Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2018
Successful outcome after outpatient transforaminal decompression for lumbar foraminal and lateral recess stenosis: The positive predictive value of diagnostic epidural steroid injection.
To analyze the positive predictive value of diagnostic 1% lidocaine containing transforaminal epidural steroid injections (TESI) for successful outcome after outpatient endoscopic decompression for lumbar foraminal and lateral recess stenosis. ⋯ The expected VAS pain reduction (>50%) from a lidocaine containing transforaminal epidural steroid injection renders it a valuable diagnostic tool in improving clinical outcome after lumbar endoscopic transforaminal decompression.
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Clin Neurol Neurosurg · Sep 2018
Does the preoperative lumbar sagittal profile affect the selection of osteotomy level in pedicle subtraction osteotomy for thoracolumbar kyphosis secondary to ankylosing spondylitis?
To investigate the different preoperative lumbar sagittal profiles of ankylosing spondylitis (AS) patients and the selection of osteotomy level for one-level pedicle subtraction osteotomy (PSO) for the correction of thoracolumbar kyphosis. ⋯ Patients in group B had significantly worse preoperative sagittal alignments compared to group A. The distribution of osteotomy levels varied between the 2 groups due to the different lumbar profiles; however, satisfactory correction was achieved in both groups. The preoperative lumbar profiles need to be considered in selecting the optimal osteotomy level. Patients with kyphotic lumbar profiles are suitable candidates for PSO at L2/L3, while L1/L2 PSO is appropriate for patients with lordotic lumbar profiles.
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Clin Neurol Neurosurg · Sep 2018
Anteromedial GPi deep brain stimulation in Tourette syndrome: The first case series from Iran.
Tourette syndrome (TS) is a neuropsychiatric disorder characterized by childhood onset motor and phonic tics. In refractory cases, deep brain stimulation (DBS) with different targets including anteromedial Globus pallidus (AM-GPi) looks promising. ⋯ Results of our study in accordance to previous ones suggest AM-GPi DBS as an effective and well-tolerated therapeutic modality for patients with medication refractory TS.
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Clin Neurol Neurosurg · Aug 2018
The change of cervical sagittal alignment after surgery for adolescent idiopathic scoliosis.
The postoperative change in cervical sagittal alignment has an impact on health-related quality of life in adolescent idiopathic scoliosis (AIS) patients who have undergone deformity correction. However, the effect of deformity correction on sagittal cervical profile is still controversial in the literatures. The objective of this study was to investigate the postoperative change in the cervical sagittal alignment of patients with AIS. ⋯ Cervical sagittal alignment after deformity correction is altered in AIS patients. An increase in cervical kyphosis after surgery is correlated with a loss of thoracic kyphosis. The change in the cervical sagittal profile may be a compensatory mechanism in response to an abnormal thoracic sagittal profile.
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Clin Neurol Neurosurg · Aug 2018
Rates, causes, risk factors, and outcomes of readmission following deep brain stimulation for movement disorders: Analysis of the U.S. Nationwide Readmissions Database.
Deep brain stimulation (DBS) surgery has proven benefit for several movement disorders and medically-refractory psychiatric conditions and is considered a fairly safe procedure. We sought to determine the national rates, causes, predictors, and outcomes associated with 30-day and 90-day readmission. ⋯ All-cause, unplanned readmission for DBS was 1.9% within 30-days and 4.3% within 90-days. Risk factors for readmission in our study, such as advanced age and multiple medical comorbidities, are not unique to DBS. Unplanned readmissions are much rarer following DBS compared to most hospital discharges but can occasionally lead to additional costs and rare complications including hematoma, stroke, and wound infection. DBS should continue to be viewed as a safe and effective treatment modality for a wide range of neurological ailments.