World Neurosurg
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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.
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Lumbar interbody spacers are widely used in lumbar spinal fusion. The goal of this study is to analyze the biomechanics of a lumbar interbody spacer (Clydesdale Spinal System, Medtronic Sofamor Danek, Memphis, Tennessee, USA) inserted via oblique lumbar interbody fusion (OLIF) or direct lateral interbody fusion (DLIF) approaches, with and without posterior cortical screw and rod (CSR) or pedicle screw and rod (PSR) instrumentation. ⋯ OLIF alone significantly reduced mobility during flexion-extension while maintaining axial compressive stiffness compared with the intact condition. Adding posterior instrumentation to the interbody spacer increased the construct stability significantly, regardless of cage insertion trajectory or screw type.
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Recently, in modern neurosurgery, a tendency toward low-traumatic surgical approaches has become clear. To provide a minimal degree of injury to the brain tissue, we have offered microsurgical approaches through a burr hole. ⋯ Burr hole microsurgery provides the ability to perform successful surgery on patients with the most diverse intracranial pathological features through a smaller opening than that used for keyhole surgery.
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Glioblastomas (GBMs) are primary brain tumors that are very difficult to treat. Magnetic resonance imaging (MRI) is the reference tool for diagnosis, postoperative control, and follow-up of GBM. The MRI tumor contrast enhancement part serves as a target for surgery. However, there are controversial data about the influence of pre- and postoperative tumor volumetric MRI parameters on overall survival (OS). ⋯ The volume of MRI contrast-enhancing GBM remnants after surgery, automatically measured by the software, was a significant predictor for early postoperative progression and death.
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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.