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OBJECTIVE The choice of surgical technique in sight-threatening Grave orbitopathy remains controversial. Available data are mostly derived from mixed cohorts with multiple surgical indications and techniques. The authors assessed predictors for visual outcome after standardized pterional orbital decompression for dysthyroid optic neuropathy. METHODS Retrospective analysis of 62 pterional orbital decompressions performed on 40 patients with dysthyroid optic neuropathy. RESULTS Visual acuity improved by an average of 3.8 lines in eyes with preoperative visual impairment (95% confidence interval [CI]: 1.8-5.8 lines, P < 0.001) and remained stable in eyes without prior visual impairment (95% CI -1.3 to 1 line, P = 0.81). Proptosis was reduced by an average of 3.1 mm (95% CI 1.8-4.3 mm, P < 0.001). Higher degrees of proptosis were predictive of worse visual outcomes (P = 0.017). New-onset diplopia developed in 2 patients, while previous diplopia resolved after surgery in 6 patients. CONCLUSIONS This cohort is the largest series of pterional orbit decompressions and the first to focus exclusively on dysthyroid neuropathy. Complication rates were low. Decompression surgery was highly effective at restoring and maintaining visual acuity in patients with dysthyroid optic neuropathy.

Objectives The negative effects of obesity on the health and quality of life of those afflicted has become an important public concern. Previous studies have shown an association between obesity and higher rates of complications and unfavorable outcomes following spine surgery. This study is to identify peri- and postoperative complication rates as well as short-term and long-term outcomes in morbidly obese patients who underwent minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) in comparison to age-matched normal-weight patients. Patients and methods We retrospectively reviewed medical records for all adult patients with a body mass index (BMI) ≥40 kg/m2 who underwent 1- to 2-level MIS TLIF for degenerative disease between February 2009 and February 2014 at a single institution and compared them to age-matched normal-weight patients (BMI 20–25 kg/m2). Duration of operation, length of hospital stay, use of analgesics, minor and major complications (infections and re-operations) as well as postoperative pain reduction within 30 days of surgery were recorded. Furthermore, we collected long-term follow-up data (>1 year) regarding complications and pain reduction. Results We identified 14 patients with a BMI ≥ 40 kg/m2 (mean, 43.2 kg/m2) who underwent MIS TLIF. Both groups showed comparable complication rates and clinical results in the short term ( Conclusion MIS TLIF is technically feasible in morbidly obese patients with no evidence of higher complication rates among this demographic compared to normal-weight individuals when followed-up in the short-term (