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  1. AU="Tzerefos, Christos"
  2. AU="Eefje Belt-van Zoen"
  3. AU="Rahmanian, Vahid"
  4. AU="Øyen, Martin Øhlund"
  5. AU="Xinyun Xuan"
  6. AU="Dana L. M. Campbell"
  7. AU="Mukta Roy"
  8. AU="Martha Funabashi"
  9. AU="Vasina, Svetlana"
  10. AU=Reber Stephan A.
  11. AU="Kenan Onel"
  12. AU="Lawrence, Marc R"
  13. AU="Zeiler, Frederick A"
  14. AU="de la Cueva, Pablo"
  15. AU="Fuh, Jerry Ying Hsi"
  16. AU="Park, Adrian J"
  17. AU="Joshi, K D"

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  1. Artikel ; Online: Greek reflections on global neurosurgery.

    Tzerefos, Christos / Tasiou, Anastasia / Fountas, Kostas N

    Brain & spine

    2023  Band 3, Seite(n) 101721

    Abstract: Introduction: Large populations in middle- and low-income countries in Africa, Asia, and Central and South Americas face a dramatic neurosurgical crisis. However, large social groups in high-income countries face similar limited access to neurosurgical ... ...

    Abstract Introduction: Large populations in middle- and low-income countries in Africa, Asia, and Central and South Americas face a dramatic neurosurgical crisis. However, large social groups in high-income countries face similar limited access to neurosurgical services. Proper identification of such a problem, analysis of the underlying causes, and proposal of potential solutions may not only address the problem at a national level, but may also provide valuable reflections on the efficient management of global neurosurgical crisis.
    Research question: To evaluate if special social groups face similar problems in Greece.
    Material and methods: The structure of the Greek health system was examined. The national census along with the registry of practicing neurosurgeons of the Greek National Society, as well as the national health map were searched.
    Results: A series of socio-economic factors, language barriers, cultural and religion differences, geographical barriers, the COVID-19 pandemic aftermath, along with the inherent malfunctioning of the Greek health system have led to this national neurosurgical crisis.
    Discussion and conclusion: An extensive redrawing of the Greek health map, reorganization of the national health system, along with adaptation of all recent advances in telemedicine may alleviate the health burden in these populations. The results of this local reformation may be applied to a global level for managing the ongoing health crisis. Moreover, the development of a European taskforce by the European Association of Neurosurgical Societies (EANS) may well facilitate the development of realistic and efficacious global solutions, and contribute to the global effort for providing high-quality neurosurgical services worldwide.
    Sprache Englisch
    Erscheinungsdatum 2023-02-24
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article
    ISSN 2772-5294
    ISSN (online) 2772-5294
    DOI 10.1016/j.bas.2023.101721
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Length of Survival, Outcome, and Potential Predictors in Poor-Grade Aneurysmal Subarachnoid Hemorrhage Patients Treated with Microsurgical Clipping.

    Lambrianou, Xanthoula / Tzerefos, Christos / Arvaniti, Christina / Tasiou, Anastasia / Fountas, Kostas N

    CNS & neurological disorders drug targets

    2023  

    Abstract: Background: Poor-grade aneurysmal subarachnoid hemorrhage (aSAH) has been associated with severe morbidity and high mortality. It has been demonstrated that early intervention is of paramount importance. The aim of our study is to evaluate the ... ...

    Abstract Background: Poor-grade aneurysmal subarachnoid hemorrhage (aSAH) has been associated with severe morbidity and high mortality. It has been demonstrated that early intervention is of paramount importance. The aim of our study is to evaluate the functional outcome and the overall survival of early microsurgically treated patients.
    Material and methods: Poor-grade aSAH patients admitted at our institution over fifteen years (January 2008 - December 2022) were included in our retrospective study. All participants underwent brain Computed Tomography Angiography (CTA). Fisher scale was used to assess the severity of hemorrhage. All our study participants underwent microsurgical clipping, and their functional outcome was assessed with the Glasgow Outcome Scale (GOS). We used logistic regression analysis to identify any parameters associated with a favorable outcome at 12 months. Cox proportional hazard analysis was also performed, identifying factors affecting the length of survival.
    Results: Our study included 39 patients with a mean age of 54 years. Thirty of our participants (76.9%) were Hunt and Hess grade V, while the vast majority (94.9%) were Fisher grade 4. The observed six-month mortality rate was 48.6%. The mean follow-up time was 18.6 months. The functional outcome at six months was favorable in 6 patients (16.2%), increased to 23.5% at 12 months. Our data analysis showed that the age, as well as the employment of temporary clipping during surgery, affected the overall outcome.
    Conclusion: Management of poor-grade aSAH patients has been dramatically changed. Microsurgical clipping provides promising results in carefully selected younger patients.
    Sprache Englisch
    Erscheinungsdatum 2023-10-19
    Erscheinungsland United Arab Emirates
    Dokumenttyp Journal Article
    ZDB-ID 2228394-8
    ISSN 1996-3181 ; 1871-5273
    ISSN (online) 1996-3181
    ISSN 1871-5273
    DOI 10.2174/0118715273258678231011060312
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel: Late-Onset Cervical Pseudomeningocele Following Ossification of the Posterior Longitudinal Ligament Surgery Successfully Treated With a Lumboperitoneal Shunt.

    Tzerefos, Christos / Paterakis, Kostas / Bouramas, Dimos / Fotakopoulos, George / Brotis, Alexandros / Fountas, Kostas

    Cureus

    2022  Band 14, Heft 10, Seite(n) e30744

    Abstract: Pseudomeningocele (PMC) is a rare complication of anterior cervical procedures resulting in pain, headaches, nerve root entrapment, and in rare cases, spinal cord compression. Here we present a 57-year-old male with increasing myelopathy due to late- ... ...

    Abstract Pseudomeningocele (PMC) is a rare complication of anterior cervical procedures resulting in pain, headaches, nerve root entrapment, and in rare cases, spinal cord compression. Here we present a 57-year-old male with increasing myelopathy due to late-onset PMC that developed two years following a 360-degree cervical surgery for ossification of the posterior longitudinal ligament (OPLL). In this case, the PMC was successfully treated with a lumboperitoneal shunt. A 57-year-old male presented with worsening symptoms and signs of cervical myelopathy. He had undergone a multilevel anterior corpectomy/fusion (ACCF), along with posterior fusion, two years earlier for severe ossification of the posterior longitudinal ligament (OPLL). Now presenting with increased myelopathy, his cervical spine MRI demonstrated a PMC in the perivertebral space, extending to and compressing the anterior cervical cord. Following a lumboperitoneal shunt insertion, the patient's myelopathy resolved.  Acute, subacute, or chronic postoperative cervical pseudomeningoceles (PMC) may be readily managed with a lumboperitoneal shunt insertion.
    Sprache Englisch
    Erscheinungsdatum 2022-10-27
    Erscheinungsland United States
    Dokumenttyp Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.30744
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel ; Online: Methodological assessment of guidelines for the diagnosis and management of cerebral vasospasm using the AGREE-II tool.

    Tasiou, Anastasia / Brotis, Alexandros G / Tzerefos, Christos / Lambrianou, Xanthoula / Fountas, Kostas N

    Neurosurgical focus

    2022  Band 52, Heft 3, Seite(n) E11

    Abstract: Objective: Rupture of an intracranial aneurysm is the most common cause of spontaneous subarachnoid hemorrhage. Despite the recent advances in its early detection, diagnosis, and proper treatment, the outcome of patients experiencing aneurysmal ... ...

    Abstract Objective: Rupture of an intracranial aneurysm is the most common cause of spontaneous subarachnoid hemorrhage. Despite the recent advances in its early detection, diagnosis, and proper treatment, the outcome of patients experiencing aneurysmal subarachnoid hemorrhage (aSAH) remains poor. It is well known that cerebral vasospasm is the most troublesome complication of aSAH, while delayed cerebral ischemia related to cerebral vasospasm constitutes the major cause of unfavorable outcomes in patients with aSAH. The need for evidence-based guidelines is of great importance for the prevention, early detection, and efficient management of aSAH-induced vasospasm. Moreover, guidelines provide young physicians with a valuable tool for practicing defensible medicine. However, the methodology, clinical applicability, reporting clarity, and biases of guidelines must be periodically assessed. In this study, the authors sought to assess the reporting clarity and methodological quality of published guidelines and recommendations.
    Methods: A search was performed in the PubMed, Scopus, and Web of Science databases. The search terms used were "clinical practice guidelines," "recommendations," "stroke," "subarachnoid hemorrhage," and "vasospasm" in all possible combinations. The search period extended from 1964 to September 2021 and was limited to literature published in the English language. All published guidelines and recommendations reporting on the diagnosis and management of vasospasm were included. Studies other than those reporting guidelines and recommendations were excluded. The eligible studies were evaluated by three blinded raters, employing the Appraisal of Guidelines for Research & Evaluation II (AGREE-II) analysis tool.
    Results: A total of 10 sets of guidelines were evaluated in this study. The American Heart Association/American Stroke Association issued guidelines found to have the highest methodological quality and reporting clarity, followed by the European Stroke Organization guidelines and the English edition of the Japanese guidelines issued by the Japanese Society on Surgery for Cerebral Stroke. The interrater agreement was moderate in the current analysis.
    Conclusions: These findings support the idea that improvement of currently existing guidelines is feasible in the following domains: the rigor of guidelines and recommendations development, clinical applicability, editorial independence, and stakeholder involvement. Furthermore, periodic updating of published guidelines requires improvement in the future.
    Mesh-Begriff(e) Brain Ischemia/complications ; Brain Ischemia/diagnosis ; Brain Ischemia/therapy ; Humans ; Intracranial Aneurysm/surgery ; Subarachnoid Hemorrhage/complications ; Subarachnoid Hemorrhage/diagnosis ; Subarachnoid Hemorrhage/therapy ; Vasospasm, Intracranial/diagnosis ; Vasospasm, Intracranial/etiology ; Vasospasm, Intracranial/therapy
    Sprache Englisch
    Erscheinungsdatum 2022-02-25
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2026589-X
    ISSN 1092-0684 ; 1092-0684
    ISSN (online) 1092-0684
    ISSN 1092-0684
    DOI 10.3171/2021.12.FOCUS21649
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel: Bursitis of the coccyx in an adult with rheumatoid arthritis mimicking a sacrococcygeal meningocele.

    Tzerefos, Christos / Koukoulis, George K / Vlychou, Marianna / Brotis, Alexandros G / Fountas, Kostas N / Paterakis, Konstantinos N

    Surgical neurology international

    2021  Band 12, Seite(n) 220

    Abstract: Background: Bursitis is a chronic inflammatory condition characterized by the deposition of cholesterol, macrophage infiltration, and bursal wall calcification. Bursitis is, however, rarely found in the sacrococcygeal region where it may present as a ... ...

    Abstract Background: Bursitis is a chronic inflammatory condition characterized by the deposition of cholesterol, macrophage infiltration, and bursal wall calcification. Bursitis is, however, rarely found in the sacrococcygeal region where it may present as a space-occupying mass.
    Case description: A 64-year-old male with rheumatoid arthritis presented with 3 years' duration of difficulty sitting and walking due to a soft-tissue mass involving the coccyx region. Once the patient's MR demonstrated a cystic lesion with erosion of the coccyx, the patient underwent gross total resection of the lesion that proved to be pathologically consistent with bursitis. Postoperatively, the patient's complaints fully resolved.
    Conclusion: Bursitis may present as a soft-tissue tumor-like lesion in the coccyx that favorably responds to gross total surgical excision.
    Sprache Englisch
    Erscheinungsdatum 2021-05-10
    Erscheinungsland United States
    Dokumenttyp Case Reports
    ISSN 2229-5097
    ISSN 2229-5097
    DOI 10.25259/SNI_369_2021
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel ; Online: The Impact of the Coronavirus Pandemic on European Neurosurgery Trainees.

    Tzerefos, Christos / Meling, Torstein R / Lafuente, Jesus / Fountas, Kostas N / Brotis, Alexandros G / Demetriades, Andreas K

    World neurosurgery

    2021  Band 154, Seite(n) e283–e291

    Abstract: Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has placed tremendous strain on the national health care systems throughout Europe. As a result, there has been a significant influence on residents' education. We ... ...

    Abstract Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has placed tremendous strain on the national health care systems throughout Europe. As a result, there has been a significant influence on residents' education. We surveyed European neurosurgery residents to estimate the magnitude of the pandemic's impact on neurosurgical training.
    Methods: An anonymous, voluntary, 44-question, web-based survey was administered to European neurosurgical residents from November 2, 2020, to January 15, 2021, by e-mail invitation. Close-ended, multiple-choice questions were used to examine the perspectives of neurosurgical trainees of different training programs in Europe regarding the pandemic's impact on education, as well as to evaluate the online webinars as a sufficient alternative educational tool, and their future role.
    Results: The total number of participants was 134 from 22 European countries. Nearly 88.8 % of respondents reported that the pandemic had a negative influence on their education. A statically significant decrease in surgical exposure, outpatient clinic involvement, and working hours was observed (P < 0.05). Webinars, although widely disseminated, were not considered as a sufficient training alternative.
    Conclusions: The SARS-CoV-2 pandemic had a significant impact on neurosurgical training. During the last year, with the outbreak of the pandemic, formal training education was heavily compromised. Online webinars do not seem to be a sufficient alternative, and some trainees estimate that a whole year of training has been compromised. Our current data have to be cautiously considered for possibly reorganizing the whole training experience. The pandemic may well function as a stimulus for optimizing neurosurgical training.
    Mesh-Begriff(e) COVID-19 ; Education, Distance ; Europe ; Humans ; Internship and Residency ; Neurosurgery/education ; Outpatient Clinics, Hospital ; Pandemics ; Surveys and Questionnaires ; Training Support ; Work Schedule Tolerance ; Workload
    Sprache Englisch
    Erscheinungsdatum 2021-07-09
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2021.07.019
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: Guidelines on the use of external ventricular drain and its associated complications: do we "AGREE II"?

    Brotis, Alexandros G / Karvouniaris, Marios / Tzerefos, Christos / Gatos, Charalambos / Fountas, Konstantinos N

    British journal of neurosurgery

    2021  Band 35, Heft 6, Seite(n) 689–695

    Abstract: Insertion of an external ventricular drain is a common procedure used in everyday practice by neurosurgeons all around the world. It consists of the placement of an external ventricular drain (EVD) into the ventricular system providing the ability to ... ...

    Abstract Insertion of an external ventricular drain is a common procedure used in everyday practice by neurosurgeons all around the world. It consists of the placement of an external ventricular drain (EVD) into the ventricular system providing the ability to measure intracranial pressure, and also divert the flow of cerebrospinal fluid (CSF) in a variety of pathological conditions. The most common complication is infection, and it may result in devastating consequences and negatively affect the outcome of these patients. The Infectious Diseases Society of America (IDSA), the Neurocritical Care Society (NCS), and The Society for Neuroscience in Anesthesiology & Critical Care (SNACC) have published recommendations for the management of EVD-Associated Ventriculitis. The objective of this study was to assess the methodological quality and reporting clarity of these recommendations using the AGREE-II tool. We found that the overall quality of the published clinical practice guidelines is acceptable. However, continuous updates and external validation should be implemented.
    Mesh-Begriff(e) Cerebral Ventricles/surgery ; Critical Care ; Drainage ; Encephalitis ; Humans ; Intracranial Pressure
    Sprache Englisch
    Erscheinungsdatum 2021-08-09
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 639029-8
    ISSN 1360-046X ; 0268-8697
    ISSN (online) 1360-046X
    ISSN 0268-8697
    DOI 10.1080/02688697.2021.1958153
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel ; Online: Valve-controlled chronic subdural hematoma drainage: A feasibility study.

    Anagnostopoulos, Vasileios / Brotis, Alexandros G / Tzerefos, Christos / Charalambidou, Alexandra / Tasiou, Anastasia / Karavelis, Antonios / Paterakis, Konstantinos N

    Brain & spine

    2022  Band 2, Seite(n) 101693

    Abstract: Introduction: Pneumocephalus after chronic subdural hematoma (CSDH) evacuation is a potential predictor of hematoma recurrence.: Research question: To study the feasibility and safety of a novel CSDH evacuation technique using a valve-controlled ... ...

    Abstract Introduction: Pneumocephalus after chronic subdural hematoma (CSDH) evacuation is a potential predictor of hematoma recurrence.
    Research question: To study the feasibility and safety of a novel CSDH evacuation technique using a valve-controlled method to avoid pneumocephalus.
    Material and methods: In a retrospective case series, we evacuated CSDH using very low-pressure valve-controlled drains and recorded the neurological, radiological, and functional outcomes. Patients with primary CSDH, without previous neurosurgical intervention, and who did not receive antiplatelet or anticoagulant therapy the week prior to the index surgery, were included in the study. Exclusion criteria were the evacuation with other treatment techniques and incomplete data files. Patients were assessed according to the Bender grading system to record the neurological status. The hematoma volume was estimated using the formula for ellipsoid volumes.
    Results: Thirty-six patients with a mean age of 73 years (±9 years) fulfilled our eligibility criteria. Our technique was effective since it decreased the CSDH volume from 141 ​ml (IQR 97 ​ml) to 20.6 ​ml (IQR 26.59 ​ml; p ​< ​0.001) and improved the neurological status according to the Bender grading system from two (IQR 0.25) to 1 (IQR 0). However, pneumocephalus and hematoma recurrence occurred in one case each (2.8%). At six months, all patients returned to their previous status, except for two patients (5.6%) who died due to irrelevant pathologies.
    Conclusions: Valve-controlled CSDH evacuation aiming to decrease the postoperative pneumocephalus and hematoma recurrence constitutes an effective and safe alternative. However, larger randomized controlled studies are required to establish its role in CSDH management.
    Sprache Englisch
    Erscheinungsdatum 2022-11-22
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article
    ISSN 2772-5294
    ISSN (online) 2772-5294
    DOI 10.1016/j.bas.2022.101693
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  9. Artikel ; Online: Critical Assessment of the Guidelines-Based Management of Severe Traumatic Brain Injury with the Appraisal of Guidelines for Research and Evaluation II.

    Karagianni, Maria D / Tasiou, Anastasia / Brotis, Alexandros G / Tzerefos, Christos / Lambrianou, Xanthoula / Alkiviadis, Tzannis / Kalogeras, Adamantios / Spiliotopoulos, Theodosis / Arvaniti, Christina / Papageorgakopoulou, Manthia / Gatos, Charalambos / Fountas, Konstantinos N

    World neurosurgery

    2023  Band 176, Seite(n) 179–188

    Abstract: Background: Severe traumatic brain injury constitutes a clinical entity with complex underlying pathophysiology. Management of patients with severe traumatic brain injury is guided by Clinical Practice Guidelines and Consensus Statements (CPG and CS). ... ...

    Abstract Background: Severe traumatic brain injury constitutes a clinical entity with complex underlying pathophysiology. Management of patients with severe traumatic brain injury is guided by Clinical Practice Guidelines and Consensus Statements (CPG and CS). The published CPG and CS vary in quality, comprehensiveness, and clinical applicability. The value of critically assessing CPG and CS cannot be overemphasized. The aim of our study was to assess the quality of the published CPG and CS, based on the Appraisal of Guidelines for Research and Evaluation II instrument.
    Methods: A systematic search was performed in PubMed, Scopus, Embase, and Web of Science focusing on guidelines and consensi about severe traumatic brain injury . The search terms used were "traumatic brain injury," "TBI," "brain injury," "cerebral trauma," "head trauma," "closed head injury," "head injury," "guidelines," "recommendations," "consensus" in any possible combination. The search period extended from 1964 to 2021 and was limited to literature published in English. The eligible studies were scored by 4 raters, using the Appraisal of Guidelines for Research and Evaluation II instrument. The inter-rater agreement was assessed using the Cronbach's alpha.
    Results: Twelve CPG and CS were assessed. Overall, the study by Carney et al. was the most Appraisal of Guidelines for Research and Evaluation II compliant study. In general, the domains of clarity of presentation, and scope and purpose, achieved the highest scores. The lowest inter-rater agreement in our analysis was "fair."
    Conclusions: The purpose of our study for assessing the quality of CPG and CS was served. We present the strong and weak points of CPG and CS. Our findings support the idea of periodically updating guidelines and improving their rigor of development.
    Mesh-Begriff(e) Humans ; Brain Injuries ; Brain Injuries, Traumatic/therapy ; Consensus ; Head Injuries, Closed ; Practice Guidelines as Topic
    Sprache Englisch
    Erscheinungsdatum 2023-01-20
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2023.01.054
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  10. Artikel: Recurrence Is Associated With Body Mass Index in Patients Undergoing a Single-Level Lumbar Disc Herniation Surgery.

    Fotakopoulos, George / Makris, Demosthenes / Kotlia, Polikceni / Tzerefos, Christos / Fountas, Kostas

    Journal of clinical medicine research

    2018  Band 10, Heft 6, Seite(n) 486–492

    Abstract: Background: The aim of the study was to assess the body mass index (BMI) and other risk factors associated with lumbar disc herniation (LDH) and clinical outcomes, in patients who undergo surgery for single-level LDH.: Methods: This was a ... ...

    Abstract Background: The aim of the study was to assess the body mass index (BMI) and other risk factors associated with lumbar disc herniation (LDH) and clinical outcomes, in patients who undergo surgery for single-level LDH.
    Methods: This was a retrospective cohort study, affecting patients that underwent surgery for single-level LDH attending our hospital between July 2009 and January 2016. The mean follow-up period was 3.5 years (1 - 8 years). To maintain adequately sized groups for analysis, level L2-L3 and L3-L4 herniations were grouped as upper disc levels (group A) and level L4-L5 (group B) and L5-S1 (group C) herniations were analyzed individually. Disk herniation was graded on T2-weighted sagittal magnetic resonance images by using a five-point scale. Pain assessment was made using the visual analog scale (VAS).
    Results: Two hundred fifty-six (256) patients met study inclusion criteria. There were 138 males (53.9%) with a mean age of 55.3 ± 12.9 years (range, 30 - 77). The association between A, B and C groups was analyzed, based on criteria such as age, sex, BMI, surgical techniques, diabetes, size of herniated disc, preoperative VAS, length of hospital stay, drop foot on admission, smoking, family history and history of injury to the lumbar spine, location of herniated disc (far lateral) and use of steroids. We found a statistically significant factor between groups in BMI (P = 0.006), family history (P = 0.001), location (far lateral) (P = 0.003) and history of injury to the lumbar spine (P = 0.003).
    Conclusions: There may be an association between severity of disc degeneration and BMI (overweight and obese adults). Furthermore, spine and neurosurgeons should be aware that BMI might be related to patients' outcome.
    Sprache Englisch
    Erscheinungsdatum 2018-04-13
    Erscheinungsland Canada
    Dokumenttyp Journal Article
    ZDB-ID 2548987-2
    ISSN 1918-3011 ; 1918-3003
    ISSN (online) 1918-3011
    ISSN 1918-3003
    DOI 10.14740/jocmr3121w
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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