World Neurosurg
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Comparative Study
Neuronavigation combined with intraoperative ultrasound and intraoperative magnetic resonance imaging vs neuronavigation alone in diffuse glioma surgery.
This study aimed to integrate intraoperative ultrasound and magnetic resonance imaging (IMRI) with neuronavigation (NN) to create a multimodal surgical protocol for diffuse gliomas. Clinical outcomes were compared to the standard NN-guided protocol. ⋯ Compared to standard NN-guided surgery, multimodal-integrated surgery using NN, IMRI, and intraoperative ultrasound significantly increased the EOR and GTR rates for diffuse gliomas.
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Chronic subdural hematoma (cSDH) ranks among the most prevalent neurosurgical conditions, with burr-hole drainage typically yielding favorable prognoses. Nevertheless, perioperative complications may arise, with remote intraparenchymal hemorrhage and subarachnoid hemorrhage occurring infrequently, while acute subdural hematoma (aSDH) remains a relatively common complication post-cSDH removal. The standard treatment for aSDH, typically large craniotomy, substantially elevates surgical risk. ⋯ Urokinase-mediated subdural thrombolysis enhances hematoma clearance rates, suggesting a shift toward minimally invasive treatments to mitigate greater trauma. However, the paucity of evidence necessitates extensive research to validate its safety and efficacy.
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Radiographic adjacent segment disease (ASD) ranges from 10% to 84%, depending on technique. Occurrence of symptomatic ASD is lower, with a range of 1.9% to 13%. ASD can be very debilitating and necessitate further procedures, leading to high morbidity. Herein, we explore the occurrence of adjacent segment disease when performing anterior column release in lateral interbody fusion. ⋯ Higher PI-LL mismatch after lumbar interbody fusion, and performance of an ACR during LLIF increased the likelihood of developing symptomatic ASD in our patients. Considering ACR to achieve the goal of correcting spinopelvic parameters should be carefully evaluated when undertaking a lateral approach.
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Osteoporosis and degenerative disc disease (DDD) are prevalent in the elderly population. Damage to the vertebral endplate, which impairs nutrient supply to the disc, serves as both a significant initiator and a hallmark of DDD. This study was aimed to explore the association between osteoporosis and endplate damage. ⋯ Our study showed a significant positive correlation between osteoporosis and endplate damage. Attention is warranted for patients with osteopenia to prevent progression to osteoporosis, potentially leading to exacerbated DDD. The management of patients with both DDD and osteoporosis necessitates comprehensive treatment strategies that address both the BMD and endplate aspects of these conditions.
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To describe single-index-level fusion surgery using a cervical pedicle screw (CPS) after the complete facet resection of spinal dumbbell tumors and to compare it with partial facet resection without fusion. ⋯ Complete facet resection with fusion using CPS significantly increased the gross total tumor removal rate, compared with partial resection without fusion. Therefore, CPS improved fusion surgery for maximal motion preservation, resulting in single-level fusion surgery.