World Neurosurg
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Venous stenting (VS) for venous sinus stenosis in the setting of idiopathic intracranial hypertension has been increasing in acceptance by neurointerventionalists. Stent-adjacent stenosis (SAS) and in-stent stenosis leading to symptom recurrence and the need for retreatment are known delayed complications. However, the effect of the dual antiplatelet therapy (DAPT) duration on these complications has remained poorly characterized. ⋯ We found no differences between 3 and ≥6 months of DAPT in terms of the risk of stent stenosis or stent survival. However, patients with a higher venous pressure gradient before VS had a greater risk of stent failure.
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Readmission after spine surgery is costly and a relatively common occurrence. Previous research identified several risk factors for readmission; however, the conclusions remain equivocal. Machine learning algorithms offer a unique perspective in analysis of risk factors for readmission and can help predict the likelihood of this occurrence. This study evaluated a neural network (NN), a supervised machine learning technique, to determine whether it could predict readmission after 3 lumbar fusion procedures. ⋯ The accurate metrics presented indicate the capability for NN algorithms to predict readmission after lumbar arthrodesis. Moreover, the results of this study serve as a catalyst for further research into the utility of machine learning in spine surgery.
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To determine the diagnostic accuracy of combined computed tomography (CT) findings for detecting posterior ligamentous complex (PLC) injury in thoracolumbar fractures using magnetic resonance imaging as a reference. ⋯ Two or more CT findings provided the best combination to confirm PLC injury; thus, this combination could be used as a criterion for injured PLC. A single CT finding lacks sufficient predictive value to confirm or rule out PLC injury. A negative CT for the 4 CT findings provided the highest sensitivity for PLC injuries.
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Due to the increasing age of patients, the evaluation of bone density is crucial, especially in preparation for spinal surgery. The aim of this study was to determine bone density using a computed tomography (CT) and to correlate Hounsfield units (HU) with bone density values of a quantitative computed tomography (QCT). ⋯ The equation allows calculating bone density values without the need for an additional QCT and without further radiation exposure or costs. With this measuring method it is possible to obtain additional information from a computed tomography.
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The endoscopic endonasal transcavernous (EET) approach is an increasingly popular approach for the cavernous sinus and surrounding structure lesions as well as a surgical corridor to pre-mesencephalic cisterns. This endoscopic study describes the main intracavernous branches of the internal carotid artery, providing nuances to improve the safety of this approach. ⋯ The MHT is a highly prevalent intracavernous branch, with 7 identifiable patterns based on DMA morphology and branch combination. This knowledge could guide surgeons in performing a safer EET approach.