World Neurosurg
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Comparative Study Observational Study
Revision strategy of symptomatic lumbar adjacent-segment degeneration: full-endoscopic decompression versus extended posterior interbody fusion.
We evaluated the clinical and imaging outcomes of full endoscopic lumbar decompression (FELD) compared with extended posterior lumbar interbody fusion (PLIF) for adjacent segment degeneration (ASD) after fusion surgery and developed a revision strategy. ⋯ The use of FELD achieved satisfactory outcomes for the treatment of radiographic stable ASD, which were not worse than those with PLIF. With less trauma and faster recovery, FELD could be an alternative option.
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In the present study, we quantified the effect of the coronavirus disease 2019 (COVID-19) on the volume of adult and pediatric neurosurgical procedures, inpatient consultations, and clinic visits at an academic medical center. ⋯ Significant reductions occurred in neurosurgical operations, clinic visits, and inpatient consultations during COVID-19. Telehealth was increasingly used for assessments. The long-term effects of the reduced neurosurgical volume and increased telehealth usage on patient outcomes should be explored.
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Case Reports Multicenter Study
Utility of P2Y12 reactive unit (PRU) assessment on ticagrelor in cerebral aneurysms treated with intracranial stenting and flow diversion: Cohort study and Case Report from 2 Neurovascular Centers.
Dual antiplatelet therapy consisting of aspirin and clopidogrel is the standard of care for neurointerventional stenting and flow diversion. Platelet function testing has been increasingly performed to identify patients with a hypo- or hyper-response to clopidogrel. Ticagrelor has been a popular alternative antiplatelet agent for such patients. We assessed the role of platelet function testing in patients receiving ticagrelor and undergoing stenting or flow diversion. ⋯ A risk of thromboembolic complications exists for patients receiving ticagrelor, which correlated with the PRUs in the present preliminary study. The findings from the present study suggest that the safe PRU range for patients receiving ticagrelor should be shifted to 0-100, which is lower than that of clopidogrel, thought to be 60-210. Further validation of the optimal PRU range for patients receiving ticagrelor is necessary.