World Neurosurg
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Virtual reality (VR) has emerged as a powerful tool for neuroanatomy education of postgraduate medical trainees. However, its use in early training in neurosurgery, such as of undergraduate, medical, and physician assistant students, has not been evaluated. We also have limited insight into how VR may be integrated with traditional teaching methods. ⋯ Integration of VR with traditional pedagogic tactics is well received by the learners and contributes to measurable learning outcomes. Our experience informs the future use of VR tools in medical education.
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To study the effect of lumbar lordosis change and pelvic parameters on surgical outcomes such as fusion versus nonfusion (pseudarthrosis), adjacent segment pathology (ASP), and reoperation in patients undergoing 1-level, 2-level, and 3-level posterior lumbar fusion (PLF). ⋯ Better restoration of lumbar lordosis reduces rates of pseudarthrosis after short-segment PLF but has no association with rates of ASP.
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Numerous studies have demonstrated a strong association between traumatic brain injury (TBI) and an increased risk of meningioma. However, this correlation remains controversial. This study utilized Mendelian randomization to explore this relationship from the perspective of genetic evidence. ⋯ The Mendelian randomization study revealed that TBI does not increase the risk of meningioma based on genetic evidence.
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Complete traumatic dorsal spondyloptosis with no neurological involvement is so rare due to the inherent stability of the thoracic spine, that only 2 other cases are reported in literature. A 31-year male with history of fall, and normal neurological examination was noted to have grade 5 dislocation at D7-D8, with locking of D7-8 bodies and expanded canal due to pedicle fractures accommodating the displaced spinal cord. As the excessive manipulation to achieve reduction was deemed too risky to be worthy, it was decided to do in-situ fixation without reduction. ⋯ Under O-arm navigation, pedicle screws were placed in D5,6,8,9&10, with D8 screws crossing onto D7. The rods had to be contoured in S shape and maneuvered across all screw heads. The patient has remained asymptomatic for more than 2 years after surgery.
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Early diagnosis of diabetes insipidus (DI), a complication following pituitary surgery, can avoid catastrophic results such as lethargy or even death. Measurement of arginine vasopressin (AVP) may help the early diagnosis, but its direct assaying is challenging. Copeptin, which is co-secreted in equimolar quantities to AVP, is suggested to be a reliable marker in prediction of postoperative DI. Therefore, this systematic review plus meta-analysis aims to discover this possible role. ⋯ Copeptin level was significantly lower in DI patients than in non-DI patients who underwent pituitary surgery. Early measurement, as soon as possible (from the first hour to 48 hours after the operation) of copeptin after pituitary surgeries has good, but not excellent, accuracy to exclude postoperative DI.