Neurosurgery
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Silent corticotrophic adenomas (SCAs) stain adrenocorticotropic hormone (ACTH)+ without causing Cushing's disease. SCAs are reportedly more aggressive, but information comes from small series. ⋯ In the largest series to date, SCAs exhibited comparable size, but increased cavernous sinus invasion and progression/recurrence versus HNAs. SCAs exhibit deficient pro-opiomelanocortin to ACTH conversion. Close follow-up is warranted for SCAs.
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The transforaminal lumbar interbody fusion (TLIF) procedure may reduce many of the risks and limitations associated with posterior lumbar interbody fusion (PLIF). However, little is known about the biomechanical difference between PLIF and TLIF. ⋯ The TLIF procedure increases the approximate biomechanical stability and reduces stress at the cage-endplate interface, except for a slight increase in screw stress. Clinically, the TLIF procedure may reduce many of the risks and limitations associated with PLIF and offer a useful alternative to the PLIF procedure.
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Review Meta Analysis
The role of radiosurgery to the tumor bed after resection of brain metastases.
Optimal postoperative management paradigm for brain metastases remains controversial. ⋯ Our systematic review supports the use of radiosurgery as a safe and effective strategy for adjuvant treatment of brain metastases, particularly when gross total resection has been achieved. With all limitations of comparisons between studies, no increase in local recurrence or decrease in overall survival compared with rates with adjuvant whole-brain radiation therapy was found.