World Neurosurg
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Comparative Study
Microendoscopy-Assisted Minimally Invasive Versus Open Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Diseases: 5-Year Outcomes.
We sought to evaluate 5-year outcomes between microendoscopy-assisted minimally invasive (MIS) and open transforaminal lumbar interbody fusion (TLIF). ⋯ Microendoscopy-assisted MIS-TLIF is comparable with open TLIF in terms of 5-year outcomes with additional benefits of reduced intraoperative iatrogenic injury, decreased initial pain, minimized activity restrictions, and accelerated ambulation recovery after surgery.
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Transoral robotic surgery has been used successfully to assist many surgical procedures. Here, we report its first use as pure robotic surgery, applied to excise an odontoid metastatic mass. ⋯ This article presents the first pure robotic surgery for odontoid. The increasing number of robot-assisted cases will demonstrate the necessity of this evolution in neurosurgery and should accelerate the process.
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Case Reports
Primary Central Nervous System Lymphoma Presenting as Growing Intracerebral Hemorrhage.
Hemorrhage at presentation in primary central nervous system (CNS) lymphoma is rare. We encountered a case of primary CNS lymphoma presenting as a growing intracerebral hemorrhage. ⋯ Although exceedingly rare, primary central nervous system lymphoma can present as growing intracerebral hemorrhage due to repeated intratumoral hemorrhages. High expression of vascular endothelial growth factor and the mass effects of hemorrhage could be associated with the onset and growth of intracerebral hemorrhage. Early evaluation and meticulous observation are important to avoid progressive, life-threatening situations in such cases.
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To evaluate relationship between gray-white matter ratio (GWR) on computed tomography and prognosis in patients with extra-axial hematoma. ⋯ The difference between preoperative or postoperative GWR values has a higher sensitivity and greater area under the curve to predict patient outcome. Measuring the difference between preoperative and postoperative GWR values may be useful as an objective early predictor of outcome in patients with extra-axial hematoma. Larger samples and multicenter prospective studies are still required.
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Although clipping and coiling of intracranial aneurysms are effective treatment options, they each have limitations. With the advent of the hybrid operating room, combined clipping and coiling for complex aneurysms in one stage becomes feasible. We report a successful case of a left posterior communicating artery aneurysm where combined clipping and endovascular treatment were applied. ⋯ Combined open surgical and endovascular approaches to treat complex cerebral aneurysms in an hybrid operating room could offer an alternative when the aneurysms appear unclipped or remnant intraoperatively. In our experience, simultaneous clipping and coiling is a safe and effective procedure for efficient treatment of aneurysms.