World Neurosurg
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Comparative Study
Comparison of Subthalamic Nucleus and Globus Pallidus Internus Deep Brain Stimulation Surgery on Parkinson's Disease-related Pain.
To analyze and compare the effects of subthalamic nucleus (STN) deep brain stimulation (DBS) and globus pallidus internus (GPi)-DBS on Parkinson disease (PD)-related pain. ⋯ Both GPi-DBS and STN-DBS were effective for analyzing PD-related pain and seemed to have similar efficacy. This study provides an important first-step toward determining different DBS targets for controlling PD-related pain. Follow-up prospective research is an appropriate next step on the path to multicenter clinical trials.
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Meta Analysis
How Center of Rotation Changes and What Affects These After Cervical Arthroplasty: A Systematic Review and Meta-analysis.
To determine how center of rotation (COR) changes and what affects changes in COR after cervical arthroplasty. ⋯ Prosthesis design affects changes in COR after cervical arthroplasty. If a constrained or semiconstrained prosthesis is chosen (2-piece implant, ball-and-socket, or ball-in-trough design), the COR location tends to shift anteriorly and/or superiorly, whereas if a nonconstrained prosthesis is chosen (3-piece implant, mobile nucleus design), the COR tends to keep the same location as preoperation. In addition, the position of the prosthesis in the intervertebral space also can affect changes in COR after cervical arthroplasty.
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Instability of the craniovertebral junction (CVJ) following odontoidectomy is relatively common. Traditionally, separate stage posterior atlantoaxial ± occipitocervical fusion is used for treatment. A transmucosal approach using a clean-contaminated route is associated with hypothetical risks of infectious complications. ⋯ Five (1.16%) patients required removal of their anterior fixation device, 4 (0.93%) related to SSI. ORs comparing our results with Medvedev et al's retrospective National Surgical Quality Improvement Program study assessing the risk associated with posterior cervical fixation showed no statistical difference between postoperative infection rates (OR = 0.72, P = 0.36). An extensive review of the literature found no evidence to suggest placement of spinal hardware via transmucosal corridor is associated with an increased risk of SSI.
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Review Historical Article
Right versus Left Approach to Anterior Cervical Discectomy and Fusion: An Anatomic versus Historic Debate.
The debate over the influence approach sidedness has on the risk of recurrent laryngeal nerve palsy (RLNP) following anterior cervical discectomy and fusion (ACDF) has its origins with the introduction of the procedure for radicular pain in the 1950s. The recurrent laryngeal nerves follow disparate courses in the lower neck secondary to differences in embryogenesis. ⋯ However, modern surgical series have not shown a clear risk of RLNP with a right- versus left-sided approach. By looking at the historical context surrounding the introduction of ACDF, we propose the dogmatic view of an increased risk of RLNP with a right-sided approach likely arose from a combination of theoretical anatomic risk and the early surgical experience of a pioneer of the procedure.
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Iatrogenic ureteral injury associated with lumbar spine surgery is an uncommon but devastating complication with associated medicolegal implications. ⋯ Ureteral injury associated with lumbar spine surgery is overreported in developed or developing countries. It should be considered in the differential diagnosis of any patient who presents with symptoms of acute abdomen after lumbar spine surgery, and patients who underwent restorative surgery had a good prognosis.