J Neurosurg Sci
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Studies in the literature with specific information concerning the neuropsychological alterations in patients with high and low grade gliomas are poor. The aim of the present study was to investigate and compare the cognitive functioning in patients with high and low-grade glioma pre- and postoperatively. ⋯ These findings demonstrated different levels of impairments in executive and memory domains and in processing speed in patients with low and high grade gliomas. These deficits may have a strong impact on quality of life. Psychiatric interventions may be useful for patients and their families; in particular for helping the patient to become aware of the illness, in bolstering coping strategies, and for facilitating their support at home.
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Surgical approaches to the thoracic spine have evolved in recent decades with the development of advanced instrumentation techniques and an increased emphasis on reducing surgical morbidity. Multiple methods to access this area have been described, from a conventional open to a more minimally invasive approach, such as anterior-based, via supra- or transmanubrium, via thoracoscopy, lateral-based approach, extreme lateral mini-thoracotomy, and dorsolateral approaches, transpedicular, costotransversectomy and the lateral extracavitary access. The technique used is often determined by the affected spinal level, pathological process, and surgeon preference. ⋯ Over time, these techniques have undergone improvement to limit approach-related morbidity and minimize soft tissue dissection, resulting in better patient outcomes. These different approaches present distinct advantages and disadvantages for which a thorough understanding of the regional anatomy is required to avoid approach-related complications. For these reasons, surgeon experience and confidence in the various techniques are major factors in the decision-making process and patient outcomes.
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Low back pain (LBP) is a common disorder with a lifetime prevalence of 85%. The pathophysiology of LBP can be various depending on the underlying problem. Only in about 10% of the patients specific underlying disease processes can be identified. ⋯ There are no studies done on the subject MIS and low back pain solely. Deriving answers from the difference in VAS back pain in MIS studies reveal a 100% improvement of back pain after surgery. But that does not imply that this procedure, which is still in its childhood, will be the solution to all low back pain patients.