Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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This retrospective study aimed to compare the patient-reported outcomes and radiographic assessment of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for degenerative spondylolisthesis with reduction versus in situ fusion. Patients receiving MI-TLIF with reduction were assigned as Group A, and those without reduction were assigned as Group B. Radiographic fusion was assessed using Bridwell's grading criteria. ⋯ However, there were no significant differences in JOA, VAS, and ODI between the two groups whenever preoperatively, or 3-month postoperatively, or at the last follow-up (p>0.05). According to MacNab criteria, the excellent and good rate was 85.37% in Group A and 86.49% in Group B (p=0.983). MI-TLIF is an effective and satisfactory surgical technique to manage degenerative spondylolisthesis regardless of reduction or not, so routine reduction may not be a requirement in MI-TLIF for degenerative spondylolisthesis.
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Traumatic atlanto-occipital dislocation (AOD) is an ominous injury with high mortality and morbidity in trauma patients. Improved survival has been observed with advancements in pre-hospital and hospital care. Furthermore, high quality imaging studies are accessible at most trauma centers; these are crucial for prompt diagnosis of AOD. ⋯ We found that patients with TBI are eight times more likely to die than patients without TBI. A high degree of suspicion for AOD during pre-hospital care, as well as, prompt diagnosis and management in the trauma center play a key role in the treatment of this devastating injury. The relationship between survival and factors such as TBI and SCI should be further explored.
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This study aims to compare the advantages and disadvantage of percutaneous endoscopic lumbar discectomy (PELD) and standard discectomy (SD) for the treatment of lumbar intervertebral disc herniation (LDH). We searched in MEDLINE, EMBASE, PubMed, Web of Science and Cochrane databases for relevant trials that compare PELD and SD for the treatment of LDH. The Cochrane Collaboration's Revman 5.3 software was used for data analyses. ⋯ In conclusion, despite PELD showing significant benefit in short term outcomes such as hospital course and mean disability period, similar clinical efficacy and long term outcomes were observed when compared to SD. Therefore, we suggest that PELD can be a feasible alternative to the conventional posterior approach for the LDH depending on surgeon preference and indication. High-quality randomized controlled trials with sufficient large sample sizes necessary further confirm these results.
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The purpose of this study was to explore the inter-device reliability of NPi-100 pupillometers (NeuroOptics, Inc.). The pupillary examination is a fundamental element of the neurological exam. Current evidence suggests that the traditional examination of the pupil with a hand held flashlight has limited inter-rater reliability. ⋯ There was no statistically significant difference between the mean maximum pupil size at rest, the minimum pupil size during light stimulation, and the mean pupil reactivity, for both the right and left eye, when assessed by two investigators, each with a different pupillometer. In addition, Cohen's Kappa assessments of pupil size and reactivity revealed an almost perfect agreement between the two pupillometers for the maximum pupil size, the minimum pupil size, and for pupil reactivity for both eyes. There is a high inter-device reliability of automated pupillary assessments by two practitioners examining the same patient using different NPi-100 pupillometers.
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The authors retrospectively analyzed cyst formations and expanding haematomas (EHs) that developed after Gamma Knife surgery (GKS) for arteriovenous malformations (AVMs), and evaluated the treatment results of these lesions. Cyst formations and/or EHs which developed after GKS for AVMs were identified in 20 patients (5.0%) out of 404 patients who underwent this procedure. There were nine patients with cyst formations, two with EHs and nine with cyst formations with EHs. ⋯ There was no recurrence of the lesions in all the patients that underwent a craniotomy. In the patient treated with a cyst aspiration, regrowth of the cyst formation occurred. Surgical treatment should be considered for symptomatic lesions and we recommend total removal of the angiomatous lesions to achieve a complete cure.