World Neurosurg
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Review Meta Analysis Comparative Study
Endoscopic Surgery Versus Stereotactic Aspiration in Spontaneous Intracerebral Hemorrhage Treatment: A Systematic Review and Meta-analysis.
To comprehensively compare the safety and efficacy of endoscopic surgery (ES) and stereotactic aspiration (SA) in patients with spontaneous intracerebral hemorrhage (sICH). ⋯ ES is a safe and effective approach for sICH treatment, leading to improved patient prognosis and quality of life compared to SA.
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Neurosurgical technologies have become increasingly more adaptive, featuring real-time and patient-specific guidance in preoperative, intraoperative, and postoperative settings. This review offers insight into how these integrative innovations compare with conventional approaches in spine surgery, focusing on machine learning (ML), artificial intelligence, augmented reality and virtual reality, and spinal navigation systems. Data on technology applications, diagnostic and procedural accuracy, intraoperative times, radiation exposures, postoperative outcomes, and costs were extracted and compared with conventional methods to assess their advantages and limitations. ⋯ Postoperatively, certain ML and artificial intelligence models have outperformed conventional methods in predicting all postoperative complications of >6000 patients as well as predicting variables contributing to in-hospital and 90-day mortality. However, applying these technologies comes with limitations, such as longer operative times (up to 35.6% longer) with navigation, dependency on datasets, costs, accessibility, steep learning curve, and inherent software malfunctions. As these technologies advance, continuing to assess their efficacy and limitations will be crucial to their successful integration within spine surgery.
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This is a single-surgeon series that prospectively evaluates the results of sacroiliac joint (SIJ) fusion for patients with SIJ dysfunction using hydroxyapatite-coated screws (HACSs) compared with titanium triangular dowels (TTDs). ⋯ Minimally invasive SIJ fusion has been shown to have good clinical outcomes for select patients. However, our experience shows that HACSs are associated with a high rate of screw lysis and poorer patient outcomes compared with TTDs. Therefore, we recommend the use of TTDs instead of HACSs for SIJ fusion surgery.
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Recanalization poses challenges after coil embolization in cerebral aneurysms. Establishing predictive models for postembolization recanalization is important for clinical decision making. However, conventional statistical and machine learning (ML) models may overlook critical parameters during the initial selection process. ⋯ The combination of DNN and XAI was found to be an accurate and explainable approach not only at predicting postembolization recanalization but also at discovering unknown features in the future.
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Review Meta Analysis
Incidence of Cement Leakage and Potential Risk Factors in Surgery for Spinal Metastasis: A Systematic Review and Meta-Analysis.
The current meta-analysis was performed to gather available evidence regarding the incidence and risk factors of cement leakage (CL) in patients undergoing surgical procedures for spinal metastasis. ⋯ This review provides insights into the incidence and risk factors associated with CL in surgical procedures for spinal metastasis. Understanding these risk factors can contribute to the development of tailored strategies aimed at minimizing CL occurrence and optimizing surgical outcomes for patients undergoing spinal metastatic surgery.