World Neurosurg
-
The causes and epidemiology of traumatic cervical spine fracture have not been described with sufficient power or recency. Our goal is to describe demographics, incidence, cause, spinal cord injuries (SCIs), concurrent injuries, treatments, and complications of traumatic cervical spine fractures. ⋯ Incidence, complications, concurrent injuries, and fusions have increased since 2005. Length of stay, SCIs, decompressions, and halo insertions have decreased. Indicated trends should guide future research in management guidelines.
-
Addition of fusion to decompression for stenosis with grade 1 degenerative spondylolisthesis is a controversial topic, and the question remains if fusion provides any benefit to the patient that warrants the increased health care utilization and perioperative morbidity. There is no consensus on indications for use of fusion over decompression alone. ⋯ Use of a decision-making protocol led to a low rate of iatrogenically increased spondylolisthesis after decompression, while retaining outcomes. These data suggest that a decision-making protocol based on clinical history, location of nerve root compression, and proven radiologic predictors of postoperative instability assigns patients to fusion or decompression in a safe and effective manner.
-
To develop an improved technique for microvascular decompression (MVD) surgery using nest-shaped Teflon fibers. ⋯ The nest-shaped Teflon fibers in MVD surgery for TN is safe and applicable. The long-term outcomes and the comparison between hollow nest-shaped implants and the standard cigar-shaped implants should be assessed in future investigations with larger sample sizes.
-
We sought to describe the novel technique and report the outcomes of cervical spondylotic radiculopathy caused by facet joint hyperplasia treated with minimally invasive surgery by laminar and lateral mass screw cofixations. ⋯ Minimally invasive surgery by lamina and lateral mass screw cofixation is safe and effective for the treatment of cervical spondylotic radiculopathy caused by facet joint hyperplasia. In addition to sufficient decompression, this technique provides relative stability to the cervical spine.
-
Endoscopic transsphenoidal surgery (ETPS) has become increasingly popular for resection of pituitary tumors, whereas microscopic transsphenoidal surgery (MTPS) also remains a commonly used approach. The economic sustainability of new techniques and technologies is rarely evaluated in the neurosurgical skull base literature. The aim of this study was to determine the cost-effectiveness of ETPS compared with MTPS. ⋯ ETPS appears to be cost-effective when compared with MTPS because the ICER falls below the commonly accepted $50,000 per QALY benchmark. Model limitations and assumptions affect the generalizability of the conclusion; however, ongoing efforts to improve rhinologic morbidity related to ETPS would appear to further augment the marginal cost savings and QALYs gained. Further research on the cost-effectiveness of ETPS using prospective data is warranted.