World Neurosurg
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Comparative Study
Prognostic factors for recovery after anterior debridement/bone grafting and posterior instrumentation for lumbar spinal tuberculosis.
Anterior debridement/bone grafting/posterior instrumentation is a common selection for the treatment of lumbar spinal tuberculosis (LST). To date, no study has focused on the prognostic factors for recovery after this surgery. ⋯ Nonparalysis, shorter symptom duration, fewer involved vertebrae, and posterior percutaneous instrumentation (compared with open instrumentation) are considered favorable prognostic factors. Patients in the percutaneous instrumentation group achieved higher JOA scores than those in the open instrumentation group in the early stages postoperatively (1-3 months), but no significant difference was observed in long-term JOA scores (6-24 months).
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Bibliometric analyses based on total citation count come with many limitations, which investigators in other fields have overcome using the average number of citations per year since publication. ⋯ These results suggest that ranking articles based on relevancy rather than historical popularity results in a list of more recently published articles and includes more studies addressing topics of surgical management and outcomes. The ability to appraise the literature in this fashion is worthwhile to those seeking a better understanding of the science underlying modern clinical practice and is thus a highly valuable tool for neurosurgical residents, program directors, and neuroscientists as they acquire an understanding of modern neurosurgery and its scientific foundation.
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Meningiomas account for 36% of primary brain tumors. The pathogenesis of these tumors is not completely established, hindering development of effective chemotherapy. Numerous studies have identified alterations in several growth factors and receptor kinases that regulate meningioma growth. These may be targets for new therapies. One of these, sometimes overlooked, is the transforming growth factor beta (TGF-β) family of proteins. Its receptors and signaling pathways play a critical role in development or progression of many forms of neoplasia. ⋯ Accumulating evidence suggests that derangement of TGF-β family signaling contributes to development and progression of meningiomas. The TGF-β family may represent new targets for chemotherapy and could include inhibitors of kinases activated by TGF-β.
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Review Case Reports
Spinal Cord Compression Secondary to Epidural Fibrosis Associated with Percutaneously Placed Spinal Cord Stimulation Electrodes: Case Report and Review of the Literature.
Spinal cord stimulation is a safe method for treating chronic pain syndromes. Spinal cord stimulators can be placed either surgically by creating a laminectomy defect for paddle leads or percutaneously by inserting electrodes. They are usually not associated with major complications. ⋯ We also reviewed the PubMed and Medline databases for all cases of significant epidural fibrosis related to spinal cord stimulator lead placement, including both surgically implanted paddles and percutaneously implanted leads. This is an uncommon complication after placement of spinal cord stimulators, but it can carry a clinically significant impact and be the source of severe morbidity. It should especially be suspected if the successful placement of the device is followed by development of a "tolerance" phenomenon, with progressive loss of satisfactory pain control and development of new myelopathic symptoms.
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Multicenter Study
A Novel Tool for Deformity Surgery Planning: Determining the Magnitude of Lordotic Correction Required to Achieve a Desired Sagittal Vertical Axis.
We sought to create a model capable of predicting the magnitude of pelvic incidence-lumbar lordosis (PI-LL) correction necessary to achieve a desired change in sagittal vertical axis (SVA). ⋯ We describe a novel model that shows how surgical correction of the PI-LL relationship affects postoperative changes in SVA. This model may enable surgeons to determine preoperatively the amount of LL necessary to achieve a desired change in SVA.