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Degenerative diseases of the lumbar spine are often treated with posterior interbody fusion surgery (PLIF) for spinal instability or intractable back pain with neurological impairment. Several lateral, less invasive procedures have been recently described (LLIF/DLIF/XLIF). The aim of this systematic review is to compare structural and functional outcomes of lateral surgical approaches to PLIF.We conducted a Medline (Pubmed), Web of Science, Science direct and Cochrane Library search for studies focusing on outcomes and complications comparing lateral lumbar interbody fusion (LLIF/DLIF/XLIF) and posterior lumbar interbody fusion (PLIF). The systematic review was reported using the PRISMA criteria.In total 1000 research articles were identified of which five studies were included comparing the outcomes and complications between the lateral and posterior approach. Three studies found significant less perioperative blood loss with a lateral approach. Average hospital stay was shorter in populations which underwent the lateral approach compared to PLIF. Functional outcomes (VAS/ODI) were similar or better with lateral lumbar interbody fusion. In the majority of the included studies, complication rates did not differ between the posterior and lateral approach. Most of the neurological deficits with XLIF/LLIF were temporary and healed completely within one-year follow up.A lateral approach (XLIF/LLIF) is a good and safe alternative for posterior lumbar interbody fusion in single level degenerative lumbar diseases with comparable functional outcomes, shorter hospital stays and less blood loss. Future prospective studies are needed to establish the role of lateral, minimally invasive approaches in spinal degenerative surgery.

Background Schwannomatosis is a relatively rare disorder and is related to neurofibromatosis type 2. Although there is clinical overlap between schwannomatosis and neurofibromatosis type 2, these diseases have to be regarded as separate entities due to the genetic origin and course of the disease. Methods A comprehensive review of the literature was conducted for relevant studies using Pubmed and Cochrane databases to discuss the epidemiology, clinical presentation, diagnostic criteria, pathological and imaging features, treatment and genetics of schwannomatosis. Results Germline mutations SMARCB1 and LZTRI together with the NF2 gene play a role in the pathophysiology of schwannomatosis. The most common symptom is pain with affection of the spine and peripheral nerves in the majority of patients. High quality contrast enhanced MRI scan is the imaging modality of choice. Treatment is conservative if asymptomatic and surgical if symptomatic. The goal is symptom control with preservation of neurological function. Conclusion Schwannomatosis is a relatively rare disorder in which the main goal is to preserve neurological function. Schraepen, C (corresponding author), Katholieke Univ Leuven, Fac Med & Life Sci, Leuven, Belgium. cedric.schraepen@student.kuleuven.be

Tinnitus is considered an auditory phantom percept analogous to phantom pain. Thalamocortical dysrhythmia has been proposed as a possible pathophysiological mechanism for both tinnitus and pain. Thalamocortical dysrhythmia refers to a persistent pathological resting state theta-gamma coupling that is spatially localized at an area where normally alpha oscillations predominate. Auditory cortex stimulation via implanted electrodes has been developed to treat tinnitus, targeting an area of activation on functional MR imaging elicited by tinnitus-matched sound presentation. The authors describe a case in which clinical improvement was correlated with changes in intracranial recordings. Maximal tinnitus suppression was obtained by current delivery exactly at the blood oxygen leveldependent activation hotspot, which colocalizes with increased gamma and theta activity, in contrast to the other electrode poles, which demonstrated a normal alpha peak. These spectral changes normalized when stimulation induced tinnitus suppression, both on electrode and source-localized electroencephalography recordings. These data suggest that thetagamma coupling as proposed by the thalamocortical dysrhythmia model might be causally related to a conscious auditory phantom percept.

International audience; 19 scalp electrode (EEG) and 8 intra-cranial electrode (iEEG) are recorded simultaneously with a common reference. EEG data is subjected to independent component analysis (ICA) and localisation of components in grey matter is estimated by the sLORETA inverse solution. Correlation between the time series of two independent components and intra-cranial recordings is very high (computed over 23552 samples, max r = 0.8 and 0.67, respectively). One component is localized underneath the site of the implanted electrode. These findings were replicated using the second row of 8 iEEGs and an independent 19-electrode EEG recording, validating the source localisation provided by combining ICA and sLORETA.