World Neurosurg
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Artificial intelligence (AI) is expected to play a greater role in neurosurgery. There is a need for neurosurgeons capable of critically appraising AI literature to evaluate its implementation or communicate information to patients. However, there are a lack of courses delivered at a level appropriate for individuals to develop such skills. We assessed the impact of a 2-day (non-credit bearing) online digital literacy course on the ability of individuals to critically appraise AI literature in neurosurgery. ⋯ Bespoke courses delivered at an appropriate level can improve clinicians' understanding of the application of AI in neurosurgery, without the need for in-depth technical knowledge or programming skills.
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Anterior pituitary dysfunction is one of the major causes of disability and morbidity in patients suffering from traumatic brain injury (TBI). The present study was undertaken to evaluate the incidence of anterior pituitary dysfunction in cases of moderate and severe TBI, its value in long-term prognostication, and the factors that predispose to a higher incidence of anterior pituitary dysfunction in acute and chronic phases. ⋯ Thyroid and gonadotropin axes were most commonly affected and deficiency of at least 1 axis was found in 82.4% patients in the acute phase and 59.3% in the chronic phase. Thyroid axis deficiency had a negative impact on prognosis in post-TBI patients.
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The enhanced recovery after surgery (ERAS) protocol is a proven method to improve postsurgical outcomes. While recent studies have shown the benefit of ERAS even in frail patient populations, myelopathy is another factor affecting outcomes in patients undergoing posterior cervical fusion (PCF). This study evaluated the benefit of an ERAS protocol in frail patients undergoing PCF. ⋯ ERAS is an effective protocol in PCF patients that may expedite return of physiologic function, lessen LOS, decrease the number of nonhome discharges, and reduce complications, irrespective of frailty or myelopathy status.
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To compare the stability of a corticopedicular posterior fixation (CPPF) device with traditional pedicle screws for decompression and fusion in adult degenerative lumbar spondylolisthesis. ⋯ CPFF fixation demonstrated similar segmental stability to traditional pedicle screw fixation whereas tensile forces and stress in surrounding cortical bone remained below the load to failure.
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The present study compares postoperative outcomes between patients with and without sickle cell disease (SCD) undergoing 1-to 3-level lumbar spinal fusion for degenerative pathologies. ⋯ Patients with SCD undergoing lumbar spinal fusion demonstrate higher risks for coagulopathic, ischemic, and infectious-related complications, as well as long-term postoperative opioid use. Awareness of the unique complication profile in SCD patients may help guide surgeons in refining perioperative management strategies to optimize outcomes in patients with SCD.