World Neurosurg
-
To measure the muscle strength around the cervical spine; clarify the relationships among muscles, cervical sagittal alignment, and cervical spondylotic myelopathy(CSM); and understand the process underlying loss of cervical lordosis. ⋯ The greater strength of the flexors relative to the extensors and the superficial muscles compared with the deep muscles plays a role in pathogenesis of CSM with DCK, indicating the importance of neck and shoulder muscle-strengthening exercises in patients showing CSM with DCK.
-
Extracranial carotid artery aneurysms (ECAAs) are extraordinarily rare, representing approximately 0.4%-4% of all extracranial artery aneurysms. As medical technology has advanced, new approaches for ECAAs treatment can be performed. Nevertheless, there is currently no consensus on the best therapeutic approach due to the information scarcity. ⋯ ECAAs are a rare clinical condition. However, a great percentage of patients could present with ischemic symptoms. Similarly, cardiovascular risk factors present as the most prevalent comorbid conditions associated with these vascular aberrancies. With this systematic review, we seek to provide insight into extracranial carotid aneurysms, identifying areas of opportunity in both the diagnosis and management of this pathology and the standardization of clinical reporting and case classification. These findings underscore the need for future research to improve the understanding and approach to this complex clinical condition.
-
Frailty is defined as a state in which depletion of physiologic reserves causes multisystem impairments independent of natural senescence. This phenomenon can be quantified by the 11-point modified frailty index (mFI-11). This study determines whether an 11-point patient questionnaire developed from the mFI-11 can be used as a predictor for discharge destination following multilevel lumbar interbody fusion surgery in elderly patients. ⋯ Increased frailty was significantly associated with nonhome discharge, discharge to home health, rehabilitation, or skilled nursing facility. This is likely due to the impact which comorbidities represented by the frailty questionnaire and mFI-11 have on patient healing and postoperative recovery. Frailty score may be incorporated into the informed consent process and shared decision-making between patients and their surgeons to better predict the likelihood of discharge home.