- Hemodynamic Analysis of Postoperative Rupture of Unruptured Intracranial Aneurysms after Placement of Flow-Diverting Stents: A Matched Case-Control Study
The authors enrolled 10 patients with intracranial aneurysms, treated with flow diverters between September 2014 and December 2018, who experienced postoperative aneurysm rupture. They matched these subjects 1:2 with 20 with postoperative unruptured intracranial aneurysms based on clinical and morphologic factors. Using computational fluid dynamics, they assessed hemodynamic changes pre- and posttreatment between the 2 groups on a number of qualitative and quantitative parameters. Compared with pretreatment, unstable flow pattern and higher energy loss after Pipeline Embolization Device placement for intracranial aneurysm may be the important hemodynamic risk factors related to delayed aneurysm rupture.
- Armed Kyphoplasty: An Indirect Central Canal Decompression Technique in Burst Fractures
This study assesses the results of armed kyphoplasty using vertebral body stents or the SpineJack in traumatic, osteoporotic, and neoplastic burst fractures with respect to vertebral body height restoration and correction of posterior wall retropulsion. The authors performed a retrospective assessment of 53 burst fractures with posterior wall retropulsion and no neurologic deficit in 51 consecutive patients treated with armed kyphoplasty. Posterior wall retropulsion and vertebral body height were measured on pre- and postprocedural CT. Armed kyphoplasty was performed as a stand-alone treatment in 43 patients, combined with posterior instrumentation in 8 and laminectomy in 4. Pre-armed kyphoplasty and post-armed kyphoplasty mean posterior wall retropulsion was 5.8 and 4.5 mm, respectively, and mean vertebral body height was 10.8 and 16.7 mm, respectively. They conclude that in the treatment of burst fractures with posterior wall retropulsion and no neurologic deficit, armed kyphoplastyyields fracture reduction, internal fixation, and indirect central canal decompression.