World Neurosurg
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Serum sodium abnormalities are one of the most common manifestations after radical craniopharyngioma (CP) excision. The aim of this study was to report the incidence and possible predictors of serum sodium disturbance and explore features of sodium destabilization manifestation among QST classification results after CP resection. ⋯ Hyponatremia/hypernatremia is common after primary CP resection. The site of tumor origin has a direct effect on the growth pattern of CP, which may serve as a useful index for anticipating sodium perturbation after surgery. The level of sodium in children and patients with type T tumors, preoperative diabetes insipidus should be monitored closely throughout hospitalization.
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Flexible stabilization has been utilized to maintain spinal mobility in patients with early-stage lumbar spinal stenosis (LSS). Previous literature has not yet established any nonfusion solution as a viable treatment option for patients with severe posterior degeneration of the lumbar spine. This feasibility study evaluates the mean 5-year outcomes of patients treated with the Total Posterior Spine System (TOPS) facet replacement system in the surgical management of lumbar spinal stenosis and degenerative spondylolisthesis. ⋯ The TOPS implant maintains clinical improvement and motion in the surgical management of LSS and spondylolisthesis, suggesting that it can be considered an option for these indications.
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Loosening of pedicle screws is a frequently observed complication in spinal surgery. Because additional stabilization procedures such as cement augmentation or lengthening of the instrumentation involve relevant risks, optimal stability of the primarily implanted pedicle screw is of essential importance. The aim of the present study was to investigate the effect of increasing the screw diameter on pedicle screw stability. ⋯ Increasing the pedicle screw diameter from a standard 6-mm screw to the largest possible diameter (8-10 mm) led to a significantly greater fatigue load.
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We sought to examine the conservative treatment of symptomatic spinal cavernomas and evaluate the efficacy and safety of surgical management of spinal cord cavernous malformations. ⋯ Patients who have experienced a hemorrhagic episode should consider surgical intervention, which decreases the risk of recurrent hemorrhage and further neurologic deterioration. In addition, surgical decompression obtained by resection of the hemorrhage and cavernoma seems to lead to slight neurologic improvement in some patients. In nonhemorrhagic cavernomas, conservative treatment might be optimal due to surgery-related morbidity risks.