World Neurosurg
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Case Reports
Prognostic factors for the survival outcome of bilateral thalamic glioma: An integrated survival analysis.
The aim of this study was to perform an integrated survival analysis of patients with bilateral thalamic glioma and to assess the influence of various prognostic factors on overall survival. ⋯ This comprehensive analysis of rare BTG patients revealed that a longer duration of symptoms (≥2 months) and low WHO grade were significantly associated with improved survival and were independent prognostic factors for overall survival.
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Endoscopic transsphenoidal surgery (ETPS) has become increasingly popular for resection of pituitary tumors, whereas microscopic transsphenoidal surgery (MTPS) also remains a commonly used approach. The economic sustainability of new techniques and technologies is rarely evaluated in the neurosurgical skull base literature. The aim of this study was to determine the cost-effectiveness of ETPS compared with MTPS. ⋯ ETPS appears to be cost-effective when compared with MTPS because the ICER falls below the commonly accepted $50,000 per QALY benchmark. Model limitations and assumptions affect the generalizability of the conclusion; however, ongoing efforts to improve rhinologic morbidity related to ETPS would appear to further augment the marginal cost savings and QALYs gained. Further research on the cost-effectiveness of ETPS using prospective data is warranted.
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The authors present a case report of a patient with a giant thoracic calcified disc. The patient underwent a posterior thoracic laminectomy and fusion without resection of the disc. The calcified disc regressed in size and lost its calcified component postoperatively.
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Congenital absence of C2 posterior arch may present with C2-C3 dislocation. Previously these cases were managed by fusing occiput-C1-C4 without including C2 in the construct. Such constructs are likely to immobilize the long segment of the cervical spine, and exclusion of C2 may not yield the best result. ⋯ Absence of the posterior arch of axis may be associated with adjacent C1-C2 along with C2-C3 dislocation, so both levels need to be addressed. The radiology should be critically evaluated for other structures developing from the C2 neural arch. It is important to include C2 to achieve a stable construct without compromising adjacent-level mobility.
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The causes and epidemiology of traumatic cervical spine fracture have not been described with sufficient power or recency. Our goal is to describe demographics, incidence, cause, spinal cord injuries (SCIs), concurrent injuries, treatments, and complications of traumatic cervical spine fractures. ⋯ Incidence, complications, concurrent injuries, and fusions have increased since 2005. Length of stay, SCIs, decompressions, and halo insertions have decreased. Indicated trends should guide future research in management guidelines.