World Neurosurg
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Microneurosurgical techniques involve complex manual skills and hand-eye coordination that require substantial training. Many factors affect microneurosurgical skills. The goal of this study was to use a systematic evidence-based approach to analyze the quality of evidence for intrinsic and extrinsic factors that influence microneurosurgical performance and to make weighted practical recommendations. ⋯ Despite the clear value of determining the effects of various factors on surgical performance, the available body of literature is limited, and it is not possible to determine standards for each surgical field. These recommendations may be used by neurosurgical trainees and practicing neurosurgeons to improve microsurgical performance and acquisition of microsurgical skills. Randomized studies assessing the factors that influence microsurgical performance are required.
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Trigeminal neuralgia (TN) is commonly associated with pathologic factors of axonopathy and demyelination resulting from neurovascular compression at the trigeminal root entry zone (REZ). Decompression surgery can relieve TN pain, likely by resolving such structural abnormalities. To test this hypothesis, we used diffusion tensor imaging (DTI) to capture the full extent of trigeminal microarchitecture changes in vivo in patients with TN. ⋯ Together, these results support that DTI permits the noninvasive detection of the trigeminal microstructural abnormalities underlying TN in vivo, and DTI-derived metrics could be considered surrogate markers of the axonal and myelin states for monitoring patients.
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Multicenter Study
A Large Multicenter Retrospective Research on Embedded Cranioplasty and Covered Cranioplasty.
Cranioplasty (CP) can be either embedded or covered, according to the implants used. However, determining which one is better in treating cranial defects is difficult. This study aimed to compare the clinical outcomes and complications of embedded CP and covered CP. ⋯ Our results show that embedded CP with PEEK has a distinct advantage in brain function improvement and fewer postoperative complications compared with covered CP with titanium mesh. However, the high cost of PEEK is an obvious drawback. This study can help both neurosurgeons and patients in choosing a better therapeutic method to achieve the most satisfactory outcome in treating cranial defects.
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Comparative Study
Comparison of MED and PELD in the Treatment of Adolescent Lumbar Disc Herniation: A 5-Year Retrospective Follow-Up.
To compare the efficacy and safety of minimally endoscopic discectomy (MED) and percutaneous endoscopic lumbar discectomy (PELD) in the treatment of adolescent lumbar disc herniation (ALDH). ⋯ Both PELD and MED are effective and safe surgical techniques for the treatment of ALDH; however, compared with MED, PELD is more advantageous for lower back pain and provides more rapid resolution of radicular pain.
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It is becoming increasingly common to incorporate chemotherapy (CT) with radiotherapy (RT) in the treatment of low-grade gliomas (LGGs) after surgical resection. However, there is a lack of literature comparing survival of patients who underwent RT or CT alone. ⋯ Our results suggest that CT alone was independently associated with longer OS compared with RT alone in patients with LGGs who underwent surgery.