World Neurosurg
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Randomized Controlled Trial Comparative Study
Preoperative Planning of Lateral Entry Point is Necessary in Percutaneous Lumbar 5th Vertebroplasty.
To compare treatment outcomes and complications between the computer-assisted preoperative planning of lateral entry approach and the traditional approach for L5 percutaneous vertebroplasty. ⋯ Owing to the hemispherical morphology and convergent pedicle axis of the L5 vertebrae, a more lateral skin entry point and convergent angle of the puncture needle should be emphasized to reach the optimal point according to the preoperative assessment. The approach involving computer-assisted preoperative planning of the lateral entry point was associated with a higher rate of bilateral cement infiltration with fewer complications.
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Review Case Reports
Spinal Cord Compression Secondary to Epidural Fibrosis Associated with Percutaneously Placed Spinal Cord Stimulation Electrodes: Case Report and Review of the Literature.
Spinal cord stimulation is a safe method for treating chronic pain syndromes. Spinal cord stimulators can be placed either surgically by creating a laminectomy defect for paddle leads or percutaneously by inserting electrodes. They are usually not associated with major complications. ⋯ We also reviewed the PubMed and Medline databases for all cases of significant epidural fibrosis related to spinal cord stimulator lead placement, including both surgically implanted paddles and percutaneously implanted leads. This is an uncommon complication after placement of spinal cord stimulators, but it can carry a clinically significant impact and be the source of severe morbidity. It should especially be suspected if the successful placement of the device is followed by development of a "tolerance" phenomenon, with progressive loss of satisfactory pain control and development of new myelopathic symptoms.
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Review Historical Article
Assessing the relevancy of "citation classics" in neurosurgery. Part II: Foundational papers in neurosurgery.
The second part of this study reanalyzes Ponce and Lozano's (2010) list of classics to create a new list of "foundational" articles in neurosurgery. Ponce and Lozano (2010) previously published a list of 106 neurosurgery classics, as defined by Garfield and his 400 citation criterion. ⋯ By assessing citation counts as a function of time, we are able to differentiate classic neurosurgical studies that are critical to modern-day practice from those that are primarily of historic interest. Given the exponential growth of literature in our field, analyses such as these will become increasingly important to both trainees and senior neurosurgeons who strive to educate themselves on the data that drive modern-day clinical decision making.
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Comparative Study
Prognostic factors for recovery after anterior debridement/bone grafting and posterior instrumentation for lumbar spinal tuberculosis.
Anterior debridement/bone grafting/posterior instrumentation is a common selection for the treatment of lumbar spinal tuberculosis (LST). To date, no study has focused on the prognostic factors for recovery after this surgery. ⋯ Nonparalysis, shorter symptom duration, fewer involved vertebrae, and posterior percutaneous instrumentation (compared with open instrumentation) are considered favorable prognostic factors. Patients in the percutaneous instrumentation group achieved higher JOA scores than those in the open instrumentation group in the early stages postoperatively (1-3 months), but no significant difference was observed in long-term JOA scores (6-24 months).
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Meningiomas account for 36% of primary brain tumors. The pathogenesis of these tumors is not completely established, hindering development of effective chemotherapy. Numerous studies have identified alterations in several growth factors and receptor kinases that regulate meningioma growth. These may be targets for new therapies. One of these, sometimes overlooked, is the transforming growth factor beta (TGF-β) family of proteins. Its receptors and signaling pathways play a critical role in development or progression of many forms of neoplasia. ⋯ Accumulating evidence suggests that derangement of TGF-β family signaling contributes to development and progression of meningiomas. The TGF-β family may represent new targets for chemotherapy and could include inhibitors of kinases activated by TGF-β.