World Neurosurg
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Review Meta Analysis
Spinal diffusion tensor imaging in the evaluation of pre- and post-operative severity in cervical spondylotic myelopathy: A systematic review of the literature.
Diffusion tensor imaging (DTI) is increasingly investigated as a potential diagnostic and prognostic tool for symptomatic degenerative cervical pathology; however, it is yet to be validated for this purpose. ⋯ DTI is associated with preoperative severity and postoperative outcomes in CSM patients, suggesting that DTI may become useful in identifying those most likely to benefit from operative intervention (Level 3 Evidence). Prospective trials with standardized DTI acquisition techniques and patient selection are required for higher-level evidence.
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Anterior cervical discectomy (ACD) is one of the most common spinal surgeries. Although rare, iatrogenic vertebral artery injuries (VAIs) are potentially life-threatening. Risk factors are anatomic, operative, and pathologic. We report a rare case of iatrogenic VAI during ACD and successful endovascular treatment with no long-term complications. We also review the literature on all VAIs associated with ACD and fusions. Risk factors and the safety and effectiveness of various management modalities are discussed. ⋯ Delayed pseudoaneurysm formation after iatrogenic VAI can occur. Endovascular embolization can be a safe treatment alternative to surgical repair.
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Multicenter Study Controlled Clinical Trial
Effects of Smoking on Subjective and Objective Measures of Pain Intensity, Functional Impairment and Health-related Quality of Life in Lumbar Degenerative Disc Disease.
Numerous studies assessed the effects of smoking on lumbar degenerative disk disease (DDD); they focused on patient-reported outcome measures (PROMs) and yielded conflicting results. ⋯ PROMs measuring SFI for pain intensity, functional impairment, and health-related quality of life were similar in smokers and nonsmokers before surgery for lumbar DDD, as well as postoperatively. The smoking status has negligible impact on the Timed Up and Go test, which appears to be a robust assessment tool for OFI.
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The pterional/frontotemporal orbitozygomatic (FTOZ) approaches are the 2 most widely used procedures for resection of sphenoid wing meningiomas; however, a comparison of outcomes and complications of these 2 approaches has not been well described yet. Here, we investigated the outcomes, complications, and predictors of favorable outcomes of these 2 approaches. ⋯ In summary, sphenoid wing meningiomas undergoing extensive skull base approach (FTOZ) and GTR had a low recurrence rate and greater RFS. Even though FTOZ with GTR is preferable to resect the sphenoid wing meningiomas, the procedure should be tailored to each patient depending on the risks and surgical morbidity.
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Multicenter Study
Cervical Spinal Cord Injury without Computed Tomography evidence of trauma (SCIWOCTET) in adults: MRI prognostic factors.
Spinal cord injury (SCI) without computed tomography evidence of trauma is underreported in adults and is considered a subtype of SCI with relatively good outcome. Despite this, few studies have been performed to determine specific imaging-related prognostic factors. Our objective is to describe the imaging characteristics of patients experiencing blunt cervical spine trauma with neurologic deficits, but without radiologic abnormalities and associated prognostic factors. ⋯ Early MRI has prognostic value in patients suffering SCI without computed tomography evidence of trauma. Lesion length is a powerful predictor of outcome in this subgroup of patients. Soft tissue injury plays a role in the severity of injury and the ability to recover in this subgroups of patients.