World Neurosurg
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The purpose of this retrospective cohort study was to evaluate the effect of tranexamic acid (TXA) on reducing perioperative blood loss and length of stay after transforaminal lumbar interbody fusion (TLIF). Spine surgery is associated with the potential for significant blood loss, and adequate hemostasis is essential to visualizing crucial structures during the approach and procedure. Although TXA use has been extensively studied in the pediatric and adult spinal deformity literature, there is a dearth of literature on its efficacy in reducing blood loss for patients who undergo 1- to 3-level TLIF. ⋯ The application of preoperative TXA for patients undergoing 1- to 3-level TLIF reduced drain output in the first 2 postoperative days, but it did not affect hospital length of stay, total blood loss, or EBL.
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This study aimed to identify the risk factors for acute obstructive hydrocephalus (AOHCP) after extra-axial cerebellopontine angle (CPA) tumor surgery using the retrosigmoid (RS) approach. ⋯ An increased risk of AOHCP after the RS approach was observed in patients with extra-axial CPA tumors with clival extension and major fourth ventricle compression. Compulsive and meticulous hemostasis must be achieved because postoperative hemorrhage is associated with AOHCP.
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The objective of this study was to determine if Medicare status and age affect clinical outcomes following anterior cervical discectomy and fusion. ⋯ Regardless of age and Medicare status, all patients undergoing cervical discectomy and fusion had significant clinical improvement postoperatively. However, Medicare patients under age 65 have a smaller magnitude of improvement in PROMs.
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The effect of prolonged symptom duration in patients undergoing ambulatory MIS-TLIF on postoperative clinical outcomes has not been well studied. We aim to compare symptom duration of pain and/or weakness on postoperative outcomes in patients undergoing outpatient MIS-TLIF. ⋯ Independent of symptom duration, patients reported significant improvement in back pain at all postoperative periods. Patients presenting with shorter symptom duration consistently reported significant improvement in leg pain postoperatively. Patients with shorter symptom duration demonstrated greater MCID achievement in back and leg pain. Patients indicated for outpatient MIS-TLIF may benefit more from earlier intervention following onset of symptoms.
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Angiographic treatment of asymptomatic cerebral vasospasm (CVS) in aneurysmal subarachnoid hemorrhage remains controversial. We sought to investigate its relationship with the development of delayed cerebral ischemia. ⋯ Cerebral angiography has a low rate of detecting moderate-severe CVS in asymptomatic patients. Moreover, there was no statistically significant difference in the rate of delayed cerebral ischemia between asymptomatic patients treated versus those not treated for CVS. There was significant association between the severity of CVS and the intensive care unit and hospital length of stay. More studies are needed to evaluate the utility of treating asymptomatic CVS in high-grade aneurysmal subarachnoid hemorrhage.