An assessment of the variation in the practice of lumbar discectomy and its role in axial back pain.

Background: Lumbar discectomy is performed for symptomatic lumbar disc herniation and is one of the most widely performed spinal surgical procedures worldwide in a variety of ways. This survey aimed at providing an overview/perspective of different practice patterns and the impact of lumbar discectomy on axial back pain with or without sciatica. Methods: An online survey was performed using the application "Google Forms." The link to the questionnaire was distributed to neurosurgeons through personal E-mail and social media platforms. Results: We received 333 responses. The largest percentage of responses across five continents was from Asia (66.97%, n = 223). The mean age of the respondents was 40.08 ± 10.5 years. A total of 66 respondents (20%) had a spine practice of 7%-90%, and 28 respondents had a spine practice of 90%-100% (8.4%). The number of respondents who practiced microscopic discectomy using a tubular retractor (n = 143 respondents, 42.9%) was nearly equal to the number of respondents who practiced open discectomy (n = 142 respondents, 42.6%). An almost equal proportion of respondents believed discectomy does not help in relieving axial back pain. Only 20.4% (n = 68) of respondents recommend bed rest for a longer duration postoperatively. Conclusions: Our survey revealed that only 22.2% of spine surgeons recommended discectomy in patients with radiological disc herniation with axial back pain alone and preferred a minimally invasive method of discectomy. Almost half of them believed discectomy to be ineffective for axial low back pain and only a few recommended prolonged bed rest postoperatively.

Anterior Microsurgical Approach to Ventral Lower Cervical Spine Meningiomas: Indications, Surgical Technique and Long Term Outcome.

Ventral lower cervical spinal meningiomas with posterior displacement of the spinal cord are rare and anterior approach has been rarely reported in the literature. The authors present their experience about eight patients operated through anterior microsurgical approach. Exposure of meningiomas was achieved through one or two corpectomies, according to meningioma extension. Tumour removal was performed thanks to the aid of a dedicated ultrasonic aspirator, and intraoperative evoked potentials were employed. Particular care was taken with the materials adopted for reconstruction of the anterior dural plane, to avoid postoperative cerebrospinal fluid leak. Vertebral fusion and stabilization were achieved by tantalum cage or titanium graft in case of one or two corpectomies respectively; anterior titanium plate fixed with screws was applied in all patients. Extent of tumour removal was related to the presence of a conserved arachnoidal plane between the tumour and the spinal cord: total removal was achieved in 2 patients, while gross total removal in the other six ones. Postoperative neurological outcome, which was favourable in all patients, was related mostly to preoperative neurologic status. No recurrence after total removal and no remnant growth after gross total removal occurred during an average follow-up period of 6, 7 years.

Fern Distortion Syndrome of Leatherleaf Fern in Costa Rica: Symptoms, Incidence, and Severity.

A syndrome has been recognized on leatherleaf fern (Rumohra adiantiformis) in Costa Rica for many years that causes widespread damage but has not been described in the literature. A full description of the syndrome, termed fern distortion syndrome (FDS), is reported here, along with evidence that FDS is a new disease and that it is associated with endophytic fluorescent pseudomonads but not with any other major groups of pathogens or pests. The main aboveground symptoms of FDS are twisting and distortions of fronds, which make the fronds unmarketable. In advanced cases of FDS, fronds are often thickened, new frond growth ceases or slows dramatically, and uneven sporulation is apparent on the underside of fronds. Symptoms of FDS belowground are reduced diameter of rhizomes and reduced overall root mass. The incidence of FDS in Costa Rica was typically over 80%, and severity typically ranged from 1.26 to 2.48 using a 0 to 3 rating scale in fields propagated vegetatively with rhizomes from fields with FDS. In contrast, in three fields planted 1.5 to 4 years previously with rhizomes derived from tissue culture, incidence and severity were markedly lower: 23 to 34% and 0.24 to 0.36, respectively. Paired sampling of symptomatic and asymptomatic plants revealed significantly greater populations of fluorescent pseudomonads inside rhizomes of symptomatic plants.

Limnology of Botos Lake, a tropical crater lake in Costa Rica.

Botos Lake, located at the Poas Volcano complex (Costa Rica) was sampled eight times from 1994 to 1996 for physicochemical conditions of the water column and phytoplanktonic community composition. Depth was measured at fixed intervals in several transects across the lake to determine its main morphometric characteristics. The lake has an outlet to the north. It is located 2580 m above sea level and is shallow, with a mean depth of 1.8 m and a relative depth of 2.42 (surface area 10.33 ha, estimated volume 47.3 hm3). The lake showed an isothermal water column in all occasions, but it heats and cools completely according to weather fluctuations. Water transparency reached the bottom on most occasions (> 9 m). The results support the idea that the lake is polymictic and oligotrophic. The lake has at least 23 species of planktonic algae, but it was always dominated by dinoflagellates, especially Peridinium inconspicuum. The shore line is populated by a sparse population of Isoetes sp. and Eleocharis sp. mainly in the northern shore where the bottom has a gentle slope and the forest does not reach the shore.

The changing morphology and increasing deceleration of supernova 1993J in M81

Twenty consecutive Very Long Baseline Interferometry images of supernova 1993J from the time of explosion to the present show the dynamic evolution of the expanding radio shell of an exploded star. High-precision astrometry reveals that the supernova expands isotropically from its explosion center. Systematic changes in the images may reflect a pattern of anisotropies and inhomogeneities in the material left over from the progenitor star. As the shock front sweeps up the material in the surrounding medium, it is increasingly decelerated and influenced by the material. After 5 years, the supernova has slowed to half of its original expansion velocity and may have entered the early stages of the adiabatic phase common in much older supernova remnants in the Milky Way Galaxy.