World Neurosurg
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A sufficient foraminoplasty is critical in percutaneous endoscopic transforaminal discectomy (PETD) for lumbar disc herniation (LDH), which may affect the progress of surgery. This study assessed repeated foraminoplasty (RF) applied in PETD for patients with LDH and lumbar foraminal stenosis. ⋯ Repeated foraminoplasty applied in PETD for patients with LDH and lumbar foraminal stenosis might improve intervertebral foramen enlargement in anterior-posterior diameter, exposure of nerve roots, surgical efficiency, and immediate relief of leg pain after surgery.
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Traumatic brain injury management guidelines vary across regions and there is limited research on real-world adherence to these guidelines. We conducted a global survey to assess the adherence of neurosurgeons to traumatic brain injury guidelines and evidence-based medicine (EBM). ⋯ Neurosurgeons from Europe and North/Central and South America tend to follow EBM guidelines more closely, while those from Asia and Africa often favor individual decision-making approaches.
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Indications for carotid endarterectomy (CEA) and reduction of complications require evaluation of the plaque properties and location of the distal end of the plaque. High cervical location can be predicted from the anatomy of the vertebral body and mandibular bones, and the locations of the posterior belly of the digastric muscle and stylohyoid muscle. Magnetic resonance (MR) imaging without contrast medium is useful for preoperative evaluation of the plaque, arteries, and bone characterization. However, no method for simultaneous evaluation of the muscle, plaque, arteries, and bone using MR imaging has been established. ⋯ M-PAB imaging using MR imaging without contrast medium is useful for preoperative evaluation of CEA. This method does not require contrast agents and avoids radiation exposure.
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Utilization of the emergency department (ED) is associated with medical and social comorbidities. These factors may also be associated with medical complications after complex surgeries. This study investigated how pre-operative ED use increases risk of posterior lumbar interbody fusion (PLIF) complications. ⋯ Patients with any pre-operative ED visit had an increased risk for post-operative ED use, readmission, and medical complications. The risk difference increased with each additional pre-operative visit. Patient counseling and protocols that reduce preventable ED visit in the pre-operative period may reduce a patient's risk for costly post-operative complications.
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Glioblastomas contacting the subventricular zone (SVZ) are associated with poor prognosis, and the impact of ventricular entry (VE) during resection remains controversial. Since glioblastomas with SVZ involvement often require VE, both SVZ involvement and VE are confounding factors. This study aimed to evaluate the effect of VE during glioblastoma resection by comparing patients with and without SVZ involvement. ⋯ VE during glioblastoma resection does not impact complications or nonlocal recurrence. Surgeons may safely perform VE during resection of both SVZ and non-SVZ glioblastomas without adverse effects.