World Neurosurg
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The modified Brain Injury Guidelines (mBIG) were developed to improve care of patients with traumatic brain injury (TBI). This study aimed to assess if utilization of mBIG by neurosurgeons would improve TBI patient throughput at a Level I trauma center, particularly for patients meeting mBIG 1 criteria. ⋯ The mBIG 1 criteria were safe and improved low-risk TBI patient throughput at a Level I trauma center. Neurosurgical involvement may be beneficial to the mBIG while still facilitating significant resource savings.
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This study aimed to investigate the incidence and risk factors for sacral fractures following lumbosacral fusion. ⋯ The overall incidence of sacral fracture was 10.8%. In our study, advanced age, low BMD, long fusion levels, and preoperative compensatory pelvic retroversion and excessive correction of it were risk factors for sacral fractures.
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This study aims to evaluate the safety and efficacy of the ultrasonic bone burr (UBB) in facilitating C1 pedicle screw placement for atlantoaxial instability treatment, compared to the conventional high-speed drill (HSD) technique. ⋯ UBB is a viable alternative for C1 pedicle screw placement, associated with reduced blood loss and shorter operation time, while achieving comparable clinical outcomes to the conventional HSD method. Nevertheless, further research with a larger sample size is needed.
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Meta Analysis Comparative Study
Comparative Analysis of Somatosensory-evoked Potentials and Transcranial Doppler Ultrasound for Cerebral Ischemia Detection in Carotid Endarterectomy: Insights from Network Meta-Analysis and Clinical Data.
This study aims to compare the diagnostic efficacy of somatosensory-evoked potentials (SEPs) and transcranial Doppler sonography (TCD) for monitoring cerebral tissue ischemia during carotid endarterectomy (CEA) using network meta-analysis and retrospective analysis of clinical data. ⋯ During CEA, SEP appears to provide a slightly more reliable indication of the ischemic condition in cerebral tissues compared to TCD.
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Postoperative delirium (POD) is frequently reported in the elderly after major surgery. Several risk factors have been identified, including age, surgical complexity, and comorbidities. ⋯ Nearly 0.5% of patients who underwent posterior spinal fusion between 2010 and 2022 developed delirium, although incidence rates have decreased over time. POD was common in elderly patients with electrolyte disturbances who underwent multilevel fusions. Patients suffering from POD had higher rates of 90-day postoperative complications. Ongoing efforts to deliver interventions to mitigate the consequences of POD among spine surgery patients are warranted.