Neurosurgery
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Randomized Controlled Trial Comparative Study
Tubular diskectomy vs conventional microdiskectomy for the treatment of lumbar disk herniation: 2-year results of a double-blind randomized controlled trial.
Transmuscular tubular diskectomy has been introduced to increase the rate of recovery, although evidence is lacking. ⋯ Tubular diskectomy and conventional microdiskectomy resulted in similar functional and clinical outcomes. Patients treated with tubular diskectomy reported more leg pain and low-back pain, although the differences were small and not clinically relevant.
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High-resolution three-dimensional (3D) magnetic resonance imaging (MRI) has demonstrated its ability to predict fine trigeminal neurovascular anatomy. ⋯ 3T MRI using 3D T2-weighted DRIVE in combination with 3D TOF-MRA and 3D T1-weighted gadolinium-enhanced sequences proved to be reliable in detecting NVC and in predicting the degree of root compression, the outcome being correlated with the latter.
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Comparative Study
A novel postoperative seizure classification for long-term mortality of patients with intractable epilepsy: comparison with the Engel system.
To explore the association of clinical seizure pattern with the long-term prognosis after epilepsy surgery is important for patient counseling and risk management. ⋯ The proposed novel classification with long-term observed frequency and duration of seizures after surgery is more informative for predicting long-term mortality than the Engel classification.
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Anterior communicating artery (A-comm) aneurysm is one of the most common intracranial aneurysms. Treatments include neurosurgical clipping or endovascular embolization. ⋯ Neuroform stent-assisted embolization provides long-term control of A-comms with a low incidence of aneurysm growth after treatment. The need for retreatment is uncommon, and retreatment is safe if performed. Subsequent bleeding from treated aneurysms was not observed in this study.
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The diagnostic accuracy and reproducibility for glioma histological diagnosis are suboptimal. ⋯ The Sainte-Anne classification was better able to distinguish pediatric malignant gliomas in terms of survival compared with the World Health Organization classification. In this series, neither of these 2 histological classifications provided a prognostic stratification of the patients.