World Neurosurg
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We describe our technique and evaluate clinical and radiographic outcomes for patients undergoing L4/5 posterior lumbar interbody fusion with 3D-navigation guided cortical bone trajectory screws (PLIF-CBT) for grade 1 or 2 degenerative spondylolisthesis with a minimum follow-up time of 12 months. ⋯ PLIF-CBT can be performed in a safe and reproducible fashion with excellent clinical outcomes at 1 year postoperatively. The outcomes did not correlate with fusion status, which was unexpectedly low at 37.5% without significant hardware abnormalities necessitating reoperations. PLIF-CBT offers several perioperative advantages compared with traditional open PLIF and requires longer-term studies to demonstrate its durability with regard to improvement in clinical pain and radiographic endpoints, including anterior and/or posterior element fusion.
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Craniovertebral junction (CVJ) meningiomas are one of the most surgically complex conditions in neuro-oncologic surgery. The aim of this work is to correlate our data with clinical outcome to outline factors leading to a worse functional prognosis. ⋯ We selected, in our experience, some predictors of worse outcome: preoperative sphincter impairment, absence of a capsule, cranial site of origin, a poor preoperative functional status, and firm consistency of the tumor.
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Case Reports
Prognostic factors for the survival outcome of bilateral thalamic glioma: An integrated survival analysis.
The aim of this study was to perform an integrated survival analysis of patients with bilateral thalamic glioma and to assess the influence of various prognostic factors on overall survival. ⋯ This comprehensive analysis of rare BTG patients revealed that a longer duration of symptoms (≥2 months) and low WHO grade were significantly associated with improved survival and were independent prognostic factors for overall survival.
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In acute ischemic stroke with large vessel occlusion, the interaction between the clot retriever and the stent is critical for achieving successful recanalization. The ideal time of stent deployment (dwell time [DT]) to improve revascularization is currently unknown. We systematically analyzed the effect of different DT on final angiographic and clinical outcomes of patients who underwent mechanical thrombectomy. ⋯ Mild prolongation of DT to 8 minutes improves revascularization outcome with fewer attempts, possibly because of better clot-stent interaction.
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Despite significant improvement in clinical care, operative strategies, and technology, neurosurgery is still risky, and optimal preoperative planning and anatomical assessment are necessary to minimize the risks of serious complications. Our purpose was to document the dural venous sinuses (DVS) and their variations identified during routine 3-dimensional (3D) venography created through 3D models for the teaching of complex cerebral anatomy. ⋯ Patient-specific models of DVS geometry could provide an improved understanding of the complex brain anatomy and better navigation in difficult areas and allow surgeons to anticipate anatomical issues that might arise during the operation. Such models offer opportunities to accelerate the development of expertise with respect to new and novel procedures as well as new surgical approaches and innovations, thus allowing novice neurosurgeons to gain valuable experience in surgical techniques without exposing patients to risk of harm.