World Neurosurg
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Quality of neurosurgical care and patient outcomes are inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. Neurosurgical laboratory-based cadaveric training is essential for the development and refinement of technical skills before their use on a living patient. Recent biotechnological advances including 3-dimensional (3D) microscopy and endoscopy, 3D printing, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging have proved to reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills in neurosurgical training. ⋯ Each workstation is equipped with a 3D surgical microscope, 3D endoscope, surgical drills, operating table with a Mayfield head holder, and a complete set of microsurgical tools. The laboratory also houses a neuronavigation system, a surgical robotic, a surgical planning system, 3D visualization, virtual reality, and computerized simulation for training of surgical procedures and visuospatial skills. In addition, the laboratory is equipped with neurophysiological monitoring equipment in order to conduct research into human factors in surgery and the respective roles of workload and fatigue on surgeons' performance.
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To compare the outcomes between patients older and younger than 65 years who underwent single-level minimally invasive transforaminal interbody fusion (MI-TLIF) surgery. ⋯ MI-TLIF presented similar safeness and acceptable outcomes and complication rate in both groups. Cyst formation may be aggravated by cage subsidence, because cage subsidence was a useful potential predictor of cyst formation.
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Comparative Study
Design-based Comparison of Spine Surgery Simulators: Optimizing Educational Features of Surgical Simulators.
Simulation-based education has made its entry into surgical residency training, particularly as an adjunct to hands-on clinical experience. However, one of the ongoing challenges to wide adoption is the capacity of simulators to incorporate educational features required for effective learning. The aim of this study was to identify strengths and limitations of spine simulators to characterize design elements that are essential in enhancing resident education. ⋯ Stakeholders from trainees to experts acknowledge the growing role of simulation-based education in spine surgery. However, different simulation modalities have varying design elements that augment learning in distinct ways. Characterization of these design characteristics will allow for standardization of simulation curricula in spinal surgery, optimizing educational benefit.
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Arteriovenous malformation surgery is particularly demanding owing to the need to control bleeding of small, deep white matter vessels during and after removal of the nidus; this is probably one of the most critical moments of arteriovenous malformation surgery. The aim of this article is to describe a useful technique based on the use of tweezers to temporarily stop the blood flow followed by coagulation with the thulium laser. ⋯ Results were good with no postoperative complications. Our results could encourage a more standardized use of the described technique.
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Comparative Study
A CT-based Comparison of Abnormal Vertebrae Pedicles between Dystrophic and Nondystrophic Scoliosis in Neurofibromatosis Type 1.
To explore the prevalence and distribution of abnormal vertebral pedicles in scoliosis secondary to neurofibromatosis type 1 (NF1-S) and to compare the abnormal vertebrae pedicles between dystrophic and nondystrophic scoliosis. ⋯ There is a significantly high prevalence of abnormal pedicles in patients with NF1-S and an increased rate of abnormal pedicles in dystrophic scoliosis compared with nondystrophic ones. The described pedicle classification system could serve as an objective tool to guide preoperative assessment.