World Neurosurg
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Comparative Study
Clinical and Radiologic Outcomes of Direct Versus Indirect Decompression with Lumbar Interbody Fusion: A Matched-Pair Comparison Analysis.
To compare the radiologic and clinical outcomes between oblique lumbar interbody fusion (OLIF) without laminectomy and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). ⋯ OLIF may achieve equivalent clinical and radiologic outcomes compared with MI-TLIF when the stenosis is minimal because the decompression performed is indirect. Furthermore, the OLIF shows less blood loss and shorter operative time, better restoration of DH, and earlier time to fusion than the MI-TLIF.
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Spinal metastases pose significant morbidity. For many histologies, the spine is a frequent site for bone metastases. This predilection is not fully understood, and there are conflicting reports regarding the distribution within the vertebral body itself. Knowing this distribution will give clues as to the underlying biologic reason for this increased incidence in the spine and lead to a better understanding of tumor dispersion and growth. ⋯ Metastatic lesions of the thoracolumbar spine have a greater propensity to localize to the posterior aspect of the vertebral body. These data support the hypothesis that there may be differences within the vertebral body leading to differential tumor dispersion and growth.
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Hematologic inflammatory markers are simple, inexpensive prognostic markers for various conditions. The prognostic significance of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and red blood cell distribution width (RDW) has been shown in a variety of tumors. We evaluated the prognostic value of these markers in glioma. ⋯ A high preoperative NLR, PLR, and MLR was predictive of a poor prognosis for patients with glioma. NLR was an independent prognostic factor for OS in patients with glioma.
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To introduce a modified percutaneous endoscopic lumbar diskectomy (PELD) technique to remove extraforaminal disk herniation at the L5-S1 segment, including the technical essentials and preliminary results. ⋯ We introduced a modified PELD technique to remove extraforaminal disk herniation at the L5-S1 segment. This technique was less invasive, effective, and safe. We also summarized a detailed protocol to identify and remove the herniated disk for nerve protection.
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Intracranial hemorrhage, such as intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and intraventricular hemorrhage (IVH), is an extremely rare complication after surgical revascularization for moyamoya disease (MMD). However, the incidence, timing, prognosis, possible mechanism, and prevention are not well known. ⋯ Intracranial hemorrhage (ICH, IVH, or SAH) after direct bypass for adult patients with MMD is an extremely rare but fatal complication. Although these hemorrhages can be associated with hyperperfusion syndrome, no effective prevention has been established.