World Neurosurg
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Malignant spinal tumors are common, continually increasing in incidence as a function of improved survival times for patients with cancer. Using predictive analytics and propensity score matching, we evaluated the influence of frailty on postoperative complications compared with age in patients with malignant neoplasms of the lumbar spine. ⋯ Frailty demonstrated a significant relationship with increased postoperative patient complications, length of stay, costs, and acute complications in patients receiving fusion following resection of a malignant neoplasm of the lumbar spine region. Frailty demonstrated better predictive validity of outcomes compared with patient age.
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Social media has become ubiquitous in modern medicine. Academic neurosurgery has increased adoption to promote individual and departmental accomplishments, engage with patients, and foster collaboration. We sought to quantitatively evaluate the adoption of one of the most used social media platforms, Twitter, within academic neurosurgery. ⋯ We demonstrate rapid uptake in Twitter use among U.S. academic neurosurgical departments, accelerated by COVID-19. With the impact of COVID-19, it is clear that there will be continued rapid adoption of this platform within neurosurgery, and future studies should explore the outcomes of peer collaboration, patient engagement, and dissemination of medical information.
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Despite potential advantages, broad carbon dioxide (CO2) laser diffusion in neurosurgery was historically prevented by several operative limitations. Nonetheless, in recent decades, significant improvements, in particular the development of surgical scanners, have made CO2 laser surgery easier and reproducible. The aim of this study was to report our preliminary experience with the SmartXide2 CO2 laser system. ⋯ In selected cases, the SmartXide2 CO2 laser system could be a helpful, reliable, and safe surgical instrument to treat different cerebral and spinal lesions. It addresses some of the limitations of laser systems and is able to cut/ablate and coagulate the tissue simultaneously, with minimal lateral thermal spread, preserving the surrounding eloquent neurovascular structures. Moreover, having no consumable accessories, it is also cost-effective.
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Tumefactive demyelinating lesions (TDLs) are a rare sequelae of idiopathic inflammatory demyelinating diseases of the central nervous system. Their propensity to mimic tumor and abscess poses a diagnostic challenge for the clinician. ⋯ Ensuing magnetic resonance imaging of the cord, in addition to cerebral spinal fluid analysis, supported the diagnosis of idiopathic inflammatory demyelinating diseases. This case highlights the need to consider the rare diagnosis of TDL when imaging shows cystic brain lesions in an otherwise healthy young adult.
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In 1985, Kawase published an anterior petrosal approach to expose the posterior cranial fossa and to minimize retraction of the temporal lobe. However, some neurosurgeons still have difficulty with removing tumors through an anterior petrosal approach because a complete understanding of the Kawase pyramid has not been achieved. We hypothesized that if anterior petrosectomy were performed with three-dimensional understanding of the Kawase pyramid, it would have a positive effect on extent of tumor resection. ⋯ Insufficient petrosectomy during an anterior petrosal approach adversely affects the extent of tumor resection. Furthering three-dimensional understanding of the Kawase pyramid could aid in complete tumor resection and better outcomes without causing damage to the surrounding organs.