World Neurosurg
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This is the first large retrospective analysis of patients undergoing anterior lumbar interbody fusion (ALIF) with concern for clinical determinants leading to reoperation for adjacent segment disease (ASD). The objective of this study is to examine the specific perioperative and clinical determinants that affect need for adjacent segment reoperation in patients who underwent 1-level and 2-level ALIF procedures for degenerative disc disorders. ⋯ Our findings support a biomechanical hypothesis of ASD onset after fusion, suggesting that the risk of ASD after ALIF lies primarily in the number of levels fused rather than any demographic or intraoperative variables.
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Meta Analysis
The efficacy of using platelet-rich plasma in spinal fusion surgery-A PRISMA-compliant meta-analysis.
Platelet-rich plasma (PRP) has been frequently used to enhance bone regeneration. A meta-analysis was conducted to systematically assess the fusion rate and pain relief of applying PRP during spinal fusion surgery. ⋯ Adding PRP did not increase the fusion rates from spinal fusion surgery. In addition, no significant difference was found in pain relief between the PRP and non-PRP treatment groups.
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Acute subdural hematoma (aSDH) is a common pathology encountered in neurosurgery. Although most cases are associated with trauma and injuries to draining veins, traumatic aSDH from injury to arteries or spontaneous aSDH because of a ruptured intracranial aneurysm can occur. For some patients without a clear clinical history, it can be difficult to distinguish between these etiologies purely based on radiography. The objective of this research was to describe a case series in which imaging was suggestive of the presence of distal cortical intracranial aneurysm associated with aSDH, but operative management demonstrated no evidence of aneurysm. ⋯ Although there are prior reports of arterial aSDH, to our knowledge, this is the first to describe the radiographic "ghost aneurysm" sign. It is important for clinicians to be aware of this potential misleading radiographic sign, which indicates active extravasation into a spherical cast of clot.
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Our aim was to define a treatment strategy for patients with severe cervical deformity (sCD). ⋯ We outline an algorithm for deciding approach, UIV, LIV, and whether to do an osteotomy for patients with sCD based on consensus recommendations among spine surgeons.