World Neurosurg
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Comparative Study
Inertial measurement unit-assisted implantation of thoracic, lumbar, and sacral pedicle screws improves precision of a freehand technique.
A method applying inertial measurement units (IMUs) was developed to implant pedicle screws in the thoracic and lumbosacral spine. This was compared with a freehand technique. ⋯ IMU-assisted implantation of pedicle screws may enhance the performance of a freehand technique in the thoracic and lumbosacral spine.
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Long-term outcome of brachial plexus re-implantation after complete brachial plexus avulsion injury.
Complete brachial plexus avulsion injury is a severe disabling injury due to traction to the brachial plexus. Brachial plexus reimplantation is an emerging surgical technique for the management of complete brachial plexus avulsion injury. ⋯ Our results demonstrate a definite but limited improvement in motor and sensory recovery after reimplantation surgery in patients with complete brachial plexus injury. We hypothesize that further improvement may be achieved by using regenerative cell technologies at the time of repair.
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Decompressive craniectomy is performed to relieve intracranial pressure as an emergency procedure. There is no large study to systematically evaluate the benefit of decompressive craniectomy versus best medical therapy. This study evaluates the survival and long-term functional outcomes of decompressive craniectomy for spontaneous intracranial hemorrhage. ⋯ We showed that decompressive craniectomy significantly improved survival compared with medical treatment with lasting benefits. This improvement came at a cost of increased length of hospital stay and related adverse events. There was no improvement in functional outcome.
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Various diseases can occur in the sellar and suprasellar regions. The potential of [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) for the preoperative evaluation of sellar and parasellar lesions was investigated. ⋯ FDG PET is useful for the preoperative diagnosis of sellar and parasellar macrolesions. High uptake in nonfunctioning pituitary adenoma, and low uptake in chordoma are significant. The difference in FDG uptake dependent on the histologic subtype may be related to the specific genetics of the craniopharyngioma subtype.
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Navigated transcranial magnetic stimulation (nTMS) is increasingly being used for mapping of various brain functions and in nTMS-based tractography in neurosurgical departments worldwide. When a department begins using nTMS data in the clinical workflow, smooth integration into the hospital's existing infrastructure is mandatory. Standardized approaches for this beyond the mapping or tractography procedures themselves have not yet been described. ⋯ Optimized integration of nTMS data can be achieved using a standardized workflow. The seamless integration and availability of nTMS data are crucial to the acceptance of these data in the clinical routine. This optimized workflow can serve as a guide for centers beginning to use nTMS data in patient care.