Neurosurgery
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Few studies have described rates of proximal clinical adjacent segment pathology (CASP) after posterior cervical decompression and fusion (PCDF). ⋯ Instrumenting to the C2 level reduces the risk for proximal CASP compared to fusion only up to C3. The type of instrumentation used at these 2 levels, form of ASP disease at C1-C2, and natural motion of the relevant proximal adjacent joint may contribute to this difference. Furthermore, within the C3 cohort, fusion across the cervicothoracic junction increased the risk for proximal CASP.
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Skull base meningioma management is complicated by their proximity to intracranial neurovascular structures because complete resection may pose a risk of worsening morbidity. ⋯ Patients undergoing resection of skull base meningiomas and who experience an immediate improvement in EQ-5D are likely to show continued improvement at 1 yr, with improved QALY and reduced cost per QALY.