World Neurosurg
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The novel coronavirus disease 2019 (COVID-19) pandemic has led to a shift to virtual residency interviews for the 2020-2021 neurosurgery match, with unknown implications for stakeholders. This study seeks to analyze the perceptions of residency program directors (PDs) and associate program directors (APDs) regarding the current virtual format used for residency selection and interviews. ⋯ Our study highlights that applicants applied to a greater number of residency programs compared with years prior, that the criteria used by PDs/APDs to evaluate applicants remained largely consistent compared to previous years, and that the virtual residency interview format may disproportionately disadvantage Doctor of Osteopathic medicine and international medical graduate applicants. Further exploring attitudes toward signaling mechanisms and standardized letters may serve to inform changes to future neurosurgery match cycles.
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Discontinuous thoracic ossification of the ligamentum flavum (TOLF) is diagnosed according to the number and distribution of involved segments seen on magnetic resonance images. When TOLF causes thoracic myelopathy, surgical intervention for these lesions becomes unavoidable. However, there are few reports on the outcomes of surgery for discontinuous TOLF. ⋯ The surgical outcome of staged decompression for discontinuous TOLF seems to be better than that of simultaneous decompression. The complication rates of these 2 strategies are similar.
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This study was conducted to elucidate the clinical significance of postoperative segmental height decrease (SHD) in anterior cervical discectomy and fusion (ACDF) using allografts. ⋯ Significant SHD was associated with decreased segmental lordosis, global cervical lordosis, and foraminal height. However, significant SHD did not result in worsening of clinical symptoms. Larger allograft size was associated with risk of significant SHD. This study demonstrates provisional results that suggest allograft resorption or fracture may be a factor that adversely affects fusion or SHD.
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We evaluated the effect of the total psoas area index (TPAI = total psoas muscle area [cm2]/height squared [m2]) on neurological complications and clinical outcomes after lateral lumbar interbody fusion and identified the appropriate TPAI to achieve a substantial clinical benefit (SCB). ⋯ The TPAI had little effect on the incidence of perioperative neurological complications. However, the TPAI was identified as one of the predictors for achieving an SCB regarding back pain.
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Midline lumbar fusion (MIDLF) is one promising new surgical technique that has been developed to minimize perioperative damage to the paravertebral stabilizing musculotendinous system. The aim of this study was to assess long-term clinical and radiological effects of MIDLF. ⋯ MIDLF is a safe, efficient method for surgical treatment of lumbar spine instability. Its limited invasiveness contributes to better preservation of paravertebral muscles and enhanced postoperative spinal stability.