World Neurosurg
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To investigate the anatomical parameters of the ideal screw trajectory for percutaneous intralaminar screw fixation of a pars defect in lumbar spondylolysis using computed tomography scans. ⋯ Percutaneous intralaminar rigid screw fixation of a pars defect in spondylolysis provides minimally invasive, low-profile instrumentation. In spondylolysis, a screw length of 3-4 cm and a screw diameter of 4-5 mm may be sufficient for pars fixation with intralaminar screws.
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Spinal anesthesia (SA) is used in lumbar surgery but initial adequate analgesia fails in some patients. In these cases, spinal redosing or conversion to general endotracheal anesthesia is required, both of which are detrimental to the patient experience and surgical workflow. ⋯ We found that age, larger height, and dural sac volume are risk factors for an inadequate first dose of SA. The availability of spinal MRI in patients undergoing spine surgery allows the preoperative measurement of their thecal sac size. In the future, this data may be used to personalize spinal anesthesia dosing based on individual anatomic variables and potentially reduce the incidence of failed spinal anesthesia in spine surgery.
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Obtaining a definitive pathological diagnosis from brain tissue sampling was challenging due to the small, non-representative sample. This study introduced a novel syringe technique for brain biopsy aimed at enhancing diagnostic accuracy by obtaining core tissue samples that better represent the targeted tissue. ⋯ The preliminary findings suggest that the syringe technique is both safe and effective for obtaining substantial volumes of brain tissue, facilitating accurate pathological evaluation in cases of complex neurological disorders.