Balloon inflation predicts recanalization of intracranial aneurysms treated with coiling alone.

BackgroundEndovascular coil embolization is a common treatment for intracranial aneurysms, but aneurysm recanalization remains a significant problem that may necessitate retreatment. This study aimed to identify patient, aneurysm, and procedural factors associated with recanalization in aneurysms treated exclusively with coil embolization.MethodsThis single center retrospective study assessed intracranial aneurysms treated with coiling-only between 2017 and 2022.

Expandable, But at What Cost? Failure Patterns in Corpectomy Cages from 373 Real-World Adverse Events.

Study Design: Cross-sectional study.

Objective: This study aimed to analyze the failure patterns of expandable corpectomy cages.

Summary Of Background Data: Expandable corpectomy cages offer significant advantages for anterior column reconstruction but introduce unique mechanical complexities.

Composite RAI, Malnutrition, and Anemia Model Superiorly Predicts 30-Day Morbidity and Mortality After Surgery for Adult Spinal Deformity.

This study examines the composite influence of frailty, malnutrition, and anemia on postoperative outcomes for patients with adult spinal deformity (ASD). In this retrospective cohort study using the 2011-2022 NSQIP database, we utilized CPT and ICD codes to identify ASD patients who underwent PSF. Subjects were stratified based on frailty status.

The hidden cost of robotic spine surgery: real-world adverse events cause 58-minute delays and undermine economic viability.

Background Context: Robotic spine surgery has experienced substantial market growth with global projections exceeding $1.2 billion by 2026. Manufacturers prominently promote enhanced screw placement accuracy, reduced radiation exposure, and improved surgical efficiency as primary value propositions.

Mind the Gap: Social media analysis of 38,609 posts highlights discrepancies between clinical focus and patient priorities in neurosurgical care.

Objective: To analyze social media discussions among cranial neurosurgical patients to identify prevalent concerns, emotional patterns, and quality of life impacts that may not be fully captured in traditional clinical assessments.

Methods: We analyzed 38,609 neurosurgery-related posts from Reddit using natural language processing and the Valence Aware Dictionary and sEntiment Reasoner (VADER) sentiment analysis tool. Posts were categorized into clinical domains (symptoms, conditions, procedures, treatments, complications, quality of life, and clinical course), with sentiment scores calculated for each category.

Assessing combined effects of risk analysis index-revised (RAI-rev), malnutrition, and anemia on morbidity and mortality after spine surgery for metastatic spinal tumors.

Purpose: This study evaluates the combined effects of frailty, anemia, and malnutrition on outcomes in spinal metastases patients.

Methods: We conducted a retrospective cohort study using the 2011-2022 NSQIP database. Adult patients undergoing spinal surgery for spinal metastases were identified using CPT and ICD codes and stratified based on Risk Analysis Index-revised (RAI-rev) frailty status; frail patients were subdivided based on anemia and malnutrition status.

Race, Region, and Reimbursement: Sociodemographic Variations in Medicare Payments for Spine Surgery in the United States, 2014-2022.

Study Design: Retrospective.

Objective: Assess whether Medicare adjustments adequately correct for systemic population-level payment variations.

Summary Of Background Data: Medicare currently uses payment adjustments for spine surgery, including clinical risk, geography, and socioeconomic status.

MOSAIC: A Multi-Feature Genomic Instability Score Independently Predicts Sarcoma Survival in 2138 Patients.

Objectives: While genomic profiling has identified prognostic markers in sarcoma, clinical risk stratification remains largely histology-based. The combined impact of multiple genomic instability features on survival remains poorly understood. This study evaluated the prognostic utility of a novel Measure Of Sarcoma Aggregate Instability Complex (MOSAIC) Score.

Precision Oncology in Non-small Cell Lung Cancer: A Comparative Study of Contextualized ChatGPT Models.

Objectives: The growing adoption of Large Language Models (LLMs) in medicine has raised important questions about their potential utility for clinical decision support within oncology. This study aimed to evaluate the effects of various contextualization methods on ChatGPT's ability to provide National Comprehensive Cancer Network (NCCN) guideline-aligned recommendations on managing non-small cell lung cancer (NSCLC).

Methodology: GPT-4o, base GPT-4, and GPT-4 models contextualized with prompts and PDF documents were asked to identify preferred chemotherapies for twelve advanced lung cancers given molecular profiles derived from the 2024 NCCN Clinical Practice Guidelines in Oncology for NSCLC.

Beyond the Clinic: A Social Media Network Analysis of 5466 Posts Reveals the Interconnected Challenges Facing Sarcoma Patients.

Objectives: Social media platforms have increasingly been investigated as a source of patient perspectives that may not emerge in clinical settings. This study aimed to explore how disease status, treatment, and the patient experience interconnect for sarcoma patients posting on a major social media platform.

Methods: We conducted a systematic thematic analysis of 5466 posts across 7 health-related subreddits using a framework of 6 major categories: physical symptoms, disease status, treatments, psychosocial impact, support systems, and daily life impact.

Subtype-Specific Patterns of Tumor Purity and Mutation Load Suggest Treatment Implications: A Cross-Sectional Analysis of 7494 Soft Tissue and Bone Sarcomas (MSK Cohort).

Objectives: Sarcomas are complex mesenchymal malignancies whose molecular characteristics can significantly influence treatment strategies. This study aimed to investigate the relationship between tumor purity, mutation load, and clinical characteristics across sarcoma subtypes, focusing on potential implications for therapeutic stratification.

Methods: This study analyzed the molecular characteristics of 7494 sarcoma cases from the Soft Tissue and Bone Sarcoma (MSK, Nat Commun 2022) data set using available case analysis.

Advances in Coccygectomy: A Comprehensive Review Evaluating Surgical Techniques for Coccygodynia.

Background: Coccygodynia presents significant challenges in diagnosis and treatment. While coccygectomy has emerged as a crucial intervention for refractory cases, significant heterogeneity exists in surgical techniques. Traditional approaches are increasingly complemented by novel methods, necessitating a comprehensive review of current surgical options.

The Association Between Clival Axial Angle and Distal Junctional Failure After Craniocervical Fusion.

Study DesignRetrospective Cohort.ObjectivesCraniovertebral instability can arise from various congenital or acquired conditions, but definitive management often requires craniocervical fusion. This study evaluates whether postoperative clivo-axial angle (CXA) can predict distal junctional failure in patients undergoing craniocervical fusion.

Indocyanine Green as a Marker for Tissue Ischemia in Spinal Tumor Resections and Extended Revisions: A Technical Note.

The increasing complexity of spinal oncology procedures, particularly in en-bloc tumor resections, creates challenges in tissue perfusion assessment due to extended operative times and extensive surgical dissection. Real-time visualization of tissue perfusion can be achieved with ICG using commercially available handheld imaging systems, offering potential advantages in spinal oncology cases. This study assessed the utility of ICG in analyzing soft-tissue viability during complex spine procedures extending beyond 7.

Racial/Ethnic Disparities in Perception of Health Literacy and Barriers to Care Among Cervical Stenosis Patients.

Study DesignCross-Sectional Survey.ObjectiveThis study aimed to assess racial disparities in self-reported barriers to care, health literacy, and health status within a large cohort of cervical stenosis patients.MethodsThis cross-sectional study used ICD-9 and ICD-10 codes to identify cervical stenosis patients recorded in the NIH All of Us Research Program between 2017 and 2022.

Analysis of ChatGPT in the Triage of Common Spinal Complaints.

Background: ChatGPT is a natural language processing chatbot with a significant prevalence in modern media with a clear application in the medical triage workflow. ChatGPT has shown significant capacity for understanding clinical vignettes, radiology reports, and even passing the American Board of Neurological Surgery board examination. There has never been an evaluation of the chatbot in triage and diagnosing spinal vignettes common to primary and urgent care practice.

ChatGPT as a Decision Support Tool in the Management of Chiari I Malformation: A Comparison to 2023 CNS Guidelines.

Objective: ChatGPT has been increasingly investigated for its ability to provide clinical decision support in the management of neurosurgical pathologies. However, concerns exist regarding the validity of its responses. To assess the reliability of ChatGPT, we compared its responses against the 2023 Congress of Neurological Surgeons (CNS) guidelines for patients with Chiari I Malformation (CIM).

Application of machine learning and artificial intelligence in the diagnosis and classification of polycystic ovarian syndrome: a systematic review.

Introduction: Polycystic Ovarian Syndrome (PCOS) is the most common endocrinopathy in women of reproductive age and remains widely underdiagnosed leading to significant morbidity. Artificial intelligence (AI) and machine learning (ML) hold promise in improving diagnostics. Thus, we performed a systematic review of literature to identify the utility of AI/ML in the diagnosis or classification of PCOS.

The Thyroid Hormone Axis and Female Reproduction.

Thyroid function affects multiple sites of the female hypothalamic-pituitary gonadal (HPG) axis. Disruption of thyroid function has been linked to reproductive dysfunction in women and is associated with menstrual irregularity, infertility, poor pregnancy outcomes, and gynecological conditions such as premature ovarian insufficiency and polycystic ovarian syndrome. Thus, the complex molecular interplay between hormones involved in thyroid and reproductive functions is further compounded by the association of certain common autoimmune states with disorders of the thyroid and the HPG axes.