World Neurosurg
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To observe the short-term to medium-term therapeutic effects and radiological outcomes of adjacent 2-level cervical spondylosis treated with artificial cervical disc replacement (ACDR) using Mobi-C and Bryan discs. To observe changes and discrepancies in the flexion-extension centers of rotation (FE-COR) of different ACDR segments. ⋯ In continuous 2-level cervical ACDR surgery, both Mobi-C and Bryan artificial cervical discs achieved satisfactory clinical outcomes in the short to medium term postoperatively. The FE-COR exhibited different trends of change. In the Mobi-C group, the FE-COR for both upper and lower segments shifted anteriorly and inferiorly, whereas in the Bryan group, whether upper or lower, the FE-COR remained closer to the preoperative state. The changes in FE-COR did not significantly affect the short-term to medium-term clinical outcomes postoperatively.
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Thoracic ossification of the posterior longitudinal ligament (T-OPLL) causes myelopathy. Although posterior decompression for T-OPLL has shown positive results, patients with kyphotic curvatures often endure poor outcomes. Posterior decompression with fusion (PDF) has demonstrated better results compared to posterior decompression alone. This study aims to evaluate the effects of the posterior procedures for T-OPLL. ⋯ Effective management of intervertebral mobility and the appropriate length of decompression are crucial for addressing the thickness and mobility of T-OPLL.
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Although magnetic resonance imaging is the primary modality of investigation for determining the extent of posterior ligamentous complex (PLC) injuries in lower lumbar fractures (LLF) (L3-L5), the reliability of computed tomography (CT) has not been well defined. The main objective of this study is to analyze the diagnostic accuracy of combined CT findings for detecting PLC injury in patients with LLF. ⋯ Among the various CT parameters, facet joint diastasis (FJDS > 4.2 mm and FJDA > 3.5 mm) is the most reliable factor in determining PLC injury.
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Comparative Study
Neuronavigation combined with intraoperative ultrasound and intraoperative magnetic resonance imaging vs neuronavigation alone in diffuse glioma surgery.
This study aimed to integrate intraoperative ultrasound and magnetic resonance imaging (IMRI) with neuronavigation (NN) to create a multimodal surgical protocol for diffuse gliomas. Clinical outcomes were compared to the standard NN-guided protocol. ⋯ Compared to standard NN-guided surgery, multimodal-integrated surgery using NN, IMRI, and intraoperative ultrasound significantly increased the EOR and GTR rates for diffuse gliomas.
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Comparative Study
What is the True Cost of Motion Preservation? A Time-driven Activity-Based Cost Analysis of Anterior Cervical Discectomy and Fusion Versus Disc Replacement.
Total disc replacement (TDR) has become a viable alternative to anterior cervical discectomy and fusion (ACDF) for select patients. Although most comparative studies have assessed outcomes, cost differences remain largely uninvestigated. This information is critical as we move towards value-based reimbursement. To address this knowledge gap, we used time-driven activity-based costing to compare total intraoperative costs between the 2 procedures. ⋯ Time-driven activity-based costing is a highly useful methodology for estimating differences in true costs between procedures and determining cost drivers. TDRs were associated with an additional $3885 of total intraoperative cost as compared to ACDFs, the majority of which was driven by the cost of implants.