Neurosurgery
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Lateral lumbar interbody fusion (LLIF) is traditionally performed with the patient in the lateral decubitus position for interbody implant insertion and indirect decompression. In cases requiring 360-degree fusion or direct decompression, the patient is repositioned to the prone position during surgery, a technique referred to as dual-position LLIF (DP-L). To improve efficiency and eliminate the need for repositioning, surgeons have adopted single-position approaches, completing the entire procedure either in the lateral decubitus or prone position. ⋯ The development of LLIF represents a notable advancement in spine surgery. SPS builds on this foundation, offering potential improvements over the original technique. While SPS has demonstrated certain advantages, there remains room for further refinement and optimization in its application.
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Minimally invasive surgery (MIS) has significantly revolutionized spine surgery by reducing morbidity, minimizing tissue damage, and improving postoperative outcomes compared with traditional open surgeries. Although MIS is well-documented for degenerative spine diseases, its full scope and limitations in spine trauma remains underexplored. Thus, this review aims to address this gap by examining relevant literature on the evolution, current practices, and future directions of MIS applications in spinal trauma care. ⋯ Based on a literature review of 85 studies, the following manuscript focuses on the indications, complications, current literature, clinical outcomes, future directions, and limitations of MIS in managing thoracolumbar and cervical spine injuries with particular emphasis on percutaneous pedicle screw fixation, lateral thoracic and lumbar corpectomies, anterior thoracoscopic/endoscopic approaches, and treatment algorithms. Although MIS for spinal trauma offers numerous advantages, continuous research and data collection are crucial to developing clear treatment algorithms and improving clinical outcomes. However, the future of MIS in spine trauma care remains promising, with advancements in technology and surgical techniques anticipated to enhance safety, efficacy, and patient satisfaction.
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The benefit of middle meningeal artery embolization (MMAE) in the treatment of chronic subdural hematoma (CSDH) has been recently demonstrated in a series of clinical trials. Whether MMAE benefits "trial-ineligible" patients remains elusive. We thus sought to explore the potential benefit of MMAE in neurologically stable (modified Rankin Scale ≤3) patients with "trial-ineligible" CSDHs because of large size: Thickness >15 mm and/or midline shift ≥5 mm. ⋯ This study emphasizes the considerable prevalence of potentially "trial-ineligible" patients with CSDHs because of large size that may still benefit from standalone MMAE.
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Anatomic features of neuromas have been explored in imaging studies. However, there has been limited research into these features using resected, ex vivo human neuroma specimens. The aim of this study was to investigate the influence that time may have on neuroma growth and size, and the clinical significance of these parameters. ⋯ This study suggests that neuromas seem to continue to grow over time and that smaller nerves may form relatively larger neuromas. In addition, sensory nerves develop relatively larger neuromas compared with mixed nerves. Neuroma size does not appear to correlate with pain severity. These findings may stimulate future research efforts and contribute to a better understanding of symptomatic neuroma development.