World Neurosurg
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Comparative Study
Vertebral Artery Sacrifice Versus Skeletonization in the Setting of Cervical Spine Tumor Resection: Case Series.
Tumors of the cervical spine often encase 1 or both vertebral arteries (VA), presenting the treating surgeon with the dilemma of whether to sacrifice or skeletonize the artery. We propose an algorithm for VA management in surgeries for cervical neoplasms METHODS: A retrospective review was carried out of 67 patients undergoing resection of cervical spine tumors with VA involvement. Patients were categorized by tumor origin (primary vs. metastatic) and degree of circumferential VA involvement: 1) abutment only; 2) <180° circumferential involvement; 3) >180° circumferential involvement without complete encasement; or 4) complete encasement. ⋯ Primary tumor disease and >180° of circumferential VA involvement should be considered as indications for intraoperative sacrifice of the VA pending preoperative angiographic evaluation for contraindications.
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A 37-year-old man presented with a 7-year history of low back pain. Magnetic resonance imaging revealed an intradural mass involving L5 vertebra impairment at the level of L4-L5. A L4-S1 laminectomy was performed. ⋯ Unlike other spinal cord SFT/HPCs in lumbar area, we firstly reported the case with invasive growth and bone structure impairment. The patient had a good prognosis after 3-year follow-up. Complete resection should be achieved to reduce the recurrence.
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We previously reported inpatient and 30-day postoperative patient-reported outcomes (PROs) of a controlled, noncrossover pilot study using preoperative mindfulness-based stress reduction (MBSR) training for lumbar spine surgery. Our goal here was to assess 3-month and 12-month postoperative PROs of preoperative MBSR in lumbar spine surgery for degenerative disease. ⋯ Three-month and 12-month results suggest that preoperative MBSR may have pain control benefits in lumbar spine surgery.
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Despite the panic and chaos that coronavirus disease 2019 (COVID-19) has generated in over 200 countries, the role of neurosurgeons has never been more relevant and challenging. The health system in Nepal was never geared to face an onslaught of an infectious disease. ⋯ In these challenging times, we neurosurgeons, who are naturally primed and trained to respond and take on challenges in difficult situations, have the ideal opportunity to shine and make a true difference during this pandemic and beyond and be "5-star doctors."