Neurosurgery
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Multicenter Study
Predictors of Discharge to a Nonhome Facility in Patients Undergoing Lumbar Decompression Without Fusion for Degenerative Spine Disease.
Patients recovering from decompressive laminectomy without fusion may require assistance with activities of daily living and physical/occupational therapy upon hospital discharge. ⋯ Preoperative status and operative course variables can influence discharge disposition in lumbar decompression patients. Identifying specific factors that contribute to a greater likelihood of dismissal to skilled facility or rehabilitation unit can further inform both surgeons and patients during preoperative counseling and disposition planning.
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Multicenter Study
Treatment of Intracranial Aneurysms With the SILK Embolization Device in a Multicenter Study. A Retrospective Data Analysis.
Flow-diverter technology has become an important stent-based embolization tool in the treatment of complex cerebrovascular pathology. We report here the experience of 4 Spanish centers with using the SILK flow-diverter (SFD) device. ⋯ The SFD device is an effective tool for the treatment of challenging aneurysms, and allows complete occlusion within a year of the procedure in most patients, with morbidity and mortality comparable to those previously reported for similar devices.
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Healthcare resource utilization and patient-reported outcomes (PROs) for intradural extramedullary (IDEM) spine tumors are not well reported. ⋯ Surgical resection of the IDEM provides improvement in patient-reported quality of life, disability, pain, general health, and satisfaction at 1 year following surgery. Furthermore, we report the granular costs of surgical resection and healthcare resource utilization in this population.
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Approximately 17% of ruptured anterior communicating artery (ACoA) aneurysms were deemed unsuitable for coil embolization during the Barrow Ruptured Aneurysm Trial (BRAT), most commonly due to unfavorable dome-to-neck ratio or small size. ⋯ ACoA lesions thought unamenable to endovascular therapy in an earlier randomized trial are now successfully coiled with increased use of adjunctive techniques, without sacrificing patient outcome or treatment durability.
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Previous studies have shown that aneurysmal subarachnoid hemorrhage (aSAH) affects health-related quality of life (HRQoL) to a large extent. However, longitudinal studies on HRQoL after aSAH are scarce, and there is limited knowledge whether different HRQoL dimension scores change over time, and if so, if the scoring differs from results from the general population. ⋯ HRQoL is stationary during the first 2 years following aSAH, and is significantly worse when compared to the general population. Rehabilitation efforts should be initiated shortly after hospitalization.