Purpose. We aimed to evaluate the demographic and clinical features of patients with cervical spinal injuries secondary to shallow-water diving and share our therapeutic outcomes. Methods. A retrospective study was carried out using data extracted from the medical files of 39 patients (3 females and 36 males) who were treated surgically (n=29) or conservatively (n=10). Demographics, clinical features, operative data, American Spine Injury Association (ASIA) impairment scales, and Karnofsky Performance Status (KPS) results were noted. Results. The average age of our series (n=39) was 31.59±14.80 (range, 14 to 92) years. The vast majority of patients (n=34, 87.2) presented with isolated cervical trauma. At initial admission, neurological deficits were diagnosed in 22 (56.4) patients. A single-level cervical involvement was noted in 18 (46.2) patients, while 21 cases (53.8) displayed injury involving multiple levels. The levels of cervical injury were C5 (n=16, 41), C6 (n=11, 28.2), C7 (n=6, 15.4), C1 (n=5, 12.8), and C4 (n=1, 2.6). A total of 22 patients had neurological deficits at admission. Surgery was performed using anterior (n=21, 72.4), posterior (n=7, 24.1), and combined anterior and posterior (n=1, 3.4) routes. Nine patients (23.1) exhibited improvement in their neurological deficits. There were significant improvements in both the ASIA impairment scale and KPS results after treatment. Conclusion. Our data indicated that dive- or fall-related cervical spinal injuries are associated with profound morbidity. Reinforcement of primary prevention, identification of target population, and increased awareness on this topic are the key steps to minimize the frequency and severity of complications and to optimize therapeutic outcomes.

Objective: We aimed to evaluate reliability, radiological outcomes, and the impacts of anterior cervical hybrid construction on the adjacent segments for the multilevel cervical degenerative disc disease (mCDDD) and spondylotic spinal stenosis (SSS). Methods: A retrospective analysis was performed using data extracted from the medical files of 195 patients (105 males, 90 females; mean age: 47.7 years). From 2008 to 2018, these patients underwent anterior cervical hybrid construction for symptomatic contiguous at least 2-level cervical degenerative disc diseases and cervical spondylosis. Clinical and radiological data including Neck Disability Index (NDI), visual analogue scale (VAS), local cervical degenerative disk disease in adjacent segments on magnetic resonance imaging (MRI) views, and complications were reviewed. Results: The mean clinical and radiological follow-up was 45.2 months (range 24 to 102). Radiculopathy and/or myelopathy were the main clinical problems in all patients. The mean VAS scores of HC for arm pain were 7.4 ± 0.8 preoperatively; 2.8 ± 0.6, 1 month after surgery; 2.3 ± 0.6, 6 months after surgery; 1.8 ± 0.6, 12 month after surgery; and 1.6 ± 0.6, 24 months after surgery. The mean NDI scores (mean ± SD) of HC significantly improved after surgery (on admission, 57.2 ± 5.5%; 1 month after surgery, 27.35 ± 5.3%; 6 month after surgery, 21.43 ± 2.8%; 12 months after surgery, 21.9 ± 2.3%; 24 months after surgery, 20.6 ± 2.6%, p = 0.006). Hoarseness and dysphagia were the most common complications and osteophyte formation was the most frequent radiographic change. Conclusion: Anterior cervical hybrid construction appears to be an acceptable option in the management of multilevel cervical degenerative disc diseases and spondylotic spinal stenosis.

The aim of our study was to report a series of 15 consecutive patients with aneurysms of the proximal segment (A1) of the anterior cerebral artery. In 15 patients with diagnosed A1 aneurysms, representing 2.1% of 720 aneurysm patients treated at a University Clinical Center between October 1999 and August 2012, clinical presentation, neuroradiological findings, surgical treatment methods and outcome were retrospectively analyzed. Mean patient age was 53.06 (range 32 to 75) years. Ten saccular aneurysms were treated with micro neurosurgical approach via standard pterional craniotomy, four fusiform aneurysms with coiling, and one fusiform aneurysm with stent. No patients died during the operation. The mean follow-up period was 32 months (range 5 months to 7 years). Clinical outcomes revealed good recovery in all patients. Despite the general opinion that A1 aneurysms are benign lesions, an increasing number of reports have demonstrated their potential complications. To date, due to the rarity of A1 aneurysms, only a few consecutive series have been reported. Conduct of multicenter studies are required in order to understand clinical features of A1 aneurysms and devise a proper treatment plan.

Introduction: Spinal hydatid cyst is a rare, but serious condition. Presentation of the case: Herein, we present a 17-year-old male patient with back pain radiating to the legs and progressive weakness in the lower limbs. CT and MRI showed a spinal-paraspinal hydatid cyst with a dumbbell appearance that caused neural foraminal widening and spinal cord compression. The case was explored via right T3-T4 hemilaminectomy, and the hydatid cyst was completely removed. Discussion: The clinical presentation, diagnosis, and surgical treatment of this rare case of spinal hydatid disease are discussed, and all published cases of primary dumbbell hydatid cyst are reviewed. Conclusion: Even if serological test results are negative, hydatid cysts should be considered in the differential diagnosis of cystic lesions of the spine.

The aim of this retrospective study was to describe a novel, simple surgical technique for the treatment of symptomatic Tarlov cysts.A total of 40 patients with symptomatic Tarlov cysts, admitted t...

Symtomatic lumbar ligamantum flavum calcification is quite rare in the young age group. The authors report a case of young adult with diagnosis of lumbar spinal stenosis, presenting with leg pain and neurological deficits. Computerized tomography (CT) scan and magnetic resonance (MR) imaging studies revealed ossification of the ligamantum flavum as the causative factor of the disease and the patient recovered completely after the decompressive operation. It is emphasized that attention should be given to this rare etiological factor of lumbar spinal stenosis. Complete relief can be achieved with early and adequate surgery.