World Neurosurg
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Parkinson disease (PD) is a neurodegenerative disorder that manifests with postural instability and gait imbalance. Correction of spinal deformity in patients with PD presents unique challenges. ⋯ Patients with PD undergoing long fusion for deformity correction are at significantly increased risk of 30-day medical complications and revision procedures after 1 year, controlling for comorbidities, age, and invasiveness. Surgeons should consider the risk of complications, subsequent revision procedures, and increased cost.
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The incidence of ischemic stroke in young adults (18-45 years old) is increasing gradually. However, performing nutritional assessment in stroke patients is often challenging due to the lack of an accepted standard for nutritional assessment. ⋯ PNI has a statistically predictive value for the 90-day prognosis of young stroke patients.
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Accurate prediction of the morbidity and mortality outcomes of traumatic brain injury patients is still challenging. In the present study, we aimed to compare the predictive value of the Richmond and Rotterdam scoring systems as two novel computed tomography-based predictive models. ⋯ The Richmond scoring system demonstrated more accurate predictions for the present outcomes. The simplicity and predictive value of the Richmond score make this system an ideal option for use in emergency settings and centers with high patient loads.
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It remains unclear whether spinal cord untethering is necessary to reduce the chances of neurologic decline in children with myelomeningocele and complex closed spinal dysraphism who undergo thoracolumbar fusion for scoliosis. We sought to determine the neurologic and functional outcomes of children with spinal dysraphism undergoing spinal fusion for scoliosis with and without prophylactic spinal cord untethering. ⋯ Our data suggest that prophylactic spinal cord untethering in children with spinal dysraphism undergoing thoracolumbar fusion for scoliosis may not be necessary in patients with moderate curvatures. Our conclusions are limited by the small sample size. A larger review of registry data may yield more powerful conclusions on the necessity of prophylactic spinal cord untethering in this patient population.