World Neurosurg
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Observational Study
Hospital volume-outcome relationship in severe traumatic brain injury: a nationwide observational study in Japan.
The hospital volume-outcome relationship in patients with severe traumatic brain injury (TBI) remains unclear. This study investigated the association between the volume of patients with severe TBI and in-hospital mortality. ⋯ Higher hospital volumes were significantly associated with lower in-hospital mortality after severe TBI. Regionalization and referral to higher-volume hospitals are beneficial for severe TBI patients.
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Although studies have continued to demonstrate the advantages of transradial access (TRA) for neurointervention, radial artery spasm (RAS) has remained a frequent cause of TRA failure. Dotter and Judkins initially described a technique to dilate areas of peripheral vascular stenosis by advancing sequentially larger catheters across the lesion over a guidewire. We have presented our institutional experience with the use of a modified Dotter technique with long radial sheaths to dilate areas of proximal flow-limiting RAS. In the present study, we reviewed the use of the Dotter technique for alleviating RAS in patients undergoing TRA for neurointervention. ⋯ Our modified Dotter technique was effective in bypassing areas of severe proximal flow-limiting RAS, obviating the need for access site conversion. Additional studies are warranted to understand the implication of the angioplasty-like effects seen within the radial artery after removal of the long radial sheaths.
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Anterior cervical discectomy and fusion (ACDF) has been considered the standard treatment for degenerative cervical disc disease; however, recent trials have shown comparable outcomes with cervical disc arthroplasty (CDA). This study aimed to observe disparities in treatment paradigms of single-level cervical disc diseases and compare inpatient outcomes between procedures. ⋯ CDA was associated with shorter LOS but greater costs compared with ACDF. Patients with greater median income and private insurance were more likely to receive CDA.
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Case Reports
Exoscopic en bloc Carotid-Sparing Total Temporal Bone Resection: Feasibility Study and Operative Technique.
To delineate the steps of exoscopic en bloc carotid artery-sparing total temporal bone resection for malignancies involving the temporal bone in a cadaveric model. ⋯ Exoscope-assisted en bloc carotid artery-sparing total temporal bone resection is a feasible technique for management of malignancies with temporal bone invasion.
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To assess differences in postoperative patient-reported outcome measures (PROMs) and minimal clinically important difference (MCID) attainment following single-level anterior cervical discectomy and fusion based on predominant preoperative pain symptom. ⋯ Predominant pain symptom demonstrated little effect on perioperative characteristics and postoperative PROMs. Anterior cervical discectomy and fusion candidates will likely experience similar clinically meaningful postoperative improvements in physical function, disability, and pain.