Neurosurgery
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Risk stratification of epilepsy surgery patients remains difficult. The Risk Analysis Index (RAI) is a frailty measurement that augments preoperative risk stratification. ⋯ The RAI frailty score predicts mortality and NHD after epilepsy surgery. This is accomplished with a user-friendly calculator: https://nsgyfrailtyoutcomeslab.shinyapps.io/epilepsy/ .
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Combination of apical control convex pedicle screws (ACPS) with traditional dual growing rods (TDGRs) had better apex control ability for early-onset scoliosis (EOS); however, there is a paucity of studies on the ACPS technique. ⋯ In this preliminary study, ACPS seems to provide better correction of apex deformity, while attaining the comparable spinal height at 2-year follow-up. Larger cases and longer follow-up are needed to achieve reproducible and optimal results.
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Recurrence after meningioma resection warrants serial surveillance imaging, but little evidence guides the optimal time interval between imaging studies/surveillance duration. ⋯ Recurrence risk after meningioma resection after an initial recurrence-free period is reported, with high-risk subgroups identified. These results can inform objective shared decision-making for optimal follow-up.
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Homelessness is associated with high risk of acute neurotraumatic injury in the ∼600 000 Americans affected on any given night. ⋯ Homeless individuals experience longer hospital stays, more inpatient complications such as myocardial infarction, and more unplanned readmissions after discharge compared with their housed counterparts. These findings combined with limited discharge options in the homeless population indicate that better guidance is needed to improve the postoperative disposition and long-term care of this vulnerable patient population.