World Neurosurg
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Survival after meningioma surgery often is reported with inadequate allowance for competing causes of death. ⋯ Cause-specific survival after meningioma surgery is greater in younger, low-comorbidity adults with spinal and benign meningioma. Those with an intracranial, progressing malignant tumor requiring cerebrospinal fluid shunting and having a severe global health-state have a significant increased risk of meningioma-related death. Redo surgery failed to improve the outcome. We recommend the use of competing risk model in meningioma studies in which unrelated mortality may be substantial, as this approach results in more accurate estimates of disease risk and associated predictors.
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Lumbar decompressions are increasingly performed at ambulatory surgery centers (ASCs). We sought to compare costs of open and minimally invasive (MIS) lumbar decompressions performed at a university without dedicated ASCs. ⋯ When accounting for care pathway, the cost of open and MIS decompression were no different. Transition from a tertiary academic hospital to a university hospital specializing in outpatient surgery was not associated with lower costs. Academic departments may consider transitioning lumbar decompressions to a dedicated ASC to maximize cost savings; however, additional studies are needed.
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To evaluate the safety and accuracy of S2 alar-iliac (S2AI) screw placement guided by a 3-dimensional (3D)-printed surgical guide template. ⋯ S2AI screw placement assisted by a 3D-printed surgical guide is safe and accurate.
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Comparative Study
Comparative Cadaveric Analysis for Surgical Corridor and Maneuverability: Far-Lateral Approach and its Transcondylar Extension.
The necessity of partial occipital condyle (OC) resection for lesions in the ventral craniocervical junction is debatable. This study's purpose was to compare the surgical exposure of the classic far-lateral approach (FLA) and transcondylar FLA. ⋯ Transcondylar FLA can significantly increase surgical exposure compared with the classic FLA, although also increasing surgical complications. Therefore, the surgical approach should be individualized according to each lesion and patient. The results of our study may assist in surgical decision-making regarding the need for OC resection.