World Neurosurg
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We sought to assess the practice patterns of ventriculoperitoneal shunt (VPS) placement by neurosurgeons at academic, community, and government-based institutions. ⋯ General surgery assistance for distal placement and neuronavigation for the proximal placement of VPS catheters are both commonly used by neurosurgeons in academic, community, and other practice locations. This survey provides the first assessment of practice patterns nationally. The results demonstrate that roughly half of the practicing neurosurgeons use general surgery assistance and neuronavigation, particularly for complex or high-risk cases.
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This study aims to report the clinical outcomes associated with the percutaneous intralaminar screw repair performed for pars defects in adults. ⋯ Minimally invasive repair of lumbar spondylolysis with percutaneous intralaminar screw fixation restores the motion segment and can provide early resumption of physical activity with minimal muscle damage, smaller skin incision, and less soft tissue dissection.
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The COVID-19 pandemic has had a profound impact on the global delivery of health care. Recent data suggest a possible impact of the pandemic on patterns of neurotrauma. The aim was to assess the impact of the pandemic on the incidence of neurotrauma, with a focus on cranial gunshot wounds (cGSWs) at a large Midwestern level 1 trauma center. ⋯ Despite the government-mandated shutdown, we observed an increase in the number of neurotrauma cases in 2020. There was a significant increase in the incidence cGSWs in 2020, with an increase in assaults and self-inflicted injuries. Further investigation into socioeconomic factors for the observed increase in cGSWs is warranted.
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Patients with malignant peripheral nerve sheath tumors (MPNSTs) of major motor nerves typically present with muscle weakness and pain. We aimed to analyze and characterize patients with MPNSTs of major motor nerves but without muscle weakness at initial presentation. ⋯ MPNSTs of major motor nerves without muscle weakness represent an underappreciated subset of cases that have potential treatment and outcome implications. These patients presented with fewer symptoms and had fewer risk factors than patients with muscle weakness. Positron emission tomography should be considered as an additional method to try to anticipate the diagnosis of an MPNST.
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Tje objective of this study was to identify factors that are independently associated with increased surgical drain output (ISDO) in patients who have undergone anterior cervical decompression (discectomy/corpectomy) and fusion (anterior cervical discectomy and fusion [ACDF]/anterior cervical corpectomy and fusion [ACCF]). ⋯ Male sex, age 50 years or older, the number of discs involved, and C3 involvement were significant risk factors for ISDO following anterior cervical decompression and fusion. Patients with these risk factors may benefit from surgical drain placement.