World Neurosurg
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Surgical intervention is a cornerstone of adult spinal deformity (ASD) management. However, there remain burdens from complications including proximal junctional kyphosis (PJK) and failure (PJF). Posterior anatomical preservation at the uppermost instrumented vertebra (UIV) has emerged as an accessible approach to potentially reduce PJK/PJF risk. ⋯ Preservation of posterior anatomical structures likely has a role in reducing the rate of PJK/PJF. Linking radiographic parameters to PJK/PJF while studying techniques that keep posterior structures intact may be steps toward improving ASD correction outcomes.
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Spinal metastasis from salivary gland malignancies is a rare clinical entity with only several reports in the literature. There is no clear guidance for its optimal management. ⋯ Spinal metastasis from salivary gland malignancies necessitates a comprehensive and multidisciplinary treatment approach due to the complex nature and variability in presentation. Long-term follow-up is essential for early detection and management of spinal metastases, given the extended latency period observed in many cases. The potential for metastasis is not solely dependent on tumor grade, emphasizing the need for ongoing vigilance in all patients with salivary gland malignancies.
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Traumatic brain injury is a major cause of disability and mortality worldwide. Acute traumatic subdural hematoma (TSDH) accounts for a large proportion of all traumatic brain injury cases. However, factors to predict postoperative prognosis in patients with acute TSDH are limited. Recently, it has been reported that inflammatory markers increase the accuracy of prognosis in various diseases. The neutrophil-to-lymphocyte ratio (NLR) is a marker for inflammation, which is easy to test, inexpensive, and can be performed quickly. However, the prognostic value of NLR in patients with acute TSDH remains controversial. This study therefore aimed to assess the predictive value of the admission and postoperative NLR in patients with acute TSDH who underwent surgical treatment. ⋯ Initial NLR was not strongly associated with 1-month mortality in patients with acute TSDH who underwent surgery. However, the postoperative 48-hour NLR was associated with 1-month mortality.
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Spinal meningiomas (SM) are rare, predominantly benign tumors that account for 1.2-12.7% of all meningiomas. While surgical resection is the primary treatment, recurrence occurs in a subset of patients, necessitating subsequent therapies such as re-operation or definitive radiation therapy (RT). This study evaluates the outcomes of definitive RT versus third surgery for recurrent WHO grade 1 SM, focusing on progression-free survival (PFS) and treatment-related toxicities. ⋯ Definitive RT appears to be a feasible alternative to third surgery for recurrent SM in selected patients, providing comparable PFS and manageable toxicities. Larger prospective studies are needed to validate these findings and refine treatment approaches for recurrent SM.
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Environmental hypothermia increases mortality in patients with major trauma, however the impact of exposure hypothermia on outcomes in isolated traumatic brain injury (TBI) is under-explored in literature. The aim of this study is to determine the relationship between environmental hypothermia and survival in patients with isolated blunt TBI. ⋯ Environmental hypothermia is associated with increased mortality at 24 hours and at hospital discharge in patients with isolated blunt TBI. Further investigation is needed to identify optimal treatment strategies for TBI patients with hypothermia and to determine whether hypothermia prevention decreases mortality.