World Neurosurg
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The impact of statin pretreatment on outcomes for patients undergoing endovascular treatment of intracranial aneurysms remains uncertain. We aimed to conduct a systematic review and meta-analysis evaluating the efficacy and safety of statins in this population. ⋯ Statin pretreatment may decrease the risk of hemorrhagic complications and in-stent stenosis after endovascular aneurysm therapy but does not improve angiographic occlusion. An increased hazard of ischemic events was found. Further data are needed to validate these findings and clarify the role of statins in patients with aneurysms undergoing endovascular procedures.
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Cervical spinal stenosis most commonly occurs at the subaxial spine. C1-C2 stenosis is relatively unusual but can be present in certain congenital or syndromic conditions such as rheumatoid arthritis. ⋯ Decompression and stabilization of the segment were performed. This case is unique as this pathology occurred at an uncommon location, leading to an unusual degree of compression and resulting in surgical intervention.
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To investigate the effect of intravertebral cleft sclerosis on the efficacy of percutaneous vertebroplasty (PVP) in osteoporotic vertebral compression fractures (OVCFs). ⋯ IVCs affect cement distribution and recovery outcomes, with IVCns achieving better results. Early treatment is advised for OVCF with intravertebral clefts.
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Concomitant diffuse idiopathic skeletal hyperostosis (DISH) and cervical ossification of the posterior longitudinal ligament (cOPLL) are primarily investigated in radiographic studies of East Asian populations. This study aimed to determine clinical prevalence of concomitant DISH/cOPLL in a large U.S. sample and to compare characteristics and complications in cOPLL patients with and without concomitant DISH who were surgically treated. ⋯ Clinical prevalence of DISH in patients with cOPLL in the United States is low; however, cOPLL patients with concomitant DISH underwent surgery more frequently than those without. Despite higher comorbidity burden, cOPLL patients with DISH may have similar short-term postsurgical risk to cOPLL patients without DISH. However, higher nonprocedural neurologic injury in cOPLL patients with DISH may indicate insidious or delayed disease sequelae.
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Double crush syndrome (DCS) is defined as multiple sites of compression along a single nerve. The combination of a compressive proximal lesion in the lumbar spine and a distal common peroneal nerve entrapment may result in compound nerve dysfunction. ⋯ This is the first series to report DCS with two active points of compression in the lumbar spine and lower extremity based on EMG and imaging findings. Common peroneal nerve decompression was found to improve average dorsiflexion strength.