World Neurosurg
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The short-term neurologic outcome of infants undergoing brain tumor surgery depends on various perioperative factors. This study was undertaken to analyze the effects of perioperative variables on the postoperative neurologic outcome in infants undergoing brain tumor surgery. ⋯ In this study, factors associated with new POND were mannitol use and to a certain extent MBT. The variables associated with prolonged LOHS were reintubation and to a certain extent POND. The anesthetic technique, location of tumor, tumor histology, and extent of tumor resection did not influence the occurrence of new POND or prolonged LOHS in infantile intracranial tumor surgery. Further prospective studies with larger samples are required for confirmation of these findings and identification of new perioperative risk factors.
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To analyze the safety and efficacy of skipping instrumentation at the C7 vertebra during posterior cervicothoracic fusions. ⋯ Skipping C7 in a multilevel posterior cervicothoracic fusion demonstrates significantly reduced estimated blood loss and faster operative times compared with the control group. In addition, postoperative assessment yielded similar rates of fusion in both groups. Serious negative outcomes of skipping C7 were not found in this retrospective study. Our study results illustrate the clinical benefits of skipping instrumentation at C7 to minimize surgical risk in patients undergoing posterior cervical fusion across the cervicothoracic junction.
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The Michigan Spine Surgery Improvement Collaborative is a statewide multicenter quality improvement registry. Because missing data can affect registry results, we used MSSIC to find demographic and surgical characteristics that affect the completion of patient-reported outcomes (PROs) at 90 days and 1 year. ⋯ A multivariate analysis from a multicenter prospective database identified surgical factors that affect PRO follow-up, up to 1 year. This information can be helpful for imputing missing PRO data and could be used to strengthen data derived from large prospective databases.
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Randomized Controlled Trial Comparative Study
Reoperation Following Primary Lumbar Discectomy With or Without Implantation of a Bone-Anchored Annular Closure Device: Surgical Strategies and Clinical Outcomes.
To determine whether presence of a bone-anchored annular closure device (ACD) impacts reoperation strategies and subsequent outcomes. ⋯ In patients undergoing post-discectomy reoperation, patients with an ACD were treated with similar operative techniques, were not exposed to additional surgical risks, and reported comparable clinical outcomes versus those without an ACD.