World Neurosurg
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To investigate how the expansion trajectory of a lateral expandable cage affects pressure distribution at the cage-endplate interface under well-controlled biomechanical loading conditions. ⋯ Of the cage designs evaluated in this study, an expandable cage with independently adjustable anterior and posterior heights lowered the maximum pressure measured at the cage-endplate interface and alleviated the potential of cage edge loading, both of which are important considerations that are fundamental for a successful fusion procedure and the mitigation of implant subsidence risk.
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Exposure to neurosurgery is important for knowledge of neurosurgical conditions that physicians may encounter. The current status of neurosurgery nonsubinternship clerkships in the United States is unknown; this study determined the availability and format of non-subinternship neurosurgery clerkships in DO (Doctor of Osteopathic Medicine)-granting and MD (Doctor of Medicine)-granting U.S. medical schools. ⋯ Most U.S. medical schools provide elective neurosurgery non-subinternships. Fewer, although still a majority, of DO-granting schools offer a neurosurgery non-subinternship compared with MD-granting schools.
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To design percutaneous endoscopic surgery via a posterolateral approach for the treatment of central cervical disc herniation. ⋯ Percutaneous endoscopic posterior lateral cervical discectomy provides a new surgical method for the endoscopic treatment of central cervical disc herniation. This treatment has a better surgical field and easier operation, which can remove the protruding cervical disc under the endoscope and make sure that the cervical spinal cord is fully decompressed. The clinical effect is satisfactory. A small amount of pedicle resection will not cause cervical instability.
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We examined the utility of passive high gamma mapping (HGM) as an adjunct to conventional awake brain mapping during glioma resection. We compared functional and survival outcomes before and after implementing intraoperative HGM. ⋯ Our results tentatively indicate that passive HGM is a safe and potentially useful adjunct to electrical stimulation mapping for awake cortical mapping, conferring at least comparable functional and survival outcomes with a nonsignificant lower rate of intraoperative epileptiform events. Considering the limitations of our study design and patient cohort, further investigation is needed to better identify optimal use cases for HGM.
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Giant pituitary adenomas (>4 cm, GPAs) have presented great challenges to surgeons because the residual tumor in the subarachnoid space can cause hemorrhage or vessel injury following apoplexy. This study aimed to investigate the factors limiting surgical success in endoscopic skull base surgery (ESS) for GPAs. ⋯ Considerable surgical planning in ESS for GPAs is crucial for complete resection and patient safety. We elucidated that lateral extension of tumors in the subarachnoid space hindered the surgical success of the suprasellar portion of the tumor.