World Neurosurg
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To assess whether early changes in enhancing tumor volume (eTV) and relative cerebral blood volume (rCBV) 1 month after convection-enhanced delivery of topotecan in patients with recurrent malignant glioma correlated with 6-month disease progression status. ⋯ In this selected population of patients with recurrent malignant glioma treated with convection-enhanced delivery of topotecan, early changes in rCBV at 4 weeks after therapy may help predict progression status at 6 months.
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World Health Organization grade II astrocytomas (AII) are the commonest low-grade glioma subset, but their prognostic factors are subject to debate. This institutional study aimed to identify prognostic factors in lobar AII. ⋯ Patients with World Health Organization grade II astrocytomas have better overall survival if their tumor is nonenhancing, amenable to surgical resection, and exhibits the IDH1 mutation. These factors should be used to guide patient management and inform prognosis.
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Magnetic resonance imaging (MRI) is a vital tool for detection of soft tissue injury (STI) after cervical spine injury (CSI). However, high cost, prolonged imaging time, and limited use in hemodynamically unstable patients necessitates that the utility of MRI in all patients with CSI be scrutinized. ⋯ MRI detected an associated STI in about 55% of patients who underwent imaging. Injuries involving multiple fractured cervical levels, fractures at C3 and C5, and widened disc space should raise the treating physician's level of suspicion for ALLI. Our data show that treatment directed by MRI findings in select cases has substantial value.
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Benchmarking of outcomes and individualized risk prediction are central in patient-oriented shared decision making. We attempted to create a predictive model of complications in patients undergoing benign intracranial tumor resection. ⋯ Our models can provide individualized estimates of the risks of postoperative complications based on preoperative conditions and potentially can be used as an adjunct for decision making in benign intracranial tumor surgery.
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Comparative Study
Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF) for Spondylolisthesis in 282 Patients: In Situ Arthrodesis versus Reduction.
The benefits of spondylolisthesis reduction via minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) remain poorly understood. The purpose was to compare the complications, perioperative factors, and fusion rates in patients undergoing MI-TLIF for degenerative spondylolisthesis between those in whom reduction was or was not performed. ⋯ Reduction of spondylolisthesis was not associated with an increase in operative time, length of stay, and perioperative and postoperative complications compared with fusion in situ. Reduction was associated with higher blood loss but also a higher rate of fusion success at 1 year. Overall, reduction did not incur additional risk and had positive perioperative outcomes.