Neurology India
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Cervical spondylotic myelopathy (CSM) is emerging as the most common cause of spinal cord dysfunction in the elderly worldwide. In the past decade, our understanding of the biomechanics of the spine has improved along with advances in spinal instrumentation and this has led to significant changes in the surgical management of CSM. This review will discuss the indications, advantages and limitations of different operative approaches as well as the complications and prognosis of surgery for cervical spondylotic myelopathy. Choice of surgical approach for CSM should be based on the clinical and radiological characteristics of the individual patient and not on the preferences of the surgeon.
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Comparative Study Clinical Trial
Clinical outcomes of two different types of open-door laminoplasties for cervical compressive myelopathy: a prospective study.
Hirabayashi open-door laminoplasty is the most typical surgical treatment option for cervical compressive myelopathy, however, this conventional approach has many complications. To minimize these complications, many modified approaches have been devised. ⋯ Both the conventional and instrumented techniques provide similar good results but the instrumented technique provided better axial pain relief and lower incidence of perioperative complications.
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Clinical Trial
Application of the Willis covered stent for the management of posttraumatic carotid-cavernous fistulas: an initial clinical study.
To evaluate the feasibility of using the Willis covered stent in the management of patients with traumatic carotid-cavernous fistulas (CCFs). ⋯ This initial experience indicates that the use of the Willis covered stent is a feasible procedure and may be an alternative treatment option for CCFs.
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Clinical Trial
An initial experience with therapeutic drug monitoring of levetiracetam as reported from a pediatric clinical setting in India.
Monitoring of levetiracetam in routine clinical practice is not strongly recommended. The aim of this study was to investigate any difference in serum levetiracetam concentration between patients on enzyme-inducing and -inhibiting antiepileptic co-medication and also to identify any correlation between levetiracetam concentration and clinical response. ⋯ Levetiracetam monitoring has a role in patients on antiepileptic polypharmacy and for confirmation of compliance.
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Patients with Guillain-Barré syndrome (GBS) require assisted ventilation frequently. However, no single factor can predict ventilator requirement. ⋯ Comprehensive assessment of clinical features may predict the need for mechanical ventilation in patients of GBS.