Articles: treatment.
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This retrospective study compared unilateral pedicle screw combined with contralateral translaminar facet joint screw (UPS+TFS) fixation with bilateral pedicle screw (BPS) fixation in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for single-segment lumbar degenerative disease. ⋯ UPS+TFS and BPS fixation during MIS-TLIF can achieve favorable clinical outcomes with no difference in long-term clinical efficacy. UPS+TFS demonstrates perioperative advantages such as reduced intraoperative blood loss, shorter operation time, reduced postoperative hospital stay, and less iatrogenic injury. Therefore, MIS-TLIF with UPS+TFS fixation is a reliable treatment for single-segment lumbar degenerative disease.
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Hemifacial spasm (HFS) is a rare movement disorder characterized by brisk, irregular, involuntary, and unilateral contraction of the facial musculature. This systematic review aims to synthesize the existing literature and compare the use of 2 microvascular decompression (MVD) techniques-transposition and interposition-used in the treatment of HFS. ⋯ Both transposition and interposition are safe and effective techniques for MVD in patients with HFS. Available literature to date does not provide conclusive evidence that 1 method is superior to the other in safety or efficacy although there are specific instances that favor the use of interposition. A prospective trial would be required to delineate the true differences between these techniques.
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Retrospective cohort. ⋯ Despite the modest daily opioid-sparing effect observed, adjunctive gabapentinoid treatment appears to increase total opioid consumption due to prolonged opioid use and may compromise pain management in the context of ALIF with posterior fixation.
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Acute hypertension can occur in 90% of postcraniotomy patients for tumor resection, and 60% to 90% of patients require treatment with antihypertensive agents. Postoperative intracranial hemorrhage is a major driver of morbidity and mortality after craniotomy for tumor resection, and perioperative hypertension is believed to be a risk factor. Many neurosurgeons impose postoperative blood pressure (BP) goals to mitigate this risk, but there is little evidence to guide the selection of a specific target BP, leading to a wide variation in patient care. In this article, we have conducted a national survey to report the current practices regarding postoperative BP management. ⋯ Most of the academic neurosurgical programs use a postoperative SBP goal after craniotomy for tumor resection. Programs are evenly divided between goals of SBP <140 mm Hg and SBP <160 mm Hg. The variability among programs indicates clinical equipoise between these 2 approaches in the context of a future clinical trial.