World Neurosurg
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The mechanical alteration in the adolescent/pediatric cervical spine after spinal fusion remains unknown. The purpose of this study was to investigate morphologic changes in the cervical spine in adolescent/pediatric patients who underwent spinal fusion. ⋯ Cervical kyphosis correction using posterior instrumentation combined with endplate destruction by anterior bone grafting is a risk factor for atrophic morphologic changes in the vertebral body in adolescent/pediatric patients. Endplate destruction and instrumentation-induced stress shielding could alter bone remodeling.
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To identify risk factors that are predictive of nonhome discharge after elective posterior cervical fusion. ⋯ Early identification of patients who are at high risk for nonhome discharge is important to implement early comprehensive discharge planning protocols and minimize hospital-acquired conditions related to prolonged length of stay and associated health care costs.
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Hydrocephalus is a common neurosurgical disorder that can lead to significant disability or death if not promptly identified and treated. Data on the burden of hydrocephalus in low-income countries are limited, given a lack of radiologic resources for the diagnosis of this condition. Here, we present an analysis of patterns of hydrocephalus from a large sample of computed tomography (CT) scans of the head performed at a public hospital in rural Haiti, a low-income country in the Caribbean. ⋯ In a large sample of CTs performed in a rural low-income setting, hydrocephalus was common, predominantly noncommunicating, and often associated with potentially operable intracranial lesions. Data of this nature can inform research, policy, and clinical collaborations that strengthen the neurosurgical capacity of low-income countries.
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Adamkiewicz arteries vasospasm in spinal cord subarachnoid hemorrhage (SAH) can affect the spinal cord. Although muscle dysfunction of extremities is a common problem after spinal cord ischemia induced by SAH, to our knowledge there are no studies on degenerative changes in peripheral nerves. We studied the histopathologic changes in sciatic nerves after spinal SAH. ⋯ We concluded that SAHs frequently affect the spinal cord and result in axonal injury to peripheral nerves, of which there is no mention in the literature.
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Recurrences of pituitary adenomas are not so rare. ⋯ A second independent de novo adenoma was present in 10 cases, probably due to changes of transcription factors.