World Neurosurg
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Concomitant diffuse idiopathic skeletal hyperostosis (DISH) and cervical ossification of the posterior longitudinal ligament (cOPLL) is primarily investigated in radiographic studies of East Asian populations. This study aimed to determine clinical prevalence of concomitant DISH/cOPLL in a large U.S. sample and to compare characteristics and complications in cOPLL patients with and without concomitant DISH who were surgically treated. ⋯ Clinical prevalence of DISH in patients with cOPLL in the U.S. is low, yet cOPLL patients with concomitant DISH underwent surgery more frequently compared to those without. Despite higher comorbidity burden, cOPLL patients with DISH may have similar short-term post-surgical risk to cOPLL patients without DISH. However, higher non-procedural neurological injury in cOPLL patients with DISH may indicate insidious or delayed disease sequelae.
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In the United States, chronic wounds affect more than 6.5 million people annually-a mean cost of $23,755 among neurosurgery patients. Current wound management solutions have disadvantages, including rejection, disease transmission from mammalian sources, and cultural issues prohibiting some products. Here, we describe preliminary use of xenograft tissue derived from axolotl (Ambystoma mexicanum) dermis for use in wound management after neurosurgical procedures. ⋯ Axolotl dermis patches support mammalian wound management, demonstrating favorable potential in improving neurosurgical wound closure and healing and overall outcomes.
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Hypopituitarism, one or more pituitary hormones inefficiently produced by the anterior pituitary or released from the posterior pituitary to adapt to the needs of the organism. Existing epidemiological data show that immune-mediated diffuse infiltration of the anterior pituitary is important in the development of hypopituitarism. However, the precise connection between immune cells and hypopituitarism remains unclear. This study aimed to elucidate the potential causal links between the 731 immune cell types and hypopituitarism risk. ⋯ Our investigation shed light on the intricate potential relationship between immune cells and hypopituitarism via genetic methods, underscoring the immune-mediated pathway in hypopituitarism pathogenesis, thereby offering valuable insights for future clinical investigations.
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In this study, we introduce a technique that combines percutaneous endoscopic lumbar discectomy (PELD) with annular suture, aiming to reduce postoperative recurrence rates and enhance clinical outcomes for patients. The repair of the annulus fibrosus plays a pivotal role in healing ruptured scars, reducing the rate of nuclear reherniation, and enhancing the hardness of scar tissue through surgical intervention. Younger patients, with their higher water content in the intervertebral discs and stronger nucleus pulposus tissue, are more suitable candidates for tissue suturing, thus achieving a higher success rate. ⋯ To enhance the safety and efficacy of the surgery, we present a detailed video demonstration of the PELD procedure and annular suture. The video showcases the use of suture needles of specific dimensions to ensure precision and effectiveness in the repair process. This meticulous approach not only improves patient outcomes but also contributes to a swifter return to daily activities, reducing the risk of long-term complications.
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We investigated whether air in the cisterns or ventricles on postoperative computed tomography (CT) (reflecting the opening of the cerebrospinal fluid spaces during surgery) is a predictor of classical or nodular leptomeningeal disease (LMD) after resection of brain metastases. ⋯ Postoperative air in the cisterns or ventricles can predict early classical or nodular leptomeningeal disease.