World Neurosurg
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This is the first large retrospective analysis of patients undergoing anterior lumbar interbody fusion (ALIF) with concern for clinical determinants leading to reoperation for adjacent segment disease (ASD). The objective of this study is to examine the specific perioperative and clinical determinants that affect need for adjacent segment reoperation in patients who underwent 1-level and 2-level ALIF procedures for degenerative disc disorders. ⋯ Our findings support a biomechanical hypothesis of ASD onset after fusion, suggesting that the risk of ASD after ALIF lies primarily in the number of levels fused rather than any demographic or intraoperative variables.
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Case Reports
Minimally invasive resection of symptomatic cervical rib for treatment of thoracic outlet syndrome.
Neurogenic thoracic outlet syndrome treatments have high morbidity and recurrence rates. We present for the first time to our knowledge a minimally invasive spine surgery technique for complete resection of a cervical rib via a costotransversectomy approach. ⋯ Resection of a cervical rib via minimally invasive spine surgery costotransversectomy is safe and well tolerated compared with existing surgical treatments such as transaxillary, supraclavicular, and infraclavicular approaches.
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Case Reports
Woven Endobridge (WEB) Device as a Re-Treatment Strategy after Unsuccessful Surgical Clipping.
Surgical clipping of intracranial aneurysms is typically robust and durable. However, residual aneurysmal components may be seen after clipping. Furthermore, there may be occasional aneurysmal recurrence. These factors are both clinically relevant because subarachnoid hemorrhage after clipping is a rare but important event. The rationale for any treatment is to substantially decrease the future risk of hemorrhage. Small series have shown coiling as a retreatment strategy after unsuccessful clipping, but none has explored the feasibility of Woven Endobridge (WEB) implantation. ⋯ WEB implantation provided a feasible option in this challenging retreatment scenario. This is a small series and prospective data are required to make outcome inferences for this population. Nonetheless, we observed no complications and high adequate occlusion rates.
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Ping-pong fracture in neonates is a well-known complication. There have been many reports on methods to achieve closed reduction using a suction technique. Here we describe in detail the steps for such a maneuver and show the favorable cosmetic outcome without the need for surgery. ⋯ The images here after reduction show a favorable cosmetic outcome. An ultrasound was done after reduction and 1 day later to exclude any intracranial complications. Images are then shown after 24 hours without recurrence of the deformity and minimal bruising of the scalp because of the suction applied to the skin over the depressed fracture.
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Despite increasing interest in endovascular therapy (EVT) for large-core strokes, little is known about the predictors of good outcome in these patients. The aim of this study was to analyze patients with large-core strokes post-EVT and to define the predictors of favorable outcome in this population. ⋯ For patients with large-core strokes (≥70 cm3) after EVT, approximately one third have favorable outcome at 90 days. Independent predictors of favorable 90-day outcomes include male sex, intravenous tissue plasminogen activator use, and lower FIV.