World Neurosurg
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Randomized Controlled Trial Multicenter Study
Endovascular aneurysm treatment with the Numen coil embolization system: A prospective, randomized, controlled, open-label, multi-center, non-inferiority trial in China.
We investigated the safety and efficacy of the Numen coil compared with the Axium coil in the treatment of intracranial aneurysms. ⋯ This trial showed that the Numen coil was noninferior to the Axium coil in terms of intracranial aneurysm embolization and can be considered as a safe and effective coil for treating patients with intracranial aneurysm in clinical practice.
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Randomized Controlled Trial Multicenter Study
Middle Cerebral Artery Aneurysm Trial (MCAAT): A randomized care trial comparing surgical and endovascular management of MCA aneurysm patients.
Whether the best management of middle cerebral artery (MCA) aneurysm patients is surgical or endovascular remains uncertain, with little evidence to guide decision-making. A randomized care trial offering MCA aneurysm patients a 50% chance of surgical and a 50% chance of endovascular management may optimize outcomes in the presence of uncertainty. ⋯ Patients with MCA aneurysms can be optimally managed within a care trial protocol.
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We aim to provide a thorough review of the literature regarding patient characteristics, treatment options, and outcomes of pancreatic cancer metastasis to the spine. We also provide an illustrative case from our institution of a patients with pancreatic adenocarcinoma presenting initially as cervical radiculopathy with an isolated cervical spine lesion. ⋯ Spinal metastasis of pancreatic cancer is rare and typically portends a poor prognosis. It is vital to recognize the presence of spinal involvement early in the disease course and initiate treatment.
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The aim of this study was to assess rates of adjacent segment degeneration (ASDeg), adjacent segment disease (ASDis), and reoperation rates as a result of adjacent segment pathology in patients who have undergone anterior cervical discectomy and fusion (ACDF) versus cervical disc arthroplasty (CDA). ⋯ Our study shows CDA results in significantly lower ASDeg, ASDis, and reoperation rates. Although CDA may be a viable alternative to ACDF, further long-term studies are warranted to ensure consistency and establish longevity of our findings.
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Multicenter Study
Risk factors for cerebral infarction early after revascularization in children younger than 5 years of age with moyamoya disease.
Cerebral revascularization is necessary for pediatric patients younger than 5 years with moyamoya disease (MMD). However, they have a high risk of developing cerebral infarction early after surgery. This study aimed to analyze the risk factors for developing cerebral infarction among these patients. ⋯ No differences were found in the risk of developing cerebral infarction early after surgery as a result of surgical procedures. However, younger patients had higher postoperative risk. Further multicenter research should examine this issue for young pediatric patients with moyamoya at high risk of developing cerebral infarction.