World Neurosurg
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Review Meta Analysis
Diagnostic Yield, Morbidity, and Mortality of Intraventricular Neuroendoscopic Biopsy - Systematic Review and Meta-analysis.
Neuroendoscopic techniques for biopsy of intraventricular tumors are increasingly used, although published data have demonstrated a wide range of outcomes. We performed a systematic review and meta-analysis to investigate the diagnostic yield, morbidity, and mortality of neuroendoscopic biopsy. ⋯ These results indicate that neuroendoscopic biopsy has a very good diagnostic yield and reasonably low complication rate. The procedure seems most advantageous for diagnosis of intraventricular lesions where cerebrospinal fluid diversion is an additional therapeutic requirement.
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Comparative Study
Minimally invasive transforaminal lumbar interbody fusion in multilevel; comparison with conventional transforaminal interbody fusion.
Minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) has shown superior or noninferior results compared with conventional TLIF in single segments. There were no comparative studies between MIS and conventional TLIF in multisegments. The purpose of this study was to compare MIS and conventional TLIF in multisegments. ⋯ MIS TLIF and conventional TLIF showed similar clinical and radiologic outcomes. MIS TLIF may be a better choice for 2- or 3-segment lumbar fusion in perioperative outcomes.
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Case Reports
Case Series of Anterior Intervertebral Graft Extrusions in Transforaminal Lumbar Interbody Fusion Surgeries.
According to the published reports, revision surgery is sometimes recommended even in patients with asymptomatic anterior lumbar intervertebral graft migrations. The main purpose of this chart review study was to report on the clinical course and outcomes of patients who had anterior intervertebral graft extrusions after transforaminal lumbar interbody fusion (TLIF). ⋯ The risks of additional and highly invasive revision surgery should be weighed against the potential short-term and long-term complications associated with graft extrusions or migrations. It was demonstrated that fusion may take longer but can be achieved, and close observation may be adequate for asymptomatic patients.
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Adult spinal deformity (ASD) surgery carries the risk of spinal cord injury. Spinal cord ischemia is often implicated in the pathogenesis but has not been directly investigated. Here we present our index case as a proof of concept for a study evaluating the role of spinal cord perfusion (SCP) changes in ASD correction. ⋯ The present case provides the first direct evidence that fluctuations in SCP may contribute to neurologic changes during ASD surgery. Further investigation is under way to further elucidate the underlying mechanisms, with the ultimate goal of developing targeted strategies for spinal cord protection during these high-risk cases.