World Neurosurg
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Over the years, feasibility & safety of EEAs has become well established & the focus has now shifted to minimising the nasal morbidity. To this end, several modifications in nasal stage have been described that have focussed primarily on preservation of nasal mucosa on right side of nasal cavity (NC). However, the issue of nasal mucosal preservation on left side of NC has largely been ignored. In this paper, the author describes a modified technique that can eliminate mucosal damage in left NC. ⋯ A combination of endonasal and trans-septal approaches utilises the advantages of both endoscopic & microscopic approaches sans the disadvantage of restricted space seen in microscopic approaches. It makes binostril approach least disruptive to left nasal mucosa & thus can reduce overall morbidity of EEAs.
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Among the reconstructive methods for treating dissecting posterior circulation aneurysms (DPCAs), there are stent-assisted coiling (SAC), and sole stenting (SS) therapy. Despite SAC being widely employed when compared to SS, no study systematically analyzed the difference in their outcomes. ⋯ The findings suggest there is no substantial basis for favoring SAC over SS across all cases. Instead, an individualized approach should be considered, according to the patient's characteristics, surgeon skills, and the available material.
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To evaluate efficacy and safety between C3 laminectomy + open-door laminoplasty and open-door laminoplasty alone. ⋯ Although C3 laminectomy + open-door laminoplasty has theoretical advantages, meta-analysis results show that the two surgical procedures are similar in terms of clinical symptoms improvement, sagittal balance, and complications. C3 laminectomy combined + open-door laminoplasty is only superior in the preservation of cervical lordosis. Limited number of studies may affect the reliability and generalizability of the results. Future high-quality, multicenter RCTs are needed to verify efficacy and safety.
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This study assessed neurological outcomes and variables associated with favorable outcomes in aSAH patients with low functional status (Glasgow Coma Scale [GCS] score ≤8) on postbleed day 7 (PBD7). ⋯ This study yielded no significant physical examination findings that predict a favorable outcome in patients with GCS score ≤8 on PBD7. This finding may inform the decision of whether to prolong hospital management or arrange for end-of-life care.
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Polyetheretherketone (PEEK) cages and structural allografts (SAs) are commonly used in Anterior Cervical Discectomy and Fusion (ACDF), yet their postoperative results remain uncertain. This meta-analysis was conducted to determine whether there were any differences in outcomes between patients who received these two grafts in ACDF. ⋯ SA demonstrates better fusion and lower subsidence rates than the PEEK cage in ACDF. Nevertheless, these two cages resulted in equally successful postoperative clinical performances.