World Neurosurg
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The present study aimed to perform a comprehensive data analysis of 47 consecutive patients treated in 8 years and to observe how clinical, radiologic, and surgical factors affect early and long-term outcomes, recurrence rate, and survival. ⋯ Among the examined variables, age seemed to strongly correlate with outcomes; better chances of recovery and a good postoperative outcome were observed in younger patients. Surfacing lesions had a better early functional outcome than did intramedullary located lesions. Patients' preoperative neurologic and functional status (mRS score ≤2) had a significant impact on late neurologic outcome. Progression-free survival correlated with the extent of tumor resection. Surgery should probably be performed before patients' neurologic decline, aiming to achieve maximal resection without compromising patients' quality of life.
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Many efforts are expended to improve health care quality in the surgical treatment of spinal conditions. However, the prevalence of reporting complications in spinal surgeries is highly heterogeneous, which is partially due to the lack of a universal and comprehensive system. ⋯ Almost one-third of spine surgical studies did not report complications in their results despite reporting clinical outcomes. The evidence quality of the study was directly related with the reporting of complications. A high heterogeneity regarding complication reporting was seen in the literature.
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To evaluate the mechanical properties of a new connector rod aiming to preserve implants in revision surgery (RS) for adjacent segment disease, a problematic complication of instrumented spinal fusion, and to assess its clinical applicability. ⋯ The connector rod is considered safe and can reduce the surgical time, blood loss, risk of complications, and medical costs. Better early postoperative clinical outcomes can be achieved with the rod owing to less surgical trauma.
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Arachnoid web (AW) is a rare phenomenon that has only been described in small case reports and case series,1 most commonly presenting with upper motor neuron signs and subtle radiographic findings, such as the classically described "scalpel sign."2 In this report, we demonstrate the use of imaging and operative techniques that have not been previously shown in the literature as a video for AW. These include high-definition magnetic resonance imaging (MRI) sequences for preoperative diagnosis, use of intraoperative ultrasonography for identification of adhesions, and operative technique for AW fenestration (Video 1). The patient consented to this manuscript. ⋯ The AW was carefully dissected, leaving the portions that were tethered onto the cord. Two weeks postoperatively, the patient's gait was markedly improved, with resolved neurologic function in the lower extremities. Follow-up MRI at 3 months demonstrated resolved medullary syrinx and normalization of the spinal cord contour.