World Neurosurg
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Lumbar pedicle screw placement surgery involves various assistive technologies, including fluoroscopic, stereotactic, or robotic navigation and intraoperative neuromonitoring (IONM). We aimed to discern neurosurgeons' preferences for screw placement techniques and IONM utility, while also considering the influence of experience. ⋯ This national survey shows that stereotactic navigation is the predominant technique for pedicle screw placement among less experienced neurosurgeons, with seasoned neurosurgeons leaning towards fluoroscopic guidance. Robotic guidance was the least utilized technique with no observed difference based on experience. Neurosurgeons employing multiple techniques use IONM the most, compared with surgeons who only use stereotactic navigation and/or robotic guidance.
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A woman in her 60s with well-controlled dyslipidemia presented with anterior chest pain. The electrocardiogram, chest radiograph, and echocardiogram were unremarkable; however, cardiac enzymes levels were elevated. Coronary angiography performed after dual antiplatelet therapy revealed spontaneous coronary artery dissection (SCAD). ⋯ Autopsy confirmed dissections of the coronary and vertebral arteries. Although SCAD is rare, it often coexists with extracoronary vascular abnormalities due to systemic arterial fragility. Therefore, consider cerebrovascular disorders and promptly implementing diagnostic and management strategies in patients with SCAD and headaches is necessary.
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This study aimed to evaluate the efficacy and safety of low-density versus high-density pedicle screw in Lenke I AIS patients through systematic review and meta-analysis. ⋯ This meta-analysis suggests that low-density pedicle screw can achieve similar clinical and radiographic outcomes compared to high-density constructs in Lenke I AIS patients, while potentially reducing costs, making it a more cost-effective option without compromising patient outcomes.
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A profound knowledge of the anatomy and surgical management of the superior petrosal vein is vital during neurosurgical procedures in the posterior fossa. The debate on preserving the superior petrosal vein or whether it can be duly obliterated is still ongoing. ⋯ Not only were the heterogenous methods but also the respective authors' conclusions analyzed. In light of the collected evidence, we come to the conclusion that occluding the superior petrosal vein poses an ineligible risk to patient safety and should be considered obsolete.
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Patient-reported outcome measures (PROMs) are utilized to assess surgical success but are limited by data collection, response bias, and subjectivity. The large volume of digital healthcare data offers a new method to utilize healthcare utilization as a longitudinal, individualized, and objective proxy for health needs among surgical patients. This study aimed to design and evaluate a novel resource utilization in spine healthcare (RUSH) clustering method that complements PROMs in evaluating post-operative patient outcomes. ⋯ RUSH clustering provides a novel, data-driven approach to measure surgical success, complementing traditional PROMs, and leveraging big data to monitor and respond to surgical outcomes.