World Neurosurg
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The mechanical alteration in the adolescent/pediatric cervical spine after spinal fusion remains unknown. The purpose of this study was to investigate morphologic changes in the cervical spine in adolescent/pediatric patients who underwent spinal fusion. ⋯ Cervical kyphosis correction using posterior instrumentation combined with endplate destruction by anterior bone grafting is a risk factor for atrophic morphologic changes in the vertebral body in adolescent/pediatric patients. Endplate destruction and instrumentation-induced stress shielding could alter bone remodeling.
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Programs that address overall wellbeing early in residency are necessary to prevent physician burnout and promote physician mental health to improve patient outcomes and ensure long and productive careers. A wellness initiative was implemented at our institution 3 years ago. We present feedback from participating residents across all levels of training. ⋯ Participating resident perceptions of the wellness program are highly favorable. The survey results, combined with the perspectives across training levels, provide insight for other programs wishing to implement program of their own.
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Nonlethal cervical spine injuries in skydiving are rare due to the associated high mortality. Here, we report an unusual pathomechanism leading to a Hangman fracture in a semiprofessional parachute athlete. ⋯ Excessive deceleration during canopy deployment may pose a risk for life-threatening cervical spine injuries in skydiving.
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This video (Video 1) demonstrates bilateral posterior communicating artery (PCoA) aneurysms that were treated through a unilateral supraorbital approach. A 53-year-old woman presented with a Hunt-Hess grade I subarachnoid hemorrhage. Computed tomography scan showed subarachnoid hemorrhage in the left sylvian fissure and basal cistern. ⋯ The patient recovered well without any complications. Postoperative angiography confirmed complete obliteration of these 2 aneurysms. For selected bilateral PCoA aneurysms with non-low-lying and posteromedial projection of the contralateral aneurysm, surgical clipping of all aneurysms via a unilateral approach is a feasible alternative.
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To explore whether computed morphologic features can be used as independent predictors of incomplete occlusion of aneurysms treated with the Pipeline embolization device. ⋯ Malapposition of stent and higher elongation value were independent negative predictors of aneurysm occlusion following flow diversion.