Neurosurgery
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Sagittal plane realignment is critical to achieve desirable clinical outcomes in adult spinal deformity (ASD). Increasingly minimally invasive (MIS) techniques are being used to treat ASD. This study's objective was to evaluate circumferential MIS (cMIS) techniques and their ability to treat sagittal plane imbalance. ⋯ MIS techniques successfully treated patients with Scoli and "+" deformities with improved HRQoL. Patients with "++" showed less improvement clinically, and, as a sequela of fusion surgery, were left with a fixed sagittal plane deformity. These results suggest that with severe sagittal plane deformities, an open rather than MIS approach should be considered.
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Diffusion magnetic resonance (dMR) imaging is widely used in clinical practice and captures a distinct molecular/cellular features of tumor tissue. The aim of this study is to correlate pretreatment tumor Apparent Diffusion Coefficient (ADC), measured by dMR imaging with overall survival in patients with glioblastoma and determine its association with gene signatures. ⋯ We demonstrate that dMR characteristics can identify highly significant survival differences and specific genomic signatures.
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Meningiomas account for approximately one-third of brain tumors. Median length of stay (LOS) is 5 days with total charges equaling approximately $55 000. Early rehabilitation improves the functional outcome for patients after surgery. The primary goal was to analyze LOS as a direct result of surgical date and to characterize the individual variables that may impact hospital course, early access to rehabilitation, and long-term functional status. ⋯ Day of surgery plays a significant role in LOS for meningioma patients. Clinicians should remain aware of factors that may delay optimal patient discharge and early access to rehabilitation facilities. Studies are needed to assess the social variables that may affect LOS and the clinical and financial implications for extended hospital courses.
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The availability of stents has widened the indications of endovascular intervention for cerebral aneurysms. ⋯ In this propensity score-matched analysis, stent implantation reduced the overall recanalization of the coiled cerebral aneurysms. However, the use of stents should be carefully decided upon.
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Moyamoya is a rare disease, and thus there have been few published studies with sufficient power for outcomes analyses of bypass surgery performed in the modern era. ⋯ Increased length of stay, increased number of procedures done in-hospital, and the presence of certain comorbidities were associated with a higher incidence of complications among pediatric patients undergoing bypass surgery for Moyamoya disease.