World Neurosurg
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There is a well-documented association between Cushing's syndrome (CS) and hypercoagulability. However, there is limited data on the risk of venous thromboembolic events (VTEs) after surgery for Cushing's disease (CD). There is no consensus on optimal postoperative anticoagulation strategies in this group. This review gathers information on the rates of VTE after surgery for CD, as well as reported prophylaxis strategies in this population. ⋯ Postoperative VTE in CD is a source of morbidity, with a rate of 2% and mortality rate of 0.2%, highlighting that surgical resection of the corticotroph adenoma does not necessarily result in immediate resolution of hypercoagulability. Increased production of coagulation factors, impaired fibrinolysis, inflammation, and CS-associated metabolic risk factors all factor into the pathogenesis of CS-associated hypercoagulability. Further study is needed on an optimal pharmacologic prophylaxis strategy.
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Postural abnormalities are a debilitating symptom of Parkinson disease (PD) that may require spinal intervention. Camptocormia is a unique abnormality most seen in PD, defined by a severe forward flexion of the trunk that completely resolves when supine. The condition presents a challenge due to an undefined pathophysiology and optimal therapeutic approach in a high-risk patient population. In this study, we systematically reviewed the literature regarding the use of spine surgery for the treatment of camptocormia in PD. ⋯ Despite an increased risk of complication and revision that is inherent to patients with PD, spine surgery has been proven as a reasonable alternative that should be prospectively studied further because 18 of 19 patients had favorable outcomes.
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The use of bibliometric analysis studies allows for the precise assessment of high impact contributions to various fields of study. A bibliometric assessment of academic works cited in filed patents enables tracking the academic studies which have been most influential in the development of new technologies in spine surgery. ⋯ This patent bibliometric analysis provides a general overview of trends in publications impacting spine surgery innovation over time. Our results highlight top instutions and regional contributions to spine surgery innovation within the United States and worldwide. As the first patent bibliometric study providing data on the most technologically impactful scholarly work in spine surgery, this study has not only historical value in terms of documenting the scientific and intellectual property developments in spine surgery in the past 50 years, but also practical relevance insofar as the identified trends and research hotspots that may provide researchers valuable insights regarding future decisions involving research efforts and resources allocation.
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Review Historical Article
Samuel Frank Clarendon Ghouralal (1925-1991): Pioneering Neurosurgeon in Trinidad.
Dr. Samuel Frank Clarendon Ghouralal emerged not only as a pioneer in neurosurgery but as a community leader in Trinidad and Tobago, contributing significantly to a region where neurosurgical care was scarce. This historical account aims to shed light on the remarkable life and career of Dr. Ghouralal, emphasizing the critical role he played in establishing and advancing neurosurgery in Trinidad and Tobago. ⋯ Dr. Ghouralal's life and achievements stand as a testament and inspiration to the transformative impact dedicated individuals can have on the advancement of neurosurgery throughout the world.
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The intricate nature of spinal surgery demands unprecedented precision to avoid severe complications such as nerve damage and paralysis. Recent advancements have steered spinal surgery toward robotic assistance, which enhances precision beyond human capabilities. These robotic systems allow for detailed preoperative planning and real-time guidance during surgery, significantly reducing the margin for error and promoting the adoption of minimally invasive techniques. This review aimed to evaluate the application of robotic systems in spinal surgeries, focusing on the accuracy and efficacy of these technologies in clinical settings. ⋯ Robotic systems significantly enhance the precision and safety of spinal surgeries. They reduce the risk of complications, minimize surgical invasiveness, and maintain or improve operative outcomes. However, challenges such as high costs and the need for specialized training persist. Continuous technological advancements and training are essential for the broader adoption of these systems in spinal surgeries.