World Neurosurg
-
Comparative Study
Subdural Drain vs Subdural Evacuating Port System for the Treatment of Non-Acute Subdural Hematomas: A Single-Center Retrospective Cohort Study.
Subdural drain (SDD) and Subdural Evacuating Port System (SEPS) are bedside options for management of nonacute subdural hematomas (SDHs). These interventions have not been compared with each other. Our objective is to compare the need for second bedside procedure, need for craniotomy, complication rate, and other outcomes related to bedside drainage of SDH with SDD or SEPS. We hypothesized that SDD would be associated with superior outcomes to SEPS. ⋯ SEPS was associated with higher risk for need of second bedside procedure and longer intensive care unit and hospital length of stay than SDD, although not increased need for craniotomy. Additional studies are needed to confirm our findings and determine if SDD may be more effective than SEPS for the treatment of nonacute SDH.
-
Technical limitations and clinical challenges have historically limited the diagnostic tools and treatment methods available for surgical approaches to the management of epilepsy. By contrast, recent technological innovations in several areas hold significant promise in improving outcomes and decreasing morbidity. ⋯ Investigation into genetic causes of and susceptibilities to epilepsy has introduced a new era of precision medicine, enabling the understanding of cell signaling mechanisms underlying epileptic activity as well as patient-specific molecularly targeted treatment options. We discuss the emerging path to individualized treatment plans, predicted outcomes, and improved selection of effective interventions, on the basis of these developments.
-
Multicenter Study
Sexual Dysfunction Secondary to Lumbar Stiffness in Adult Spinal Deformity Patients before and after Long-Segment Spinal Fusion.
Sexual function is an important factor contributing to quality of life. Adult spinal deformity (ASD) patients may have sexual limitations due to lumbar spinal stiffness that may be affected by long-segment fusion. ⋯ This study found that sexual dysfunction scores due to lumbar stiffness significantly improved after surgery for ASD. Additionally, lumbar stiffness-related sexual dysfunction is strongly related to overall outcome measured by Oswestry Disability Index and Scoliosis Research Society-22r total score, highlighting the importance of sexual health on overall outcome in ASD patients.
-
To identify rates, risks, and complications of red blood cell (RBC) transfusion in metastatic spinal tumor surgery. ⋯ RBC transfusion after metastatic spinal tumor surgery may increase the risk of early postoperative complications. Future research into preoperative patient optimization and decreasing intraoperative blood loss is needed.
-
To assess the early mortality in pediatric glioma and identify predictors of early mortality, which may provide insight into the therapeutic strategies for children with a high risk of early mortality. ⋯ We found a decrease in early mortality during the past 40 years. The death rates within 1 month and 3 months after diagnosis were 1.32% and 2.44%, respectively. Age at diagnosis, histologic subtype, the extent of resection, chemotherapy, and radiation were associated with early mortality in pediatric glioma.