World Neurosurg
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Observational Study
The surgical strategy "CSF decompression" facilitates outcomes of adults with Chiari malformation type I: An observational, real-world, single center study of 528 patients.
We designed this study to introduce the surgical strategy cerebrospinal fluid (CSF) decompression in treatment of Chiari malformation type I and compared CSF decompression with other surgical strategies to provide a solid basis for patient counseling. ⋯ CSF decompression, but not a specific surgical technique or operative method, was associated with favorable neurological outcomes in ADULT patients with Chiari malformation type I. The surgical technique and operative method should be selected according to the characteristics of each patient and the intraoperative condition to normalize CSF circulation at the craniovertebral junction area. The intraoperative target, smooth CSF flow out from the fourth ventricle and in to the bilateral Luschka foramina, could be observed.
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The rhomboid lip is a neural tissue encountered during cerebellopontine angle surgery, with differing shape and extent among individuals. This study aimed to investigate the variation of rhomboid lips during posterior fossa surgery. ⋯ Morphological classification of the rhomboid lip and understanding of its anatomical details contribute to safe surgical field development for neurosurgeons.
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Tubular retractors in minimally invasive lumbar stenosis permit surgeons to achieve satisfactory neural decompression while minimizing the morbidity of the surgical access.1-3 Transtubular lumbar decompression requires intraoperative image guidance and microscopic magnification to achieve precise and reproductible surgical results. Use of 2-dimensional image guidance in transtubular lumbar decompression has a major limitation due to the lack of multiplanar orientation. Consequently, there is a risk of incomplete decompression and excessive bone removal resulting in iatrogenic instability. ⋯ This tailors the bone resection to achieve adequate neural decompression while minimizing the risks of potential spine instability. After precise placement of the tubular retractor, bone removal and neural decompression are accomplished under robotic exoscope magnification with 4k 3D images. Using a 3D robotic exoscope (Modus V, Synaptive, Toronto, Canada) allows better tissue magnification and improves surgeon ergonomics during lumbar decompression through tubular retractors.5,6.
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It is important to have a diverse workforce in clinical and research environments. A cross-sectional study was conducted to examine the possible presence of gender, perceived skin color, education, academic productivity, and career progression inequalities among neurosurgeons in the United Kingdom. ⋯ This study identified important gender, skin color, education, academic productivity, and career progression inequalities in the 2023 UK consultant neurosurgery workforce.
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Neurosurgeons demonstrate some of the highest levels of burnout among surgeons, yet little research has been done to understand the underlying stressors that neurosurgeons and trainees experience and the emotional responses to them. Our goal was to conduct a feasibility study identifying job stressors and emotional responses among neurosurgeons rather than generalize findings across the profession. ⋯ The results of our study provide an understanding of neurosurgical professionals' unique emotional landscape, emphasizing the need for reforms in administrative practices, enhanced, healthy coping strategies, and career stage-specific mental health support.