World Neurosurg
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Review
Artificial Discs in Cervical Disc Replacement: A Meta-Analysis for Comparison of Long-term Outcomes.
Cervical disc replacement (CDR) has emerged as an alternative to anterior cervical discectomy and fusion for the surgical treatment of degenerative cervical disc disease. Although comparison of the 2 techniques has been studied in the literature, a thorough assessment of all artificial discs between each has not been performed. The objective of the present study was to examine the long-term outcomes of 5 artificial discs. ⋯ The results of the present meta-analysis indicate that surgical and clinical outcomes may differ among different CDR devices. These findings may assist surgeons in tailoring their decision making to specific patient profiles. Future multicenter efforts are needed to validate associations found in this study.
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Review Case Reports
Intraspinal Canal Schwannoma with Extensive Calcification: Case Report and Literature Review.
Schwannomas are the most common benign tumors in the intraspinal location, with slow-growing and nonaggressive features. Calcification is not a common histopathological and radiological feature in schwannoma. ⋯ Although intraspinal schwannoma with extensive calcification is rare, which increases the difficulty of an accurate diagnosis preoperatively, the tumor can be completely removed with or without excision of the nonfunctional nerve roots.
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Randomized Controlled Trial
Effect of Sevoflurane Postconditioning on the Incidence of Symptomatic Cerebral Hyperperfusion after Revascularization Surgery in Adult Patients with Moyamoya Disease.
Various experimental studies have reported neuroprotective effects of sevoflurane postconditioning against cerebral ischemia-reperfusion injury. We therefore investigated its neuroprotective effects on hyperperfusion-related transient neurologic deterioration, called symptomatic cerebral hyperperfusion (SCH), and also identified predictive factors for SCH in patients with moyamoya disease after revascularization surgery. ⋯ Sevoflurane postconditioning did not reduce the incidence of SCH after revascularization surgery in patients with moyamoya disease. Rather, a decreased vascular reserve, operation on the dominant hemisphere, increased temporal occlusion time, and decreased intraoperative minimum PaCO2 were associated with SCH in these patients.
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Review Historical Article
The Story of the Development and Adoption of the Glasgow Coma Scale: Part I, The Early years.
The Glasgow Coma Scale and its derived Score have been adopted worldwide for assessing the degree of impaired responsiveness in traumatic brain injury and other kinds of acute brain damage. In this historical vignette, we describe how the foundations for their enduring success were laid during their initial development. To provide a unique additio nal background and context, the material from interviews with one of the originators of the scale was brought together with information from key publications in the early years after the first description of the scale in 1974. ⋯ These collaborations were accompanied by the creation of the total Glasgow Coma Score with a 6-point motor subdivision. The observation that outcomes after severe head injury were similar in the different countries, despite marked variations in management, stimulated controversy that promoted further interest in traumatic brain injury research and a recommendation for the worldwide use of the scale as a common severity marker. Inclusion of the scale in major developments such as the Advanced Trauma Life Support (ATLS) and the National Traumatic Coma Databank cemented its influential position in clinical care and research for the succeeding decades.
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Patients with single-ventricle congenital heart disease may present for scoliosis correction. These patients undergo a series of cardiac operations that create a novel circulation that has a significant impact on the management of their spinal surgery. ⋯ Patients who have undergone a Fontan procedure can successfully undergo a lengthy scoliosis correction, but it requires multidisciplinary planning.