Neurosurgery
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Multicenter Study
After 9 Years of 3-Column Osteotomies, Are We Doing Better? Performance Curve Analysis of 573 Surgeries With 2-Year Follow-up.
In spinal deformity treatment, the increased utilization of 3-column (3CO) osteotomies reflects greater comfort and better training among surgeons. This study aims to evaluate the longitudinal performance and adverse events (complications or revisions) for a multicenter group following a decade of 3CO. ⋯ Over 9 yr, 3COs are being performed on an increasingly disabled population while gaining a greater correction at the osteotomy site. Revisions and complication rate decreased while success rate improved during the 2-yr follow-up period.
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Early brain injury (EBI) after subarachnoid hemorrhage (SAH) is an important determinant of clinical outcomes. However, a major hindrance to studies of EBI is the lack of radiographic surrogate marker. ⋯ SEBES may be a surrogate marker of EBI and predicts DCI and clinical outcomes after SAH.
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Acute spinal cord injury (SCI) is managed by avoiding hypotension and elevating mean arterial pressure (MAP) to attain optimal perfusion of the spinal cord. Few studies have been published regarding complications related to this treatment paradigm. ⋯ PRES is a potential complication of elevated MAPs in patients with SCI, particularly if the blood pressure rises above the goals of standard treatment paradigms. The neurosurgical staff should be suspicious of possible PRES early in the course of acute SCI in patients with unexplained neurological decline. This case series is the first report of PRES in patients with acute SCI.
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Overlapping surgeries have recently become a controversial topic. ⋯ These results reject the hypothesis that overlapping surgeries are predictive of worse outcomes. When considered in the context of the current debate regarding overlapping surgeries, these results argue against claims that overlapping surgeries are dangerous or harmful to patients.
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Anorexia nervosa (AN) is one of the most challenging psychiatric disorders to treat. The poor clinical outcomes warrant novel treatments for AN, especially in severe and persistent cases. ⋯ Capsulotomy enabled patients with refractory AN to normalize their weight, especially those in life-threatening conditions. While it appears to be an acceptable life-saving treatment, it is indicated only when fulfilling strict criteria given its complications and irreversibility.