Introduction: Verification of new decompression procedures has traditionally been based on observing the occurrence of decompression sickness (DCS) in test dives. Several hundred exposures are required to determine the safety of a procedure with any degree of certainty. The number of venous gas emboli (VGE) corresponds with the risk of getting DCS and detection of VGE has been used as an alternative method for validation of decompression procedures. We propose a new and improved method for validation based on detection of VGE.
Methods: Our Bayesian statistics method combines results from ultrasound detection of VCE in test dives with knowledge about the correspondence between VGE and DCS risk obtained from a large number of previous experimental studies. Our algorithm is implemented in a computer program; it estimates DCS risk and 95% credible intervals for the tested procedure.
Results: We have applied the method to available VGE data from tested air diving procedures with between 7 and 14 test dives for each procedure. The estimated credible intervals correspond to confidence intervals from 130-250 dives using the binomial distribution of the traditional "DCS observation validation."
Discussion: We conclude that, compared with previous methods, the proposed method can greatly reduce the number of dives required to validate or reject new decompression procedures.
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J Neurosurg Spine
January 2025
3Department of Orthopedic Surgery, Haeundae Bumin Hospital, Busan, South Korea.
Objective: Conventional decompression surgery for beak-type ossification of the posterior longitudinal ligament (OPLL) of the thoracic spine, whether approached anteriorly or posteriorly, poses several challenges, including technical complexity, cerebrospinal fluid leakage, incomplete decompression, and potential neurological deterioration. Therefore, the authors introduce a novel technique, anterior sliding decompression osteotomy (ASDO), for thoracic myelopathy caused by OPLL and evaluate the efficacy and safety of this technique.
Methods: Six patients (4 men and 2 women) who underwent ASDO surgery for beak-type OPLL in the thoracic spine with a follow-up period of at least 2 years were included in the cohort.
J Neurosurg Pediatr
January 2025
2Division of Pediatric Neurosurgery, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
Objective: The aim of this study was to assess the effectiveness of a postoperative multimodal pain control protocol on perioperative pain scores in children undergoing decompression for Chiari type I malformation (CM-I).
Methods: This retrospective matched cohort study included patients < 21 years of age who underwent elective suboccipital craniectomy and C1 laminectomy for CM-I with or without duraplasty at a single center from January 2020 to July 2023. A standardized, multimodal postoperative pain protocol was implemented in August 2021 that did not use narcotic patient-controlled analgesia.
J Neurosurg Spine
January 2025
1Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; and.
Objective: Smartphones and wearable devices can be effective tools to objectively assess patient mobility and well-being before and after spine surgery. In this retrospective observational study, the authors investigated the relationship between these longitudinal perioperative patient activity data and socioeconomic and demographic correlates, assessing whether smartphone-captured metrics may allow neurosurgeons to distinguish intergroup patterns.
Methods: A multi-institutional retrospective study of patients who underwent spinal decompression with and without fusion between 2017 and 2021 was conducted.
Orthop Surg
January 2025
Department of Spine Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, People's Republic of China.
Objective: Unilateral biportal endoscopic discectomy (UBE) is an emerging and minimally invasive surgeryfor lumbar spinal degenerative disease. However, the efficacy, safety and the radiological changes of dural sac and paraspinal muscle of UBE compared with the conventional percutaneous transforaminal endoscopic discectomy (PTED) remains to be determined. The purpose of the study was to comprehensively compare the clinical efficacy between UBE and PTED in the surgical treatment of lumbar spinal degenerative disease.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Department of Trauma Surgery, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Purpose: The aim was to assess the long-term functional outcome and quality of life after staged surgical treatment of complex Lisfranc and Chopart injuries in a patient cohort, and to perform a systematic review of the literature.
Methods: A retrospective cohort of all trauma patients with complex Lisfranc and/or Chopart injuries treated at our level 1 trauma center between July 1, 2010, and July 1, 2020 with ≥ 3 years follow-up was analyzed in terms of management, complications, and patient-reported outcomes (American Orthopaedic Foot & Ankle Society midfoot score, AOFAS and Foot Function Index, FFI). A systematic review of the literature (according to PRISMA 2020 guidelines) was performed of studies published between January 2000 to April 2024.
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