World Neurosurg
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The purpose of this study was to analyze the outcomes and complications of the endoscopic endonasal approach (EEA) performed on patients with Cushing disease at our Pituitary Center during the past 11 years. ⋯ The EEA for Cushing disease resulted in remission and complication rates comparable with previous analyses of EEA, as well as microsurgical series. Preoperative adrenocorticotropic hormone levels were associated with invasiveness.
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To study clinical outcome of giant intracranial aneurysms (diameter ≥25 mm) treated with different surgical modalities and to analyze factors affecting prognosis. ⋯ Giant intracranial aneurysms are effectively treated with craniotomy and surgical treatment. Older age, aneurysm location in posterior circulation, and higher Hunt and Hess grade are risk factors affecting prognosis.
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Flow diversion has become a popular treatment option for a variety of cerebral aneurysms. We sought to compare conscious sedation and general anesthesia for flow diverter placement in a matched cohort study. ⋯ Placement of a flow diverter can be safely performed under conscious sedation and is associated with reduced procedure length. The ideal candidate is cooperative, requires an intervention that is not too complex, and has an experienced operator performing the intervention.
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The primary treatment strategy for chronic atlantoaxial rotatory fixation (chro-AARF) is traction followed by bracing or application of a halo device. However, to complete these conservative therapies, patient cooperation is mandatory. If conservative therapy fails, surgery is required for reduction and prevention of recurrence. It has been considered that surgery for atlantoaxial rotatory fixation necessitates solid bony fusion. However, once bony fusion is achieved, loss of range of motion is problematic. Here, we report a patient with chro-AARF who was successfully treated with temporary internal fixation using a C1 lateral mass screw and C2 pedicle screw (Goel-Harms technique) without any grafting of bone or use of bone substitute materials. ⋯ When conservative therapy cannot be continued, Goel-Harms surgery as a temporary internal fixator without bone grafting might be a suitable alternative for selected patients with chro-AARF.
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Oblique lumbar interbody fusion is a commonly used surgical method of achieving lumbar interbody fusion. There have been some reports about complications of oblique lumbar interbody fusion at the L2-L3 level. However, to our knowledge, there have been no reports about ureter injury during oblique lumbar interbody fusion. We report a case of ureter injury during oblique lumbar interbody fusion to share our experience. ⋯ Our study shows that a low threshold of suspicion of ureter injury and careful manipulation of retroperitoneal fat can be helpful to prevent ureter injury during oblique lumbar interbody fusion at the upper level.