World Neurosurg
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This study aims to compare the impact of 3 surgical techniques-stand-alone cage placement (SAC), anterior cervical plate (ACP) fixation, and total disc replacement (TDR)-on cervical lordosis restoration and segmental height after anterior cervical discectomy at C5-6 level. To eliminate the effect of lordosis between different levels, patients operated on at the same level were included in the study. Restoring cervical lordosis is crucial for improving patient outcomes, including pain reduction and preventing mechanical complications. ⋯ SAC placement, ACP fixation, and TDR, all effectively restore cervical lordosis and segmental height after anterior cervical discectomy at the C5-6 level. Despite early differences, the long-term results were similar, suggesting that the choice of technique should be based on individual patient needs and specific surgical considerations.
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Adult isthmic spondylolisthesis (AIS) results in the anterior translation of the vertebral body with neural encroachment. Although oblique lumbar interbody fusion (OLIF) is minimally invasive technique that uses a retroperitoneal plane to achieve indirect decompression compared to transforaminal lumbar interbody fusion (TLIF), research on OLIF for AIS remains limited. Therefore, we aimed to compare the clinical and radiologic outcomes of these 2 surgical techniques for AIS. ⋯ OLIF is more advantageous than TLIF in terms of blood loss, operative time, hospital stay, and anterolisthesis correction. In addition, good clinical outcomes were obtained with indirect decompression alone, regardless of the severity of foraminal stenosis. Therefore, OLIF is a good surgical option for the treatment of AIS.
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This study aimed to identify risk factors for major adverse events (AEs) after lumbar fusion surgery in patients aged 75 and older and evaluate the role of several common geriatric comprehensive assessment items in predicting postoperative major AEs. ⋯ Preoperative frailty, hypoalbuminemia, female sex, greater body mass index, and higher Charlson comorbidity index grade were risk factors for 90-day major AEs after lumbar fusion surgery in older patients. The predictive nomogram that we developed using this data can enhance preoperative risk counseling and optimization for older patients.
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To investigate the potential of composite inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), in predicting outcomes in patients with posterior circulation large vessel occlusion who underwent mechanical thrombectomy (MT). ⋯ Among the assessed markers, NLR emerged as the strongest predictor of clinical outcomes following MT for posterior circulation large vessel occlusion.
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Laser interstitial thermal therapy (LITT) is a minimally invasive modality for addressing intracranial pathology. LITT is recognized as a primary therapeutic option for a range of intracranial pathologies, particularly in inaccessible lesions. In the present study, we systematically review the evidentiary base supporting contemporary applications of LITT. ⋯ In MTLE, LITT offers comparable rates of seizure freedom and reduction compared to anterior temporal lobectomy with potentially improved neuropsychiatric outcomes. LITT is an advantageous option for treating brain tumors, RN, and MTLE, among other pathologies. Continued investigation in emerging LITT applications can help clinicians expand the use of magnetic resonance imaging-guided stereotactic laser ablation technology into the treatment of a broad spectrum of central nervous system pathologies.