World Neurosurg
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3D navigation offers real-time guidance in surgery. However, there is limited and inconsistent data regarding the usability, safety, and efficacy. To address gaps in knowledge about 3D navigation in spinal surgery, we conducted a comprehensive review of success rates, complications, revisions, radiation exposure, and operative time associated with FDA-approved 3D surgical navigation tools. ⋯ 3D navigation in spinal procedures has higher surgical success rates than 2D fluoroscopy and freehand navigation. Included studies exhibited varying limitations, including no patient follow-up (n = 1), less than 10 patients (n = 6), various types of spinal disorders (n = 1), and varying comorbidities among participants (n = 2). Improving 3D navigation tools remains imperative to decrease operative time and radiation exposure.
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To evaluate the effects of admission serum C-reactive protein-to-albumin ratio (CAR) in traumatic spinal cord injury (TSCI) severity evaluation and prognosis. ⋯ Serum CAR is a readily available biomarker for assessing the severity of TSCI and predicting prognosis, which is clinically relevant for the functional recovery of patients with TSCI.
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Intracranial solitary fibrous tumor (SFT) is a rare central nervous system (CNS) tumor that lacks a reliable prognostic clinical model. Uncertainty persists regarding the treatment outcomes of surgery and adjuvant radiotherapy (ART). To address this, we investigated the efficacy of ART and applied machine learning (ML) to develop accurate prognostic models. ⋯ Although ART did not lead to a substantial decrease in cancer-specific deaths, it did improve OS. This underscores the broader health benefits of ART, including effective management of comorbid conditions. Caution is advised when interpreting these survival benefits because of potential confounding factors in patient health and treatment management. Our web tool and ML models aid in clinical decision-making.
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To identify the clinical and surgical characteristics and treatment options of patients suffering delayed (> 1 month) screw back-out after anterior cervical discectomy and fusion (ACDF). ⋯ The risk of screw back-out is low, but it can be a devastating complication. The majority of reported cases developed pharyngoesophageal injury and dysphagia. Surgery is often required to remove the hardware and repair any damage to the esophagus or hypopharynx, and may require prolonged antibiotics and NPO. Rarely, patients may be asymptomatic and treated conservatively; but in 7 patients in this series in whom back-out was initially managed conservatively there worsening back-out or injury that occurred an average of 29 months later.
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Subarachnoid hemorrhage (SAH) is a severe neurological event with high mortality. The choice of sedatives in SAH management may influence patient outcomes. This study aimed to investigate the association between sedatives and in-hospital mortality among SAH patients. ⋯ Dexmedetomidine is associated with significantly lower in-hospital mortality in SAH patients. These findings underscore the importance of sedative choice for SAH patients, suggesting that dexmedetomidine could enhance patient outcomes.