Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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The aim of this study was to demonstrate the techniques of modified lateral lumbar interbody fusion and investigate its approach related complications. Fifty-two patients underwent with modified lateral lumbar interbody fusion (LLIF) in our center were studied retrospectively. There were 20 males and 32 females, aged from 45 to 82 years old (averaged at 66.0 ± 11.2). ⋯ Only one case had residual numbness in anterior thigh at the last follow-up. The incidence rate of complications increased significantly in patients underwent three or more levels interbody fusion compared to patients underwent one or two levels interbody fusion (X2 = 5.163, P = 0.023). The modified lateral lumbar interbody fusion may reduce the approach related complications of traditional lateral lumbar interbody fusion through the operation under the direct visualization, the improved transpsoas approach and the novel designed retractor.
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Antiplatelet therapy at the time of spontaneous intracerebral hemorrhage (sICH) may increase risk for hemorrhage expansion and mortality. Current guidelines recommend considering a single dose of desmopressin in sICH associated with cyclooxygenase-1 inhibitors or adenosine diphosphate receptor inhibitors. Adult subjects with sICH and concomitant antiplatelet therapy admitted to a large, tertiary care center were included. ⋯ Multiple logistic regression controlling for significant covariates did not reveal a significant effect of desmopressin on relative or absolute hematoma expansion (OR 0.65 [95% CI 0.18-2.43] and OR 1.55 [0.48-4.99], respectively). We failed to find evidence that desmopressin administration for antiplatelet reversal in sICH reduces the incidence of hematoma expansion. Larger studies, focusing on the early phase of sICH, are needed to characterize the clinical efficacy and safety of desmopressin for antiplatelet reversal before widespread implementation.