World Neurosurg
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Revision surgery for patients with persistent, recurrent, or progressive syringomyelia following foramen magnum decompression (FMD) for Chiari malformation I-syringomyelia (CM-SM) is not uncommon and presents both strategic and technical challenges. ⋯ Dural incision and tonsillar manipulation during the first surgery, spinal cord atrophy prior to revision CTL, and severe intradural adhesions during revision CTL are significant risk factors associated with poor prognosis in revision surgery for CM-SM.
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Alcohol use disorder carries major effects shown to limit social support, increase recovery times, and lead to a higher incidence of surgical complications. This retrospective cohort study investigated the influence of AUD on perioperative outcomes and adverse events after spinal fusions in the largest sample size to date and spanning 11 years. ⋯ We found that AUD carries a significantly negative influence over perioperative outcomes and adverse events after spinal fusion in a large database population.
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To summarize the clinical characteristics, pituitary function assessment, postoperative pathological features, and postoperative recurrence of surgically treated pituitary adenomas (PAs). ⋯ The management of patients with surgically treated PAs is limited by deficiencies in pathological classification, assessment of hypopituitarism, and detection of recurrence.
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Postoperative inflammatory parameters are important markers of surgical site infection. Some authors have reported that spine surgery with instrumentation elevates CRP levels more than that without instrumentation does. However, those studies compared early postoperative inflammatory markers with or without instrumentation in different patients, although CRP levels vary widely among patients. Therefore, we investigated the impact of early postoperative inflammatory reaction with or without instrumentation in the same patients. ⋯ Early postoperative trends were significantly higher after PLIF than after laminotomy for all three indices, with a significant interaction between time and N-level for CRP and NC.
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The purpose of this retrospective cohort study was to compare the 2-year radiological outcome and revision rates in patients with adult spinal deformity treated with either pedicle subtraction osteotomy (PSO) or posterior lumbar interbody fusion (PLIF), when PLIF was used to improve sagittal balance. ⋯ A significantly lower revision rate was seen for patients undergoing PLIF compared with PSO at a 2-year follow-up. A satisfactory sagittal correction was obtained for both groups regardless of the procedure. Thus, PLIF could be a viable option in selected cases.