World Neurosurg
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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.
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In this study, we introduce a technique that combines percutaneous endoscopic lumbar discectomy (PELD) with annular suture, aiming to reduce postoperative recurrence rates and enhance clinical outcomes for patients. The repair of the annulus fibrosus plays a pivotal role in healing ruptured scars, reducing the rate of nuclear reherniation, and enhancing the hardness of scar tissue through surgical intervention. Younger patients, with their higher water content in the intervertebral discs and stronger nucleus pulposus tissue, are more suitable candidates for tissue suturing, thus achieving a higher success rate. ⋯ To enhance the safety and efficacy of the surgery, we present a detailed video demonstration of the PELD procedure and annular suture. The video showcases the use of suture needles of specific dimensions to ensure precision and effectiveness in the repair process. This meticulous approach not only improves patient outcomes but also contributes to a swifter return to daily activities, reducing the risk of long-term complications.
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Hypopituitarism, one or more pituitary hormones inefficiently produced by the anterior pituitary or released from the posterior pituitary to adapt to the needs of the organism. Existing epidemiological data show that immune-mediated diffuse infiltration of the anterior pituitary is important in the development of hypopituitarism. However, the precise connection between immune cells and hypopituitarism remains unclear. This study aimed to elucidate the potential causal links between the 731 immune cell types and hypopituitarism risk. ⋯ Our investigation shed light on the intricate potential relationship between immune cells and hypopituitarism via genetic methods, underscoring the immune-mediated pathway in hypopituitarism pathogenesis, thereby offering valuable insights for future clinical investigations.