World Neurosurg
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Recent advances within the last decade have allowed robotics to become commonplace in the operating room. In the field of neurosurgery, robotics assist surgeons in pedicle screw placement and vertebral fusion procedures. The purpose of this review is to look at currently used spinal robots available on the market and compare their overall accuracy, cost, radiation exposure, general adverse events, and hospital readmission rates. ⋯ This review summarizes the findings comparing the individual robotic systems and their comparison to freehand surgery. As robotics become more popular in clinical practice, additional research is needed to assist hospitals and surgeons in making an informed decision about implementing robotics in spinal surgery.
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To compare the rates of postoperative hemorrhages for aneurysms associated with brain AVM evaluating the lesion that was initially treated. ⋯ Hemorrhage rates were lower when treating the aneurysm first, but their risk was higher when treating infratentorial lesions. The decision on which lesion should be treated first should be individualized according to the feeder vessels, the AVM and aneurysmal size, location, and overall functionality of the patients.
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The Spinal Instability Neoplastic Score (SINS) is used in determining instability in patients with spinal metastases. Intermediate scores of 7 to 12 suggest possible instability, but there are no clear guidelines to address patients with these scores. ⋯ Complication rates after surgery versus radiotherapy in the intermediate SINS category are similar, but the complication types differ. Patients in the 10-12 SINS subgroup, due to larger lytic area and higher probability of vertebral body fracture, could benefit from stabilization before radiotherapy.
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This study evaluates the extent of perfusion abnormalities in pediatric traumatic head injury patients by using computed tomography perfusion (CTP) and compares the efficacy of voxel based and whole brain perfusion data clinically with functional outcome scales GOSE-P and MRS. ⋯ The comparative analysis highlights the complementary roles of voxel-based and whole brain perfusion CT in predicting functional outcomes in pediatric head injury cases. Clinicians should consider both approaches when evaluating cerebral perfusion status and making treatment decisions. Further research is warranted to validate these findings and refine imaging protocols to optimize predictive accuracy in this vulnerable population.
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To investigate the risk factors and their diagnostic efficacy for postoperative intestinal mucosal barrier dysfunction (IBD) following severe traumatic brain injury (sTBI). ⋯ Intraoperative iICP could act as an independent and quantifiable predictor with high diagnostic efficacy for IBD in patients with sTBI after emergency surgery.