World Neurosurg
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Spine surgery relies heavily on imaging, with radiography-based devices being the major operating room imaging modality. Radiation exposure is an occupational risk historically recognized shortly after the discovery of radiation itself. Exposure of both patients and operating room staff is of increasing concern as the knowledge regarding the hazards of radiation is steadily accumulating. ⋯ We discuss the methods to reduce operating room staff exposure to the minimal amount, thus reducing occupational risks. We recognize that increasing awareness to radiation exposure hazards and promoting the knowledge of methods to reduce exposure of surgeons, nurses, and technicians could result in a reduction of exposure to radiation.
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To determine whether complications in lumbar fusion surgery could be estimated from patient factors and perioperative laboratory values. In addition, risk scores for detection of patients prone to complications were defined. ⋯ Patients with postoperative complications and extended LOS seem to show significant differences in various perioperative laboratory values and patient factors. Perioperative risk assessments using cut-off values and risk scores may help identify patients prone to complications and extended resource use.
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Prognostic factors of favorable and unfavorable clinical outcome after aneurysmal subarachnoid hemorrhage (SAH) are still not completely known. We retrospectively analyzed the aneurysm location as a factor for patients' outcome after aneurysmal SAH. ⋯ Despite the usual prognostic factors (good admission status, younger age, absence of CVS) for a favorable outcome after SAH, the aneurysm location (carotid bifurcation artery) itself seems to be a prognostic factor. Also, aneurysms of the carotid bifurcation artery showed less occurrence of an early hydrocephalus, which is an indicator for the presence of an early brain injury. According to these results, we question if experimental animal models (especially the endovascular model using the perforation of the carotid bifurcation artery) have to be re-evaluated.
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Case Reports
Epidural spinal cord stimulation: A novel therapy in the treatment of restless legs syndrome.
We report a unique finding of a patient whose restless legs syndrome (RLS) symptoms abated after the placement of a spinal cord stimulator for chronic neuropathic pain. RLS is a common disorder, with many patients unable to find sufficient relief from their symptoms. ⋯ Epidural stimulation may be an additional, alternative, or novel therapy in the treatment of RLS.
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The objective of the current study was to compare the clinical features and outcomes between younger and older patients with skull base chordoma (SBC). ⋯ In younger patients, there were more SBCs located in the occipitocervical regions, and younger patients tended to undergo more aggressive resection. The tumor signal intensity of younger patients with SBC was higher in T2 images but lower in enhanced T1 images. A younger age was a favorable factor for a longer progression-free survival and a good neurologic status at follow-up.