World Neurosurg
-
The rationale for treatment of dural arteriovenous fistulas (dAVFs) without cortical venous reflux is symptomatic resolution. Most studies of dAVF treatment, including those for stereotactic radiosurgery, have focused on angiographic obliteration instead of clinical symptomatic outcome. ⋯ Rates of clinically significant symptomatic improvement/resolution of symptoms referable to "low-risk" dAVFs are even greater than their angiographic obliteration rate, an important factor in patient counseling and when considering the optimal treatment approach for these dAVFs.
-
Although not life threatening, hemifacial spasm (HFS) can be disabling and significantly affect quality of life (QOL). The aim of this study was to assess the major factors affecting the QOL and further to investigate the impact of microvascular decompression (MVD) on QOL in patients with HFS. ⋯ HFS affects QOL both physically and mentally. Patients with severe HFS symptoms or a higher educational level are at higher risk of worse QOL. MVD not only provides high spasm-relief rate but also leads to significantly higher QOL after surgery.
-
Comparative Study
Multilevel Posterior Column Osteotomies Are Not Inferior For the Correction of Rigid Adult Spinal Deformity Comparing to Pedicle Subtraction Osteotomy.
Posterior column osteotomy (PCO) has been used for the correction of various spinal deformities. However, little evidence is available regarding the effects of multilevel PCO in adult spinal deformity (ASD) surgery. This study aimed to show the usefulness of PCO in rigid ASD surgery by assessing radiographic and clinical outcomes. We also aimed to assess the corrective potential of multilevel PCOs compared with a single-level pedicle subtraction osteotomy (PSO). ⋯ Multilevel PCOs for the correction of rigid ASD were slightly superior to PSO, regarding clinical outcomes. Radiographic outcomes were similar between groups. Thus, multilevel PCOs may be a viable option for the treatment of rigid ASD with a mobile segment.
-
Smoking status has been shown to affect postoperative outcomes after surgery. The aim of this study was to determine whether patients' smoking status impacts 30-day complication and readmission rates after elective complex spinal fusion (≥3 levels). ⋯ Our study suggests that smoking does not significantly affect 30-day readmission rates after complex spinal surgery requiring ≥3 levels of fusion. Further studies are necessary to corroborate our findings.
-
To investigate the role of lumbosacral transitional vertebra (LSTV) in the pathogenesis of adolescent lumbar disc herniation (ALDH) and the association between LSTV type and the herniation level of ALDH. ⋯ The LSTV is associated with LDH in adolescents and the sacralization of L5 may contribute to the L4/5 disc herniation in adolescent patients.