World Neurosurg
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Review
Comprehensive Management of Intracranial Aneurysms Using Artificial Intelligence: An Overview.
Intracranial aneurysms (IAs), an asymptomatic vascular lesion, are becoming increasingly common as imaging technology progresses. Subarachnoid hemorrhage from IAs rupture entails a substantial risk of mortality or severe disability. The early detection and prompt intervention of IAs posing a high risk of rupture are paramount for optimizing clinical management and safeguarding patients' lives. ⋯ Furthermore, AI can meticulously analyze extensive aneurysm datasets to forecast aneurysm growth, rupture hazards, and prognostic scenarios, offering clinician's invaluable assistance in decision-making. This article comprehensively examines the latest advancements in the utilization of AI in aneurysm treatment, encompassing detection and segmentation, rupture risk assessment, prediction of therapeutic outcomes, and facilitation of microcatheter shaping. A brief discussion is held on the challenges and future paths for clinical AI deployments.
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Cervical disc herniation often necessitates surgery in elderly patients when nonoperative treatments fail. This study compares discharge outcomes of anterior cervical discectomy and fusion (ACDF) vs. posterior cervical decompression and fusion (PCDF) in geriatric patients. ⋯ ACDF in geriatric patients with cervical disc herniation was associated with higher rates of home discharge compared to PCDF. Tailored surgical approaches based on patient demographics may improve recovery outcomes.
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The purpose of this study is to determine the impact of community-level socioeconomic status (SES) on surgical outcomes and patient-reported outcome measures (PROMs) following revision lumbar fusion. ⋯ While there are socioeconomic differences based on DCI, community-level SES was not predictive of worse surgical outcomes following revision lumbar fusion. Patients from the most distressed communities were able to achieve similar improvement after revision surgery. This should encourage spine surgeons to feel comfortable discussing an indicated revision lumbar procedure with patients, and not view SES as a barrier to successful outcomes.
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Biocompatible computer-assisted design (CAD) implants for cranioplasty are associated with high costs and considerable waiting time. We present the results of the first cranioplasty experience in our country using polymethylmethacrylate (PMMA) with customized 3D molds of the cranial defect. ⋯ Cranioplasty with PMMA and 3D custom mold is a safe and low-cost technique that would benefit patients in middle- and low-income countries. Compared to CAD implants, the cost was reduced by 95%-97%. This technique can be implemented on a large scale with remarkable benefits in low- and middle-income countries.
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To investigate the efficacy of intrathecal combined administration of autologous bone marrow-derived mesenchymal stem cells (BMSCs) and Schwann cells (SCs) in urinary function improvement in complete spinal cord injury (SCI) patients for the first time. ⋯ The combined intrathecal administration of BMSCs and SCs significantly improved the urodynamic study parameters, urinary incontinence rate, and incontinence quality of life in complete SCI-induced neurogenic bladder.