World Neurosurg
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Thirty years have passed since Kambin's first clinical series of lumbar disc herniations (LDH) treated by arthroscopic microdiscectomy. Despite several advances in this interim, sequestrated LDHs over the dorsal aspect of the dura, and high-grade up- or downward disc migration have been a relative limitation of the transforaminal endoscopic technique. The interlaminar window was the next step to deal with such highly migrated LDHs. Favorable outcomes were obtained in 70-90% of the patients in the long-term, but recurrence rates remained high (approximately 12%), and the approach could be limited by the size of the interlaminar window. Few relevant studies have addressed the role of translaminar full endoscopic technique for migrated LDHs. To describe an innovative modification of the translaminar full endoscopic approach with Tom Shidi needles. ⋯ Translaminar full endoscopic technique with Tom Shidi needles is a promising modification of the previously presented interlaminar and translaminar endoscopic routes in the treatment of migrated LDHs to fasten surgical procedures and increase the safety of spinal canal manipulation.
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The exhaustive information regarding the types of trigeminal pore (TP) or trigeminal impression (TI), internal acoustic opening (IAO), and related surgical approaches is lacking in the literature. Therefore, this study is performed to further elucidate the types of TP or TI, IAO, and the relationships with critical surgical landmarks in the skull base. ⋯ Investigating the relationship of TI and IAO with relevant structures suggests that surgical approaches involving the TP and IAO indicated that surgical approaches considering the TI and IAO variations may be used in the development of surgical processes and primary surgical interventions.
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The ophthalmic artery normally travels with the optic nerve through the optic canal. However, sometimes, the ophthalmic artery travels through a foramen within the optic strut named an accessory optic canal, double optic canal, or ophthalmic canal. This variant puts individuals at an increased risk for blindness or death during anterior clinoidectomy due to unforeseen hemorrhage of the ophthalmic artery or internal carotid artery when the optic strut is separated from the body of the sphenoid bone. Several features make the accessory optic canal difficult to recognize on imaging: its variant nature, small size, and ability to masquerade as a caroticoclinoid foramen or a pneumatized sphenoidal structure. Hence, improved methods of presurgical identification are warranted. The aim of this study was to assess the size and shape of the optic canal, with and without a concomitant accessory optic canal, to determine whether measurement of the optic canal may provide useful information regarding the presence of an accessory optic canal. ⋯ Asymmetry in optic canal size can help indicate the presence of a unilateral accessory optic canal before surgery.
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The surgical treatment of thoracic spinal tuberculosis has garnered enormous interest from researchers toward the development of posterior surgical techniques that have contributed to greater use of the 1-stage posterior approach. This study aims to demonstrate the initial clinical experience of a modified total posterior approach, in which the 1-stage posterior approach preserves the posterior spinal column structure by combining with the endoprosthetic implant fusion for thoracic spinal tuberculosis. ⋯ This approach offered some advantages in terms of intraoperative exposure, blood loss volume, and length of surgery. Further, multicenter studies with large samples are needed to understand the precise effects and implications of the approach.
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A major critique of the h-index is that it may be inflated by noncritical authorship. We propose a modified h-index (hm), incorporating critical authorship, complementary to the h-index. We analyze its relationship to the traditional h-index, and how each varies across professional categories relevant to academic neurosurgery. This analysis is not meant to critique authorship decisions, affect career development, alter academic legacy, or imply that the concepts of team science or midlevel authorship contributions are not valuable. ⋯ The h-index can be influenced by noncritical authorship, and hm, using critical contributions, can be used as a complement reflecting critical academic output in neurosurgery. Leaders deciding on hiring or promotion should consider disparities in productivity predicated on noncritical authorship contributions.