World Neurosurg
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Despite the ubiquitous use of the Glasgow Coma Scale (GCS) worldwide, no study to date has objectively and quantitatively assessed its impact on the scientific literature and clinical practice. Therefore, we comprehensively analyzed scientific publications and clinical practice guidelines employing the GCS to gauge its clinical and academic impact, identify research hotspots, and inform future research on the topic. ⋯ At the turn of the 50th anniversary of the GCS, we provided a unique and detailed description of the "path to success" of the GCS both in terms of its scientific and clinical impact. These results have not only a historical but also an important didactic value. Ultimately our detailed analysis, which revealed some of the factors that led the GCS to become such a widespread and highly influential score, may assist future researchers in their development of new outcome measures and clinical scores, especially as such tools become increasingly relevant in an evidence-based data-driven age.
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Review Meta Analysis Comparative Study
Comparison of Anterior Controllable Antedisplacement and Fusion Versus Laminoplasty in the Treatment of Multisegment Ossification of Cervical Posterior Longitudinal Ligament: A Meta-Analysis of Clinical.
This study aims to provide a comprehensive summary of the existing literature and conduct a systematic evaluation of the clinical outcomes associated with anterior controllable antedisplacement and fusion (ACAF) and posterior laminoplasty (LP) for the treatment of multisegment ossification of the cervical posterior longitudinal ligament (OPLL). ⋯ The findings of this study suggest that, in the treatment of multilevel cervical OPLL, ACAF yields superior outcomes compared to LP. Specifically, ACAF improves postoperative neurologic function, reduces postoperative pain, lowers intraoperative blood loss, improves postoperative cervical curvature, and decreases the incidence of C5 nerve root paralysis and postoperative axial symptoms. Nonetheless, ACAF is associated with longer operative times and a higher incidence of postoperative dysphagia, though the overall incidence of postoperative complications is similar. It is important to note that these conclusions should be interpreted cautiously due to the limited sample size and the variable quality of the included studies. Further research involving larger, high-quality studies is warranted to validate these findings.
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Brainstem surgery is more difficult and riskier than surgeries in other parts of the brain due to the high density of critical tracts and cranial nerves nuclei in this region. For this reason, some safe entry zones into the brainstem have been described. The main purpose of this article is to bring on the agenda the significance of the intrinsic structures of the safe entry zones to the brainstem. ⋯ The second purpose is to remind surgeons of clinical syndromes that may occur in case of surgical injury to these delicate structures. Advanced techniques such as tractography, neuronavigation, and neuromonitorization should be used in brainstem surgery, but detailed neuroanatomic knowledge about safe entry zones and a meticulous surgery are more important. The axial brainstem sections we have drawn can help young neurosurgeons better understand this complex anatomy.