World Neurosurg
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Multicenter Study
Gelatin Paste as an Alternative Cost-Effective Hemostatic Agent in Cranial Surgery: Doing More with Less.
To present an alternative cost-effective hemostatic agent (HA) for cranial surgery and to describe the technique to produce it. ⋯ The presented technique offers a reliable and cost-effective way of achieving hemostasis in cranial surgery, therefore allowing hospitals with limited resources to perform advanced procedures in a safer way.
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The evolution of minimally invasive endovascular approaches and training paradigms has reduced open neurovascular case exposure for neurosurgical residents. There are no published estimates of open neurovascular case volumes during residency or Committee on Advanced Subspecialty Training (CAST) accredited fellowships. ⋯ Strong neurovascular training can be obtained through dedication and planning. Completion of a CAST accredited cerebrovascular fellowship will often more than double aneurysm case exposure of trainees.
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Comparative Study
Radiographic and Clinical Outcomes of Surgical Correction of Poliomyelitis-Related Spinal Deformities: A Comparison Among Three Types of Pelvic Instrumentations.
We compared the clinical and radiographic outcomes of corrective surgery in patients with poliomyelitis-related spinal deformity (PSD) using 3 types of pelvic fixation and investigated the incidence and risk factors for complications. ⋯ The present study showed satisfactory correction of spinopelvic deformity for 42 patients with PSD. Compared with the Galveston technique and iliac screw fixation, the use of S2AI significantly decrease the operative time and estimated blood loss and obtained similar correction of PO. Patient age at surgery and grade >2 SRS-Schwab osteotomy were significant risk factors for complications.
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Comparative Study
Differences in the electrophysiological monitoring results of spinal cord arteriovenous and intramedullary spinal cord cavernous malformations.
Spinal arteriovenous malformations (SAVMs) and intramedullary spinal cord cavernous malformations (ISCCMs) have a very low incidence of disease. The purpose of this study was to compare the differences in electrophysiologic monitoring in these 2 surgeries. ⋯ Electrophysiological monitoring provides effective guidance during operation on spinal vascular malformations. Electrophysiologic monitoring revealed that surgical resection of SAVMs resulted in more permanent changes and postoperative dysfunction when compared with ISCCMs. The incidence of both false-positive and -negative results suggests that electrophysiologic monitoring cannot fully predict the complete function of the patients.
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Previous studies have indicated traumatic brain injury (TBI) as a risk factor for stroke and myocardial injury. Whether TBI increases new onset of major adverse cardiovascular and cerebrovascular events (MACCE) is not well established. ⋯ Our results showed that patients with TBI have a significantly greater risk of MACCE than the control group. We hope this information will remind critical-care physicians and neurosurgeons to keep in mind the long-term effects of TBI on MACCE.