World Neurosurg
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The surgical treatment of craniovertebral junction (CVJ) lesions remains a difficult process requiring advanced experience. The aim of this study was to present our experience and the clinical results of a posterior and posterolateral approach used for CVJ lesions in our clinic, and to discuss these in light of current literature. ⋯ A posterior or a posterolateral approach is a safe surgical technique that can provide total tumor resection for CVJ region lesions, including posterior, posterolateral, lateral, and anterolaterally located tumors. Isolated anterior and anterolateral tumors with small lateral extension may require a far lateral or extreme lateral approach combined with other cranial base techniques.
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To compare unilateral dominant-side video-assisted thoracoscopic sympathectomy (U-VATS) with bilateral procedures (B-VATS) in terms of efficacy and complications and to identify predictors of outcome after U-VATS. ⋯ U-VATS proved to be equally effective as B-VATS with less postoperative pain, shorter hospital stay, less frequent compensatory sweating, and better improvement of planter hyperhidrosis. The results suggest that patients with preoperative Hyperhidrosis Quality of Life Questionnaire scores >80 are better operated via B-VATS, whereas lower scores are indicated for U-VATS.
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To determine the influence of preoperative workers' compensation (WC) status on patient-reported outcome measures following lumbar decompression with or without fusion. ⋯ WC patients improve less than NWC patients. However, WC patients who return to work have similar VAS back and neck pain improvements as NWC patients.
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Increased posterior cervical decompression and fusion (PCDF) procedures over the past decade have raised the prospect of bundled payment plans. The American Society of Anesthesiologists (ASA) Physical Status Classification system may enable accurate estimation of health care costs, length of stay (LOS), and other postoperative outcomes in patients undergoing PCDF. ⋯ High ASA class is strongly associated with increased costs, LOS, and adverse outcomes following PCDF and could be useful for preoperative prediction of these outcomes.
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Case Reports
Interhemispheric Approach for Clipping of a Pericallosal Artery Aneurysm: 2-Dimensional Operative Video.
Pericallosal artery aneurysms are rare, accounting for 2%-9% of all intracranial aneurysms. They are most commonly saccular and wide necked. Although typically small, they are more prone to rupture compared with other aneurysms in the anterior circulation. ⋯ Meticulous dissection avoids rupture without proximal control. We highlight the key surgical steps and microsurgical techniques in approaching these aneurysms. The patient tolerated the operation well with an uneventful postoperative course.