Surg Neurol
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Failed back surgery syndrome (FBSS) is a condition in which there is failure to improve satisfactorily after back surgery. It is characterized by intractable pain and various degrees of functional disability after lumbar spine surgery. It is estimated that this complication occurs in 5% to 10% of patients after spinal surgeries. The major causes of FBSS are fibrosis and adhesions, spinal instability, recurrent herniated disk, and inadequate decompression. The purpose of this study is to report on the postsurgical outcome after a redo spinal surgery. ⋯ The current study shows that successful management of patients with FBSS could be achieved with proper patient selection, correct preoperative diagnosis, and adequate surgical procedure targeting the underlying pathology.
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A recent randomized trial for ruptured aneurysm resulted in poorer outcomes for the surgical group than the endovascular group. However, the surgical results seemed to be worse than could be expected for experienced neurosurgeons in Japan. We therefore analyzed our own surgical results and evaluated them for a comparison with the trial results. ⋯ Surgical clipping is a safe and reliable treatment and can be the first choice for small ruptured aneurysms of the anterior circulation with a good grade.
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Cerebrospinal fluid (CSF) leaks are widely recognized as commonly occurring postoperative complications of neurosurgical procedures. We will focus on the direct costs associated with CSF leaks in a single center across multiple neurosurgical procedures, based on a retrospective analysis. We will also compare the costs of using a synthetic agent to prevent such leaks with these costs from a more recent study. ⋯ Our analysis establishes that CSF leaks occur with high frequency and incur significant costs across all types of surgical procedures. A direct correlation of this complication (and ensuring costs) is observed with more extensive procedures, and reduction of these significant costs can be achieved by using augmentation of the dural closure with DuraSeal.