World Neurosurg
-
This study aimed to examine the mechanism of occipital condyle fractures (OCFs), their clinical symptoms, computer tomography (CT) scan findings, treatment options, and classification. ⋯ OCFs are predominantly present in cases of high-energy trauma, with high-resolution thin-layer CT scans serving as the preferred diagnostic method. The application of the modified Anderson-Montesano classification, distinguishing between stable and unstable fractures, facilitates the determination of suitable treatment strategies. Stable OCFs can be managed using a rigid neck brace, while unstable OCFs may require Halo-vest frame fixation or surgical intervention.
-
Management of interhemispheric pathologies requires surgical intervention through a restricted anatomical corridor ensconced within critical cerebral structures. The use of retractors to facilitate operative access may cause damage to cerebral tissue. The development of an innovative retraction technique designed to alleviate cerebral damage in such cases is imperative. In this study, we present a novel and gentle retraction method to facilitate the interhemisferic approach. ⋯ The ideal retraction technique during the interhemispheric approach is still a challenge. Our novel retraction technique may help minimize brain parenchymal damage during surgical resection of interhemispheric lesions.
-
This study analyzed the effectiveness and safety of ultra-low dose fluorescein sodium (FL)-guided malignant glioma resection and its potential to predict the pathological characteristics of glioma. ⋯ Ultra-low-dose FL-guided resection of malignant gliomas is safe and effective. The Ki67 positivity rate was directly proportional to the intensity of FL, indicating its potential to predict gliomas during pathological examination.
-
Cervical spine procedures represent a major proportion of all spine surgery. Mitigating the revision rate following cervical procedures requires careful patient selection. While complication risk has successfully been predicted, revision risk has proven more challenging. This is likely due to the absence of granular variables in claims databases. The objective of this study was to develop a state-of-the-art model of revision prediction of cervical spine surgery using laboratory and operative variables. ⋯ Our deep learning approach successfully predicted 3-month revision outcomes from demographic variables, standard laboratory values, and operative variables in a cervical spine surgery cohort. This work used standard laboratory values and operative codes as meaningful predictive variables for revision outcome prediction. The increased performance on certain procedures evidences the need for careful development and validation of one-size-fits-all risk scores for spine procedures.
-
The impact of cervical sagittal alignment on cervical facet joint degeneration (CFD) and the risk factors for CFD in patients with degenerative cervical myelopathy (DCM) were investigated in the current study. ⋯ The load distribution tends to shift to a more shear-like pattern in the sigmoid and kyphosis types and in those with a higher cSVA, thereby promoting CFD. Aging, cervical malalignment, low bone mineral density, DD, and modic change were revealed to result in high risks of CFD.