Neurosurgery
-
Review
Prognostic Factors in Patients With Spinal Chordoma: An Integrative Analysis of 682 Patients.
The low incidence of spinal chordoma precludes a prospective study of prognostic factors with a large patient cohort. ⋯ In patients with spinal chordoma, young age, location in sacral spine, dedifferentiated pathology, and chemotherapy were negative predictors of PFS, while young and old age, bladder or bowel dysfunction at presentation, dedifferentiated pathology, recurrence or progression, and metastases portended a worse OS.
-
Reoperation has been increasingly utilized as a metric evaluating quality of care. ⋯ In this national analysis, unplanned cranial reoperation was primarily associated with operative indices, rather than preoperative characteristics, suggesting that reoperation may have some utility as a quality indicator. However, hypertension and thrombocytopenia were potentially modifiable predictors of reoperation.
-
Revascularization for moyamoya disease (MMD) effectively prevents future ischemic events. However, small subsets of patients with persistent or new symptoms due to inadequate collateralization require repeat revascularizations. ⋯ Repeat revascularization can safely and effectively prevent future ischemic events. Indirect bypass has a higher rate of repeat revascularization than direct bypass.