Segmental and overall lumbar lordosis after single-level minimally invasive transforaminal lumbar interbody fusion: a systematic review and meta-analysis.

Objective: Because of heterogeneity in previous studies, the effect of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) on postoperative segmental lordosis (SL) and lumbar lordosis (LL) remains unclear. Given this evidence gap, the authors performed a systematic review and meta-analysis of studies reporting lordotic outcomes after single-level MI-TLIF. The authors also performed a meta-regression to identify preoperative factors associated with lordosis after surgery and assessed correlations between lordotic changes and patient-reported outcomes.

Erratum to 'Cost differences between autologous and nonautologous cranioplasty implants: A propensity score-matched value driven outcomes analysis' [World Neurosurgery: X (22C) (2024) (100358)].

[This corrects the article DOI: 10.1016/j.wnsx.

Spinal cord metrics derived from diffusion MRI: improvement in prognostication in cervical spondylotic myelopathy compared with conventional MRI.

Objective: A major shortcoming in optimizing care for patients with cervical spondylotic myelopathy (CSM) is the lack of robust quantitative imaging tools offered by conventional MRI. Advanced MRI modalities, such as diffusion MRI (dMRI), including diffusion tensor imaging (DTI) and diffusion basis spectrum imaging (DBSI), may help address this limitation by providing granular evaluations of spinal cord microstructure.

Methods: Forty-seven patients with CSM underwent comprehensive clinical assessments and dMRI, followed by DTI and DBSI modeling.

Percutaneous Screw Distraction for Anatomic Restoration: Case Series.

Background And Objectives: Percutaneous pedicle screw fixation with distraction reduces morbidity after traumatic thoracolumbar burst fractures; however, there are substantial limitations, particularly for correction of kyphosis. The use of fixed-angle screws may offer improved anatomic restoration, facilitating greater postdistraction vertebral height restoration and spinal canal fragment reduction. We examined the radiographic results of distraction across fixed-angle screws immediately after surgery and in long-term follow-up.

Establishing a Benchmark for Iatrogenic Hemodilution and Blood Transfusion in Long-Segment Spine Fusion Surgery.

Study Design: Single-center retrospective cohort study.

Objective: To identify risk factors for transfusion during long-segment thoracolumbar fusion surgery and benchmark cutoffs that could be used by the operative team to guide the use of transfusion.

Summary Of Background Data: Perioperative transfusion for patients undergoing long-segment thoracolumbar fusion surgery is common.

Exoscope for revision of right lateral femoral cutaneous nerve decompression.

The exoscope serves as a valuable addition or alternative to traditional microscope systems in surgery, offering 3D visualization and magnification with enhanced maneuverability. In lateral femoral cutaneous nerve decompression for meralgia paresthetica, the exoscope is effective in identifying strictures of neural compression and minimizing iatrogenic nerve damage that may lead to improved pain management outcomes for patients. In this report, the specific case presented showcases how the exoscope aided in surgical decompression of the lateral femoral cutaneous nerve of a patient with refractory meralgia paresthetica with remote previous decompression and resultant scarring.

Hospital cost differences between open and endoscopic lumbar spine decompression surgery.

Objective: In recent years, fully endoscopic decompression surgery for degenerative spine disease has become increasingly popular in the US. Although an endoscopic approach has demonstrated some benefits compared with open procedures in randomized controlled trials, the cost of advanced technologies remains contested. The authors evaluated the differences in costs and cost drivers between open and endoscopic decompression surgical procedures performed at a single institution.

Influence of Patient and Technical Variables on Combined Direct and Indirect Cerebral Revascularization: Case Series.

Background: Cerebral bypass for flow augmentation is an important technique for selected neurosurgical patients, with multiple techniques used (direct, indirect, or combined).

Objective: To assess the impact of patient and technical variables on direct and indirect bypass flow after combined revascularization.

Methods: This was a retrospective, single-institution review of patients undergoing direct superficial temporal artery-to-middle cerebral artery bypass with indirect encephaloduro-myosynangiosis for moyamoya disease and steno-occlusive cerebrovascular disease over a 2-year period.

Combined subtemporal and pterional approach for clipping of multiple aneurysms.

Background: Despite ongoing improvements in endovascular techniques, open surgical management of basilar apex aneurysms is occasionally necessary.[2] Critical dissection of perforating vessels from the aneurysm is facilitated by the lateral trajectory of the subtemporal approach.[1] Incorporation of additional trajectories can facilitate treatment of multiple aneurysms within the same procedure.

Evaluation of disease severity and treatment intensity as cost drivers for ruptured intracranial aneurysms.

Background: Previous studies have not evaluated the impact of illness severity and postrupture procedures in the cost of care for intracranial aneurysms. We hypothesize that the severity of aneurysm rupture and the aggressiveness of postrupture interventions play a role in cost.

Methods: The Value Driven Outcomes database was used to assess direct patient cost during the treatment of ruptured intracranial aneurysm with clipping, coiling, and Pipeline flow diverters.

Initial Treatment for Unruptured Intracranial Aneurysm and Its Follow-up: A Cost Analysis of Pipeline Flow Diverters versus Coiling.

Purpose Intracranial aneurysms are relatively common epidemiological problems for which the surveillance, treatment, and follow-up are costly. Although multiple studies have evaluated the treatment cost of aneurysms, the follow-up costs are often not examined. In our study, we analyzed how follow-up costs after treatment affected the overall cost of different endovascular techniques for treating aneurysms.

Analysis of Treatment Cost Variation Among Multiple Neurosurgical Procedures Using the Value-Driven Outcomes Database.

Background: Health care costs comprise a substantial portion of total national expenditure. Although interest in cost-effectiveness analysis in neurosurgery has increased, there has been little cross-comparison of neurosurgical procedures. The aim of this study was to compare costs across elective neurosurgical procedures to understand whether drivers of cost differ.

Two-stage surgical treatment for a giant sellar psammomatoid juvenile ossifying fibroma: case report.

Psammomatoid juvenile ossifying fibroma (PJOF) is an uncommon, benign fibro-osseous tumor. It is a purely surgical disease, and a review of the literature revealed that adjuvant therapies, including chemotherapy and radiation, play a limited role. The authors report the case of a 16-year-old male refugee who presented with a giant sinonasal PJOF with parasellar invasion, after having been unable to undergo earlier surgical treatment.

Sequelae and management of radiation vasculopathy in neurosurgical patients.

The term "radiation vasculopathy" defines a heterogeneous and poorly defined complex of vessel injury due to radiation. Radiation vasculopathy remains underrecognized and poorly treated with respect to head and neck radiotherapy. Distinct injury patterns to small (≤ 100-μm), medium (> 100-μm), and large (> 500-μm) vessels can occur, resulting in carotid stenosis, intracranial stenosis, and vascular anomalies (e.

Analysis of cerebrovascular aneurysm treatment cost: retrospective cohort comparison of clipping, coiling, and flow diversion.

OBJECTIVE With the continuous rise of health care costs, hospitals and health care providers must find ways to reduce costs while maintaining high-quality care. Comparing surgical and endovascular treatment of intracranial aneurysms may offer direction in reducing health care costs. The Value-Driven Outcomes (VDO) database at the University of Utah identifies cost drivers and tracks changes over time.

Assessment of cost drivers and cost variation for lumbar interbody fusion procedures using the Value Driven Outcomes database.

OBJECTIVE Efforts to examine the value of care-combining both costs and quality-are gaining importance in the current health care climate. This thrust is particularly evident in treating common spinal disease where both incidences and costs are generally high and practice patterns are variable. It is often challenging to obtain direct surgical costs for these analyses, which hinders the understanding of cost drivers and cost variation.

Analysis of Anterior Cervical Discectomy and Fusion Healthcare Costs via the Value-Driven Outcomes Tool.

Background: Examining the costs of single- and multilevel anterior cervical discectomy and fusion (ACDF) is important for the identification of cost drivers and potentially reducing patient costs. A novel tool at our institution provides direct costs for the identification of potential drivers.

Objective: To assess perioperative healthcare costs for patients undergoing an ACDF.