World Neurosurg
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The aim was to assess the effectiveness and safety of reconstructing a cranial bone defect after decompressive craniectomy using an autologous bone flap banked in a subcutaneous pocket in the patient's abdominal wall. ⋯ This preliminary and limited experience has led us to believe that the subcutaneous preservation of autologous bone flap is feasible. This method may be a very inexpensive option that preserves the viability of the bone flap, which can be ultimately responsible for the good cosmetic results and the very low infection rate.
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Anterior instrumentation has been used for surgical treatment of spinal tuberculosis, but there are different regimens of antituberculous chemotherapy used in combination with surgical intervention. The objective of this prospective study was to determine the efficacy of an antituberculous chemotherapy regimen by following a series of patients with spinal tuberculosis, for a minimum of 3 years, who underwent single-stage anterior radical debridement, autogenous bone grafting, and instrumentation. ⋯ In conclusion, postoperative chemotherapy with the 9-month three-drug regimen of isoniazid, rifampicin, and ethambutol is effective when combined with surgical treatment of spinal tuberculosis using single-stage anterior autogenous bone grafting and instrumentation.
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Covered stents have recently become available for intracranial use, such as aneurysms, arterial dissections and carotid-cavernous fistulas (CCFs). However, there have been few reports of the successful application of covered stents for the treatment of traumatic CCFs (TCCFs). The purpose of this study is to investigate the efficacy and safety of endovascular treatment of TCCFs with covered stent. ⋯ Although larger sample and long-term follow-up are required, our series shows that covered stent is an effective, safe, and microinvasive method to treat TCCFs.
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Previous research has suggested that increases in length of stay and hospital cost in patients undergoing spine surgery can be due to comorbidities, especially diabetes mellitus. To study how endocrine comorbidities impact spine surgery cost, we conducted the further analysis. ⋯ HbA1c elevation and hypothyroidism have an additive effect on hospital cost in lumbar decompression and fusion female patients. The finding of a surge in hospital cost parameters in elderly female hypothyroid patients undergoing surgery on their cervical spine needs more investigation.
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Controlled Clinical Trial
Therapeutic efficacy of injectable calcium phosphate cement in osteoporotic vertebral compression fractures: prospective nonrandomized controlled study at 6-month follow-up.
Alternative biocompatible filler materials replacing polymethylmethacrylate (PMMA) cement have been introduced and clinically tested. Callos calcium phosphate cement (CPC) is one of them. A prospective nonrandomized controlled study was performed to assess the clinical and radiologic results after balloon kyphoplasty with Callos CPC in osteoporotic vertebral compression fractures. ⋯ Subsequent loss of augmentation properties during follow-up is a serious problem of kyphoplasty using injectable CPC in osteoporotic vertebral compression fractures. The clinical use of injectable CPC in kyphoplasty should be reconsidered.