Neurosurgery
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Multicenter Study
Culture of olfactory ensheathing cells for central nerve repair: the limitations and potential of endoscopic olfactory mucosal biopsy.
Autotransplantation of olfactory ensheathing cells (OECs) into the damaged central nervous system is a potential therapeutic strategy for spinal cord and root cord injuries. One limiting factor has been the poor OEC yields from human mucosal biopsies. Previous studies have only commented on their success in obtaining mucosal specimens containing olfactory mucosa, but have not commented on the yield of OECs from those specimens. ⋯ We have provided evidence that biopsies closer to the cribriform plate can produce larger yields of OECs, and that patient factors like age and mucosal disease adversely affect the culture yield.
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Randomized Controlled Trial
Autologous iliac bone graft with anterior plating is advantageous over the stand-alone cage for segmental lordosis in single-level cervical disc disease.
Anterior cervical discectomy and fusion (ACDF) with autologous iliac bone graft and plating has been a standard surgical method for single-level cervical disc disease. The stand-alone cage was introduced to reduce graft-related morbidity. However, problems due to focal kyphosis at the operated level have been on the rise. It has been difficult to derive a conclusive answer from previous studies for the indications of each method. ⋯ The stand-alone cage and autologous bone graft with plating had similar clinical outcomes, but stand-alone cage fusion may be disadvantageous from a radiological viewpoint.
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Randomized Controlled Trial
Effect of severity of rod contour on posterior rod failure in the setting of lumbar pedicle subtraction osteotomy (PSO): a biomechanical study.
Rod failure has been reported clinically in pedicle subtraction osteotomy (PSO) to correct flat back deformity. ⋯ Results suggest that in the setting of PSO, the fatigue life of posterior spinal fixation rods depends largely on the severity of the rod angle used to maintain the vertebral angle created by the PSO and is significantly lowered by rod contouring.
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Comparative Study
Results of stent-assisted vs non-stent-assisted endovascular therapies in 489 cerebral aneurysms: single-center experience.
Whether the addition of stenting to intracranial aneurysm coil embolization results in benefit in terms of occlusion rates or additional risk in terms of periprocedural adverse events is not clear. ⋯ Stent-assisted aneurysm treatment resulted in higher total occlusion rates than non-stent-assisted treatment, with acceptable, comparable periprocedural event rates.
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Endovascular coil embolization of ruptured aneurysms is performed under general anesthesia at most centers for perceived improved image quality and patient safety. ⋯ In the authors' experience, conscious sedation with local anesthetics for endovascular treatment of ruptured intracranial aneurysms is feasible and safe in most patients with low-grade SAH. It may allow direct evaluation of the patient's neurological status, potentially leading to earlier detection and response to intraprocedural complications.