World Neurosurg
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This study examined radiographic changes in local and global spinal alignments and clinical outcomes following tumor resection without spinal fixation in patients with lumbar dumbbell tumors (LDTs). ⋯ Tumor resection without spinal fixation had no substantial impact on local and global spinal alignments and led to satisfactory clinical outcomes, suggesting that spinal fixation may not always be necessary when resecting LDTs.
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Surgical resection of intracranial meningioma carries the risk of several complications, including intraoperative blood loss. The objective of this study was to investigate preoperative clinical and radiographic factors predictive of intraoperative estimated blood loss (EBL). ⋯ Intratumoral flow voids, larger maximal tumor diameter, and skull base location were independently predictive of EBL ≥500 mL. Intratumoral flow void presence was the strongest predictor, with 5.68 times the odds of high EBL. Each 1-cm increase in tumor diameter had 58% greater odds of high EBL. Skull base location was associated with 3.35 times the odds of high EBL. These results can inform preoperative patient counseling and blood management preparation.
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Persistent spinal pain syndrome (PSPS) poses a significant medical challenge, often leading to diminished quality of life for affected individuals. In response to this clinical dilemma, spinal cord stimulation (SCS) has emerged as a promising intervention aimed at improving the functional outcomes and overall well-being of patients suffering from this debilitating syndrome. In case a therapy with percutaneous lead fails (e.g., due to a dislocation), surgical lead can be used as a stable alternative. This results in a more invasive procedure and does not allow for intraoperative monitoring. The aim of this study is to investigate the efficacy and safety of the use of surgical leads, as there have been only a few case series published so far. ⋯ SCS with surgical leads is a safe secondary technique to treat PSPS, where treatment with percutaneous leads fail. The results show a promising long-term effect concerning pain intensity and functional outcome.
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Aneurysmal subarachnoid hemorrhage (aSAH) has an incidence of 6-7 per 100,000 person-years. Despite advancements in treatment, 26% of patients die and 19% remain dependent after hemorrhage. Long-term neuropsychological sequelae affect about half of the survivors, significantly affecting their quality of life. This study aims to assess aSAH characteristics and identify predictive factors of clinical outcomes in young patients. ⋯ Young patients with aSAH show distinct characteristics and prognostic factors compared with older patients. Despite higher postoperative complications, young patients generally have better outcomes, emphasizing the need for age-specific management strategies in aSAH.
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To study the incidence of congenital posterior arch defects of the atlas and in combination with other congenital variations in the Chinese population. ⋯ The incidence of congenital posterior arch defects of the atlas was low in a Chinese population. There was no difference between male and female individuals. Types A and B were the 2 major defects in this Chinese population, and the prevalence of type A and B combined with other congenital cervical variations were higher than those of types C, D, and E.