World Neurosurg
-
Choriocarcinoma (CC) is a rare and aggressive form of germ cell tumor. There is limited evidence describing clinical outcomes in patients with primary CC and brain metastases (BM). Only a few single case reports have documented the use of stereotactic radiosurgery (SRS) for CC BM. ⋯ SRS is a feasible and viable approach for CC BM, particularly in cases where immediate surgical management is not necessary. This is the largest report to date evaluating the outcome of CC BM treated with SRS.
-
In full-endoscopic spine surgery via transforaminal approach (FESS-TF), the outside-in method facilitates treatment for various cases; however, the technique is difficult to perform. To facilitate this procedure, we developed a duckbill release technique. In this article, we aimed to introduce the details of this technique and investigate its effectiveness. ⋯ The duckbill release technique for the outside-in method in FESS-TF could be efficient because it is a simple and time-saving approach.
-
One-third of patients with neurogenic claudication caused by lumbar spinal stenosis have low-grade degenerative spondylolisthesis. Decompression in these patients is considered a risk factor for instability, and it remains unclear whether instrumented fusion should be added. This study aims to assess the long-term clinical outcomes of decompressive surgery without instrumented fusion in patients with symptomatic spinal stenosis regardless of low-grade degenerative spondylolisthesis. ⋯ This cohort study showed comparable satisfaction and clinical outcomes after decompressive surgery for symptomatic spinal stenosis in patients with and without grade 1 degenerative spondylolisthesis. Decompressive surgery can, therefore, be considered an effective treatment for symptomatic lumbar spinal stenosis, even if it is accompanied by degenerative spondylolisthesis. Therefore, routinely adding instrumented spondylodesis is not deemed necessary.
-
Review
Infrastructural Barriers to the Neurosurgical Care of Brain Tumors in LMICs: A Systematic Review.
Appropriate surgical infrastructure is important for improving patient outcomes. However, low- and middle-income countries (LMICs) often struggle to provide adequate brain tumor surgery due to fractured infrastructure. This study aims to identify and evaluate barriers to surgical care infrastructure for brain tumors in LMICs. ⋯ The review highlights key barriers in infrastructure while providing effective neurosurgical care to brain tumors in LMICs. To overcome these challenges, targeted strategies need to be implemented by stakeholders, policymakers, and health ministries.