World Neurosurg
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To evaluate the clinical efficacy of large-channel endoscope-assisted posterior lumbar interbody fusion (Endo-PLIF), minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), and open posterior lumbar interbody fusion in the treatment of degenerative diseases of the lumbar spine. ⋯ All three operative methods had satisfactory efficacy. Endo-PLIF can be employed to treat lumbar degenerative diseases more precisely and in a minimally invasive fashion, but a learning curve and improvement in surgical instruments are needed.
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Identification of Key Risk Factors for Rupture in Small Intracranial Aneurysms: A Multicenter Study.
Predicting rupture risk in small intracranial aneurysms (IAs) < 5 mm is crucial for guiding clinical decisions. This study aims to identify key clinical and morphological risk factors associated with rupture in small IAs, providing better insight for decision-making. ⋯ This study identifies and validates critical risk factors associated with small IA rupture and presents a clinically useful, high-accuracy predictive model to aid in individualized patient management.
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The application of the transorbital (TO) approach for vascular lesions has been scarcely explored. In this anatomic study, we examine the carotid and middle cerebral arteries from the TO perspective and investigate the feasibility of vascular clipping in a pseudovascularized model. ⋯ The TO approach provides anatomic access to the lateral and dorsal carotid siphon, complete posterior communicating artery, and proximal middle cerebral artery. This preliminary study suggests potential application in the elective treatment of paraclinoid and posterior communicating aneurysms.
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The objective of this study was to assess the therapeutic efficacy of minimally invasive puncture and drainage (MIPD) facilitated by a 3-dimensional (3D)-printed guide plate in the management of primary brainstem hemorrhage (PBH). ⋯ MIPD guided by 3D printing technology is more effective than conservative treatment in PBH cases without extensive hemorrhage. This approach can alleviate hematoma pressure earlier, mitigate neurological deficits, reduce HAP incidence, shorten hospital stay, and decrease mortality and disability rates associated with PBH.
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The preservation of olfaction during the surgical resection of anterior skull base meningiomas presents a significant challenge. This study presents a modified endonasal endoscopic L-shaped approach designed to maximize tumor resection while preserving olfaction, a vital function that profoundly impacts the quality of life. ⋯ The L-shaped modification for endoscopic resection of anterior skull base meningiomas provides effective exposure with the possibility of preserving olfaction. Future studies are needed to validate these outcomes, but careful patient selection and meticulous planning are essential for optimal results.