World Neurosurg
-
Cost-effectiveness analysis of deep brain stimulation in patients with Parkinson's disease in Japan.
Deep brain stimulation (DBS) is an effective surgical option for treating Parkinson's disease (PD). DBS is invasive, with a high initial cost. In Japan, questions have been raised about its cost-effectiveness and the resulting improvements in outcome. The aim of this study was to evaluate the cost-effectiveness of DBS for PD in Japan, particularly whether early or late DBS is more cost-effective. ⋯ Our model suggests that DBS is cost-effective in the Japanese health care system. DBS is more cost-effective if performed in the intermediate rather than early or late stages of PD.
-
Review Case Reports
Use of Intramedullary K-wire to Enhance Fibular Graft Placement in 4-level Thoracolumbar Corpectomy for Pott's Disease: Case Report and Review of Literature.
Reports of tuberculosis involving ≥4 contiguous spinal levels are rare. Surgery is often required in this population for neurological decompression and stabilization. These patients appear to be particularly predisposed to complications that include incomplete recovery of neurological function after decompression as well as post-treatment kyphosis. In settings with limited available instrumentation, reconstruction of the anterior column can be challenging. ⋯ At follow-up five-and-a-half months after the operation, the patient had recovered full strength and was ambulating without difficulty. Imaging at this time demonstrated stable restoration of alignment without graft dislodgement. Intramedullary fibular K-wire placement in this procedure helped to optimize anterior column reconstruction. The principles used in this report may prove beneficial to surgeons in developing countries who encounter pathology of this extent.