World Neurosurg
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Temporo-occipital junction arteriovenous malformations (TOJ-AVMs) do not often involve eloquent brain cortex, but rather exist beside functional fiber tracts. The objective of this study was to determine the outcomes after surgical treatment in patients with TOJ-AVMs and to identify risk factors associated with postoperative neurologic deficits. ⋯ Patients with TOJ-AVMs have a high risk of surgical morbidity, although they often have relatively low S-M scores; LFD is a crucial risk factor associated with postoperative neurologic deficits in patients with TOJ-AVMs.
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Multicenter Study
Surgeon and patient's radiation exposure through vertebral body cement augmentation procedures: a prospective multicentric study of 49 cases.
Vertebral body cement augmentation as a treatment option for osteoporotic or traumatic fractures has become increasingly popular during the past decade. However, these surgical procedures require numerous fluoroscopic examinations, resulting in high radiation exposure for the patient and the surgical team. The aim of this study was to evaluate the level of radiation exposure of the spine surgeon and the patient during these percutaneous procedures. ⋯ Values of radiation doses for surgeon and patient were lower than those reported in the previous literature. The recommended annual dose limit is set to 500 mSv for extremities and 150 mSv for lens. According to our results, the exposure dose to the eye exceeds the annual limit after 3500 procedures. However, there is increasing concern among surgeons about radiation exposure, and there is still a need for solutions as preventive measures.
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Although intraoperative magnetic resonance imaging (iMRI) increasingly is used during glioma resection, its role in skull base surgery has not been well documented. In this study, we evaluate our experience with iMRI for skull base surgery. ⋯ Despite the unique challenges associated with skull base tumor surgery, iMRI can be safely obtained while adding a modest although not prohibitive amount of time to the procedure. The immediate evidence of residual tumor with a patient still in position to have additional resection may influence the surgeon to alter the surgical plan and attempt further resection in a critical area.
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Stereotactic radiosurgery (SRS) for large vestibular schwannomas (VS) remains controversial. We studied the tumor local control and toxicity rates after hypofractionated SRS for VS > 3 cm. ⋯ Overall, 80% of large VSs were adequately controlled by CK with 97 months of median follow-up. Patients with previous surgery and NF2 also appeared to have higher rates of tumor progression, and less favorable functional outcomes.
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To evaluate whether preoperative multirow detector computed tomography (MDCT) findings were associated with clinical outcome 24 months after dynamic stabilization for painful degenerative lumbar spine disease. ⋯ Clinical improvement after dynamic stabilization was significantly associated with 7 independent baseline imaging findings. Preoperative evaluation of these MDCT parameters may improve therapy selection for patients with degenerative lumbar spine disease.