World Neurosurg
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Radiographic nonunion rates in the literature for posterolateral lumbar fusions with pedicle screws (PLFs) range from 8.1% to 43.3% but may not represent nonunion rates. A few small studies have reported reoperations for symptomatic nonunions (operative nonunions) to range from 3.2% to 13.9%. The objective of this study is to determine operative nonunion rates for 1-level, 2-level, 3-level, and ≥4-level PLFs and to determine the risks for these nonunions. ⋯ Our study reports results from one of the largest cohort of patients for the first time with single-level and multilevel instrumented PLFs and found a 2-year operative nonunion rate of 1.08% with increased risk of nonunion for constructs that included L5-S1 and ≥3-level fusions. Operative nonunion combines clinical and radiographic data and provides an alternative measure of fusion rates.
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Single neuron or unit recording enables researchers to measure the electrophysiologic responses of single neurons using a microelectrode system. This approach is widely used in cognitive science and has become more widespread in humans with the use of hybrid (micro-within-macrowire) depth electrodes that enable the implantation of microwires into the brain parenchyma. ⋯ The addition of hybrid depth electrodes for the purpose of in vivo single neuron recording in robot-enhanced stereoencephalography procedures is safe and does not impact the accuracy of targeting or patient safety.
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The purpose of this study was to test the application of diffusion tensor imaging (DTI) in patients with hemifacial spasm (HFS), to make more accurate diagnoses before surgery and to judge the degree of recovery more accurately after surgical microvascular decompression. To our knowledge, this is the first study to test the validity of DTI for diagnosis and postsurgical evaluation of HFS. ⋯ The use of DTI improves diagnosis and treatment of HFS.
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The purpose of this study was to explore the relationship between mean platelet volume (MPV) and aneurysm recurrence in aneurysmal subarachnoid hemorrhage (aSAH) patients who received endovascular treatment for intracranial aneurysms. ⋯ A low perioperative MPV may be associated with aneurysm recurrence in aSAH patients who receive endovascular treatment for intracranial aneurysms. Therefore, MPV can be used in clinical settings to screen for patients at high risk for aneurysm recurrence.
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Observational Study
Awake craniotomy in low-resource settings: Findings from a retrospective cohort in the Philippines.
Awake craniotomy is a technique used to maximize resection of lesions in eloquent areas of the brain and preserve function. Although its use in high-income centers is well documented for tumors and vascular lesions, reports of its use in low-middle-income countries are limited. There are no published series from the Philippines. ⋯ Our experience shows that awake craniotomy is feasible in low-middle-income country settings and is safe and effective for excision of tumors, arteriovenous malformations, and cavernomas.