Journal of neurological surgery. Part A, Central European neurosurgery
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J Neurol Surg A Cent Eur Neurosurg · Jul 2015
The Fate of Type II Odontoid Fractures after Posterior Atlantoaxial Fusion: Where Does Healing Occur?
Anderson and D'Alonzo type II odontoid fractures often require surgical intervention. Our goal was to understand the pattern of healing in patients who had a posterior atlantoaxial fusion for a type II odontoid fracture. ⋯ There is a high rate of fusion across the fracture site of a type II odontoid fracture after posterior atlantoaxial fixation. In young patients with acute type II fractures who are not candidates for anterior screw fixation, posterior atlantoaxial instrumentation without fusion may be sufficient for fracture healing, thus allowing for the possibility of implant removal and preservation of C1-C2 motion.
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J Neurol Surg A Cent Eur Neurosurg · May 2015
Effect of insurance and racial disparities on outcomes in traumatic brain injury.
We evaluated outcome and resource utilization disparities between commercially insured, Medicaid, and Medicare patients. We further analyzed racial disparities in a subset cohort. ⋯ Insurance and racial disparities continue to exist for TBI patients. Insurance status appears to have an impact on short- and long-term outcomes to a greater degree than patient race.
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J Neurol Surg A Cent Eur Neurosurg · May 2015
Multicenter StudyEffect of anular closure on disk height maintenance and reoperated recurrent herniation following lumbar diskectomy: two-year data.
To assess the potential benefits of disk reherniation reduction and disk height maintenance in limited diskectomy combined with the implantation of the anular closure device. ⋯ Limited lumbar diskectomy combined with the use of an anular closure device provided very low rates of disk reherniation and exhibited excellent disk height maintenance and sustained disability, leg pain, and back pain improvement within a 24-month postoperative study period. As with prior diskectomy studies, disk height maintenance was correlated with lower nucleus removal, although recurrence was less than in prior reports of limited diskectomy. Anular closure may allow for achievement of both objectives.
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J Neurol Surg A Cent Eur Neurosurg · May 2015
Long-term outcome after adjacent two-level anterior cervical discectomy and fusion using stand-alone plasmaphore-covered titanium cages.
Reports on long-term outcome of stand-alone contiguous two-level anterior cervical discectomy and fusion (ACDF) using stand-alone Plasmaphore-coated titanium cages (PCTCs) are rare, and data on follow-ups > 3 years are missing. ⋯ Stand-alone contiguous two-level ACDF using PCPT proved to be effective, yielding good long-term clinical and functional outcomes. The relatively high rate of subsidence did not affect the good clinical and functional long-term outcome.
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J Neurol Surg A Cent Eur Neurosurg · May 2015
Transcranial electric stimulation for intraoperative motor evoked potential monitoring: dependence of required stimulation current on interstimulus interval value.
To evaluate the relationship between stimulus intensity by constant current transcranial electric stimulation and interstimulus interval (ISI) for eliciting muscle motor evoked potentials (MEPs) in three different hand muscles and the tibialis anterior muscles. ⋯ In adult neurosurgical patients with a normal motor status, a train of 5 pulses and an ISI of 3 ms provide the lowest motor thresholds. We provided evidence of the dependence of required stimulation current on ISI.