World Neurosurg
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Comparative Study
Sacroiliac joint degeneration after lumbar or lumbosacral fusion surgery - a comparative study of the number of fused segments and sacral fusion.
In this study, we aimed to investigate whether multi-segment fusion or fusion-to-sacrum increases sacroiliac joint (SIJ) pathology compared with single-segment fusion or a non-fused sacrum. ⋯ SIJ degeneration occurs independent of the number of fused segments or sacrum involvement.
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A plethora of studies has substantiated the remarkable clinical efficacy of anterior cervical discectomy and fusion (ACDF) in the treatment of cervical spondylotic myelopathy.1,2 This procedure effectively removes the posterior osteophytes and protruding nucleus pulposus, achieving direct decompression of the spinal cord and effectively alleviating compression symptoms. Concurrently, by distracting the intervertebral space, ACDF contributes to the restoration of the physiological curvature of the cervical spine. However, several pressing issues remain to be addressed during the surgical process. ⋯ Assisted by 3D microscopy, ACDF surgery offers a high-definition visual field that enhances precision, thereby reducing procedural risks and improving clinical outcomes. This technology alleviates the physical strain on surgeons, fosters collaborative teamwork, and facilitates educational exchanges. With a relatively short learning curve, 3D microscopy significantly enhances the safety and efficiency of ACDF procedures.
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To develop and validate a clinical-radiomics nomogram for predicting early ischemic stroke risk in patients who sustain a transient ischemic attack (TIA). ⋯ The nomogram, based on clinical ABCD2 score, carotid plaque components and radiomics score, shows good performance in predicting the risk of recurrent ischemic events in patients with TIA.
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For symptomatic stenosis in the middle cerebral artery (MCA), intracranial angioplasty and stenting are frequently employed. However, limited data exist regarding their long-term impact. Our study demonstrates the long-term advantages in preventing ischemic events through a 5-year follow-up period. ⋯ In the treatment of symptomatic MCA atherosclerotic stenoses, intracranial angioplasty and stenting are demonstrated to be technically feasible and safe. Its early and long-term efficacy on ischemic event prevention is acceptable, with a reduced level of restenosis, although the representative sample is tiny.
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Here we describe our experience managing intracranial dural arteriovenous fistulas (DAVFs) via endovascular embolization using a transarterial embolization (TAE) technique with liquid embolic agents. We illustrate the technical nuance of using dual arterial access for angiographic control runs in complex DAVFs supplied by multiple feeders from 2 distinct arterial systems. ⋯ In this initial series of patients with DAVF managed by endovascular embolization, dual arterial access was feasible, safe, and effective in achieving fistula obliteration. Dual-arterial access conveniently provides simultaneous access for control angiography and embosylate delivery intraoperatively.