World Neurosurg
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Anterior cervical discectomy and fusion (ACDF) is the gold standard approach for surgical management of many manifestations of cervical spine pathology. In recent years, total disc replacement (TDR) has emerged as a motion preserving modality that is proposed to decrease the rate of adjacent segment disease (ASD). In patients with multi-level disease, hybrid constructs with ACDF at 1 level and TDR at an adjacent level have been performed with success. ⋯ Multiple surgical options were discussed with the patient including multi-level anterior fusion, posterior laminoplasty, and posterior decompression and fusion.4-6 Following discussion of risks, benefits, and alternatives, the patient consented to the anterior hybrid approach. The patient underwent an uncomplicated hybrid anterior fusion and disc arthroplasty and was discharged home on postoperative day 1. The present video serves as technique guide and case study of a non-contiguous construct with satisfactory motion preservation and clinical outcome (Video 1).
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Multicenter Study Observational Study
The HSACAT Project: A Prospective Multicentre Observational Study of Spontaneous Subarachnoid Haemorrhage in Catalonia (Spain).
Incidence, clinical course, and fatality of spontaneous subarachnoid hemorrhage (SAH) are evolving, with prevalence of risk factors diminishing, implementation of early detection programs and strategies for priority aneurysm exclusion, technical refinement with less invasive procedures, and improvements in neurocritical care. Modern epidemiological and prognostic data are lacking, especially in southern European and Mediterranean populations. ⋯ Even when most patients received timely aneurysm treatment, case fatality rates were considerably high. Data provided by the HSACat project may have public health effects and be used to guide prevention programs and screening strategies.
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We describe a novel yet simple training exercise for residents who are being introduced to endoscopic spine surgery. ⋯ One of the lessons learned with this exercise that we will consider in future courses would be to place a radiodense "lesion" that could be visualized on fluoroscopy and serve as a radiologic target to find. This can help guide the trainee in knowing where to search if the "lesion" is more difficult to find.
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Multicenter Study
Lumbar Endoscopic Unilateral Laminectomy for Bilateral Decompression in Degenerative Spondylolisthesis.
Degenerative spondylolisthesis is an important cause of chronic low back pain and radiculopathy in the adult U.S. ⋯ Patients with low-grade degenerative spondylolisthesis causing severe stenosis can safely be treated with lumbar endoscopic unilateral laminectomy for bilateral decompression. A head-to-head trial should be undertaken to provide a higher level of clinical evidence.
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To evaluate long-term outcomes of surgical resection for congenital brain tumors (CBTs) in infants under one year of age and to identify factors related to survival. ⋯ Surgical resection remains crucial for treating CBTs in infants under one year, yet the aggressive nature of malignant tumors results in suboptimal outcomes regarding prognosis.