World Neurosurg
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Investigations showed that low back pain of occupational drivers might be closely related to the whole-body vibration. Restricted by ethical concerns, the finite element method had become a viable alternative to invasive human experiments. Many mechanical behaviors of the human spine inside of the human body were unclear; therefore, a human whole-body finite element model might be required to better understand the lumbar behavior under whole-body vibration. ⋯ The model developed in this study could reflect the biomechanical response of the human lumbar spine under vibration and could be used in further vibration analysis and offer proposals for protecting human body under whole-body vibration environment.
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Carotid near occlusions show a lower risk of stroke than other types of severe stenosis. However, emerging evidence suggests that near occlusion with full collapse differs from that without full collapse. The results of treatment with carotid artery stenting for near occlusion with full collapse are presented. ⋯ Carotid artery stenting for near occlusion with full collapse seems to be a feasible and safe procedure that can be performed by an experienced neuro-interventional team.
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To characterize the volume dependence of both facilities and surgeons on postoperative complications after lumbar fusion and characterize the role of socioeconomic status. ⋯ Both high-volume facilities and high-volume surgeons show lower rates of complications and readmission. There are significant socioeconomic disparities regarding which patients can access high-volume surgeons.
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Chiari malformation type I (CMI) is a common neurologic condition and surgery is the standard treatment. We aim to establish the cerebrospinal fluid (CSF) flow change as a potential objective indicator of surgical efficacy to improve symptoms. ⋯ Patients with CMI often present with a constellation of symptoms. We showed a significant association between improved CSF flow after decompression and symptom alleviation. Further, our study suggests that the presence of improved CSF flow postoperatively could represent an objective indicator for improved patient outcomes.
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Paragangliomas are rare neuroendocrine tumors that may localize to the spine causing progressive low back pain variably accompanied by radiculopathy. Recurrence, follow-up duration, and role of adjuvant therapy remain unestablished. ⋯ Given nonspecific clinical and radiologic features, spinal paragangliomas are diagnosed via biopsy or after surgery. Complete surgical resection is often necessary to alleviate symptoms and prevent tumor recurrence. In cases with benign metastases, long-term surveillance is important and adjuvant medical and radiotherapeutic treatment may be beneficial.