World Neurosurg
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This study evaluates the impact of L4-L5 minimally invasive surgery (MIS)- transforaminal lumbar interbody fusion (TLIF) on adjacent-level parameters. ⋯ L4-L5 MIS-TLIF had a more consistent effect on L3-L4 than L5-S1. Although adjacent-level SL and DA decreased over time, their association with ASDeg appears limited, suggesting a multifactorial etiology. L4-L5 MIS-TLIF provides demonstrable clinical benefits with lasting PRO improvements and low adjacent-level reoperations.
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This study focused on identifying factors influencing recurrent lumbar disc herniation (RLDH) by analyzing demographic data, body mass index (BMI), and radiologic disc properties in patients undergoing single-level unilateral lumbar disc herniation surgery. ⋯ We found that factors like gender, age, DM, obesity, surgical level, disc degeneration, and disc types do not significantly impact RLDH. However, the higher occurrence of HT in recurrent cases indicates a potential area for further research.
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Visual impairment affects 55%-80% of medial sphenoid wing meningiomas (mSWMs) patients, making optic nerve decompression a critical surgical goal. Complete resection often leads to better visual outcomes. However, involvement of critical neurovascular structures increases postoperative morbidity and mortality, with vascular injury reported in 18%-20% of cases. This study aims to evaluate the relationship between the extent of resection (EOR), visual outcomes, and the incidence of vascular injury, seeking to identify the optimal surgical approach for mSWMs. ⋯ Cavernous sinus-extension and T2-hyperintensity predict poor resection rates in mSWMs. While visual outcomes are not directly affected by EOR, long-term visual status may decline due to tumor recurrence and radiotherapy. Vascular injury incidence is not associated with EOR. Thus, the "maximal safe resection" of mSWMs involves a surgical strategy balancing targeted aggressive and conservative resection for maximal cytoreduction and functional preservation.
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Middle meningeal artery (MMA) embolization for the treatment of chronic subdural hematomas (cSDHs) is becoming increasingly prevalent. It is essential to optimize the safety and cost effectiveness of the postprocedural management. In this study, we examined our cases over time to determine the most appropriate postprocedural destination. ⋯ MMA embolization for cSDH is a safe procedure with low rate of procedure-related complications. In carefully selected patients, the necessity ICU admission postoperatively should be weighed against better hospital resource utilization.
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To investigate factors influencing the long-term prognosis of patients with sacral Tarlov syndrome after nerve root cuff reconstruction. ⋯ Patients with sacral Tarlov cysts undergoing nerve root cuff reconstruction, particularly those with longer preoperative disease duration and dysuria, are at increased risk of poor long-term prognosis.