World Neurosurg
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To evaluate the association between postoperative lumbar curve progression and the shoulder height in patients with Lenke type 2B/C adolescent idiopathic scoliosis (AIS). ⋯ Postoperative lumbar curve progression is a risk factor for deterioration of shoulder imbalance in patients with Lenke 2B/C AIS during the follow-up period.
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We report a retrospective analysis of hardware failure in patients requiring instrumentation for spinal metastasis. ⋯ The rate of hardware failure in this cohort was 13.8%, although operative revision rate was 3.4%. Spinal instrumentation in patients with poor preoperative functional status or multiple myeloma may be more likely to develop instrumentation failure.
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To investigate the efficacy and safety of a prophylactic intravenous administration of tranexamic acid (TXA) 30 minutes before skin incision on perioperative blood loss in patients treated with posterior lumbar interbody fusion (PLIF). ⋯ A prophylactic intravenous administration of TXA 30 minutes before skin incision effectively reduces the perioperative blood loss, duration of tube drainage, and hospitalization time, and it does not increase the risk of complications. However, TXA may not be able to decrease the rate of blood transfusion.
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and importance: Epistaxis is a rare presentation of the ruptured cavernous carotid aneurysm (CCA) especially nontraumatic type. Both endovascular therapies and open surgeries have a role in the treatment with various outcomes, but the standard procedure is not well established. We report a successful high-flow bypass with cervical internal carotid artery ligation for aneurysm repair and review the related literature. ⋯ In cases of massive or recurrent epistaxis without coagulopathy or nasal pathology, a CCA should be considered. Immediate cessation of bleeding is necessary. Flow-preservation bypass with proximal ligation of the parent artery is one of the effective procedures for the treatment of this condition with low morbidity.
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Dysphagia is a common complication after anterior cervical discectomy surgery (ACDS). Recent studies have shown that reducing the endotracheal tube cuff pressure, local irrigation with methylprednisolone, and minimizing the pharynx/esophagus retraction can decrease the incidence of postoperative dysphagia after ACDS. This is the first study assessing the efficacy of all these 3 measures simultaneously. ⋯ Postoperative dysphagia occurs frequently after ACDS. We show that the adoption of preventive measures during surgery can reduce the rate of dysphagia. Future evaluations in a large clinical trial are mandatory.