World Neurosurg
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Evidence available to clinicians and patients to inform treatment decisions is ideally produced by randomised controlled trials (RCT). The objective of this study was to assess the extent to which Neurosurgical practice is supported by RCT-level evidence. ⋯ The RCT level evidence supporting Neurosurgical practice is varied and the outcomes tested remain predominantly heterogenous. There remain important Neurosurgical conditions where treatment strategies are not underpinned by high quality evidence. Pragmatic RCTs, well-designed observational studies as well as robust audit and registry processes may provide the real-world evidence for treatment decisions in Neurosurgical care.
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Pituitary neoplasms account for 15% of all intracranial neoplasms and affect 20% of the population. ⋯ Despite advancements in endoscopic endonasal pituitary surgery, disparities in access and outcomes persist across racial, socioeconomic, and insurance groups. These findings underscore the need for targeted interventions to address these inequalities and ensure equitable access to quality care.
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This study investigates the prognostic value of the apparent diffusion coefficient (ADC) in MRI for patients with acute posterior circulation stroke (PCS) undergoing endovascular therapy (EVT). ⋯ High ADC values and unilateral infarction are independent predictive factors for the prognosis of PCS patients after EVT. Combining these factors provides the highest predictive accuracy, aiding in clinical decision-making for PCS treatment.
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Surgery is the preferred option for lumbar spinal stenosis (LSS) when conservative methods cannot meet the needs. Recent advancements in surgical techniques have brought various new methods for treating LSS. ⋯ Endoscopic decompression can effectively improve short-term back VAS scores and reduce hospital stays, while IPSD is effective in reducing long-term back VAS scores with minimal surgical duration and blood loss.