World Neurosurg
-
To investigate the factors for pulmonary embolism (PE) development and the necessity of inferior vena cava (IVC) filter placement. Specifically, propose a scoring system to identify patient populations who benefit from IVC filter placement. ⋯ The risk of PE is relatively low after long-segment posterior thoracolumbar fusion. Smoking (former and current), history of cocaine/cannabis use, and history of venous thromboembolism are risk factors in such patients. We recommend prophylactic IVC filter use only in high-risk subgroups and under discretion between physician and patient in medium-risk subgroups.
-
Patients with brain metastases (BrMs) from esophageal cancer have poor prognosis, the incidence of which is expected to rise due to improved survival from the primary tumor and increased neuroimaging. We aimed to identify patient and esophageal cancer characteristics associated with longer survival in patients with BrMs and, secondly, to compare the prognosis of patients with HER2 overexpression. ⋯ The median survival from esophageal-to-brain metastasis was 8.4 months. Patients with a single lesion, KPS score >70, and treatment with surgical resection was correlated with improved survival. Further, HER2+ patients had distinct patient and BrM characteristics.
-
Pain is a complex sensory and emotional experience that significantly impacts individuals' well-being. Lumbar radicular pain (LRP) is a prevalent neuropathic pain affecting 9.9% to 25% of the population annually. Accurate identification of pain patterns in LRP is essential for diagnosis and management. Artificial intelligence has potential in health care but faces challenges in reliability and accuracy. This study aimed to investigate the accuracy and consistency of LRP patterns demonstrated by ChatGPT-4o. ⋯ ChatGPT currently lacks the capacity to accurately and consistently represent LRP patterns. AI tools in health care require further refinement, validation, and regulation to ensure reliability and safety. Future research should involve multiple AI platforms and broader medical conditions to enhance generalizability.
-
Suprasellar hypothalamic-opticochiasmatic glioma (HOCG) and craniopharyngioma (CP) have similar appearances on conventional magnetic resonance imaging (MRI) and are difficult to distinguish. Moreover, these tumors are situated near vital structures like the optic chiasm and hypothalamus, rendering conventional surgery susceptible to significant complications. We mainly discussed the surgical application value and diagnostic value of diffusion tensor imaging (DTI) in HOCG and CP. ⋯ DTI enhances the accuracy of HOCG and CP differentiation. Furthermore, patterns of tractography described in this study assist neurosurgeons in delineating the surgical pathway and tumor resection range without damaging important fiber bundles, thereby avoiding permanent neurological deficits and improving survival quality for patients.
-
Cerebrospinal fluid (CSF) leaks are a known complication of lumbar fusion surgery. There is a scarcity of literature describing the management of this complication. The aim of this study was to identify patients who are at risk of requiring further intervention for managing CSF leaks. ⋯ Spine surgeons should be aware of certain patient and procedure-specific characteristics that increase the risk of requiring an intervention for CSF leak management after lumbar fusion to improve patient outcomes.