World Neurosurg
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Anterior cervical discectomy and fusion (ACDF) is a commonly performed procedure. Cerebrospinal fluid (CSF) leaks, although uncommon, may occur and can be a potentially serious complication. Little is known regarding the fusion rate after durotomy in ACDF. This study sought to investigate the clinical outcomes and fusion rates of patients with CSF leak after ACDF. ⋯ ACDFs with CSF leak had a 100% fusion rate in this series, with generally excellent clinical outcomes, although it is difficult to conclude definitively that there is no effect on fusion rates because of the small sample size. However, given the relative rarity of this complication, this study provides important data in the clinical literature regarding outcomes after CSF leak in ACDFs.
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Preoperative Predictors of Spinal Infection within the National Surgical Quality Inpatient Database.
Surgical-site infections (SSIs) are a major cause of morbidity and mortality, increasing the length and cost of hospitalization. In patients undergoing spine surgery, there are limited large-scale data on patient-specific risk factors for SSIs. ⋯ Analysis of a large national patient database revealed many independent risk factors for SSIs after spinal surgery. Some of these risk factors can be modified preoperatively to reduce the risk of postoperative infection.
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Optic pathway gliomas (OPGs) are rare neoplasms in children with an unpredictable clinical course. There is significant controversy regarding the optimal management and outcome of these patients. ⋯ The initial role of surgery in newly developed OPG is biopsy for tissue diagnosis and relief of the hydrocephalus, if present, followed by chemotherapy. Chemotherapy decreases or stabilizes the tumor size in most cases, leading to preservation of both visual and endocrinal functions. The most significant prognostic factor confirmed in this study was the age of the patient.
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To analyze the relationship between clinical factors and spontaneous canal remodeling. ⋯ During posterior fixation, the degree of the reduction of the vertebral body by distraction can affect the degree of postoperative reduction and spontaneous bone remodeling. Therefore, close attention must be given to the indirect reduction technique through distraction during the operation. Because comminuted fracture fragments affect spontaneous canal remodeling, the degree of postoperative resorption can be estimated by preoperative computed tomography imaging.
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Case Reports
Intraoperative supratentorial extradural haematoma complicating excision of a giant vestibular schwannoma.
A man developed a rare and unexpected contralateral intraoperative complication during a translabyrinthine resection of a large cystic vestibular schwannoma. ⋯ Although the development of postoperative extradural hematomas resulting from cerebrospinal fluid overdrainage is reported in the literature, this case is unique in that infratentorial surgery led to the development of a supratentorial hematoma.