World Neurosurg
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Comparative Study
Comparison of Single-Level and Multilevel Decompressive Laminectomy for Multilevel Lumbar Spinal Stenosis.
This study aimed to clarify whether multiple compressions of nerve roots resulted in poorer surgical outcome when patients were treated with single-level decompressive laminectomy or multilevel decompressive laminectomy. To reach this we compared preoperative and postoperative Oswestry Disability Index (ODI) scores, Visual Analogue Scale (VAS) scores, and walking duration of multilevel lumbar spinal stenosis (LSS) patients treated with single-level and multilevel decompressive laminectomy. ⋯ Recovery in terms of ODI scores, VAS scores, and walking duration was better in LSS patients undergoing single-level laminectomy than in those undergoing multilevel laminectomy. Also, the rates of operative complications and postoperative follow-up spondylolisthesis were higher in patients treated with multilevel laminectomy.
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Gross total resection (GTR) in patients with glioblastoma (GB) and anaplastic astrocytoma (AA) is associated with improved survival. We examined how tumor location, tumor grade, and age affected this benefit. ⋯ Our results demonstrate complex interaction between tumor grade, frontal lobe location, and age in their various contributions to survival benefit gained from GTR. The greatest survival benefit of GTR relative to STR was observed in patients ≤50 years old with frontal AAs.
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The persistence of synchondrosis in adulthood can confound diagnostic decisions made during patient management. ⋯ The localization and level of the remnant of the dentocentral synchondrosis are extremely important from the clinical viewpoint because of odontoid and C2 fractures. Neurosurgeons should thus be aware of the possible presence of a persistent (remnant) C2 dentocentral synchondrosis in adult subjects in order to avoid misdiagnosis with C2 fracture.
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Few studies have demonstrated detailed physical risk factors of hemorrhagic complications (HCs) associated with the Angio-Seal closure device. This retrospective study aimed to identify the risk factors of HC due to Angio-Seal use. ⋯ Patients with a BMI <21 may require careful hemostasis monitoring, and it is better not to undergo arterial puncture site closure using Angio-Seal for those with a femoral artery depth <11.1 mm.
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Many methods for treating complex anterior cerebral artery (ACA) aneurysms are available; however, there is substantial variation among methods because of various aneurysm locations, the relationship of the aneurysm to arterial branches, aneurysm size and other morphologic characteristics, and the diameters of the parent or branching arteries. ⋯ Treatment of complex ACA aneurysms should be tailored according to the location and nature of the aneurysm and collateral circulation. Viable and feasible treatment strategies must be established by the neurovascular surgeon.