World Neurosurg
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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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Deep brain stimulation (DBS) of the anterior cingulate cortex (ACC) is a recent technique that has shown some promising short-term results in patients with chronic refractory neuropathic pain. Three years after the first case series, we assessed its efficacy on a larger cohort, with longer follow-up. ⋯ Follow-up results confirm that ACC DBS alleviates chronic neuropathic pain refractory to pharmacotherapy and improves quality of life in many patients.
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To evaluate accuracy of a computed tomography (CT)-guided frameless stereotactic drilling and catheter system. ⋯ Highly accurate catheter placement is achievable using this novel flexible catheter and bone anchor system placed via frameless stereotaxy, with an average deviation between planned and actual target point of 1.60 mm ± 0.98 (1.40 mm, 0.40-4.00 mm).
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The use of an external ventricular drain is required for the treatment of many diseases, such as traumatic brain injury and subarachnoid hemorrhage (SAH). Meningitis and ventriculitis are frequent complications arising from the use of external ventricular drain therapy. This study aimed to determine the sensitivity, specificity, and cutoff point for cell index (CI) in patients with traumatic brain injury, SAH, and hemorrhagic stroke. ⋯ Therefore, CI is valuable for the diagnosis of infection, but was inadequate for monitoring treatment. We hope to use the new cutoff point proposed by this study in our institution to improve patient clinical outcome.
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Traumatic brain injury (TBI) in older patients is becoming an increasing problem, and methods that help predict outcomes in this population are needed. The objective of this study was to evaluate skeletal muscle mass as a predictive marker for TBI outcome in older patients. ⋯ Reduced skeletal muscle mass was associated with poorer outcome after TBI in our cohort of older patients. Our results suggest that identifying patients with low muscularity may contribute to better stratification in this population.