World Neurosurg
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To investigate outcomes and prognostic factors of ruptured middle cerebral artery (MCA) aneurysms, treated via endovascular approach, with improving treatment materials and techniques. ⋯ Endovascular treatment for patients with ruptured middle cerebral artery aneurysms may offer favorable clinical and angiographic outcomes. With the evolution of treatment materials and updated techniques, treatment complications have become less common than previously reported in literature, and clinical outcomes have been improved in recent years.
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The center of rotation (COR), instantaneous center of rotation (ICR), instantaneous axis of rotation, instantaneous helical axis, finite helical axis, and helical axis of motion are important kinematic parameters for evaluating the quality of intervertebral motion of the cervical spine (QIMC). These parameters embody different concepts and are calculated using various methods. In this review, the distinctions and connections between these kinematic parameters are analyzed according to the concepts, research, and measurement techniques to provide a theoretic basis for future research and new research directions. ⋯ COR was the simplest but not the most accurate parameter to evaluate the QIMC. Conversely, instantaneous helical axis/helical axis of motion were the most accurate, but relatively complex parameters to evaluate the QIMC. ICR showed dynamic changes during flexion-extension motion, but not the three-dimensional kinematic motion of the cervical spine. These parameters were equivalent only in certain situations but cannot be substituted for each other in the clinic. A dynamic radiographic in vivo study was the most convenient and frequently used research method to calculate COR, but failed to describe the dynamic movement. The method of perpendicular bisectors was widely used to calculate the COR or ICR. Therefore, a combination of new research and calculation methods to simply and effectively evaluate the QIMC requires further investigation.
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Although postoperative urinary retention (POUR) is common after spine surgery, the association of this adverse event with other morbidities and patient-reported outcomes is not fully understood. We sought to examine the sequelae of POUR after lumbar spine surgery. ⋯ POUR is common after lumbar spine surgery, and the demographic, diagnostic, and surgical factors that are associated with POUR are identified. POUR is associated with several adverse events, and patients who have POUR were less likely to be satisfied with surgery up to 2 years after surgery.
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Multicenter Study
First ICP monitoring or first operation:which one is better？.
For patients with TBI, traditional methods such as clinical examination and imaging data are the primary references used for deciding whether to operate or not. Intracranial pressure (ICP) monitoring based on lateral ventricles or parenchymal pressure is a more direct reflection of ICP. However, the research on whether the outcome results of ICP monitoring are better than results based on clinical signs and imaging is sparse. Therefore, we compared treatment results for patients with TBI based on ICP monitoring and traditional methods. ⋯ For patients with TBI with cerebral contusion volume >20 mL, both 6-month good recovery rate and favorable outcome rate were significantly higher in the ICP monitoring group than the traditional methods group.
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Comparative Study
Minimally Invasive Sacroiliac Joint Fusion using Triangular Titanium vs. Cylindrical Threaded Implants: a comparison of patient-reported outcomes.
Minimally invasive fusion of the sacroiliac (SI) joint has gained popularity for the treatment of refractory dysfunction. The purpose of this study was to compare the clinical outcomes of minimally invasive SI joint fusion between cylindrical threaded implants (CTIs) and triangular dowel implants (TDIs). ⋯ SI joint fusions with TDI or CTI offer a significant improvement in pain, disability, and quality of life. However, no difference was observed between devices to suggest superior clinical outcomes. Increased revision rates in the Rialto group warrants further investigation.