World Neurosurg
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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 postoperative 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.
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To compare the efficacy of navigation-assisted modified minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and MIS-TLIF in the treatment of low-grade isthmic spondylolisthesis in the elderly. ⋯ Compared with MIS-TLIF, navigation-assisted modified MIS-TLIF has the advantages of less trauma, rapid recovery, accurate screw placement, high fusion rate, high surgical satisfaction, and good safety.
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To describe our experience in the resection of gliomas involving the insula and analyze the variables implicated in the management and prognosis of these tumors. ⋯ Surgery for insular gliomas is a complex task that needs to be managed with adequate preoperative and intraoperative assessment to achieve maximum safe resection with low morbidity for better functional and oncologic outcomes. Adequate anatomic understanding, radiologic analysis, awake craniotomy, and cortical and subcortical mapping are paramount to pursue this aim.
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In the Brazilian public national healthcare system, botulinum toxin type A has traditionally been the sole treatment option for patients with dystonia. However, as of October 2022, deep brain stimulation (DBS) garnered positive recommendations for the condition. This study aims to assess the cost-effectiveness of DBS in treating adults with generalized and cervical dystonia within the Brazilian healthcare context, considering its recent inclusion. ⋯ From the perspective of the Brazilian public health system, the combination of DBS and BCP appears to be cost-effective for the treatment of both generalized and cervical dystonia when compared to BCP alone.
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Endoscopic management of pediatric hydrocephalus is always challenging because of the different anatomical structure of the ventricles. The aim of this study is to document the endoscopic anatomy of the ventricular system and to show the variations and deformations. ⋯ The compliance of the brain deteriorates with increasing intracranial pressure in pediatric hydrocephalus and the intraventricular anatomical structures differ from the normal anatomy. Developmental anomalies of the ventricle are also significant and since all these variations are often unpredictable on preoperative imaging, awareness of endoscopic anatomy, variations, and deformations will improve operative safety in children.