Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jan 2018
ReviewDiagnostic accuracy of magnetic resonance imaging in post-traumatic brachial plexus injuries: A systematic review.
Computed Tomographic Myelography (CTM) is a gold-standard imaging test for evaluating the brachial plexus and has been used for a long time. Another imaging test more recently used is Magnetic Resonance imaging (MRI), which is also part of the plexus evaluation. The purpose of this study was to determine the accuracy of MRI in diagnosing post-traumatic injuries of the brachial plexus. ⋯ The heterogeneity of the studies made it impossible to create meta-analyzes. MRI has been an excellent test for assessing traumatic brachial plexus injuries in clinical practice; however, the quantitative analysis of studies identified a lack in methodological rigor. Future studies should focus on methodological rigor, providing more accurate assessments of modalities and their benefits.
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Clin Neurol Neurosurg · Jan 2018
ReviewPre-optimization of spinal surgery patients: Development of a neurosurgical enhanced recovery after surgery (ERAS) protocol.
Despite surgical, technological, medical, and anesthetic improvements, patient outcomes following elective neurosurgical procedures can be associated with high morbidity. Enhanced recovery after surgery (ERAS) protocols are multimodal care pathways designed to optimize patient outcomes by addressing pre-, peri-, and post-operative factors. Despite significant data suggesting improved patient outcomes with the adoption of these pathways, development and implementation has been limited in the neurosurgical population. ⋯ of this study will guide further efforts to limit post-operative morbidity in patients undergoing elective spinal surgery and to highlight the impact of ERAS care pathways in improving patient reported outcomes and satisfaction.
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Clin Neurol Neurosurg · Jan 2018
Comparative StudyClinical and radiographic comparison of cervical disc arthroplasty with Prestige-LP Disc and anterior cervical fusion: A minimum 6-year follow-up study.
To retrospectively compare the long-term clinical and radiographic outcomes of cervical disc arthroplasty (CDA) with Prestige-LP Disc and anterior cervical discectomy and fusion (ACDF) for single-level cervical degenerative disc disease. ⋯ Both CDA with Prestige-LP Disc and ACDF showed good clinical outcomes at a minimum 6-year follow-up. Compared with ACDF, CDA preserved the motion and reduced the incidence of ASD.
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Clin Neurol Neurosurg · Jan 2018
Relationship of T1 slope with loss of lordosis and surgical outcomes after laminoplasty for cervical ossification of the posterior longitudinal ligament.
T1 slope (T1S) has emerged as a predictor of kyphotic alignment change after laminoplasty. Although it was reported that patients with cervical ossification of the posterior longitudinal ligament (OPLL) and higher T1S had more pronounced lordotic curvature before surgery and higher loss of cervical lordosis after surgery, few studies have attempted to correlate these findings with clinical outcomes. We aimed to investigate the relationship of T1S with loss of cervical lordosis and surgical outcomes after laminoplasty for cervical OPLL. ⋯ Although the degree of alignment compromise is correlated with the preoperative T1S, clinical outcomes demonstrate overall improvement after cervical laminoplasty with cervical OPLL, regardless of preoperative T1S.
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Clin Neurol Neurosurg · Dec 2017
Restrictive transfusion threshold is safe in high-risk patients undergoing brain tumor surgery.
To assess the safety of a restrictive threshold for the transfusion of red blood cells (RBCs) compared to a liberal threshold in high-risk patients undergoing brain tumor surgery. ⋯ A restrictive transfusion threshold did not significantly influence in-hospital mortality or complication rates, length of stay, or discharge disposition in patients at high operative risk.