World Neurosurg
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To explore the prevalence and distribution of abnormal vertebral pedicles in adolescent idiopathic scoliosis (AIS) in Chinese people. ⋯ There is a significantly high prevalence of abnormal pedicles in AIS in Chinese people, with a total prevalence of 65%. Female sex, proximal thoracic location, major curve greater than 70 degrees, and concave pedicle may be risk factors for type C and D pedicles.
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Programs that address overall wellbeing early in residency are necessary to prevent physician burnout and promote physician mental health to improve patient outcomes and ensure long and productive careers. A wellness initiative was implemented at our institution 3 years ago. We present feedback from participating residents across all levels of training. ⋯ Participating resident perceptions of the wellness program are highly favorable. The survey results, combined with the perspectives across training levels, provide insight for other programs wishing to implement program of their own.
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Traumatic brain injury (TBI) is a devastating neurologic injury and remains a major cause of death in the world. Secondary injury after TBI is associated with long-term disability in patients with TBI. This study evaluated adrenomedullin (AM) on secondary injury and neurologic functional outcome in rats after TBI. ⋯ AM can improve neurologic function and ameliorate brain injury in rats with TBI. AM exerts its neuroprotective effect via its anti-inflammatory and antiapoptotic effect.
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Case Reports
Immediate Cranioplasty for Postcranioplasty Infection in Patients with Ventriculoperitoneal Shunt.
Patients with a ventriculoperitoneal (VP) shunt tend to develop epidural fluid accumulation after cranioplasty and also have a higher frequency of syndrome of the trephined after bone flap removal. Thus treatment of patients with postcranioplasty infection and a VP shunt is often challenging. ⋯ Immediate cranioplasty and obliteration of the epidural dead space with a vascularized free latissimus dorsi muscle flap is an alternative for patients with postcranioplasty infection who are unfavorable candidates for temporary bone flap removal because of the risk of neurologic deterioration.
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In the United States, the number of posterior cervical fusions has increased substantially. Perioperative neurologic complications associated with this procedure, such as spinal cord and peripheral nerve injuries, can have significant effects on patient health. We examined the impact of perioperative neurologic deficits on mortality in patients undergoing posterior cervical fusion. The secondary aim was to understand the risk factors for perioperative neurologic complications. ⋯ Perioperative neurologic deficits are serious complications of posterior cervical fusion and can independently predict in-hospital mortality and morbidity. As this procedure continues to be used increasingly, attention should be directed toward preventing these complications and intervening earlier in patients who have a neurologic deficit. Future efforts should be geared toward screening for at-risk patients with the initiation of surgical prehabilitation.