World Neurosurg
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Patients with an aneurysmal subarachnoid hemorrhage (aSAH) and World Federation of Neurosurgical Societies (WFNS) grade I on admission are generally considered to have a good clinical outcome. ⋯ Despite their neurologically optimal clinical condition on admission, 1 in 5 patients with WFNS grade I aSAH has an unfavorable clinical outcome or is dead at 6-month follow-up. Additional multivariable analysis in larger patient cohorts is necessary to identify the extent to which preventable complications contribute to unfavorable outcomes in these patients.
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The optimal surgical procedure for degenerative cervical kyphosis with stenosis (DCKS) remains controversial. The purpose of this study is to describe the preliminary clinical and radiologic results of anterior controllable antedisplacement fusion (ACAF) as a surgical technique for DCKS. ⋯ ACAF, correcting cervical kyphosis and simultaneously enlarging the volume of the spinal canal, is a good choice for DCKS.
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Magnetic resonance imaging (MRI) plays an important role in the assessment of spinal cord status for cervical spondylotic myelopathy (CSM). Diffusion tensor imaging (DTI) also is a novel investigation tool with good sensitivity to detect changes in CSM, but it is not routinely used in spinal cord evaluation. ⋯ DTI was closely related to the severity of CSM, and cutoff values of DTI enabled the surgeons to predict the surgical outcomes in patients with CSM. These evaluation metrics may reflect the pathologic conditions of the spinal cord quantitatively, and potentially evaluate the functional status of spinal cords.
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Surgical treatment of brainstem cavernous malformations (CMs) remains a great challenge for neurosurgeons. Several cases published in the literature have addressed surgical approaches. However, no surgical approach has been reported to provide better exposure for CMs located in the superior midbrain. ⋯ The transcallosal anterior interforniceal approach can provide good exposure and direct visualization to superior midbrain CMs. Complications are short-term and reversible.
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Although previous studies have used National Surgical Quality Improvement Program (NSQIP) data to study complications of thoracolumbar spinal deformity surgery, investigation of cervical spine deformity surgery has been limited. We performed a retrospective analysis of the NSQIP database to identify predictors of complications after cervical spine osteotomy. ⋯ This study is the largest to date of patients undergoing cervical osteotomy and provides useful clinical data for patient selection and counseling and 30-day reoperation and readmission rates.