World Neurosurg
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This study examines the risk of developing symptomatic retro-odontoid pseudotumor (ROP) following cervical laminoplasty. ROP can result in cervical myelopathy, leading to substantial morbidity. Identifying the risk factors for symptomatic ROP is essential to improving patient outcomes after laminoplasty. ⋯ This study highlights that a high preoperative RS ratio is a significant risk factor for symptomatic ROP, with a notable increase in O-C2 ROM observed in the ROP group following laminoplasty. These findings suggest that ROP is a progressive condition that may worsen after surgical intervention, particularly in patients with pre-existing retro-odontoid masses.
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In recent years, a modified percutaneous vertebroplasty procedure, known as Vesselplasty, has demonstrated favorable clinical outcomes in the treatment of osteoporotic vertebral compression fractures (OVCFs). However, there have been no reports on the application of Vesselplasty for Genant grade 3 OVCFs. This study aims to evaluate the efficacy and clinical outcomes of Vesselplasty in treating Genant grade 3 OVCFs, thereby providing evidence-based guidance for clinical decision-making. ⋯ Both Vesselplasty and PVP techniques effectively alleviate pain symptoms in patients with Genant grade 3 OVCFs. However, Vesselplasty demonstrates superior efficacy in restoring vertebral height, correcting kyphotic deformity, and reducing the risk of cement leakage.
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Minimally invasive keyhole approaches to the anterior skull base and circle of Willis require small incisions near distal branches of the temporal division (TD) of the facial nerve. Few studies have focused on planning the incision to avoid the TD branches and maximize exposure in these approaches. This study aimed to define a safe zone away from the TD branches for skin incision during minimally invasive keyhole approaches using reliable and practical skin landmarks. ⋯ Identifying a safe zone for preserving TD branches is crucial for surgical incisions planned in the superolateral region of the orbit. This study provides a clinically applicable and reproducible landmark for planning incisions commonly used during minimally invasive keyhole approaches.
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In adults, the conus medullaris (CM) tip usually terminates at the mid aspect of the L1 vertebra. However, variations exist. Beside the location, differences in the CM's shape are believed to be closely related to neurological conditions. ⋯ The majority of participants had the CM at the caudal level of L1. We did not observe any highly positioned CM above T12. There is good reliability of interobserver agreement of the current methods for description of the location and shape of CM.
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Patients in the neurological intensive care unit (ICU) are at an increased risk of venous thromboembolism (VTE). Anticoagulation is often indicated because deep venous thrombosis (DVT) can develop into pulmonary embolism (PE). However, anticoagulation also increases the risk of intracranial bleeding. Physicians must weigh the opposing risks carefully. It is commonly believed that upper extremity DVT (UEDVT) is less likely to develop into PE as compared to lower extremity DVT (LEDVT), but this lacks evidence, and our study investigates its validity. ⋯ In this sample of neurocritical care patients, the coexistence of DVT and PE did not differ in patients with upper versus lower extremity DVT. This should be considered in the neurocritical care unit when deciding whether to treat patients with DVT with anticoagulants.