World Neurosurg
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Medical publications reflect the development of training, research, and health services. No objective data are available regarding neurosurgical publications from Morocco. Bibliometrics were used to evaluate the contribution of Moroccan neurosurgeons (MONSs) in neurosurgical journals worldwide and to discuss the strategies that can be applied to increase the quantity and quality of publications on this subject. ⋯ Academic neurosurgeons in Morocco should prepare their residents and young researchers on research methodology and medical writing. Moroccan neurosurgical research should be more focused on modern neurosurgical topics by highlighting our particularities. More high level of evidence studies should be reported in English-language neurosurgical journals with a high impact factor and good scientific reputation. MONSs should continue to collaborate more often with each other and with foreign centers to further improve the quality and number of international publications, regardless of the difficulties they face.
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Case Reports
Hemostatic thrombin-gelatin matrix leading to intracranial cyst formation : case report.
Local hemostatic agents have been used in the neurosurgical field for many years; it is safe and efficient with no fatal complication reported in the literature. We routinely used a gelatin-thrombin hemostatic agent (FloSeal Hemostatic Matrix) for hemostasis in minimally invasive endoscopic-assisted surgery for more than 500 patients with intracerebral hemorrhage. However, 2 cases with sterile cyst formation were encountered. ⋯ These sterile cysts were very close to the ventricle wall on images. We hypothesized that cyst wall may be formed not only by hemostatic agent-related fibrosis and inflammation according to the previous literature review but also by the presence of the check valve mechanism between the cyst and the ventricle, which caused further dilation of the cyst.
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Comparative Study
Comparison of Segmental Lordosis and Global Spinopelvic Alignment after Single-Level Lateral Lumbar Interbody Fusion or Transforaminal Lumbar Interbody Fusion.
Lateral lumbar interbody fusion (LLIF) has steadily increased in popularity. Compared with the traditional transforaminal lumbar interbody fusion (TLIF), LLIF is thought to allow for greater improvement in lordosis. However, there are limited direct comparison data on the degree of regional and global alignment change after single-level LLIF and TLIF procedures. This study compared the changes in spinal sagittal alignment in patients who underwent either procedure. ⋯ LLIF achieved greater improvements in SL than TLIF. However, regionally and globally, there were no significant differences with either procedure after a single-level intervention. The increased lordosis from LLIF compared with TLIF may be more impactful globally in multilevel fusions.
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Rising cost and limited resources remain major challenges to U.S. health care and neurosurgery in particular. To ensure an efficient and cost-effective health care system, it is important that referrals to neurosurgery clinics are appropriate, and that referred patients have a reasonably high probability of requiring surgical intervention or, at a minimum, ongoing neurosurgical follow-up. This retrospective study tests the null hypothesis that the probability of a referred patient requiring surgery is independent of referring provider credentials and referring service specialty. ⋯ Our data strengthen the concept of having interdisciplinary teams led by physicians at the primary care level to ensure appropriate referrals. Training and adherence to guidelines must continually be reinforced to ensure proper referrals.
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Confirming the exact location of a fistula and the origins of draining veins during surgery for dural and perimedullary arteriovenous fistulas (AVFs) is crucial but sometimes inadequately performed, which can result in incomplete elimination of the lesion. Intraoperative digital subtraction angiography (DSA) is the gold standard for confirming the hemodynamics of an AVF; however, it cannot reveal the location of an AVF in the operative field. In this study, the efficacy of intraoperative intraarterial fluorescence video angiography during surgery for craniocervical junction dural and perimedullary AVFs was investigated. ⋯ Intraarterial fluorescence video angiography, particularly frame-by-frame review, enables surgeons to distinguish the flow dynamics of AVFs and contributes to the planning of effective surgical strategies for optimal results.