British journal of neurosurgery
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BACKGROUND CONTEXT. Proximal junctional kyphosis (PJK) following surgical treatment of lumbar degenerative kyphosis (LDK) is one of the critical complications leading to the failure of instrumentation and additional extensive surgery. However, most previous studies have focused on idiopathic scoliosis resulting from variable surgical techniques. ⋯ Spinal biomechanics may be changed after long instrumented fusion surgery. Thorough consideration of these factors is needed in the treatment strategy of LDK patients. A long-term follow-up study should be conducted.
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A working knowledge of the legal principles of medical negligence is helpful to neurosurgeons. It helps them to act in a "reasonable, responsible and logical" manner, that is a practice that is consistent with the surgical practice of their peers. This article will review and explain the relevant medical law in relation to duty of care with illustrative neurosurgical cases.
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The author of the following article has requested that it be retracted from publication in British Journal of Neurosurgery : Sri D. The management of spinal dural fistulas: a 13-year retrospective analysis. British Journal of Neurosurgery 2013;27(4):471 – 4. ⋯ The retraction is not made on the basis of any concerns with the data or findings of the study. D. Sri sincerely apologises for the inconvenience caused.
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Cavernomas constitute 5-10% of all the vascular malformations of the CNS. They commonly present during the 2nd and 5th decades of life. ⋯ These cavernomas appear to have the ability to grow very rapidly, resulting in significant morbidity. It is not known whether waiting after acute hemorrhage from an intraventricular cavernoma improves our ability to remove the lesion safely or if waiting unnecessarily increases the risk of hydrocephalus, additional bleeding, or further lesion growth.
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Observational Study
Seven years of cranioplasty in a regional neurosurgical centre.
In recent years craniectomy has been widely used in the management of traumatic brain injury and ischaemic stroke. The objective of this study was to evaluate the indications, techniques and outcomes for patients undergoing cranioplasty over a recent 7-year period in a geographically distinct population. ⋯ Cranioplasty is often considered as a low-risk procedure following craniectomy. In our cohort, a 20% risk of major complications, including death, was identified. These findings contribute to the literature, emphasising that cranioplasty is a high-risk procedure. Whilst compelling reasons may guide the undertaking of craniectomy, it is essential that consideration is given to the significant subsequent risks of cranioplasty.