Journal of neurosurgical sciences最新文献

{"title":"Pycnogenol® improves retinal microcirculation and symptoms of optic nerve ischemic damage after sudden, reversible unilateral loss of vision: a pilot evaluation.","authors":"Gianni Belcaro, Maria R Cesarone, Claudia Scipione, Valeria Scipione, David Cox, Roberto Cotellese, Mark Dugall, Morio Hosoi, Marcello Corsi, Beatrice Feragalli, Corrado Gizzi, Patrizia Torino Rodrigues","doi":"10.23736/S0390-5616.24.06374-4","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06374-4","url":null,"abstract":"<p><strong>Background: </strong>The aim of this pilot registry study was to investigate the use of Pycnogenol<sup>®</sup> (French maritime pine bark, standardized extract) in subjects 2 weeks after an episode of sudden loss of vision (SLV).</p><p><strong>Methods: </strong>Visual acuity, retinal edema, vasospasms, distal retinal circulation and blood flow at the Zinn-Haller circle (distal optic nerve) were examined over 4 weeks. In addition, symptoms of neurological alterations (ION: ischemic optic neuritis) associated with retinal flow decrease were monitored. One registry group used only the standard management (SM, control group), a second group used SM+ 150 mg Pycnogenol<sup>®</sup>/day (Pycno150) and another group used SM+100 mg Pycnogenol<sup>®</sup> /day (Pycno100).</p><p><strong>Results: </strong>Sixty subjects completed the study. 18 in the control group, 20 in the Pycno150 group and 22 subjects in the Pycno100 group. The registry groups were comparable at inclusion. No dropouts were observed in the two Pycnogenol<sup>®</sup> groups whereas 2 dropouts occurred in the SM group (due to the occurrence of a new, minor visual loss episode). No side effects or tolerability problems were observed during the registry study. After 4 weeks, the visual acuity score of the affected eye was significantly higher in the Pycno150 group compared to the Pycno100 group and both Pycnogenol<sup>®</sup> groups showed significantly higher acuity scores in comparison with controls using SM (P<0.05). In parallel, after 4 weeks, the retinal edema score was significantly lower in both Pycnogenol<sup>®</sup> groups compared to controls (P<0.05 vs. SM patients) and even lower (P<0.05) with the 150 mg Pycnogenol<sup>®</sup> dose compared to the 100 mg Pycnogenol<sup>®</sup> dose. After 4 weeks, retinal systolic and diastolic blood flow velocities of the affected eye were significantly higher in the two Pycnogenol<sup>®</sup> groups in comparison with controls using SM (P<0.05). The improvements in 150 mg Pycnogenol<sup>®</sup> group were significantly higher compared to the low-dose 100 mg/Pycnogenol<sup>®</sup> group (P<0.05). At the end of the study, blood flow velocity in the Zinn-Haller circle was significantly higher in both Pycnogenol<sup>®</sup> groups compared to the control group (P<0.05) and was higher (P<0.05) with the 150 mg Pycnogenol<sup>®</sup> dose compared to the 100 mg dose. ION symptoms (vision loss, visual field loss, loss of color vision, flashing lights) improved significantly in the Pycnogenol<sup>®</sup> groups compared to controls (P<0.05), with better improvements in the Pycno150 group compared to the Pycno100 group (P<0.05).</p><p><strong>Conclusions: </strong>The study showed a dose-dependent effect of Pycnogenol<sup>®</sup> on blood flow velocity increase, reduction of retinal edema, ION symptoms and increase in visual acuity. Pycnogenol<sup>®</sup> was shown to be effective and safe in improving retinal microcirculation after an episode o","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventriculo-atrial shunt and European regulations: a delicate balance.","authors":"Luca Massimi, Marco Obersnel, Paolo Frassanito, Federico Bianchi, Gianpiero Tamburrini","doi":"10.23736/S0390-5616.25.06465-3","DOIUrl":"https://doi.org/10.23736/S0390-5616.25.06465-3","url":null,"abstract":"<p><strong>Background: </strong>European regulations on medical devices have been introduced to improve medical standards. However, these changes are leading to the transient lack of medical tools with possible disadvantages. Herein, the problem is addressed for the first time in neurosurgery with regards to ventriculo-atrial shunt (VAS).</p><p><strong>Methods: </strong>Children undergoing VAS in the 2020-2022 period at a single Institution were enrolled. Patients receiving VAS with Pudenz cardiac catheter (distal slit \"valves\") were assigned to group A (2020-2021) while those with VAS harboring proximal adjustable valve to group B (2021-2022, Pudenz no more available). The complications leading to shunt malfunction within 2 years from VAS were analyzed.</p><p><strong>Results: </strong>Twenty-four children belonged to group A (M/F ratio: 2.4; mean age: 42.5 months) and 18 to group B (MF/ratio: 1.8, mean age: 48.1 months). Statistically significant differences were found about: 1) patients needing shunt revision: 7 cases (29%) in group A vs. 11 cases (61%) in group B; 2) number of shunt revisions: 8 in group A vs. 16 in group B; 3) number of children with mechanical complications: 2 (8.3%) in group A vs. 7 (39%) in group B; 4) number of mechanical complications: 2 (group A) vs. 9 (group B). No differences in other complications or placement-to-revision time were detected.</p><p><strong>Conclusions: </strong>The lack of simple surgical tools (Pudenz catheter) may make VAS more prone to mechanical complications. Prospective and multicenter trials are needed to produce scientific evidence. In the meantime, a multidisciplinary discussion on the European regulation (including Doctors and Manufacturers) is welcome.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased preoperative levels of circulating erythrocytic hemoglobin might predict high-grade histology (WHO grade 2-3) in falcine and parasagittal meningiomas.","authors":"Filippo Gagliardi, Silvia Snider, Pierfrancesco DE Domenico, Matteo Braga, Lina R Barzaghi, Gianluca Nocera, Marcella Callea, Maria R Terreni, Pietro Mortini","doi":"10.23736/S0390-5616.24.06371-9","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06371-9","url":null,"abstract":"<p><strong>Background: </strong>Falcine/parasagittal lesions account for the largest rate of high-grade (WHO grade 2-3) lesions. The ability to preoperatively estimate the tumors' grade and outcome would be of great value in customizing treatment.</p><p><strong>Methods: </strong>This is a single-center, retrospective study designed to assess the pre-operative peripheral blood markers' diagnostic and prognostic role in patients harboring falcine (FM) and parasagittal (PM) high-grade meningiomas. N=116 patients undergoing surgical resection were included. A propensity score-matched analysis accounted for gender imbalances in low-grade (LG) vs. high-grade (HG) cohorts.</p><p><strong>Results: </strong>Seventy-three (N.=73) FM (63%) and 43 PM (37%) lesions were included. Patients harboring HG lesions showed significantly higher Hb levels than LG (mean 14.5±1.40 vs. 13.5±1.16 g/dL, P<0.001). Multivariate analysis controlling for demographics, lesion characteristics, blood markers, and steroid dose confirmed preoperative Hb as an independent predictive value of lesion grade (OR 1.75, 95% CI:1.01-3.07, P=0.04). Accordingly, patients showing increased Hb levels >15.4 g/dL achieved shorter OS (60.4 months, 95% CI: 14.7-106.1 vs. 134.7 months, 95% CI: 111.2-158.2) compared to patients with lower Hb values, P<0.001. Data were confirmed in matched cohorts.</p><p><strong>Conclusions: </strong>Increased levels of circulating erythrocytic hemoglobin might be independent predictors for high-grade histology and be associated with shorter overall survival in falcine and parasagittal meningiomas.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal MGMT promoter methylation cut-off to predict better survival in glioblastoma patients undergoing gross-total resection.","authors":"Claudia Fanizzi, Petra Bintintan-Socaciu, Elena Pirola, Giorgio Fiore, Ilaria Carnicelli, Leonardo Tariciotti, Andrea Parlangeli, Elena Scagliotti, Silvia M Tabano, Gianluca Lopez, Stefano Ferrero, Stefania Navone, Laura Guarnaccia, Giovanni Marfia, Manuela Caroli, Marco Locatelli","doi":"10.23736/S0390-5616.25.06421-5","DOIUrl":"https://doi.org/10.23736/S0390-5616.25.06421-5","url":null,"abstract":"<p><strong>Background: </strong>O6-Methylguanine-DNA methyltransferase (MGMT) promoter percentage of methylation in gliomas has been proved to be the most important predictive factor in temozolomide (TMZ) response. Nevertheless, an agreement about the cut-off to discriminate between a \"methylated\" and \"unmethylated\" status has not been reached yet. Many reports have analyzed the correlation between methylated status cut-off and survival, but they lacked sample homogeneity. Our aim was to calculate a clinical significant cut-off considering a homogenous group of patients.</p><p><strong>Methods: </strong>We retrospectively analyzed 96 patients who underwent a complete removal of glioblastoma in our Institution. All the patients underwent to radiation therapy plus concomitant TMZ and twelve cycles of adjuvant TMZ as described by Stupp. Receiver operating characteristic (ROC) curve analysis was performed and 21% was determined as the optimal cut-off.</p><p><strong>Results: </strong>The median OS was significantly higher in methylated patients compared to unmethylated ones (median 48 months vs 22 months respectively 95% CI 30-42 vs. 15-19, P<0.001). No difference was observed for PFS. The multivariate analysis with Cox regression model identified MGMT methylation status as an independent predictive factor for OS (P<0.001).</p><p><strong>Conclusions: </strong>We confirmed the prognostic role of MGMT methylation status even in a highly selective group of patients with the best outcome. We calculated a cut-off of 21% to be highly predictable of survival.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposal of a new score system (Cervical Surgical Score) for management of degenerative cervical myelopathy.","authors":"Francesco Costa, Francesco Restelli, Elio Mazzapicchi, Emanuele Rubiu, Giulio Bonomo, Marco Schiariti, Niccolò Innocenti, Carla D Anania, Andrea Cardia, Maurizio Fornari","doi":"10.23736/S0390-5616.23.06165-9","DOIUrl":"10.23736/S0390-5616.23.06165-9","url":null,"abstract":"<p><strong>Background: </strong>To date, no shared algorithms with the aim of guiding surgical strategy in complex cases of degenerative cervical myelopathy (DCM) exist. Our purpose is to present the Cervical Surgical Score (CSS) which could help in identifying complex DCM cases, suggesting a surgical strategy.</p><p><strong>Methods: </strong>We created the CSS based on multidisciplinary and literature-focused discussions, based on eight parameters including number of levels of cervical pathology and myelopathy, type and predominance of compression and grade of clinical myelopathy. We prospectively enrolled surgical DCM patients in a 15-months period, collecting clinical and radiological data. During outpatient clinic a specific surgical indication was offered to DCM patients. To validate the score, each outpatient clinic surgical indication was compared a posteriori to the one that resulted from multidisciplinary CSS scoring, focusing on patients for which both an anterior and posterior approach were considered suitable.</p><p><strong>Results: </strong>A total of 100 patients operated on for DCM at our Institution between December 2021 and February 2023 were prospectively enrolled. In 53% of patients the pathology was present at more than two levels. According to CSS calculation, 14% of patients resulted in the \"grey zone\", where both an anterior and posterior approach were deemed feasible. Among them, in 42.8% of cases the CSS allowed a modification of the originally planned surgery. Looking at outcome, an improvement of m-JOA score in 62% of patients was disclosed.</p><p><strong>Conclusions: </strong>This preliminary study showed the reliability and usefulness of CSS in detecting complex DCM cases, requiring further analysis by expert spine surgeons, suggesting a surgical strategy.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"158-166"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical epidemiology, management and outcomes of traumatic cervical spinal-cord and spine injuries: a systematic review of 1645 pooled cases.","authors":"Promise T Jaja, Linda Iroegbu-Emeruem, Iqra Kulsoom, Amechi Odeku","doi":"10.23736/S0390-5616.25.06404-5","DOIUrl":"https://doi.org/10.23736/S0390-5616.25.06404-5","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical spine (mostly atlanto-axial) accounts for over half of the acute traumatic disruptions of the spinal cord and its coverings; alongside its persisting neurological deficits. Two-thirds of the etiology were fairly evenly distributed between traffic crashes, falls, assault and other occupation-related injuries. We described the etiological mechanisms, neuro-anatomical level, severity, treatment and outcomes of traumatic cervical spinal-cord and spine injuries (C-SCI+SI).</p><p><strong>Evidence acquisition: </strong>We systematically reviewed PubMed and Cochrane CENTRAL on 16th May 2023, using a prospectively registered protocol (CRD42023417530). The search strategy combined search words (from the keywords; \"cervical spinal cord injury,\" \"conservative\" and \"operative\" \"treatment\") using Boolean operators. These yielded 787 and 55 records from PubMed (then 223 after delimiting to 10 years) and CENTRAL respectively; after records screening, 106 and 1 record were relevant respectively. Seventy-six reports were recruited for the quasi-quantitative synthesis following full-text review and methodological quality/bias assessment (using Joanna Briggs Institute critical appraisal tools).</p><p><strong>Evidence synthesis: </strong>Seventy-six reports yielded 1645 pooled cases. Weighted-mean age (N.=1512) was 46.3 years, with male (70.2%; gender N.=1525) preponderance. C-SCI+SI were mostly caused (N.=1079) by falls (42.1%) and road traffic crashes (42.2%); presenting(N.=178) with neck pain (71.4%) mostly and under one-fifth had neurological deficits (-plegias or -paresis, 11.8%; radiculopathy, 6.2%). The commonest vertebral levels (N.=1525) were 23.9% for the second cervical vertebra (c2), c5(20.4%) and c6(20.0%). Treatment (N.=1297) was combined pre-operative non-operative [skull traction (72.0%/842), cervical collar (13.9%/163)] in 90.2%, with solely non-operative (33.9%/439) options also used. Operative implant-based arthrodeses (66.2%/858) were done, using anterior (68.5%), posterior (20.2%/173) and combined (10.4%/89) approaches. Good bony fusion (89.0%) and clinical improvements (43.2%) were reported.</p><p><strong>Conclusions: </strong>Mostly low-level evidence showed C-SCI+SI occurring more amongst the middle-aged and men; following falls or road traffic crashes. The second, fifth and sixth cervical levels are mostly affected; with excellent post-intervention bony-union, with neurological improvements in two-fifths. Better international reporting standards are advocated.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"69 2","pages":"187-199"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bed rest duration and development of cerebrospinal fluid leaks after intradural spinal surgery: a meta-analysis of comparative studies.","authors":"Alberto Benato, Fabio Zeoli, Flavia Beccia, Marco Battistelli, Alessandro Rapisarda, Alessandro Olivi, Filippo M Polli","doi":"10.23736/S0390-5616.25.06470-7","DOIUrl":"10.23736/S0390-5616.25.06470-7","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative cerebrospinal fluid (CSF) leaks and related complications are a major concern after intradural spinal surgeries. The role of prolonged bed rest in reducing the incidence of these complications has been debated. This meta-analysis aimed to evaluate whether early versus late mobilization affects the incidence of CSF leak-related complications (CLRC) after intradural spinal surgery.</p><p><strong>Evidence acquisition: </strong>Following PRISMA guidelines, we conducted a systematic review and meta-analysis of comparative studies on early ambulation (EA) versus prolonged bed rest (PBR) in patients undergoing intradural spinal surgery. Studied considered for inclusion defined EA as mobilization on postoperative day 1, while PBR as mobilization on postoperative day 3. The primary outcome was the incidence of CLRC, defined as pseudomeningocele, durocutaneous fistula, or wound dehiscence. Secondary outcome was the incidence of medical complications.</p><p><strong>Evidence synthesis: </strong>Three retrospective comparative studies with a total of 949 patients were included in the analysis. No significant difference was found in the incidence of CLRC between the EA and PBR groups. Length of hospital stay (LOS) and postoperative medical complications incidence were significantly lower in the EA group.</p><p><strong>Conclusions: </strong>This meta-analysis found that EA does not increase the risk of CLRC compared to PBR, while shortening LOS and reducing medical complications occurrence. These findings suggest that early mobilization could be a safe and effective postoperative strategy, reducing hospital stay and complication rates.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"69 2","pages":"210-217"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year clinical and radiologic outcomes of Surpass Evolve flow diverter for large unruptured intracranial aneurysms.","authors":"Hyun J Han, Joonho Chung, Chang K Jang, Jung-Jae Kim, Keun Y Park, Yong B Kim","doi":"10.23736/S0390-5616.23.06161-1","DOIUrl":"10.23736/S0390-5616.23.06161-1","url":null,"abstract":"<p><strong>Background: </strong>Surpass Evolve Flow Diverter (SE-FD; Stryker Neurovascular, Kalamazoo, MI, USA) was launched in 2019 as a new generation FD of Surpass Streamline. The aim of this study was to report the effectiveness and safety of SE-FD insertion for unruptured intracranial aneurysm at one-year follow-up.</p><p><strong>Methods: </strong>Between November 2019 and October 2021, a total of 106 patients with 108 aneurysms were treated with FD in single institution. Of these, SE-FD insertion was performed in 40 patients with 41 aneurysms. At one-year follow-up, clinical and angiographic outcomes were retrospectively evaluated from electronic medical record and aneurysm database.</p><p><strong>Results: </strong>There were 12 male and 28 female patients (mean age 59.1 years, 95% CI: 55.3-62.9). Fusiform aneurysm dissection was 46.3% (19/41). Mean maximum aneurysm diameter was 13.2 mm (SD 5.53), and 34.1% (14/41) of aneurysms were 15 mm or bigger. Among 41 aneurysms, complex aneurysm (recurred, thrombosed, or branch artery-incorporated) was accounted for 41.5% (17/41). All procedures were successfully conducted with 7.3% (3/41) of procedure-related complications. At one-year follow-up (N.=40), neurologic morbidity was noted in 2 cases (5.0%; both with modified Rankin Scale [mRS] 1) without any mortality. At one-year follow-up (N.=41), radiologic outcomes were adequate occlusion in 33 (80.5%) and complete occlusion in 29 (70.7%). There was no retreatment in our cohort.</p><p><strong>Conclusions: </strong>Surpass Evolve Flow Diverter seemed to be safe and effective for the treatment of dissecting/fusiform or complex aneurysms at one-year follow-up. However, further study is needed to evaluate long term results.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"167-173"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of predicted postoperative segmental lumbar lordosis in spinal fusion using an intraoperative robotic planning and guidance system.","authors":"Ghani Haider, Vaibhavi Shah, Thomas Johnstone, Nicolai Maldaner, Martin Stienen, Anand Veeravagu","doi":"10.23736/S0390-5616.23.06142-8","DOIUrl":"10.23736/S0390-5616.23.06142-8","url":null,"abstract":"<p><strong>Background: </strong>Restoring lumbar lordosis is one of the main goals in lumbar spinal fusion surgery. The Mazor X-Align^™ software allows for the prediction of postoperative segmental lumbar lordosis based on preoperative imaging. There is limited data on the accuracy of this preoperative prediction, especially in patients undergoing short segment lumbar fusion. The objective of our study was to determine the accuracy of predicted postoperative segmental lumbar lordosis using the Mazor X-Align^™ software in patients requiring short segmental fusion.</p><p><strong>Methods: </strong>Retrospective analysis of adult patients undergoing pedicle screw spinal instrumentation of not more than four levels using the Mazor X^™ Robot (Medtronic Inc., Minneapolis, MN, USA) between July 2017 to June 2020. The robotic guidance software, Mazor X-Align^™ (Medtronic Inc., Minneapolis, MN, USA) was used to calculate the predicted segmental lumbar lordosis based on preoperative CT-imaging and the plan was executed under intraoperative robotic guidance. Predicted segmental lumbar lordosis was compared to achieved segmental lumbar lordosis on 1-month postoperative x-rays using the Cobb angle methodology.</p><p><strong>Results: </strong>A total of 15 patients (46.6% female) with a mean age of 61.5±10.9 years were included. All patients underwent posterior lumbo-sacral spinal fusion with the Mazor X^™ robotic system with 11 patients (73.3%) undergoing anterior column reconstruction prior to posterior fixation. Instrumentation was performed across a mean of 2.6 levels per case. Preoperative, the mean segmental lumbar lordosis was 30.2±13.6 degrees. The mean planned segmental lumbar lordosis was 35.5±17.0 degrees while the mean achieved segmental lumbar lordosis was 35.8±16.7 degrees. There was no significant mean difference between the planned and achieved segmental lumbar lordosis (P=0.334).</p><p><strong>Conclusions: </strong>The Mazor X^™ intraoperative robotic planning and guidance is accurate in predicting postoperative segmental lumbar lordosis after short segmental fusion. Our findings may assure surgical decision making and planning.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"144-149"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A landmark study on spine and spinal cord injuries treated surgically in Italy.","authors":"Rossella Rispoli, Barbara Cappelletto","doi":"10.23736/S0390-5616.25.06471-9","DOIUrl":"10.23736/S0390-5616.25.06471-9","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"141-143"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}