World Neurosurg
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There are critical disparities in the neurosurgical care provided around the globe due to challenges in resource allocation, training, and infrastructure. Global neurosurgical collaborations have replaced classical mission trips to address these disparities. However, the development of these collaborations and the impact of research funding on their growth has not yet been systematically studied. In this article, we use a graph theoretical approach to investigate trends in funding and co-authorship between and among authors from high-income countries (HICs) and authors from low- and middle-income countries (LMICs). ⋯ This work shows significant and rapid growth in international neurosurgical partnerships, especially in HIC-LMIC and LMIC-LMIC collaborations. Also, a significant positive relationship exists between research funding and LMIC-HIC co-authorship trends. This work encourages us as a community to continue to expand our translational collaborations with LMIC neurosurgeons and establish funding mechanisms independent of HIC authors.
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This work aims to describe the evolution of the VATS approach from a multiportal access to a biportal access for thoracic herniated disc surgery. Thoracic disc herniation remains a challenging pathology for spine surgeons. Video-Assisted Thoracoscopic Surgery (VATS) of the thoracic spine was described in the 90s and represented an important technical leap by including minimally invasive options for thoracic pathology. Nowadays, VATS in thoracic surgery tends to evolve towards an even less invasive technique, from a multiportal approach to a biportal one. ⋯ This access allows the surgeon to manipulate the instrumentation confidently, and the camera does not fog up as often. Extracting a piece of rib is unnecessary, and theoretically, we only manipulate one or at most two intercostal nerves, so the patient's recovery is favorable.
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In poor-grade aneurysm subarachnoid hemorrhage (PaSAH), the use of external ventricular drainage (EVD) may be closely related to the occurrence of shunt-dependent hydrocephalus (SDHC). The purpose of this study was to investigate the effect of EVD on SDHC and prognosis after microsurgical clipping patients with PaSAH. ⋯ EVD implantation is an independent risk factor for SDHC after PaSAH, and a large drainage volume in the first 3 days after EVD implantation is an independent risk factor for SDHC after PaSAH. The drainage volume on the first day after surgery is the best predictor of SDHC after PaSAH. SDHC after PaSAH is the strongest independent risk factor for poor prognosis and prolongs hospital stay.
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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.
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Adult spinal deformity (ASD) is a common problem in today's aging adult population, particularly in the thoracolumbar spine. This can lead to severe pain and disability, leading to poorer quality of life. Traditionally, open deformity correction has been the mainstay of treatment for these patients as it provides an excellent operative corridor; however, this comes with severe risk and high complication rates. There has been a trend towards more minimally invasive approaches to correct the deformity while persevering the muscle and soft tissue surrounding the bony spine across the fusion. ⋯ This technique provides benefits of spinal rotational and coronal plane correction and restores lordosis with current advancements of today's technologies without the downsides of an open surgical approach.