World Neurosurg
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Hydatid cyst disease, commonly caused by Echinococcus granulosus, rarely occurs in paraspinal muscles. Among the few reported cases, the current case is the largest paraspinal hydatid cyst disease ever reported in literature with a review of management of such large lesions. ⋯ Hydatid disease should be kept as one of the differential diagnoses for back swelling, especially in endemic regions. Giant-sized hydatid cysts of paraspinal muscles, though rare, cannot be ruled out on clinical ground alone. Thorough history taking and detailed examination should be aided with radiologic investigations like magnetic resonance imaging for an accurate diagnosis. En bloc excision of the cyst combined with preoperative and postoperative medical therapy is an effective method of treating this condition and significantly reducing complication rates.
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Review Meta Analysis
Conservative versus surgical treatment for odontoid fracture: Is the surgical treatment harmful? Systematic review and meta-analysis.
Odontoid fracture is a common injury especially in elderly people. Despite some recent studies arguing in favor of surgery, the best treatment is still being debated. ⋯ Based on this meta-analysis of nonrandomized comparative studies, surgical treatment seems not to be inferior to conservative treatments. The conclusions of this study remain limited by the low quality of the evidence available. Randomized controlled studies are required.
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Meta Analysis
Long-term opioid prescriptions following spine surgery: A meta-analysis of prevalence and risk factor.
Opioids are frequently prescribed for back pain, but the prevalence of and risk factors for long-term opioid use after spine surgery were not clearly reported. We conducted a systematic review and meta-analysis to summarize the evidence for long-term opioid use (>90 days) among adults who underwent spine surgery. ⋯ Patients undergoing spine surgery represent a high-risk surgical population requiring special attention and targeted interventions, with the strongest evidence for those treated with opioids before surgery and those with psychiatric comorbidities.
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Case Reports
A Rare Case Documenting Endoscopic Fenestration of a Symptomatic Porencephalic Cyst in an Adult.
A porencephalic cyst is an aberrant accumulation of cerebrospinal fluid within the brain parenchyma. Its occurrence is rare, with an incidence of 3.5 per 100,000 live births. Etiology is considered the result of perinatal cerebral ischemia or hemorrhage, leading to parenchymal loss. ⋯ Our case depicts a porencephalic cyst presenting with nondominant parietal lobe symptoms in adulthood. We hypothesize that a membrane between the cyst and ventricle allowed formation of a 1-way valve that led to slowly progressive cyst enlargement, eventually causing mass effect and nondominant parietal lobe symptoms. Endoscopic fenestration of the cyst membrane into the lateral ventricle was successful in reducing cyst volume and improving mass effect.
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We sought to evaluate dynamic balance and postural stability in patients with adult spinal deformity (ASD) compared with published age-matched normative data. ⋯ ASD patients demonstrated impaired postural stability, diminished sensory integration, and delayed response to external perturbations compared with normal control data. Postural stability and quality of life metrics correlated with self-reported falls. These findings suggest that ASD patients have abnormal postural stability and may be at elevated risk of falls.