World Neurosurg
-
Hyponatremia is a common complication following endoscopic endonasal resection (EER) of pituitary adenomas. We report a single-center, multisurgeon study detailing baseline clinical data, outcomes, and factors associated with postoperative hyponatremia. ⋯ Hyponatremia is a common postoperative complication of EER for pituitary lesions that can cause significant morbidity, increased readmissions, and increased healthcare costs.
-
The present study described a modified technique of atlantoaxial arthrodesis in patients with atlantoaxial instability (AAI) along with the postoperative clinical and radiological results. ⋯ Modified atlantoaxial arthrodesis via intraarticular autografting using the structural iliac bone combined with posterior instrumentation appears to be an efficient alternative treatment method for AAI patients with concurrent pathologies, even when the C1-2 posterior arches are unavailable for the grafting bed.
-
Population-based studies on the cause of readmission within 90 days after surgery or radiotherapy for metastatic spine tumors are scarce. We aimed to investigate the risk factors for readmission within 90 days after initial surgical or radiation treatment for metastatic spine tumors. ⋯ These study findings offer a better understanding of the causes of readmission following radiotherapy or surgical treatment in patients with metastatic spine tumors, and these results can help reduce postoperative morbidity and medical costs among these patients.
-
Intramedullary spinal cord lipomas without spinal dysraphism are rare. Although they are benign tumors, they can cause significant neurological deficits. Their tight adherence to the spinal cord presents a challenge for resection. Therefore, we review our institutional experience treating adult patients with intramedullary lipomas in the absence of dysraphism and report long-term outcomes after resection. ⋯ Subtotal resection is a safe and effective treatment. Detethering of the spinal cord, resection of exophytic components, and tumor debulking can improve symptoms and prevent further deterioration in most cases. The resection can be assisted using a laser to vaporize the fatty tissue of the lipoma without physical manipulation of the spinal cord.
-
Neurosurgeons may resort to caffeine, alcohol, and various drugs to maintain peak performance as they grapple with work demands and escalated stress. The prevalence of this controversial strategy remains largely unexplored. ⋯ Reflecting on our results on job-associated drug use by neurosurgeons, we propose the judicious use of pharmacological or nonpharmacological adjuncts, alongside the prioritization of neurosurgeons' well-being.