World Neurosurg
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To investigate the long-term clinical outcomes of staged surgical resection in giant Pituitary Neuroendocrine Tumors. ⋯ Staged surgery for giant Pituitary Neuroendocrine Tumors is a safe and effective clinical surgery strategy.
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Deep brain stimulation (DBS) is a well-established treatment for motor circuit disorders such as Parkinson disease, dystonia, and essential tremor, particularly when pharmacological interventions are insufficient.1-3 The increase in DBS-related publications and the growing number of patients receiving DBS highlight the acceptance and refinement of the procedure.3,4 Despite its widespread use, comprehensive anatomical knowledge of deep brain nuclei remains critical for enhancing clinical efficacy. Accurate targeting of the complex three-dimensional anatomy of the target nuclei is crucial for maximizing therapeutic effects and minimizing adverse side effects. However, existing anatomical guides often lack depth perception.5,6 We dissected specimens prepared using the Klingler method,7 proceeding sequentially from lateral to medial, medial to lateral, and superior to inferior. ⋯ Our models were evaluated via augmented reality within a real-world context, and radiological models of these nuclei generated through segmentation were analyzed. Thus, our models and videos offer a novel method for visualizing the complex anatomy of deep brain nuclei, which could help enhance the precision of DBS procedures and may improve patient outcomes. This advanced understanding of spatial anatomical relationships may be beneficial for the continued development and success of DBS therapy.
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The prevalence of osteoporotic vertebral fractures has increased with aging populations, necessitating effective treatments such as percutaneous kyphoplasty combined with posterior screw fixation. However, biomechanical research on the effects of using short screws on fixation stability and bone stress or on the impact of bone cement bonding to screws on structural strength is lacking. This study aimed to optimize short-segment fixation strategies for osteoporotic thoracolumbar burst fractures by analyzing the biomechanical effects of pedicle screw length and bone-cement augmentation. ⋯ Short screws in injured vertebrae without contact with the bone cement can achieve satisfactory stability and stress distribution. It is feasible to implant short screws in the injured vertebrae, reduce the number of bilaterally injured vertebrae, and inject bone cement through the non-pedicle approach during the surgical procedure, which simplifies the surgical process.
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Review Meta Analysis Comparative Study
Laser interstitial thermal therapy versus open surgery for mesial temporal lobe epilepsy: A systematic review and meta-analysis.
Epilepsy surgery offers a vital treatment option for drug-resistant mesial temporal lobe epilepsy, with temporal lobe resection (TLR) and magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) being fundamental interventions. This meta-analysis specifically examines seizure outcomes at extended follow-up periods exceeding 24 months, visual field deficits as measured by perimetry, and complication rates both overall and categorized based on duration as minor (transient <6 months) or major (persistent >6 months) to inform clinical decision-making. For seizure freedom, TLR was superior, with 72.5% [65.6%, 78.5%] of patients achieving postoperative seizure freedom compared to 57.1% [51.2%, 62.7%] for MRgLITT (P value <0.01). ⋯ TLR provides superior seizure freedom but comes with an increased risk of transient complications. Although there was no statistical significance in visual field deficits, the trend suggests a higher frequency with TLR. The study's extensive data analysis, including rigorous sensitivity checks, ensures the robustness of these conclusions, reflecting a comprehensive analysis of the available data at this time point.
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Review
Beyond Surgery: Navigating Postoperative Care for Cauda Equina Syndrome Through a Scoping Review.
Cauda equina syndrome (CES) is a serious neurological injury that can result in permanent disability. Our objective was to review the evidence for rehabilitation strategies for CES in a scoping review. ⋯ Despite the risk of devastating injury and a recent Getting It Right First Time pathway recommending rehabilitation post CES surgery, there is very limited literature on rehabilitation for CES. Future high-quality rehabilitation trials following CES surgery are needed to guide treatment decisions and optimize postsurgical outcomes.