World Neurosurg
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Fractures of the atlas are typically considered stable or unstable based on the integrity of the transverse ligament. Whereas stable Jefferson burst fractures can be treated nonoperatively, unstable fractures with disruption of the transverse ligament often require surgical intervention. Atlas osteosynthesis has been proposed as a motion-preserving alternative to atlantoaxial fusion. Intraoperative navigation may facilitate safe placement of C1 instrumentation. ⋯ Atlas osteosynthesis is an attractive motion-preserving approach to the treatment of unstable atlas fractures, avoiding the morbidity of atlantoaxial fusion. Classically reserved for Jefferson fractures with Dickman type II transverse ligament injury, atlas osteosynthesis may also be a viable option for type I transverse ligament injuries. Intraoperative navigation can be particularly useful for screw placement in the setting of traumatically distorted anatomy with lateral mass displacement.
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To compare the clinical outcomes of unilateral biportal endoscopic discectomy (UBED) and percutaneous interlaminar endoscopic discectomy (PIED) for treating L5/S1 disc herniation. ⋯ UBED indicates similar short-term efficacy compared with PIED for treating L5/S1 disc herniation. No difference was found in facet joint preservation between the 2 groups. We believe the increased cost of UBED as the result of surgical consumables will decrease in the future.
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Perioperative neurocognitive disorders (PND) are common perioperative complications associated with various poor outcomes. Regional cerebral oxygen saturation (rSO2) monitoring is a non-invasive technique based on near-infrared spectroscopy detection. Due to the considerable controversy among currently published studies on the application of intraoperative rSO2 monitoring in adult patients undergoing elective non-cardiac surgery, this study aims to conduct a systematic review and meta-analysis to provide more comprehensive and robust evidence to support clinical decision-making. ⋯ Despite the presence of heterogeneity and the inclusion of a limited number of studies for some outcomes, it is still recommended that clinical anesthesiologists routinely perform intraoperative rSO2 monitoring and optimize intraoperative anesthesia management based on the monitoring results to maximize rSO2 and improve cerebral perfusion, thereby improving patients' neurocognitive outcomes. Further large-scale high-quality studies are needed to confirm the conclusions of this study.
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To scrutinize and compare the accuracy of measurements obtained from photogrammetric models against direct measurements taken on dry skulls, with the aim to verify the feasibility of photogrammetry for quantitative analysis in microsurgical neuroanatomy. ⋯ The role of two photogrammetric models is validated as quantitative analysis technique for laboratory neuroanatomical studies showing acceptable measurement error, high intra- and inter-rater reliability as well as good to very good agreement compared to direct measurement on dry skulls, replacing the expensive and time-consuming methods like CT scans and neuronavigation system.