World Neurosurg
-
Cervical laminoplasty is generally not indicated in patients with kyphosis because of poor outcomes. Therefore, data on the effectiveness of posterior structure-preserving techniques in patients with kyphosis are limited. This study investigated how laminoplasty with muscle and ligament preservation can benefit patients with kyphosis via risk factor analyses of postoperative complications. ⋯ Although patients with kyphosis had a significantly higher incidence of AP, C2-C7 cervical laminoplasty with muscle and ligament preservation may not be contraindicated in selected patients with kyphosis by risk stratification for AP and AL using newly identified risk factors.
-
Hyperspectral Imaging (HSI) in Brain Tumor Surgery - Evidence of Machine Learning-Based Performance.
Hyperspectral imaging (HSI) has the potential to enhance surgical tissue detection and diagnostics. Definite utilization of intraoperative HSI guidance demands validated machine learning and public datasets that currently do not exist. Moreover, current imaging conventions are dispersed, and evidence-based paradigms for neurosurgical HSI have not been declared. ⋯ In a limited number of publications, neurosurgical HSI has demonstrated unique capabilities in contrast to the established imaging techniques. Multidisciplinary work is required to establish communicable HSI standards and clinical impact. Our HSI paradigm endorses systematic intraoperative HSI data collection, which aims to facilitate the related standards, medical device regulations, and value-based medical imaging systems.
-
Cranioplasty after craniectomy can result in high rates of postoperative complications. Although determinants of postoperative outcomes have been identified, a prediction model for predicting cranioplasty implant survival does not exist. Thus, we sought to develop a prediction model for cranioplasty implant survival after craniectomy. ⋯ We have developed the first prediction model for cranioplasty implant survival after craniectomy. The findings from our study require external validation and deserve further exploration in future studies.
-
The aim of this study was to analyze the characteristics of alleged medical malpractice litigation involving spine surgery in Beijing between 2013 and 2018. ⋯ This study comprehensively summarized the medical alleged malpractice litigation after spine surgery in Beijing. Given the rapid growth rate of spine surgery and the burden of related alleged medical malpractice litigation, it is valuable for spine surgeons to understand the potential legal impact of spine surgery. The most common complaint addressed in this study is inadequate consent. The findings in the present study highlight that in China, spine surgeons should pay more attention to communication with patients and perform spine surgery based on abnormal imaging as opposed to what the history and physical examination dictate, which can help reduce the litigation rate and improve the patient experience.
-
The craniovertebral junction (CVJ), or the "first junction," can be affected by a variety of pathological states. Some of these conditions could represent a gray area in that they can be treated by general neurosurgeons or such specialists as skull base or spinal surgeons. ⋯ Identifying what represents clinical stability or instability is key to successful diagnosis and, hence, treatment. In this report, the second in a 3-article series, we describe our approach to managing CVJ pathologies in a case-based fashion to illustrate key concepts.