World Neurosurg
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To compare patient-reported outcomes (PROMs), postoperative patient-reported satisfaction, and minimum clinically important difference (MCID) achievement after minimally invasive surgery lumbar decompression (MIS-LD) in patients stratified by their preoperative 12-Item Short-Form Mental Component Score (SF-12 MCS). ⋯ Patients with inferior mental health preoperatively showed worse mean short-term postoperative clinical outcome for leg/back pain, physical function and disability, short-term and long-term postoperative satisfaction for leg pain and disability, and long-term satisfaction for sleeping/lifting/walking/standing/sex/travel.
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The aim of this study was to compare accuracy of surgical plans generated from in-person and telemedicine evaluations and assess the reasons for surgical plan changes between initial evaluation and surgery. The secondary objective was to assess the effect of changes in surgical planning on postoperative outcomes. ⋯ Telemedicine and in-person evaluations generated similarly accurate surgical plans. Changes to the initial surgical plans most often involved adding operative levels. Our findings show that telemedicine visits are an acceptable option for preoperative assessment to generate surgical plans; however, further research is needed.
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Indocyanine green videoangiography (ICG-VA) with FLOW 800 (Carl Zeiss AG) has been used as a visualization tool to guide arteriovenous malformation (AVM) surgery since 2011. We performed a systematic review and evaluated the quality of evidence available on this topic. In addition, we present a series of our own cases demonstrating the unique use of ICG-VA in the localization and removal of deeper seated AVMs. ⋯ We present cases highlighting the usefulness of this technique for the localization of certain AVMs. We believe the use of ICG-VA can guide the removal of deeper seated AVMs, because it can reveal surface feeders and draining veins that can be followed to a hidden nidus. Larger, registry-based studies are needed to confirm these findings and improve the overall quality of evidence.
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Aesthetic complications following neurosurgical procedures impact patient quality of life and self-perception. Postoperative temporal hollowing frequently is seen after temporal craniotomy, resulting mainly from atrophy of the temporal muscle. Autologous fat grafting is a tailorable method to correct such approach-related sequelae. We herein present our clinical patient series and discuss pearls and pitfalls of this method. ⋯ Autologous fat grafting is a valuable method for correcting postoperative temporal hollowing that provides stable results, high patient and surgeon satisfaction, and can be tailored to the patient's individual needs. It should not be considered a merely aesthetic operation but an important rehabilitation step towards restoring the patient's quality of life.
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To investigate the influence of body mass index (BMI) on perioperative outcomes, postoperative patient-reported outcome measures (PROMs), and minimal clinically important difference (MCID) achievement among workers' compensation (WC) claimants undergoing minimally invasive lumbar decompression (MIS-LD). ⋯ Patients with higher levels of obesity were more likely to experience longer length of stay and delayed discharge following MIS-LD. Increasing BMI was generally not a significant predictor of postoperative pain, disability, or physical health PROMs at most timepoints. MCID achievement rates for disability relief were significantly higher for non-obese patients.