World Neurosurg
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Anterior cervical diskectomy and fusion (ACDF) is the main surgical treatment of cervical radiculopathy. Controversy exists about the need to resect the posterior longitudinal ligament (PLL) to directly decompress the nerve roots, or if it is sufficient to indirectly decompress with diskectomy and graft placement. The objective of this study was to determine the effect of PLL resection after ACDF. ⋯ ACDF leads to a high rate of success in improvement of preoperative radiculopathy. Excision of PLL during surgery leads to 3.8 times greater odds of improvement in this symptom, with no significant difference in the complication rate.
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The purpose of this study was to identify which stage of intraplaque hemorrhage (IPH) is an independent risk factor for ipsilateral new ischemic lesions (NILs) after carotid artery stenting (CAS). ⋯ Screening for recent IPH in carotid plaques using multicontrast atherosclerosis characterization sequence may identify plaques at a higher risk for cerebral embolism during CAS.
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The management of pituitary apoplexy, caused by acute hemorrhage and/or infarction of a pituitary adenoma, is debated. ⋯ EEA for pituitary apoplexy is effective in rapidly improving headache and visual symptoms. Although neuro-ophthalmic deficits often improve over time, panhypopituitarism persists in most patients after surgical resection.
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The relationship between race and neurosurgical outcomes is poorly characterized despite its importance. The influence of race on short-term patient outcomes in a pituitary tumor surgery population was assessed. ⋯ This study suggests that the effect of race on outcomes is partly mitigated for individuals who can attain access, and when socioeconomic factors and comorbidities are controlled for. The noted significant difference in emergency department visits could be indicative of confounding variables that were not well controlled for and requires further exploration.
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This is a surgical video that showcases the surgical repair of a young male patient with idiopathic scoliosis in a hybrid operating room with the utilization of a new imaging modality Advanced Radar Target Identification System (ARTIS) PHENO (Siemens Medical Solutions, Pennsylvania, USA) and augmented reality (Video 1). A 17-year-old male patient with idiopathic scoliosis underwent scoliosis repair in a hybrid operating room with segment reality surgical planning. The use of augmented reality helped in visualization of proper screw trajectory, and the use of ARTIS PHENO helped in identification of correct screw placement and rod fixation. Intraoperative use of new imaging modalities as augmented reality imaging and ARTIS PHENO can decrease surgical complication and time.