World Neurosurg
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Management decisions for brainstem arteriovenous malformations (AVMs) are complicated by balancing the risks of treatment and natural progression to hemorrhage. The present study seeks to compare radiosurgery and conservative management outcomes in brainstem AVMs. ⋯ Our results suggest that when patients with brainstem AVM are selected cautiously, radiosurgery may achieve obliteration and symptom relief without increasing subsequent hemorrhage risk.
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A retrospective study was conducted to clarify the risk factors of postoperative low back pain (LBP) for lumbar spine disease. ⋯ Type of surgery, operation time, number of operative level, and type of disease were risk factors for the postoperative LBP. Patients underwent PLIF with shorter symptom duration, longer operation time severe LM IMAT, and lumber spondylolisthesis reported more severe LBP before the operation. Patients underwent discectomy with shorter operation times.
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Cervical spine surgery is a common procedure for treatment of wide variety of pathologies. In this paper we report approach-related complication rates experienced by our patients. ⋯ Both the posterior and the anterior approaches are highly efficacious in preventing neurologic deterioration and in most cases improve neurological function. This study demonstrates that the anterior approach was associated with significantly lower rates of complication especially infection related complications.
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Ventral defect caused by resection of the lesions involving the upper cervical spine commonly has been reconstructed with a fabricated mesh cage. Recently, a clival screw and plate fitted to the osseous anatomy of the craniovertebral junction was developed for this pathologic status. ⋯ The clivus plate system fixation is biomechanically superior to the conventional fashioned mesh cage fixation in flexion, lateral bending and axial rotation, but equavalent in extension.
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Although chronic subdural hematoma (CSH) can be treated by surgery, little is known about age-dependent symptoms and age-adjusted rates of restoring functional integrity. To evaluate the clinical symptoms and the course of CSH in patients of different age groups (AGs), we reviewed patients with CSH treated at our department over the past 22 years. ⋯ CSH predominantly caused unspecific symptoms such as headache and cognitive decline. CSH surgery immediately relieved symptoms in patients of all AGs. However, improvement rates significantly depended on patient age. This should be taken into consideration when advising on surgical treatment of CSH.