World Neurosurg
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This study was to evaluate the initial efficacy of lateral lumbar interbody fusion (LLIF) in treating degenerative lumbar spinal stenosis (DLSS), encompassing a spectrum of stenosis severity from minor to extreme cases. ⋯ Under certain indications, patients with varying degrees of DLSS, ranging from mild to extreme, can achieve favorable outcomes through LLIF, and preoperative imaging revealing severe or extreme stenosis does not automatically disqualify patients from undergoing indirect decompression surgery.
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In recent decades, many physicians have chosen to opt out of Medicare, allowing them to set their own pricing models for their patients. Characterization of Medicare opt-outs has not been thoroughly studied in any surgical specialty, including Neurosurgery. Our study characterizes the factors that may influence a neurosurgeon's decision to opt out of Medicare acceptance and contextualizes them both within the field and across various surgical specialties. ⋯ The circumstances influencing a neurosurgeon's decision to opt out of Medicare acceptance are multifaceted, and our findings suggest that physician experience, specialty, location, and practice structure may all play roles and should be further investigated.
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Each year, thousands of individuals, particularly young adults, experience traumatic brachial plexus injuries (TBPIs), leading to significant limitations, permanent disabilities, reduced quality of life, and infrequent return to work. Current treatments and assistive devices have shown limited success, resulting in considerable social and economic challenges for patients. Given the devastating nature of this injury and the lack of literature on return to work rates among young adults, this study aims to determine the percentage of individuals reintegrating into work after a TBPI. ⋯ Preliminary findings indicate that approximately 60% of patients with TBPI return to work, although most require a change in their occupational roles. Despite variations in health care systems and governmental support, the reintegration of patients with TBPI into work and society remains a critical and universal challenge. This comparative analysis highlights disparities in TBPI research and outcomes, providing valuable insights for future improvements in patient care and support mechanisms.
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Brainstem cavernous malformations are relatively rare lesions with a higher tendency of hemorrhage than supratentorial cavernous malformations. Due to the compact arrangement of fiber tracts and nuclei of the region, any hemorrhagic event can cause severe neurological deficits. This eloquent architecture of the area also makes any surgical attempt challenging. ⋯ The paramedian supracerebellar infratentorial translateral mesencephalic sulcus approach is used to resect the lesion with the patient in a dynamic lateral semisitting position. The paramedian variant of the supracerebellar infratentorial approach provides a relatively bridging vein-free corridor compared with midline approaches.6 With the patient in the semisitting position, gravity retraction of the brain provided a natural corridor with a clear surgical field. In the dynamic lateral semisitting position, we aimed to reduce the risk of venous air embolism associated with the sitting position by keeping the patient in the lateral decubitus position during the dural and extradural phases of the surgery.7.
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We explored the impact of various craniotomy approaches on the outcomes and long-term cognitive function of microsurgical clipping for superiorly projecting anterior communicating artery (ACoA) aneurysms. ⋯ The anterior position of the A2 segment can offer better visualization of the aneurysm dome, bilateral A2, and AcoA, leading to reduced operative time and gyrus rectus aspiration frequency, potentially enhancing long-term cognitive function.