World Neurosurg
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Multicenter Study
Discharge to Inpatient Care Facility After Anterior Lumbar Interbody Fusion: Incidence, Predictors, and Postdischarge Outcomes.
Despite a significant number of patients being discharged to inpatient care facilities after anterior lumbar interbody fusion (ALIF), the current literature remains limited regarding the predictors associated with a nonhome discharge and the impact of continued inpatient care in a facility on postdischarge outcomes. ⋯ With an increasing focus toward minimizing costs associated with postacute care, providers should understand the need of appropriate preoperative risk stratification and construction of care pathways aimed at a home discharge to reduce the occurrence and/or risk of experiencing postdischarge complications.
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Spontaneous cerebellar intracerebral hemorrhage (scICH) constitutes ∼10% of all cases of spontaneous ICH, with a mortality of 20%-50%. Suboccipital craniectomy (SOC) is commonly performed for scICH causing brainstem compression or hydrocephalus. However, SOC requires long anesthesia times and results in a high complication rate. We present a series of patients who minimally invasive scICH evacuation as an alternative to traditional SOC. ⋯ Minimally invasive scICH hematoma evacuation is a feasible alternative to SOC with numerous advantages that could lead to improved radiographic and clinical results.
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Randomized Controlled Trial Comparative Study
Intravenous Administration of Tranexamic Acid Significantly Reduces Visible and Hidden Blood Loss Compared with Its Topical Administration for Double-Segment Posterior Lumbar Interbody Fusion: A Single-Center, Placebo-Controlled, Randomized Trial.
Tranexamic acid (TXA) significantly reduces the visible and hidden blood loss associated with joint replacement. At present, many studies have examined the safety and effectiveness of the intravenous or topical administration of TXA after posterior lumbar surgery. However, randomized and controlled trials examining the presence of differences in the effect of TXA on the visible and hidden blood loss between these 2 modes of administration are lacking. The current study investigated the effects of intravenous and topical administrations of TXA on the visible and hidden blood loss of patients undergoing posterior lumbar interbody fusion (PLIF). ⋯ For patients undergoing double-segment PLIF, both administrations of TXA can reduce blood loss, extubation time, and the length of hospital stay. Moreover, intravenous administration can reduce both visible and hidden blood loss more efficiently.
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Comparative Study
Weekend versus Weekday Admission in Spinal Cord Injury and Its Effect on Timing of Surgical Intervention.
We sought to compare timing of intervention for patients with spinal cord injury (SCI) requiring surgical procedures during weekend versus weekday admissions. ⋯ In this national study, patients with SCI who were admitted during the weekend received surgical intervention as early as patients admitted during a weekday. Furthermore, no differences in complication or mortality rates between groups were found.
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Multicenter Study Observational Study
Ruptured Intracranial Aneurysms treated with Woven Endobridge Intrasaccular Flow Disruptor (WEB): a multi-center experience.
The woven endobridge intrasaccular flow disruptor (WEB) device for ruptured broad-based intracranial aneurysm (rBBA) remains underrepresented in existing studies. In this case series, the safety and efficacy results of the use of WEB in rBBA were evaluated from a multi-center experience. ⋯ The WEB device for rBBA is a fast and effective treatment, with a low rate of aneurysm rebleeding; however, procedure-related complications seem not negligible. Further evaluation comparing this device with other treatment options should be performed.