World Neurosurg
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The purpose of this study was to investigate differences between measurements of spine on two-dimensional (2D) radiography and three-dimensional (3D) computed tomography (CT) images taken of patients with adolescent idiopathic scoliosis. ⋯ Significant differences among the 2D, 2D XP, and 3D measurement methods were observed on both the sagittal plane and coronal plane of the scoliotic spines as a result of variations in posture during imaging and differences in measurement methods.
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Although posterior procedures are used for most cases of basilar invagination, transoral decompression is an important tool in complex deformities with severe degeneration and neural compression. ⋯ With proper patient selection, transoral odontoidectomy can be safely performed in a limited-resource setting.
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Spinal meningiomas are benign extra-axial tumors that can present with neurological deficits. Treatment partly depends on the degree of disability as there is no agreed-upon patient selection algorithm at present. We aimed to elucidate general patient selection patterns in patients undergoing surgery for spinal meningioma. ⋯ Patients treated surgically had a decreased incidence of complications, comorbidities, and Medicaid payer status. A pattern of increased utilization of health care resources and spending was also observed in the surgery group. The results indicate a potentially underserved population of patients with spinal meningioma.
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Endovascular therapy is the first-line treatment for the cavernous sinus dural arteriovenous fistulas, particularly transvenous embolization. This study aimed to assess the trans-superior ophthalmic vein approach to embolization for its safety, efficacy, and viability as a first-line treatment in selected patients, with a description of the microsurgical and endovascular techniques. ⋯ Microsurgical dissection for exposure and direct cannulation of the superior ophthalmic vein as a route for fistula obliteration delivers excellent clinical outcomes, with a low rate of complications. Not only is it safe and effective as an alternative approach but it can also serve as first-line treatment in selected patients.
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To compare patient-reported outcome measure (PROM) scores and minimum clinically important difference (MCID) achievement rates among patients undergoing single-level anterior cervical discectomy and fusion (ACDF) in patients with varying severity of preoperative visual analog scale (VAS) neck score. ⋯ Patients with single-level ACDF presenting with greater baseline neck pain showed poorer physical function/pain/disability/mental health at preoperative/intermediate postoperative time points, but had comparable long-term PROMs by 2 years. MCID attainment was lower among patients with greater preoperative neck pain; MCID among the VAS neck score >8 cohort were only significantly inferior for neck pain.