World Neurosurg
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In the present study, we sought to evaluate the timing and outcomes in patients with hemorrhagic stroke who received tracheostomy. ⋯ In our cohort, early tracheostomy in patients with hemorrhagic stroke may help reduce hospital stays and hospital costs, but not in-hospital mortality. Future prospective multicenter studies are warranted to validate these findings.
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Multicenter Study
Current training status of neurosurgical residents in South Korea: A Nationwide multicenter survey.
In South Korea, special legislation was introduced in December 2016 to limit residents' training time to a maximum of 80 hours per week. The aim of this study was to survey the current training system and environment of neurosurgical residents and to find ways to improve the quality of neurosurgical training. ⋯ The major reason that neurosurgical residents are dissatisfied with the current training system and environment is the excessive time spent on it. These survey results are expected to be used as the basis for improvement of the residents' training system and work environment in South Korea.
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Distal catheterization in the ophthalmic artery beyond the origin of the central retinal artery has been attempted to avoid visual complications in cases of transarterial embolization (TAE). Although avoiding visual complications is important, extraocular complications have been rarely reported and discussed. Here, we report a case of an intraorbital arteriovenous fistula (AVF) presenting with impaired extraocular movement after a provocation test and discuss the potential risks associated with TAE at the third segment of the ophthalmic artery. ⋯ In intraorbital hypervascular lesions, occlusion of the third segment of the ophthalmic artery is associated with a potential risk of extraocular complications.
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The psoas muscle (PS), 1 of the paravertebral core muscles, is associated with sarcopenia. It also has clinical relevance in lateral-access spinal surgery (LASS) as a determinant structure affecting the operative window. We aimed to identify age-related patterns of PS degeneration, and we propose that our results be used to evaluate the operative window in LASS. ⋯ In patients without sagittal imbalance, the PS showed significant imaging characteristics. Our detailed data may aid the identification of degeneration patterns and specific preoperative planning regarding the operative window for LASS.
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Comparative Study
Laminectomy versus Corpectomy for Spinal Metastatic Disease-Complications, Costs, and Quality Outcomes.
The landmark Patchell trial established surgical decompression followed by adjuvant radiotherapy as standard-of-care for patients with spinal cord compression caused by metastatic cancer. However, little comparative evidence exists with regard to the choice of specific surgical approaches for these patients. We sought to conduct a comparative analysis of outcomes of surgical options for spinal metastatic disease. ⋯ Our findings highlight distinct complication profiles and quality outcomes associated with selection of surgical approach for patients with spinal metastases. These findings must be interpreted with a clear understanding of the limitations.