World Neurosurg
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Randomized Controlled Trial
Effect of Tranexamic Acid on Prevention of Hemorrhagic Mass Growth in Patients with Traumatic Brain Injury.
Intracranial hemorrhage is a common complication of traumatic brain injury (TBI). The purpose of this study is evaluation of the effect of tranexamic acid (TXA) on hemorrhagic mass growth in TBI patients. ⋯ Administration of a short dose of TXA does not lead to significant prevention of growth of posttraumatic hemorrhagic lesion or improvement of clinical outcomes.
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Randomized Controlled Trial Comparative Study
Comparative Study of Cortical Bone Trajectory-Pedicle Screw (Cortical Screw) versus Conventional Pedicle Screw in Single-Level Posterior Lumbar Interbody Fusion: A 2-Year Post Hoc Analysis from Prospectively Randomized Data.
The aim of this study was to report 2-year follow-up outcomes of posterior lumbar interbody fusion (PLIF) with cortical bone trajectory-pedicle screw (CS), in terms of fusion rates, clinical outcomes, surgical outcomes, and complications, and to compare these outcomes with outcomes for PLIF with conventional pedicle screw (PS). ⋯ We suggest that CS in single-level PLIF may be an alternative to PS.
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Pediatric intracranial aneurysms (IAs) are rare. Compared with adult IAs, they are more commonly giant, fusiform, or dissecting. Treatment often proves more complex, and recurrence rate and de novo aneurysmogenesis incidence are higher. A consensus regarding the most appropriate algorithm for following pediatric IAs is lacking. ⋯ We propose incidental untreated IAs to be followed by magnetic resonance angiography without contrast enhancement. Follow-up modality and interval for treated pediatric IAs is determined by initial aneurysmal complexity, treatment modality, and degree of posttreatment obliteration. Recurrence or de novo aneurysmogenesis requiring treatment should be followed by digital subtraction angiography and appropriate retreatment. Computed tomography angiography is preferred for clipped IAs, whereas contrast-enhanced magnetic resonance angiography is preferred for lesions treated endovascularly with coil embolization and lesions treated microsurgically in a manner other than clipping.
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Multicenter Study
Assessment of a novel adult cervical deformity frailty index as a component of preoperative risk stratification.
To determine the value of a novel adult cervical deformity frailty index (CD-FI) in preoperative risk stratification. ⋯ Greater frailty was associated with greater risk of major complications for patients undergoing cervical spine deformity surgery. The CD-FI may be used to improve the accuracy of preoperative risk stratification and allow for adequate patient counseling.
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Review Biography Historical Article
Paul of Aegina (625-690), his work and his contribution to neurological surgery: trephinations and laminectomies in the Dark Ages.
The purpose of this historical review is to summarize the work of Paul of Aegina, especially his contribution to the treatment of neurosurgical disorders and trauma. Paul performed trephinations for head injuries in the tradition of the Egyptian and the Greek schools of medicine. However, he was an innovator in the treatment of several spine injuries, as his choice to perform laminectomies and his description of them as safe and successful is unprecedented in the history of the recorded medicine and surgery. ⋯ Thus, he may be considered the historic father of spine surgery for his pioneering surgical innovations. This shows clearly that innovation in science and medicine was significantly increased through the rise of Islam and the Arabic conquest of the Middle East. The so-called "Dark Ages" were not so dark after all.