Neurosurgery
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Many patients with unruptured intracranial aneurysms (UIAs) remain untreated if the risk of treatment exceeds the estimated risk of aneurysm rupture, potentially leading to diagnosis-related stress and anxiety. Working status may serve as a marker for the total level of function including mental health and psychological burden of the condition. The aim of the study was to assess the working status before and after a diagnosis of an untreated UIA. ⋯ The work participation of patients diagnosed with UIA is low prediagnosis compared with the general population and decreases significantly postdiagnosis.
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Single-position prone transpsoas (PTP) lateral interbody fusion has been proposed as an alternative to lateral lumbar interbody fusion performed in the lateral decubitus position. The advantages to this single-position technique include facilitating segmental lordosis, obviating the need for repositioning for posterior instrumentation, and providing access for posterior decompression. ⋯ This review provides a detailed technical description of the PTP technique at L4-L5. In addition, we provide technical pearls aimed at improving surgical ergonomics, workflow, and safety.
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Anterior lumbar interbody fusion (ALIF) is an established surgical approach for spinal fusion, offering distinct advantages in restoring lumbar lordosis, indirectly decompressing neural elements, and facilitating high fusion rates because of the increase in the fusion surface area. Traditionally, ALIF is performed with the patient in a supine position, necessitating repositioning for additional posterior interventions, which increases operative time, anesthetic time, and complexity. The recent development of single position lateral ALIF (SPL-ALIF) enables anterior and posterior access without repositioning, enables gravity facilitated retroperitoneal access, and optimizes surgical efficiency, particularly in cases necessitating multilevel anterior column fusion. ⋯ The technique may be less effective in cases requiring direct decompression or in patients with complex vascular anatomy or extensive retroperitoneal scarring. These challenges necessitate careful patient selection to optimize outcomes and minimize intraoperative risks. Future studies are warranted to validate the clinical benefits of SPL-ALIF, particularly concerning fusion rates, patient-reported outcomes, and complication profiles, thereby solidifying its role in the evolving landscape of minimally invasive spine surgery.
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Multicenter Study Observational Study
Safety and Efficacy of Management for Intraprocedural Rupture During Endovascular Treatment for Intracranial Aneurysms.
Although intraprocedural rupture (IPR) is rare, it is a devastating complication of endovascular treatment (EVT) for intracranial aneurysms. Very few studies have been conducted on IPR, and the safety and efficacy of management techniques of IPR have not been investigated. ⋯ Although the setting of IPR may be miscellaneous, and optimal management varies depending on individual cases, heparin reversal might be associated with ischemic complications, and its role in the successful hemostasis in IPR during EVT for ruptured aneurysms remains unclear.
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Review
Beyond Pedicle Screw Placement: Future Minimally Invasive Applications of Robotics in Spine Surgery.
Advancements in spine surgery have dramatically enhanced minimally invasive techniques, prominently through integrating robotic systems. Although pedicle screw placement remains the most widespread application of this technology, new developments are emerging to create innovative future avenues for these tools. ⋯ We also discuss the potential for integrating artificial intelligence and augmented reality with robotic systems. If the current trajectory of research and innovation continues, there is promise in creating fully autonomous robotic systems that can revolutionize spine surgery by processing, planning, and performing procedures without heavy reliance on the surgeon.