World Neurosurg
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Atlantoaxial injuries pose a significant threat to morbidity and mortality. This retrospective study aims to analyze clinical and radiologic results, failure rates, and complications in a series of patients treated with a halo vest, validating the effectiveness of this device through long-term follow-up. ⋯ Based on our results, the halo vest is a valid treatment for atlantoaxial injuries in selected patients. These patients include young and middle-aged individuals (up to 65 years old) with C1 and/or C2 fractures. Halo vest treatment is associated with minor complications and yields a high percentage of excellent/good clinical results.
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Postoperative pain is the most common undesirable outcome after neurosurgery. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that is administered parenterally and carries a theoretical increased risk of bleeding. Our study aims to determine whether ketorolac after craniotomy for tumor resection significantly changes the rate of postoperative adverse events, adequately controls pain, and decreases concurrent narcotic use. ⋯ Ketorolac is a safe and effective option for pain control after craniotomy for tumor resection. Prospective data are needed to better validate these retrospective observations.
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Unilateral biportal endoscopy (UBE) with unilateral laminotomy for bilateral decompression (ULBD) is an essential neurosurgical procedure for the treatment of lumbar spinal stenosis. This technique offers significant advantages over traditional full laminectomy and spinal fusion fixation, providing surgeons with greater operational freedom and precision in decompression. The UBE-ULBD procedure stands out because of its distinct working and observation channels, which significantly augment the surgeon's maneuverability. ⋯ Choi et al. 1 suggest that there is no statistically significant difference in postoperative visual analog scale and Oswestry Disability Index scores among the 3 techniques. However, microdiscectomy ULBD is associated with more pronounced trauma, including denervation pain of muscles. The percutaneous endoscopic ULBD offers shorter operative times and less muscle trauma and blood loss, which may have a multifaceted positive impact on postoperative recovery and symptom alleviation for patients.
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This study examined the clinical significance of residual hyperintense area on T2-weighted magnetic resonance imaging (T2R) without gadolinium-enhanced lesions at the end of initial treatment (debulking surgery, concomitant radiotherapy, and temozolomide) in patients with glioblastoma. ⋯ The T2R at the end of initial treatment can predict local recurrence. However, the distant recurrence occurred frequently in T2D group. Thus, attention should be paid to local recurrences in T2R group and distant recurrences in T2D group.
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Unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) is an advanced, minimally invasive spinal surgical technique characterized by the use of 2 discrete portals-one for clear visualization and continuous irrigation and the other for the dexterous manipulation of surgical instruments. This configuration not only affords an expanded view (0° or 30°) but also enhances the freedom of movement for instruments, thereby augmenting the precision and flexibility of the surgery. The superiority of UBE-TLIF lies in its capacity to facilitate rapid postoperative recovery with minimal trauma, reduced intraoperative bleeding, abbreviated hospital stays, and significant amelioration of postoperative lower back pain. ⋯ This technique reduces neural irritation during the procedure, leading to an improved patient experience postoperatively. UBE-TLIF offers a safe, efficacious, and swiftly recuperative minimally invasive option for the treatment of lumbar degenerative diseases. It diminishes reliance on costly equipment, thereby facilitating the dissemination and application of this technology in community hospitals.7.