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https://www.selleckchem.com/products/4sc-202.html 8% (P less then 0.001 and P = 0.042, respectively), respectively. However, the CSA of the semispinalis capitis muscle did not differ significantly between the two groups. In terms of the level, conservation of the multifidus muscle was significantly different according to the approach at all levels, and the conservation of the deep extensor muscles was significantly different at the C3-4 level. Conclusions MPA was effective in preserving the volume of deep cervical extensor muscles and helping minimize postoperative musculoskeletal complications. In addition, muscle preservation was more effective at the C3-4 level.Background Ecchordosis physaliphora (EP) is a congenital, uniformly asymptomatic, hamartomatous lesion of the primitive notochord. Herein we report, to our knowledge, the first credible case report of unprovoked intra-sphenoidal rupture resulting in recurrent pneumocephalus and cerebrospinal fluid (CSF) leak, definitively captured over serial imaging during clinical and radiologic surveillance. Case description A 68-year old woman with Marfan syndrome presented to the Emergency Department with the worst headache of life. Imaging demonstrated extensive pneumocephalus and revealed a small, dorsal midline clival lesion consistent with EP and a trans-sphenoidal defect. Remote imaging encounters confirmed typical EP without pneumocephalus or cortical defect, and an uneventful clinical course years preceding presentation. Over the ensuing months during neurosurgical follow-up, the patient reported recurrent headaches, imbalance, and unprovoked clear rhinorrhea. Further imaging demonstrates an apparently enlarging the first documented spontaneous rupture of EP resulting in recurrent pneumocephalus, credibly captured over serial radiologic surveillance. Clinical presentation A 68 year-old woman with history of hypertension, hyperlipidemia, and Marfan syndrome presented to the Emergency Department reporting the "wo

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