World Neurosurg
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To examine the effects of chronic preoperative steroid therapy on 30-day perioperative complications after anterior lumbar fusion (ALF). ⋯ Chronic preoperative steroid therapy is associated with perioperative complications after ALF. Decisions about the discontinuing or holding steroid therapy preoperatively should be determined through an interdisciplinary approach between the medical and surgical teams.
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The number of metastases that can be treated safely and effectively with Gamma Knife stereotactic radiosurgery (SRS) remains controversial despite continuing evidence to support its expanded utilization. We endeavored to elucidate the survival outcomes for patients who presented with ≥15 brain metastases at the time of initial SRS. ⋯ SRS is an effective means of managing extensive brain metastases, particularly in patients with breast cancer. The primary tumor type, systemic disease, and performance status heavily influence survival outcomes.
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Vertebrobasilar insufficiency (VBI) is associated with high rates of morbidity and mortality, especially after failure of first-line medical and/or endovascular therapies. Although the optimal therapeutic strategy for refractory VBI remains unclear, surgical bypass represents a potentially life-saving treatment in this patient subset. ⋯ Refractory VBI has high morbidity, with cerebral bypass representing a safe and potentially efficacious treatment for selected patients. Long-term post-bypass outcomes are dependent on the level of irreversible preoperative neurologic injuries.
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Comparative Study
Validity of a smartphone application (SagittalMeter Pro) for the measurement of sagittal balance parameters.
The study was aimed to compare the validity, reproducibility, precision, and efficiency of a picture archiving and communication system (PACS) and a smartphone application, which is an educative app to easily measure sagittal balance parameters (SagittalMeter Pro), for measuring spinopelvic sagittal parameters. ⋯ The study shows PACS and SagittalMeter Pro are equivalent in terms of their abilities to measure spinopelvic sagittal parameters, and that the time required to obtain measurements was significantly less for SagittalMeter Pro. We believe that SagittalMeter Pro may be helpful when planning spinal surgery.
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Case Reports
Endoscopic transnasal cryo-assisted removal of orbital cavernous hemangiomas: case report and technical hints.
Cryoprobe devices are used by ophthalmic and orbital surgeons for extraction of fluid-filled intraorbital lesions. No series has described cryodissection via an exclusively transnasal approach. We describe 2 cases of purely endoscopic transnasal removal of intraconal orbital hemangiomas with the aid of a dedicated cryoprobe. ⋯ Cryoprobes represent an adjunctive tool in the orbital surgeon's armamentarium useful in the extraction of fluid-filled intraorbital lesions. This preliminary experience suggests that their use can ease the removal of intraconal hemangiomas with an exclusively transnasal approach. The analysis of further cases is necessary to confirm safety and efficacy.