World Neurosurg
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The National Health Service faces substantial challenges with staffing in the face of administrative turbulence just after a global pandemic resulting in significant economic losses. This staffing crisis extends to neurosurgical training with pervasive problems with the balance between trainees and consultants. ⋯ Creating a sustainable neurosurgery training program to adequately fill gaps in the National Health Service will require long-term solutions and the commitment of multiple stakeholders. The first step to achieving these goals would be to maximize the available opportunities to allow trainees maximize training time to become competent day-one consultants.
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Randomized Controlled Trial
The effects of supplemental dexmedetomidine anesthesia on intracranial aneurysm patients undergoing intracranial interventional embolization.
Intracranial aneurysm (IA) has been identified in approximately 0.4%-3% of the population and associated with 3%-10% mortality. IA is the major factor attributing to spontaneous subarachnoid hemorrhage. We aim to investigate that whether employing dexmedetomidine (DEX), an α2 adrenergic receptor agonist, as a supplementation could impact the outcomes of patients with intracranial interventional embolization. ⋯ Our study demonstrated that employing DEX as supplementation during anesthesia could effectively reduce surgical stress and improve cognitive function, ultimately improving patients' recovery from intracranial interventional embolization.
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To identify risk factors for development of deep venous thrombosis (DVT) in patients undergoing spinal irrigation and débridement for an infection with subsequent peripherally inserted central catheter placement and to determine if chemoprophylaxis mitigates the risk of developing DVT. ⋯ Patients undergoing spinal débridement with subsequent peripherally inserted central catheter placement are at high risk for postoperative DVT. Multiple spine débridement procedures, a history of diabetes, and previous DVT are risk factors for postoperative DVT. Chemoprophylaxis does not mitigate patients' risk for postoperative DVT.
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Spontaneous spinal cerebrospinal fluid (CSF) leaks are a rare entity that can lead to intracranial hypotension and associated headaches, meningismus, and patient debility. Surgical treatment may be necessary for patients who do not respond to conservative management. Surgical repair of CSF leaks located in the ventral thoracic spine traditionally require an invasive, open approach. ⋯ The endoscopic approach described here for treatment of this rare entity allows for removal of bony spicules/osteophytes and dural repair without the morbidity associated with traditional open dorsolateral or ventrolateral approaches.
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Observational Study
Sacroiliac Joint Fusion - A Shift Towards Variant Anatomy and Clinical Implications.
To investigate impact of patient factors and sacroiliac joint (SIJ) anatomical structure on SIJ fusion outcomes. ⋯ A pathological SIJ has a significantly higher prevalence of variant joint anatomy. There appears to be a trend toward differences in surgical outcomes based on SIJ anatomy. Future research with larger sample sizes is necessary to confirm these differences.