World Neurosurg
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Low back pain and neck pain are primary causes of disability, with low back pain being a frequent reason for medical consultations. After conservative and pharmacological treatments, spinal injections are considered the next option. Despite multiple guidelines, spinal blocks remain controversial in terms of indication, technique, and operator, leading to considerable interinstitutional variability. The absence of regional studies in Latin America on how spinal surgeons handle spinal injections prompts the objectives of this study: to evaluate spinal surgeons' knowledge and experience, analyze techniques, and identify barriers and challenges in implementing spinal injections, including resource limitations, technology access, and training. ⋯ The study addresses a critical gap in the literature by focusing on spinal interventions in Latin America, where there is a notable lack of regional studies. The majority of the surgeons enrolled perform their own spinal injections, and they are interested in keep on learning. The findings not only contribute to the global discourse on spinal care but also offer a basis for the development of region-specific guidelines and educational initiatives.
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Intramedullary spinal cord lipomas without spinal dysraphism are rare. Although they are benign tumors, they can cause significant neurological deficits. Their tight adherence to the spinal cord presents a challenge for resection. Therefore, we review our institutional experience treating adult patients with intramedullary lipomas in the absence of dysraphism and report long-term outcomes after resection. ⋯ Subtotal resection is a safe and effective treatment. Detethering of the spinal cord, resection of exophytic components, and tumor debulking can improve symptoms and prevent further deterioration in most cases. The resection can be assisted using a laser to vaporize the fatty tissue of the lipoma without physical manipulation of the spinal cord.
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To explore mortality risk factors and to construct an online nomogram for predicting in-hospital mortality in traumatic brain injury (TBI) patients receiving invasive mechanical ventilation (IMV) in intensive care unit (ICU). ⋯ We constructed and validated an online nomogram based on routinely recorded factors at admission to ICU and at the beginning of IMV to target prediction of in-hospital mortality among TBI patients on IMV in ICU.
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Observational Study
The prognostic impact of Progesteron-receptor expression in surgical intracranial meningioma on performance status and quality of life. A single-center observational study.
The relationship between meningiomas and gonadal steroid hormones has been the subject of debate, and there is limited understanding of the connection between patient, tumor characteristics, and progesterone receptor (PGR) status. ⋯ The study found that PGR + meningioma patients tend to have better postoperative recovery and earlier clinical debut without any association with age prevalence or grading.
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Factors impacting the rate of aneurysm occlusion after flow diversion (FD) have been well described in the literature. In this article, we sought to evaluate those variables to develop and validate a scoring system predicting aneurysm incomplete occlusion after FD. ⋯ The proposed ABC scoring system can be used to evaluate the risk of aneurysm incomplete occlusion after treatment with FD, identifying patients who would benefit from adjunctive coiling or alternative treatment modalities.