World Neurosurg
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To determine whether operative duration of anterior cervical discectomy and fusion (ACDF) significantly affects patient-reported outcome measures (PROMs) 90 days after surgery and at 1-year follow-up. ⋯ All groups improved after ACDF regardless of surgical duration. Further, surgical duration was not a predictor of differing improvement in physical function or disability.
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We sought to investigate the risk factors of suboptimal postoperative outcomes after short-segment surgery for degenerative lumbar spinal stenosis and severe sagittal imbalance and to recommend the appropriate candidates for the short fusion. ⋯ Symptomatic sagittal imbalance and severe degeneration of paraspinal muscle are the risk factors predisposing suboptimal surgical outcomes after lumbar short-segment decompression and fusion for degenerative lumbar spinal stenosis. We believe essential spinal function and substantial quality of paraspinal muscle are the keys to long-lasting good outcomes.
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The optimal surgical procedure for minimal surgical intervention in symptomatic degenerative lumbar spinal stenosis (DLSS) is unknown. This article presents a method of minimally invasive decompression alone and reports the long-term outcomes and complications of patients treated with minimally invasive bilateral or unilateral laminotomy decompression performed by one surgeon. ⋯ Minimally invasive laminotomy decompression is an effective procedure and achieves beneficial long-term clinical results for DLSS.
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Case Reports
Failure of flow diverter endothelization visualized with optic coherent tomography technology.
We report a case of an intracranial aneurysm of the left posterior inferior cerebellar artery, which was treated with a flow-diverting stent. One year later at follow-up, the patient presented with new symptoms due to mass effect in the posterior fossa and a 3-fold enlargement of the aneurysm. Digital subtraction angiography showed an increase in size of the aneurysm with jet flow into the sac. ⋯ Parent vessel sacrifice was performed by coiling of the left vertebral artery. The patient had a codominant right vertebral artery and tolerated the procedure well. Two years later, follow-up magnetic resonance angiography showed significant decrease of the size of the aneurysm and symptom regression, with a modified Rankin scale of 1 (functionally independent).
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The objective of this study was to conduct a retrospective analysis of the safety and efficacy of one-session treatment with cranioplasty and superficial temporal artery-middle cerebral artery (STA-MCA) bypass after decompressive craniectomy in hemorrhagic moyamoya disease (MMD). ⋯ One-session treatment with extracranial to intracranial bypass and cranioplasty are safe and effective in patients with MMD who have undergone previous decompressive craniectomy due to hemorrhagic attack.