World Neurosurg
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Endoscopic endonasal surgery is a feasible approach to lesions of the pediatric skull base. Olfactory outcomes following endoscopic endonasal approach (EEA) have been reported in the adult literature, but pediatric outcome data is lacking. The purpose of this preliminary study is to evaluate post-operative olfactory outcomes in pediatric patients who underwent EEA through transsphenoidal and/or transclival corridors. ⋯ Olfactory preservation is possible following pediatric EEA, though 40% of patients will develop some degree of microsmia in the immediate post-operative period and 20% will have some persistent dysfunction at 6 months. Long-term data is necessary to determine if microsmia continues to improve over time.
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Postoperative delirium (POD) is a frequent complication observed in patients following spinal surgeries. The incidence of POD is particularly concerning for major procedures like lumbar spinal fusion, leading to a range of detrimental outcomes. However, existing research on the prevalence and risk factors associated with POD after lumbar spinal fusion is limited, especially when relying on data from large-scale national databases. ⋯ Overall, our analysis revealed a relatively low prevalence of POD following lumbar spinal fusion surgery. Nevertheless, it is critical to investigate and understand the independent predictors of POD to effectively prevent and mitigate its negative impact on patient outcomes.
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Atlanto-axial injuries pose a significant threat to morbidity and mortality. This retrospective study aims to analyze clinical and radiological results, failure rates, and complications in a series of patients treated with a halo vest, validating the effectiveness of this device through long-term follow-up. ⋯ Based on our results, the halo vest is a valid treatment for atlanto-axial injuries in selected patients. This includes young and middle-aged individuals (up to 65 years old) with C1 and/or C2 fractures. Halo vest treatment is associated with minor complications and yields a high percentage of excellent/good clinical results.
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To identify delays for surgery to stabilize subaxial cervical fractures and the main reasons for them across Latin America. ⋯ We documented significant and concerning delays in providing spinal decompression and stabilization surgery to patients with cervical spine fractures. Only 17% of patients have surgery in the recommended time <24 hrs., more than half of the patients must wait for more than 72 hours, and nearly half of patients wait for longer than a week.