World Neurosurg
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Spine surgery relies heavily on imaging, with radiography-based devices being the major operating room imaging modality. Radiation exposure is an occupational risk historically recognized shortly after the discovery of radiation itself. Exposure of both patients and operating room staff is of increasing concern as the knowledge regarding the hazards of radiation is steadily accumulating. ⋯ We discuss the methods to reduce operating room staff exposure to the minimal amount, thus reducing occupational risks. We recognize that increasing awareness to radiation exposure hazards and promoting the knowledge of methods to reduce exposure of surgeons, nurses, and technicians could result in a reduction of exposure to radiation.
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To determine whether complications in lumbar fusion surgery could be estimated from patient factors and perioperative laboratory values. In addition, risk scores for detection of patients prone to complications were defined. ⋯ Patients with postoperative complications and extended LOS seem to show significant differences in various perioperative laboratory values and patient factors. Perioperative risk assessments using cut-off values and risk scores may help identify patients prone to complications and extended resource use.
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To establish an arteriovenous malformation (AVM) grading score for patients with ruptured AVM and associated intracerebral hemorrhage (ICH) to predict clinical outcome. ⋯ Based on the AUROC analysis, the AVICH score predicts outcome of patients with ruptured AVM and associated ICH better than the ICH score, the Spetzler-Martin, or the supplemented Spetzler-Martin grading system. An external validation is needed before the AVICH score is tested in a prospective multicenter cohort.
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Review Meta Analysis Comparative Study
Treatment of middle cranial fossa arachnoid cysts: a Systematic Review and Meta-analysis.
To review the literature and analyze the efficacy and safety of 3 surgical methods (neuroendoscopic fenestration, microsurgical fenestration, and cystoperitoneal shunting) for middle cranial fossa arachnoid cysts (MCFACs). ⋯ All 3 surgical methods are effective for MCFACs, but considering safety, neuroendoscopic fenestration may be the best initial procedure.
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Somatosensory evoked potential (SSEP) monitoring is performed to examine postoperative clinical findings when a monitoring event was noted intraoperatively and to ascertain the alarm threshold for intraoperative neural damage. ⋯ Compared with the traditional SSEP baseline before skin incision, the baseline acquired after spine exposure results in more accurate monitoring. A >60% decrease in SSEP amplitude could be a more suitable alarm threshold.