World Neurosurg
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Early evidence suggests that middle meningeal artery (MMA) embolization is an efficacious minimally invasive neuroendovascular technique for the management of chronic subdural hematoma (cSDH). Particle and liquid embolic materials are commonly used to embolize the MMA; however, studies comparing the safety and outcomes between these 2 materials are limited. ⋯ Our series shows that liquid embolic and particle embolization are equally safe and effective among patients undergoing MMA embolization for management of cSDH.
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Adjacent segment degeneration (ASD) is a common phenomenon after lumbar fusion. Lateral lumbar interbody fusion (LLIF) may provide an alternative treatment method for ASD. This study used finite element analysis to evaluate the biomechanical effects of LLIF with various fixation options and identify an optimal surgical strategy for ASD. ⋯ LLIF with BPSF is recommended when performing LLIF surgery for ASD after L4-5 and L5-S1 PLIF. Considering cage subsidence and biomechanical effects on the adjacent segment, LLIF with LSF may be a suboptimal option for ASD surgery.
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Work-related pain among neurosurgeons remains understudied, yet can have long-term consequences which affect operative efficiency and efficacy, career longevity, and life outside of work. ⋯ Ergonomics training did not appear to make a difference in neurosurgeons' pain severities. This may signify a need to optimize ergonomics pedagogy to achieve observable benefits.
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The efficacy of tubular microdiscectomy (TMD) in the treatment of recurrent lumbar disc herniation (rLDH) is still unclear, especially compared with the endoscopic technique. We performed a retrospective study to analyze this question. ⋯ TMD seems to be an efficient technique for the surgical treatment of leg pain caused by rLDH. In the literature, this technique seems to be at least as good as the endoscopic technique and is easier to master.
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To assess opioid usage in surgical and nonsurgical patients with lumbar disc herniation receiving different treatments and timing of treatments. ⋯ Early surgery in patients with lumbar disc herniation is associated with lower long-term average daily MME, incidence of opioid use, and 1-year cumulative MME burden compared with nonsurgical and late surgery treatment approaches.