World Neurosurg
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Comparative Study
Comparison of Patient Outcomes and Cost of Overlapping versus Non-overlapping Spine Surgery.
Overlapping surgery recently has gained significant media attention, but there are limited data on its safety and efficacy. To date, there has been no analysis of overlapping surgery in the field of spine. Our goal was to compare overlapping versus nonoverlapping spine surgery patient outcomes and cost. ⋯ Overlapping spine surgery may be performed safely at our institution, although continued monitoring of patient outcomes is necessary. Overlapping surgery does not lead to greater hospital costs.
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Case Reports
Management of iatrogenic direct carotid cavernous fistula occurring during endovascular treatment of strokes.
Traumatic carotid cavernous fistula may occur as a complication of endovascular treatment of acute stroke. We report 3 cases of such lesions. ⋯ One patient became symptomatic with right eye proptosis, chemosis, and right lateral gaze diplopia 3 weeks post thrombectomy. He underwent endovascular embolization via transfemoral transvenous approach via the inferior ophthalmic vein.
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Neuroendoscopy is useful for assessing status of perforators, parent arteries, and aneurysms beyond the straight line of microscopic view during aneurysm clipping. We aimed to evaluate the clinical usefulness of our endoscopic indocyanine green angiography (ICGA) system, which can simultaneously display visible light and indocyanine green fluorescent images. ⋯ The endoscopic ICGA system with dual imaging of visible light and indocyanine green fluorescence was very useful for assessing geometry of aneurysms and surrounding vessels before clipping and for evaluating completeness of clip position after clipping.
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Multicenter Study
Ryanodine receptor 1 polymorphism is not associated with aneurysmal subarachnoid hemorrhage or its clinical sequelae.
The pathophysiologic mechanisms underlying cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) remain poorly understand. Ryanodine receptors (RYR) are intracellular calcium channels involved in the regulation of vascular smooth muscle cells and cerebrovascular tone and diameter. Previous work reported an association between an RYR polymorphism and cerebral vasospasm. Here, we sought to assess the impact of that RYR polymorphism on aSAH and its clinical sequelae. ⋯ Contrary to a previous report, the RYR1 SNP rs35364374 was not associated with aSAH or its clinical sequelae.
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Controlled Clinical Trial
Clinical and radiological findings after multilevel cervical total disc replacement: defining radiological changes to predict surgical outcomes.
This study compared the radiologic parameters between preoperation and postoperation for patients who underwent multilevel cervical total disk replacement (MCTDR) and assessed which parameters were related to successful clinical outcomes after MCTDR. ⋯ MCTDR was effective in reducing pain and improving cervical lordosis in patients with multilevel cervical disk herniation or stenosis. Despite a significant decrease in the flexion angle, it could maintain C2-7 ROM presumably by compensating with C2-7 extension angle increase. Clinical success after MCTDR was crucially related to retaining original C2-7 ROM and minimizing ROM angular changes at both the C2-7 and MCTDR levels.