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The Impact involving Major depression upon Outcomes throughout People Using Cardiovascular Malfunction and also Diminished Ejection Small fraction Treated from the GUIDE-IT Test.
5±0.6. Initial complete/near-complete occlusion was demonstrated in 30/35 (85.7%) patients. On angiographic follow-up at a mean of 6 months, 9/24 (37.5%) patients showed progressive thrombosis, 13/24 (54.2%) showed stable occlusion, and 2/24 (8.5) showed recanalization. Thromboembolic events occurred in 2/35 (5.7%) patients, intraoperative technical complications occurred in 2/35 (5.7%) patients, and access-site complications occurred in 2/35 (5.7%) patients. The were no cases of retreatment, rehemorrhage, or procedural-related permanent morbidity or mortality. CONCLUSION Coil embolization performed via 'shouldering' with a single Atlas stent and 'framing' with a spherical 3D Stryker coil is a feasible, safe, and effective neuroendovascular treatment for WNBAs. The incidence of glossopharyngeal neuralgia (GPN)/neuropathy (GPNo) is rare, with approximately 0.4-0.8 cases per 100,000 person-years with less than 3 percent of those cases being associated with cardiac arrhythmias or syncope1-7. The exact relationship between GPN and cardiac arrhythmias remains unknown; however, it is suspected that GPN also involves vagal dysfunction, which can lead to syncope, cardiac dysfunction, or even seizures8. Most of these cases are successfully treated with medical management with or without placement of a cardiac pacemaker. We present the only reported case of GPNo with cardiac dysfunction refractory to medical management and pacemaker placement that was successfully treated with Gamma Knife Radiosurgery (GKR). BACKGROUND Giant presacral Tarlov cysts (TCs) with pelvic extension were extremely rare and have many special features different from normal TCs in examination, diagnosis, symptoms and treatment. We report 3 rare cases of giant presacral Tarlov cysts with pelvic extension and review the pertinent literature. CASE DESCRIPTION We reported 3 cases of giant presacral TCs with rare pelvic extension and analyzed the symptoms, diagnoses and surgical procedures. Operations with the key point of blocking the inlet of the fistula from inside the dural sac were preformed in all 3 cases. All 3 patients revealed alleviation of previous symptoms with no serious complications. Postoperative magnetic resonance image (MRI) showed all the cysts were well blocked with no cyst recurrence. CONCLUSION Giant Tarlov cyst with pelvic extension was extremely rare and was often discovered by gynecological ultrasound where it might be misdiagnosed as adnexal mass. Different from normal TCs patients, the patient may also present with abdominal symptoms like hydronephrosis, abdominal or pelvic pain due to the cyst's ventral mass effect. Thus, patients with abdominal and back symptoms at the same time should be paid particular attention for lumbosacral MRI examination to avoid misdiagnosis. Surgical procedures are recommended for symptomatic cases. However, cyst resection by laparotomy are doomed to postoperative recurrence because the fistula still existed. We describe a simple procedure with the key point of blocking the inlet of cyst fistula, which is more applicable and minimize the probability of cyst recurrence. BACKGROUND The Oswestry Disability Index (ODI) is a widely utilized patient-reported outcome instrument in lumbar spine surgery, but its relationship to the increasingly scrutinized but still heterogeneous patient satisfaction metrics has not been well described. One popular metric is the North American Spine Society (NASS) patient satisfaction index. This study aimed to determine whether change in ODI predicts patient satisfaction. METHODS Adult patients at a neurosurgery spine clinic completed the ODI and NASS questionnaires at various times in their care between September 2014 and November 2018. Scores were retrospectively analyzed using ordinal logistic regression. RESULTS One thousand thirty-seven patients were identified (mean age 59.3 ± 14.7 years, 54.2% male). ALK targets At 3, 12, and 24 months postoperatively, 684 (84.5%), 400 (83.3%), and 215 (80.9%) patients, respectively, expressed satisfaction (NASS score 1 or 2). Mean ± SD improvements in ODI at 3, 12, and 24 months postoperatively were 16.8 ± 17.5 (n=675), 18.4 ± 17.5 (n=396), and 19.7 ± 17.7 (n=213). For every unit improvement in ODI, the odds of selecting the next most satisfied NASS score at 3, 12, and 24 months postoperatively increased by 6.8% (95% CI 5.6-8.1%), 5.8% (95% CI 4.4-7.1%), and 6.0% (95% CI 4.2-7.9%), respectively. Every 10-unit improvement increased the odds, respectively, by 93.8% (95% CI 73.2-117.0%), 75.0% (95% CI 53.8-99.1%), and 79.4% (95% CI 50.3-114.1%). CONCLUSIONS Improvements in ODI are predictive of increased patient satisfaction as defined by the NASS index. A 10-point improvement in ODI nearly doubled the odds of increased satisfaction 3 months postoperatively. AIM To compare the clinical outcome between bilateral percutaneous endoscopic debridement and lavage (PEDL) and unilateral PEDL treatment for lumbar spine tuberculosis (LST). METHODS A total of 40 patients with LST who underwent either bilateral PEDL (group A) or unilateral PEDL (group B) were reviewed. Perioperative parameters were assessed by operative time, intraoperative fluoroscopy times, and days of postoperative continuous irrigation and vacuum drainage. Clinical outcomes were evaluated in the Oswestry Disability Index (ODI), visual analog scale (VAS), erythrocyte sedimentation rate (ESR) and C-reactive protein(CRP). All patients were followed up for at least 18 months after treatment. RESULTS The average operative time and the intraoperative fluoroscopy times were increased in group A than those in group B. There was no statistical significance between two groups in postoperative continuous irrigation and vacuum drainage days. The ESR and CRP curves in two group showed a similar trend during 18 months follow up. The VAS and ODI in two groups significantly decreased 6 months and 18 months postsurgery. There was no significant difference in the incidence of complication between the two groups. CONCLUSIONS Two procedures yielded comparable and satisfactory results. Unilateral PEDL showed shorter operative time and decreased intraoperative fluoroscopy times than bilateral PEDL. We suggest the use of unilateral PEDL rather than bilateral PEDL in the treatment of LST.
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