World Neurosurg
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Superior laryngeal neuralgia (SLN) is a relatively rare disorder that is characterized by neck pain. There are only a few reported cases and treatment options for SLN to date. In this study, we report 3 patients with SLN who were treated with Gamma Knife radiosurgery (GKRS) at the time of diagnosis. ⋯ This preliminary report provides encouraging evidence that GKRS represents an effective, safe, and relatively durable noninvasive treatment option for patients with SLN.
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Glioblastoma evades conventional therapies through a variety of mechanisms, including suppression of the immune system. This immunosuppressive microenvironment provides a potential target for treatment. ⋯ Although immunotherapy has already demonstrated efficacy for a variety of other malignancies, its efficacy in glioblastoma is still unclear. Identifying predictive biomarkers and improving the management of immune-related adverse effects will help to realize the full potential of these therapies.
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Routine preoperative blood testing has become a dogma. The general practice is to order preoperative workup as a knee-jerk response rather than individualize it for each patient. The fact that the bleeding brain tends to swell, which coupled with limited options for proximal control, packing, and overall hemostasis, leads to an overemphasis on the preoperative coagulation profile. ⋯ We conclude that patients without a history of coagulopathy and normal physical examination do not require routine coagulation screening before elective craniotomy.
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Observational Study
Postoperative Changes in Moderate to Severe Nonspecific Low Back Pain After Cervical Myelopathy Surgery.
Cervical myelopathy patients sometimes experience concurrent nonspecific moderate to severe low back pain (msLBP). However, postoperative changes in msLBP after cervical myelopathy surgery have rarely been reported. Awareness of postoperative changes in msLBP may be helpful in consultation. Therefore, the objective of this study was to examine postoperative changes in msLBP. ⋯ Although the exact pathophysiology was not demonstrated, cervical myelopathy surgery may directly and indirectly improve msLBP.
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Comparative Study
Minimally Invasive Transforaminal Versus Direct Lateral Lumbar Interbody Fusion: Effect on Return to Work, Narcotic Use, and Quality of life.
Direct lateral (DLIF) and transforaminal (TLIF) lumbar interbody fusions have been shown to produce satisfactory clinical outcomes with significant reduction in pain and functional disability. Despite their increasing use in complex spinal deformity surgeries, there is a paucity of data comparing outcome measures, which this study addresses. ⋯ Both MIS TLIF and DLIF provide long-term improvement in pain andfunctional outcomes, with an overall reduction in postoperative narcotic requirement. However, there was a significantly longer time to return to work and a greater incidence of reoperation in the TLIF cohort compared with the patients who underwent DLIF.