World Neurosurg
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Unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) is an advanced, minimally invasive spinal surgical technique characterized by the use of 2 discrete portals-one for clear visualization and continuous irrigation and the other for the dexterous manipulation of surgical instruments. This configuration not only affords an expanded view (0° or 30°) but also enhances the freedom of movement for instruments, thereby augmenting the precision and flexibility of the surgery. The superiority of UBE-TLIF lies in its capacity to facilitate rapid postoperative recovery with minimal trauma, reduced intraoperative bleeding, abbreviated hospital stays, and significant amelioration of postoperative lower back pain. ⋯ This technique reduces neural irritation during the procedure, leading to an improved patient experience postoperatively. UBE-TLIF offers a safe, efficacious, and swiftly recuperative minimally invasive option for the treatment of lumbar degenerative diseases. It diminishes reliance on costly equipment, thereby facilitating the dissemination and application of this technology in community hospitals.7.
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Postoperative delirium (POD) is a frequent complication observed in patients following spinal surgeries. The incidence of POD is particularly concerning for major procedures like lumbar spinal fusion, leading to a range of detrimental outcomes. However, existing research on the prevalence and risk factors associated with POD after lumbar spinal fusion is limited, especially when relying on data from large-scale national databases. ⋯ Overall, our analysis revealed a relatively low prevalence of POD following lumbar spinal fusion surgery. Nevertheless, it is critical to investigate and understand the independent predictors of POD to effectively prevent and mitigate its negative impact on patient outcomes.
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Unplanned reoperation postspinal surgery (URPS) leads to prolonged hospital stays, higher costs, decreased patient satisfaction, and adversely affects postoperative rehabilitation. This study aimed to develop and validate prediction models (nomograms) for early URPS risk factors using machine learning methods, aiding spine surgeons in designing prevention strategies, promoting early recovery, reducing complications, and improving patient satisfaction. ⋯ The established model can effectively predict URPS in patients and can assist spine surgeons in devising personalized and rational clinical prevention strategies.
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There are many studies on postoperative cognitive function after surgical clipping (SC) and endovascular coiling (EC) for unruptured cerebral aneurysms, but few reports focusing on possible subclinical damage. The aim of the present study was to detect the subclinical damage after surgical intervention. ⋯ 123IMP-SPECT revealed a statistically significant reduction in ipsilateral CBF in patients who had an uneventful clinical course and no cognitive problems. The subclinical consequence could persist for at least 2 years following SC, and was less pronounced following EC.
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Rathke cleft cysts are congenital, non-neoplastic sellar cysts derived from remnants of embryonic Rathke pouch. Presentation of Rathke cleft cysts can be incidental; however, in larger cysts, presentation can be with headaches, visual deterioration, and pituitary and endocrine dysfunction. Here we report a rare case of identical twin boys with Rathke cleft cysts, highlighting the likely genetically driven development of cyst in this identical twin and need for cranial imaging in identical twins with anomalies of the brain.