World Neurosurg
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Some patients with glioblastoma multiforme (GBM) survive 3-5 years (or longer) after diagnosis. The goal of this study was to identify differences between the long-term survivors (LTS) and those who had a shorter overall survival (non-LTS groups). ⋯ Several differences were identified between the LTS and non-LTS groups. These differences will likely be incorporated into future prognostic models. They may also aid in differentiation between recurrent disease and treatment-related changes.
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Oblique lumbar interbody fusion (OLIF) is useful as surgical treatment of degenerative lumbar disease. However, revision surgery has often resulted in worse surgical outcomes than primary surgery. Thus, we compared the usefulness of OLIF as primary surgery (PS) versus revision surgery (RS). ⋯ Most radiological outcomes were similar between the RS and PS groups, with no differences in complications or the requirement for additional posterior decompression. However, OLIF resulted in relatively poor clinical outcomes when used as RS. Thus, revision spine surgery tends to result in poor outcomes compared with those of primary spine surgery; however, OLIF can be a tolerable option for revision spine surgery.
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Traditional laminectomy for excision of spinal tumors involves extensive dissection of the midline spinous ligaments, greater blood loss, and risk of delayed segmental instability. The minimally invasive technique of spinal tumor resection using tubular retractors can achieve safe and complete tumor resection while preserving the structural and functional integrity. The authors present their experience of minimally invasive spinal surgery for spinal tumors in this case series. ⋯ This series demonstrates the feasibility, safety and effectiveness of the keyhole approach for excision of intradural and extradural spinal tumors extending up to 2 levels. Careful case selection, good preoperative planning, meticulous microsurgical resection, and watertight dural closure are crucial for successful outcome. Early mobilization, less blood loss, and avoidance of delayed instability are the advantages of minimally invasive spinal surgery when compared with open surgery.
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Occipitocervical fixation using bilateral C2 pedicle screws (C0-C2BiPS) and occipitocervical fixation using bilateral C2 translaminar screws (C0-C2BiLS) provide satisfactory stability. Bilateral fixation is not feasible for cases of C2 unilateral pedicle morphology abnormality and ipsilateral laminectomy. This study proposed and evaluated novel occipitocervical fixation using C2 unilateral pedicle screw and contralateral translaminar screws (C0-C2PSLS). ⋯ Novel C0-C2PSLS provides similar stabilization effect as C0-C2BiPS and C0-C2BiLS constructs and has potential for clinical use, especially for cases of C2 unilateral pedicle morphology abnormality and ipsilateral laminectomy.
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Vagus nerve stimulation (VNS) therapy is an increasingly popular treatment for medically intractable epilepsy. During a review of our cases, we noted that one of the senior authors give patients 1 week of antibiotic prophylaxis after VNS surgery while the other does not. We reviewed our experience with postoperative antibiotic prophylaxis after VNS surgery. ⋯ Just as with any hardware implantation, infection of the hardware can lead to significant morbidity. However, the use of postoperative oral antibiotic prophylaxis did not show benefit in reducing the infection rate.