World Neurosurg
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The treatment of spinal metastasis carries significant surgical morbidity, and decompression and stabilization are often necessary. Less invasive techniques may reduce risks and postoperative pain. This study describes the differences between a mini-open (MO) procedure and a traditional open surgery (OS) for symptomatic spinal metastasis, and reports differences in outcome for similar patients undergoing each procedure. ⋯ Although further studies are needed, the MO approach appears to result in decreased blood loss and postoperative pain, without compromising neural element decompression or spinal stability. These findings are consistent with the use of muscle sparing, minimally invasive pedicle screw fixation.
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Few studies have addressed the causes of poor expansion of the spinal canal after open-door laminoplasty (ODL) that require revision surgery. The aim of this study is to identify the reasons of poor expansion of the spinal canal after ODL and to discuss the surgical methods and clinical outcomes of the posterior revision surgery. ⋯ The main causes of poor expansion of the spinal canal after ODL were inadequate expansion degree of the spinal canal and improper expanded range of the spinal canal. Posterior revision surgeries, such as ODL, LCF, and laminectomy of responsible lamina, could guarantee fine clinical results.
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Secreted phosphoprotein 1 (SPP1) is an important extracellular glycoprotein that is associated with immune regulation, tumorigenesis, and cell signaling. However, the prognostic value of SPP1 in patients with glioma has not yet been clarified, especially in lower-grade gliomas. The objective of this study is to evaluate the prognostic merit of SPP1 in lower-grade gliomas. ⋯ The present study showed that SPP1 overexpression is related to worse overall survival in patients with lower-grade glioma. Moreover, SPP1 could be considered as an independent factor in lower-grade gliomas.
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Maffucci syndrome (MS) and Ollier disease (OD) are rare diseases characterized by multiple benign enchondromas. The incidence of skull base (SB) enchondromas and the risk of malignant transformation remain unknown. Most SB lesions are asymptomatic, and surgical resection carries significant morbidity. Observation may be a reasonable strategy. We report our experience with observation of probable SB enchondromas in MS/OD patients. ⋯ Primary SB lesions in OD/MS patients frequently present in the petroclival junction. Cranial screening and close observation should be considered in MS/OD patients, given the increased risk of intra-axial intracranial tumors, de novo chondrosarcomas, or malignant degeneration of previously known lesions. In asymptomatic patients, observation appears to be a safe strategy in this cohort. Further case accumulation and follow-up are required to better understand the long-term outcomes.
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To identify predictors of atherosclerotic change in aneurysms and parent arteries, and to retrospectively analyze outcomes from clipped aneurysms that showed atherosclerotic changes. ⋯ FRS, diabetes mellitus, and aneurysm size as predictors of atherosclerosis in patients undergoing aneurysm surgery can help guide surgical decisions and performance.