog, beetle odors did not affect cell proliferation, neurogenesis, the stress-decreased cell proliferation or neurogenesis in DG. Finally, the presence of fox urine odors decreased mouse dentate cell proliferation and neurogenesis but did not affect the stress-induced decrease in cell proliferation or neurogenesis. Taken together, we conclude that olfactory processing via activation of sensory neurons in MOE is responsible for the conspecific odor-produced protective effect against the stress-decreased cell proliferation and neurogenesis. Phylogenetic distances of the odor-generating species and mice might contribute to the odors' protective effects against the stress-induced decreases in cell proliferation and neurogenesis.