World Neurosurg
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It is well known that clinical improvements following surgical intervention are variable. While all surgeons strive to maximize reliability and degree of improvement, certain patients will fail to achieve meaningful gains. We aim to analyze patients who failed to reach minimal clinically important difference (MCID) in an effort to improve outcomes for minimally invasive deformity surgery. ⋯ Definable causes of failed MIS ASD surgery are often identifiable and similar to open surgery. In some cases the cause is treatable and structural. However, it is also common to see failure due to pathologies unrelated to the index surgery.
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To determine whether Thoracolumbar Injury Classification and Severity Score (TLICS) and the Thoracolumbar AOSpine Injury Score (TL AOSIS) have any superiority to each other in terms of the reliability of their recommendations for guiding the treatment strategy of thoracolumbar spine injuries. ⋯ Recommendations of TL AOSIS might be more reliable than those of TLICS particularly for guiding the surgical management of complete burst fractures.
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To evaluate change in fear of movement and the relationship of fear of movement and pain intensity to low back disability and general health-related quality of life over a 2-year period. ⋯ We found that greater levels of fear of movement were related to greater levels of low back disability, following lumbar spine surgery, in a longitudinal study. This shows the need to address fear of movement in prehabilitation/rehabilitation pre- or postsurgically to improve health outcomes for patients who undergo lumbar spine surgery.
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The relationship between race and neurosurgical outcomes is poorly characterized despite its importance. The influence of race on short-term patient outcomes in a pituitary tumor surgery population was assessed. ⋯ This study suggests that the effect of race on outcomes is partly mitigated for individuals who can attain access, and when socioeconomic factors and comorbidities are controlled for. The noted significant difference in emergency department visits could be indicative of confounding variables that were not well controlled for and requires further exploration.
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Cerebellar ectopy is a rare finding, with few cases previously reported. Intraventricular localized cerebellar ectopy was described in only 1 case within the fourth ventricle. ⋯ We describe, for the first time to our knowledge, the case of a child with ectopic cerebellar tissue harboring the supratentorial ventricular system. Plausible etiologic mechanism consists in the herniation of the cerebellar germinal tissue into the ventricular system through the ependyma, allowing cell migration to the supratentorial compartment, followed by maturation into the normal cerebellum.