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1%). On a scale of 0-10, 10 being very difficult, the average participant expected level of difficulty with visualization was 6.89 and expected level of difficulty with instrumentation was 7.3. On postdissection assessment, there was a nonstatistically significant change to 6.93 and 7.5, respectively. Participants endorsed on a scale of 0-10, 10 being very realistic, an overall model realism of 7.0 and haptic realism of 7.1.
A 3D printed model of the pediatric skull base may provide a realistic model to help participants gain experience with anatomic limitations characteristic of the pediatric anterior skull base.
A 3D printed model of the pediatric skull base may provide a realistic model to help participants gain experience with anatomic limitations characteristic of the pediatric anterior skull base.
Pelvic morphology is an important element in determination of spinal alignment. We retrospectively examined the correlation between spinal alignment, severity, and pelvic morphology in lumbar disc herniation (LDH) surgery.
The study included 62 cases of paramedian LDH surgeries (L4-5 19 cases; L5-S1 43 cases). For all cases, we performed x-ray imaging of the whole spine in the standing position preoperatively and 1 week postoperatively and measured spinopelvic parameters. Comparing preoperative parameters of patients with 82 healthy subjects, we examined changes before and after surgery. We also examined the relationship between preoperative severity and parameters.
Compared with healthy subjects, patients with LDH exhibited significantly decreased lumbar lordosis and sacral slope and increased pelvic tilt and sagittal vertical axis (P < 0.01). Japanese Orthopaedic Association score improved from 16.1 ± 4.6 preoperatively to 23.5 ± 3.2 1 week postoperatively (P < 0.01). Spinopelvic parameters observed preoperatively improved significantly 1 week postoperatively (P < 0.01). Correlation analysis did not confirm any correlation of severity with preoperative pelvic tilt, sagittal vertical axis, or pelvic incidence. However, cases with high pelvic tilt/pelvic incidence were significantly more likely to be severe cases (R
= 0.08, P= 0.027). A significant decrease in pelvic tilt was observed in cases with a large improvement in postoperative Japanese Orthopaedic Association score (P= 0.031).
For LDH cases, pelvic retroversion is important to avoid pain. The range of mobility for pelvic retroversion varies depending on pelvic morphology of individuals. In cases of LDH, ratio of pelvic tilt to pelvic incidence correlates strongly with severity.
For LDH cases, pelvic retroversion is important to avoid pain. The range of mobility for pelvic retroversion varies depending on pelvic morphology of individuals. In cases of LDH, ratio of pelvic tilt to pelvic incidence correlates strongly with severity.
Deep brain stimulation (DBS) of the bilateral subthalamic nucleus (STN) is a standard surgical treatment option in patients with advanced Parkinson's disease. Adverse effects on cognitive function have been reported, impacting the quality of life of patients and caregivers. We aimed to investigate a quantitative predictive preexisting cognitive factor for predicting postoperative cognitive changes.
Thirty-five patients underwent STN-DBS. A battery of neuropsychological tests were used to examine executive function, processing speed, and visuospatial function both preoperatively and 1 year postoperatively. A multiple logistic regression analysis was performed to investigate the relationships between preoperative factors and cognitive outcomes. The predictive value of the preoperative factors for global cognitive decline during long-term follow-up were evaluated.
The patients exhibited significant changes in processing speed and visuospatial function after surgery. Using reliable change index values, loweg after STN-DBS. Furthermore, a low score on the Similarities subtest may predict future global cognitive deterioration.
The NeVa M1 thrombectomy device is a novel hybrid-cell stent retriever with multifunctional zones for optimized retrieval of resistant clots located in the M1 segment of the middle cerebral artery. The objective was to evaluate the safety and efficacy of the NeVa in a "real-life" setting.
Twenty-nine consecutive patients (median age 77 years) treated with the NeVa M1 for acute ischemic stroke of the M1 segement were retrospectively reviewed. First-pass and final modified thrombolysis in cerebral infarction (mTICI) scores, device-related complications, symptomatic intracranial hemorrhage, and 90-day modified Rankin scale (mRS) scores are reported. Primary outcome parameters were first-pass mTICI 2b-3 reperfusion and mRS 0-2 at 90 days.
Median National Institutes of Health Stroke Scale scores decreased from 16 to 12 after treatment. mTICI 2b-3 reperfusion rates were 55% after the first pass, 79% after 1-2 passes, and 100% after the final pass. mTICI 2c-3 was obtained in 48% after the first pass, 62% after 1-2 passes, and 72% after the final pass. Rescue treatment was performed in 4 patients (14%). Device-related complications included 1 asymptomatic caroticocavernous fistula, 1 asymptomatic M2 dissection, and 1 symptomatic intracranial hemorrhage. The procedure-related vasospasm rate was 48%. A 90-day mRS of 0-2 was achieved by 31%.
The NeVa M1 provides a high first-pass complete reperfusion rate with an adequate safety profile. To retrieve resistant clots, the stent design exerts high mechanical traction forces, which may trigger vasospasm and vessel wall damage. Large, comparative studies are warranted to draw a definite conclusion on this device.
The NeVa M1 provides a high first-pass complete reperfusion rate with an adequate safety profile. To retrieve resistant clots, the stent design exerts high mechanical traction forces, which may trigger vasospasm and vessel wall damage. Large, comparative studies are warranted to draw a definite conclusion on this device.Spontaneous reossification is a very rare phenomenon following a large calvarial defect, particularly in adults. A 29-year-old woman with acute subdural hematoma and brain edema underwent emergent decompressive craniectomy and evacuation of hematoma. Follow-up examination 2 years later showed a well-formed bone along the craniectomy site. To our knowledge, this is the first case report with total spontaneous reossification in adults. A literature review is provided, and the physiology of the process is suggested. Pericranium, diploë, and, above all, dura mater collaborate in spontaneous bone formation. THZ531 mouse All these layers are very important, and they must be respected during dissection.