World Neurosurg
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Patient BMI is an Independent Predictor of 30-Day Hospital Readmission after Elective Spine Surgery.
Hospital readmission within 30 days of index surgery is receiving increased scrutiny as an indicator of poor quality of care. Reducing readmissions achieves the dual benefit of improving quality and reducing costs. With the growing prevalence of obesity, understanding its impact on 30-day unplanned readmissions and patients' perception of health status is important for appropriate risk stratification of patients. The aim of this study was to determine if obesity is an independent risk factor for unplanned 30-day readmissions after elective spine surgery. ⋯ Preoperative obesity is an independent risk factor for readmission within 30 days of discharge after elective spine surgery. In a cost-conscious health care climate, preoperative BMI can identify patients at risk for early unplanned hospital readmission.
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The utility of virtual and augmented reality based on functional neuronavigation and intraoperative magnetic resonance imaging (MRI) for glioma surgery has not been previously investigated. ⋯ Combining virtual and augmented reality based on functional neuronavigation and intraoperative MRI can facilitate resection of gliomas involving eloquent areas.
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The caudal zona incerta (cZI) is an increasingly popular deep brain stimulation (DBS) target for the treatment of tremor-predominant disease. The dentatorubrothalamic tract (DRTT) is a white matter fiber bundle that traverses the cZI and can be identified using diffusion-weighted magnetic resonance imaging fiber tractography to ascertain its precise course. In this report, we compare 2 patient cases of cZI DBS, a responder and a nonresponder. ⋯ Preoperative diffusion-weighted magnetic resonance imaging fiber tractography imaging of the DRTT has the potential to improve and individualize DBS planning.
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The purpose of this report is to describe the surgical methodology and effectiveness of minimally invasive oblique lumbar interbody fusion (OLIF) assisted by spinal endoscopy, which can treat disk herniation from the central to contralateral foramen. OLIF showed indirect decompression effects on reduction of spondylolisthesis and a foraminal widening effect on disk height restoration. ⋯ OLIF with spinal endoscopic discectomy can achieve neural decompression without additional posterior decompression and can be used as an alternative treatment in selected cases.
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The Pipeline Embolization Device (PED) has been used and shown to be safe under monitored anesthesia care (MAC). We present the results of the first study, to our knowledge, assessing the safety and feasibility of same-day discharge in patients undergoing treatment with the PED, using MAC. ⋯ PED treatment under MAC is feasible and safe. This has brought forth an era of outpatient treatment of CAs where patients are discharged home 6 hours after the procedure.