World Neurosurg
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Surgical Strategy and Decision Making in Recurrent Atlanto-Axial Dislocations: The Role of Traction.
To analyse patients with recurrent atlanto-axial dislocation and give a criterion of an ideal patient who can benefit from redo surgery. ⋯ The best candidates who can benefit after redo surgery are the ones who exhibit either clinical and/or radiological improvement on the trial of traction, as the pathological C1-C2 joints are either not fused or have undergone pseudoarthrosis. Those patients who do not exhibit significant clinical or radiological improvement post-trial of traction should not be offered subsequent surgical intervention.
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Decentralized federated learning (DFL) may serve as a useful framework for machine learning (ML) tasks in multicentered studies, maximizing the use of clinical data without data sharing. We aim to propose the first workflow of DFL for ML tasks in multicentered studies, which can be as powerful as those using centralized data. ⋯ We demonstrate that the DFL workflow without data sharing should be a more appropriate method in ML tasks in multicentered studies. And the DFL workflow should be further exploited in clinical researches in other departments and it can encourage and facilitate multicentered studies.
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Pseudarthrosis is a common complication of transforaminal lumbar interbody fusion (TLIF) that can affect the long-term prognosis and increase revision surgery risk. Therefore, it is crucial to investigate the risk factors associated with pseudarthrosis and develop a predictive model. ⋯ History of smoking, osteoporosis, and change of mean disc height are all independent risk factors of pseudarthrosis following TLIF surgery; a nomogram based on these may help predict the probability of pseudarthrosis.
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This study evaluates the efficiency and cost-effectiveness of an oncological outpatient neurosurgery protocol using enhanced recovery after surgery principles in a European healthcare setting. Additionally, it assesses the impact of incorporating hospital at home (HaH) for perioperative follow-up on program efficiency and costs. ⋯ Outpatient neurosurgery with HaH follow-up offers substantial cost savings without compromising care quality in a public health setting. Inpatient care's higher costs are largely due to bed utilization, while the integration of HaH does not add significant costs, making it a viable alternative for postoperative management.