World Neurosurg
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It remains unclear whether fusion for lumbar degenerative disc disease with positive discography produces better outcomes compared with nonoperative treatment. The aim of this study was to compare outcomes of patients with discography-concordant lumbar degenerative disc disease electing for fusion versus nonoperative treatment. ⋯ Comparison of long-term outcomes for patients with back pain and concordant discography did not demonstrate a significant difference in outcome measures of pain, health status, satisfaction, or disability based on whether the patient elected for fusion or nonoperative treatment.
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Clinical Trial
Increased survival using delayed gamma knife radiosurgery for recurrent high-grade glioma: a feasibility study.
The current study retrospectively assessed delayed gamma knife radiosurgery (GKRS) in the management of high-grade glioma recurrences. ⋯ The current study shows a survival benefit for high-grade glioma recurrences when GKRS was administered after standard therapy. This is a relevant improvement compared with earlier studies that had had not been able to provide a beneficial effect timing radiosurgery in close vicinity to EBRT.
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Review Case Reports
Endoscopic resection of a giant intradural retroclival ecchordosis physaliphora: surgical technique and literature review.
To report the first complete resection of a giant ecchordosis physaliphora using an endoscopic transclival approach and to provide a current review of the literature. ⋯ An endoscopic endonasal transclival approach provided a direct, minimally invasive route for safe and complete resection of this rare prepontine tumor, as it has for similarly located skull base chordomas. Our experience highlights the utility of endoscopy in visualization of both pathologic entities and nearby critical neurovascular structures in the management of ecchordosis physaliphora and other cranial base neoplasms.
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Comparative Study
Skull base chordoma and chondrosarcoma: influence of clinical and demographic factors on prognosis: a SEER analysis.
Chordomas and chondrosarcomas are rare skull base tumors, with similar radiographic and clinical presentations. We investigated factors influencing long-term survival in these 2 tumors using the Surveillance Epidemiology and End Results (SEER) database. ⋯ Consistent with previous case series, skull base chordomas have significantly worse prognosis than chondrosarcomas. Patients in the SEER database had worse survival overall compared with existing case series for both chordomas and chondrosarcomas, suggesting selection bias in the existing literature.
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To adapt a study exploring the needs of neurosurgery patients in a tertiary care hospital in Canada to examine, for the first time, the perspectives of neurosurgery patients in a low-income country with limited health care resources. ⋯ Qualitative research methodology in neurosurgery can be successfully adapted from resource-abundant to resource-poor contexts. In low-income countries, patients are faced with limited options for self-education and self-empowerment, and fatalistic and paternalistic attitudes may be prevalent. Local cultural values and expectations can influence practice differently than they do in resource-rich countries.