World Neurosurg
-
Analysis of complications with staged surgery for less invasive treatment of adult spinal deformity.
Spinal deformity surgery is often invasive and lengthy. Staging surgery over separate operative days may reduce complications. Staging is often used in minimally invasive treatment of adult spinal deformity (ASD). ⋯ cMIS staged surgeries appear safer than HYB staged surgeries, and equally safe to cMIS unstaged surgeries. Perioperative complications were significantly higher for HYB staged surgeries. HYB surgeries may have better results when performed in a single setting, whereas cMIS surgeries can be performed in 1 or 2 stages depending on surgeon preference.
-
We have discussed the clinical features and neuroimaging findings and investigated the correlations between the clinical characteristics and different neuroradiologic phenotypes of cerebral small vessel disease (CSVD). ⋯ The present study has provided a comprehensive analysis of the clinical correlation of characteristics and neuroradiologic phenotypes in patients with CSVD. The insights from these findings could be used to refine the management strategy for patients with CSVD.
-
To study whether and when mere dorsal decompression is enough in the full endoscopic key hole technique for foraminal stenosis. ⋯ Stenosis is mainly caused by dorsal structures; mere dorsal decompression is enough. In both cases, the ventral and dorsal structures contributed to the stenosis. When there is no herniated soft fragment contributing to the stenosis, ventral decompression is not always necessary. If intraoperative exploration detects less tension formed by the ventral abnormal structures, mere dorsal decompression is enough to settle the symptoms.
-
Endovascular coiling of anterior communicating artery (ACoA) aneurysms has evolved dramatically. Ruptured ACoA aneurysms are more likely to be smaller. We aimed to investigate the safety and efficacy of endovascular coiling of very small ruptured ACoA aneurysms compared with surgical clipping. ⋯ Patients with very small ruptured ACoA aneurysms can be safely and effectively treated with endovascular coiling. However, smaller ACoA aneurysms still require surgical clipping. A smaller aneurysm size limits the use of endovascular coiling.
-
We explored the external ventricular drain (EVD) practices in Thailand. ⋯ The results of the present study have identified QI opportunities in EVD management in Thailand. The development of an EVD-related QI process, reliable tracking of EVD infection rates, adaptation of U.S. guidelines to create standardized EVD protocols, and examination of the association between EVD practices and clinical outcomes in low-to middle-income countries are urgently needed.