World Neurosurg
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Comparative Study
Early vs. Delayed Surgical Management of Ruptured Arteriovenous Brain Malformations in a Tertiary Referral Center in Colombia, South America.
Surgical timing after rupture of brain arteriovenous malformations (AVMs) is controversial. There is scarce literature on AVM surgical outcomes from developing countries. This study aims to determine if there is a difference between early and delayed surgical resection for patients with ruptured brain AVMs. ⋯ In this case series of 31 patients from a developing country, there were no differences in clinical outcomes at the final follow-up between acute and delayed surgical interventions for ruptured AVMs. The most important factor associated with the final outcomes was the initial Glasgow Coma Scale.
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This study aimed to assess variances in paravertebral muscle structure in individuals with idiopathic scoliosis (IS) through imaging techniques. ⋯ In IS patients, the paravertebral muscles on the concave side are more prominent and exhibit more fat infiltration compared to those on the convex side. This fat infiltration positively correlates with the Cobb angle, scoliosis duration, body mass index, and age, possibly indicating scoliosis progression.
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Comparative Study
Patient Reported Physical and Mental Health Outcomes Following Lumbar Spinal Fusion versus Total Hip and Total Knee Replacement.
Total hip and knee arthroplasty (THA/TKA) are reliable surgical procedures for alleviating pain and optimizing function. Spinal fusion has also been shown to be beneficial, however the comparative benefit of THA/TKA to lumbar spinal fusion is incompletely understood. ⋯ Spinal fusion, total knee arthroplasty, and total hip arthroplasty all significantly improved PROMs at 1-year follow-up. At baseline, spinal fusion patients had better physical function scores and worse mental health scores compared with joint arthroplasty patients, while spinal fusion resulted in mean smaller gains in patient reported physical function and higher gains in patient reported mental health function compared with arthroplasty.
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In the Brazilian public national healthcare system, botulinum toxin type A has traditionally been the sole treatment option for patients with dystonia. However, as of October 2022, deep brain stimulation (DBS) garnered positive recommendations for the condition. This study aims to assess the cost-effectiveness of DBS in treating adults with generalized and cervical dystonia within the Brazilian healthcare context, considering its recent inclusion. ⋯ From the perspective of the Brazilian public health system, the combination of DBS and BCP appears to be cost-effective for the treatment of both generalized and cervical dystonia when compared to BCP alone.
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Anterior and posterior compression of the cervical spinal cord is usually called pincer cervical spondylotic myelopathy (p-CSM), and surgery is generally recommended; however, there is some controversy about the choice of surgical approach because single anterior or posterior surgery cannot effectively relieve contralateral compression, and combined surgery may cause problems related to trauma and effects on cervical spine function. ⋯ ACDF is an effective method for treating pincer spinal cord compression in terms of neurologic recovery, radiologic parameters, fusion rates, and complications, especially for patients younger than 60 years of age with single operative segments.