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I recently reached a significant spinal cavernous malformation milestone: #100 resected microsurgically. These are the most common vascular malformation in my practice & teach so much about zones of entry into cord tissue, safe resection techniques, and handling of cord tracts…

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Michael T. Lawton, MD

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119,461 просмотров • 1 год назад •via X (Twitter)

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The spinal cord is a scary thing to incise. The cord has a midline fissure that makes it easier there, but paramedian cord does not. However, myelotomy along dorsal root entry zone (DREZ) is safe for dorsal spinal cord cavernous malformations, entering posteromedial to descending corticospinal tract & dancing around posterior spinal artery…
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It’s surprising how misleading spinal MRI can be at predicting surface presentation of spinal cord cavernomas, which is why I always visually inspect all surfaces. It’s always a relief when I find a spot where it comes to the pia & be accessed w/out traversing normal cord tissue...
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