World Neurosurg
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Unilateral biportal endoscopy (UBE) with unilateral laminotomy for bilateral decompression (ULBD) is an essential neurosurgical procedure for the treatment of lumbar spinal stenosis. This technique offers significant advantages over traditional full laminectomy and spinal fusion fixation, providing surgeons with greater operational freedom and precision in decompression. The UBE-ULBD procedure stands out because of its distinct working and observation channels, which significantly augment the surgeon's maneuverability. ⋯ Choi et al. 1 suggest that there is no statistically significant difference in postoperative visual analog scale and Oswestry Disability Index scores among the 3 techniques. However, microdiscectomy ULBD is associated with more pronounced trauma, including denervation pain of muscles. The percutaneous endoscopic ULBD offers shorter operative times and less muscle trauma and blood loss, which may have a multifaceted positive impact on postoperative recovery and symptom alleviation for patients.
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This study examined the clinical significance of residual hyperintense area on T2-weighted magnetic resonance imaging (T2R) without gadolinium-enhanced lesions at the end of initial treatment (debulking surgery, concomitant radiotherapy, and temozolomide) in patients with glioblastoma. ⋯ The T2R at the end of initial treatment can predict local recurrence. However, the distant recurrence occurred frequently in T2D group. Thus, attention should be paid to local recurrences in T2R group and distant recurrences in T2D group.
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The subsidence of vertebral body replacement may occur after anterior cervical corpectomy and fusion (ACCF), which may lead to cervical kyphosis, spinal cord compression, and neurological dysfunction. The authors aim to investigate the risk factors for early subsidence of 3D-printed artificial vertebral body (3D-PAVB) after ACCF surgery and to provide guidance for clinical practice. ⋯ The occurrence of early subsidence of 3D-PAVB post ACCF surgery is influenced by 2 independent risk factors: smoking and low HU. To predict the likelihood of this outcome, it is advisable to consider smoking history and measure CT HU value prior to surgery. A lower CT HU value is indicative of a greater risk of subsidence.
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Thoracic dorsal arachnoid webs are intradural membranes that may cause obstruction of cerebrospinal fluid flow and spinal cord compression. Although well recognized, they are rare and there is a paucity of long-term data on their natural history and prognosis. We reviewed radiographic features, surgical indications, and pathologic specimens of patients diagnosed with focal thoracic dorsal arachnoid webs. ⋯ Most patients in a large series of patients with dorsal arachnoid webs did not undergo surgical intervention, but those with myelomalacia and syrinx experienced radiographic and clinical deterioration without surgery. Surgery to treat symptomatic arachnoid webs results in significant clinical improvement with low surgical morbidity.
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Endoscopic endonasal surgery is a feasible approach to lesions of the pediatric skull base. Olfactory outcomes after endoscopic endonasal approach (EEA) have been reported in the adult literature, but pediatric outcome data are lacking. The purpose of this preliminary study is to evaluate postoperative olfactory outcomes in pediatric patients who underwent EEA through transsphenoidal and/or transclival corridors. ⋯ Olfactory preservation is possible after pediatric EEA, although 40% of patients will develop some degree of microsmia in the immediate postoperative period and 20% will have some persistent dysfunction at 6 months. Long-term data are necessary to determine whether microsmia continues to improve over time.