World Neurosurg
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The purpose of this study was to determine the sensitivity and specificity of using the spinal midline (M line) on a radiographic anteroposterior (AP) view for detecting pedicle screws (PSs) breaching the medial pedicle wall. ⋯ Assessment of the M line via an intraoperative radiographic AP view is a simple, readily available, complementary method for detecting PSs that have breached the medial pedicle wall in the thoracic, lumbar, and sacral spine. In particular, the M line has a strong negative predictive value, which is much more meaningful.
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Metastatic subdural hematoma with dural metastasis in the setting of an underlying malignancy is a rare condition that is difficult to diagnose and associated with a poor prognosis. Knowledge of this rare entity is of a paramount importance to neurosurgeons, as its diagnosis may affect the management plan and overall survival. Here, we report a rare case of atraumatic subdural hematoma with dural metastasis in a patient with poorly differentiated adenocarcinoma of unknown origin. ⋯ Metastatic subdural hematoma with dural metastasis should be included in differential diagnosis of subdural hematoma, especially in patients with atypical presentation and in the presence of an underlying malignancy, as it may affect the management plan and overall survival.
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Review Meta Analysis Comparative Study
Systematic and Comprehensive Comparison of Incidence of Restenosis between Carotid Endarterectomy and Carotid Artery Stenting in the Patients with Atherosclerotic Carotid Stenosis.
The purpose of the present study was to conduct a meta-analysis to systematically compare the incidence rates of in-stent restenosis after carotid artery stenting (CAS) and restenosis after carotid endarterectomy (CEA) for patients with atherosclerotic carotid stenosis. ⋯ Although CAS was preferred over CEA, regardless of restenosis >50% or >70% after revascularization within 1 year, no significant difference was observed with extension of the follow-up period to >1 year. CAS was not associated with a greater cumulative incidence of occlusion or the cumulative incidence of restenosis for symptomatic patients.
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Review Meta Analysis
Safety and efficacy of laminoplasty versus laminectomy in the treatment of spinal cord tumors: a systematic review and meta-analysis.
Laminectomy (LAMT) and laminoplasty (LAMP) have been widely applied on patients with spinal cord tumors (SCTs). However, the clinical efficacy of LAMP versus LAMT remains controversial. The purpose of this study is to assess the safety and efficacy of LAMP compared to LAMT in the treatment of SCTs. ⋯ LAMP might be a safer and more effective surgical method in the treatment of SCTs. In addition, the advantage of fusion in preventing the occurrence of spinal deformity should not to be ignored. However, because of the lack of high quality randomized controlled trials and adequate data, the safety and validity of LAMP was undermined.
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Review Meta Analysis
Risk Factors for Restenosis Following Carotid Revascularization: a Meta-analysis of Hazard Ratios.
Carotid artery restenosis after carotid endarterectomy (CEA) or carotid artery stenting (CAS) will occur in 3%-30% of cases. Restenosis can lead to more frequent clinical and imaging monitoring and the potential for reoperation. We sought to define the demographic, clinical, and radiographic characteristics that influence the restenosis risk after carotid revascularization. ⋯ Diabetes, dyslipidemia, female gender, renal failure, hypertension, and smoking were associated with an increased risk of restenosis, and patch endarterectomy and symptomatic status at presentation were associated with a decreased risk of carotid restenosis. Both female gender and current smoking status were only associated with recurrent stenosis after CEA, and hypertension was only associated with restenosis after CAS.