World Neurosurg
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Clinical Trial
A Prospective Validation Study of the First 3D Digital Exoscope for Visualization of 5-ALA Induced Fluorescence in High Grade Gliomas.
We report on the first use of a digital 3-dimensional (3D) exoscope equipped with a 5-aminolevulinic acid (5-ALA) fluorescence visual system. ⋯ Visualization of 5-ALA-induced tumor fluorescence with use of the Orbeye 3D digital exoscope was feasible and associated with a high positive predictive value.
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Comparative Study
Perioperative Comparison of Robotic-Assisted versus Fluoroscopy-Guided Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF).
Robotic surgical systems have been developed to improve spine surgery accuracy. Studies have found significant reductions in screw revision rates and radiation exposure with robotic assistance compared with open surgery. The aim of the present study was to compare the perioperative outcomes between robot-assisted (RA) and fluoroscopically guided (FG) minimally invasive (MI) transforaminal lumbar interbody fusion (TLIF) performed by a single surgeon. ⋯ Our results have demonstrated that RA MI-TLIF provides perioperative outcomes comparable to those with FG MI-TLIF. A reduced radiation dose to the patient was observed with RA compared with FG MI-TLIF. No differences were noted between the RA and FG cohorts in operative times, complication rates, revision rates, or length of stay.
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The Sofia catheter is a new large-bore aspiration catheter that allows easy access and good reperfusion. In this study, we analyzed the efficacy and safety of the Sofia catheter in comparison with stent retrievers as a contact aspiration thrombectomy (CAT) tool for large vessel occlusion. ⋯ The Sofia Plus is a large-bore aspiration catheter with high FPE and good accessibility. Use of this catheter resulted better angiographic outcome compared with the stent retriever, but there was no difference in clinical outcomes in this study. Further studies are needed to compare in new generation aspiration catheters.
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It is difficult to predict which patients with idiopathic normal pressure hydrocephalus (iNPH) will improve after shunt surgery. This study investigated the association between preoperative imaging parameters in patients with iNPH and long-term outcome after shunt placement. ⋯ Higher Evans index is a predictor of long-term cognitive improvement after shunt placement; however, no cutoff value demonstrates sufficient accuracy for the selection of shunt candidates. None of the evaluated imaging features was predictive of long-term gait or urinary improvement. The utility of imaging to predict a response to shunting is limited, and no imaging feature alone can be used to exclude patients from shunt surgery.
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Gastric stromal tumor is a potentially malignant mesenchymal tumor that is difficult to diagnose before surgery. Computed tomography is the most commonly used tool for diagnosing gastrointestinal stromal tumor. This study combined peripheral nerve analysis and computed tomography for diagnosis and prognosis of gastrointestinal stromal tumor. This study shows that computed tomography can accurately show the location, shape, and size of gastric scrotal tumors and has important clinical value in identifying benign and malignant tumors as well as early clinical judgment and treatment and prognosis.