World Neurosurg
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The biomechanical study was performed to investigate the effect of a novel pedicle screw anchor in increasing the pullout strength of pedicle screws. ⋯ A novel anchor for standard pedicle screws resulted in significantly less axial movement during fatigue and a greater failure force compared a screw with no anchor. The anchor may provide a stronger bone-to-screw interface, than a non-anchor screw, without the complications of cement augmentation.
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Regulatory agencies are standardizing quality metrics on the basis of which surgical procedures will be evaluated. We attempted to create a predictive model of perioperative complications in patients undergoing craniotomies for glioma resection. ⋯ The presented models can assist in the preoperative estimation of the complication risk for glioma patients and be used as an adjunct for outcome benchmarking in this population.
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There is accumulating evidence that extent of resection (EOR) in intrinsic brain tumor surgery prolongs overall survival (OS) and progression-free survival (PFS). One of the strategies to increase EOR is the use of intraoperative MRI (ioMRI); however, considerable infrastructure investment is needed to establish and maintain a sophisticated ioMRI. We report the preliminary results of an extraoperative (eoMRI) protocol, with a focus on safety, feasibility, and EOR in intrinsic brain tumor surgery. ⋯ An eoMRI protocol appears to be a safe and practical method to ensure maximum safe resections in patients with brain tumors and can be performed readily in all centers with MRI capabilities.
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Our objective was to analyze the relevance, potential prognostic factors, and complications of endoscopic third ventriculostomy (ETV) in patients with shunt failures. ⋯ This study confirms that ETV should be considered as the first therapeutic option before shunt revision in cases of initial obstructive hydrocephalus.
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To perform a retrospective chart review of surgically treated patients with spinal dural arteriovenous fistula (SDAVF), a rare disease but the most common vascular malformation of the spine, focusing on clinical characteristics and functional outcome during long-term follow-up. ⋯ Surgical treatment of SDAVFs is safe and effective and leads to an improvement of neurologic symptoms in most patients. Surgical treatment of SDAVFs also provides long-term stability.