World Neurosurg
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To study the effect of lumbar lordosis change and pelvic parameters on surgical outcomes such as fusion versus nonfusion (pseudarthrosis), adjacent segment pathology (ASP), and reoperation in patients undergoing 1-level, 2-level, and 3-level posterior lumbar fusion (PLF). ⋯ Better restoration of lumbar lordosis reduces rates of pseudarthrosis after short-segment PLF but has no association with rates of ASP.
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Cervical synovial cyst (CSC) is a rare condition that often leads patients to seek medical attention due to cervical stenosis symptoms. There's ongoing debate about the best management strategy. To address this, a review of literature from the past 20 years (2003-2023) was conducted using keywords like "cervical synovial cyst," "cervical ganglion cyst," and "cervical juxtafacet cyst." Data on patient demographics, imaging characteristics, treatment methods, and clinical outcomes were collected. ⋯ Most cases were treated surgically, with decompression performed with or without fusion. Patients generally reported symptom improvement regardless of the surgical method. Overall, surgical intervention effectively improved neurological symptoms associated with CSCs.
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Early diagnosis of diabetes insipidus (DI), a complication following pituitary surgery, can avoid catastrophic results such as lethargy or even death. Measurement of arginine vasopressin (AVP) may help the early diagnosis, but its direct assaying is challenging. Copeptin, which is co-secreted in equimolar quantities to AVP, is suggested to be a reliable marker in prediction of postoperative DI. Therefore, this systematic review plus meta-analysis aims to discover this possible role. ⋯ Copeptin level was significantly lower in DI patients than in non-DI patients who underwent pituitary surgery. Early measurement, as soon as possible (from the first hour to 48 hours after the operation) of copeptin after pituitary surgeries has good, but not excellent, accuracy to exclude postoperative DI.
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Five billion people worldwide lack access to safe, timely, and affordable surgical and anesthesia care. This deficit is greatest in low- and middle-income countries, especially for specialty surgical services including neurosurgery, due to insufficient personnel, resources, and infrastructure. The southeastern European nation of the Republic of Moldova is one such middle-income country. ⋯ This article provides the first-ever description of the history and current state of neurosurgery in Moldova and presents key recommendations to guide the international neurosurgery community in developing neurosurgical care in countries with an unmet need.