Journal of neurosurgical sciences最新文献

{"title":"Experience with the utilization of new-generation shared-control robotic system for spinal instrumentation.","authors":"Ghani Haider, Vaibhavi Shah, Ivan Lopez, Katherine E Wagner, Martin N. Stienen, Anand Veeravagu","doi":"10.23736/S0390-5616.24.06206-4","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06206-4","url":null,"abstract":"BACKGROUND\u0000Robotic assistance in spine surgery is emerging as an accurate, effective and enabling technology utilized in the treatment of patients with surgical spinal pathology. The safety and reproducibility of robotic assistance in the placement of pedicle screw instrumentation is still being investigated. The objective of this study was to present our experience of instrumented spinal fusion utilizing an intraoperative robotic guidance system.\u0000\u0000\u0000METHODS\u0000We retrospectively reviewed all cases of spinal instrumentation of the thoracic and lumbo-sacral spine using the Mazor X robotic system (Medtronic Inc, Minneapolis, MN, USA), performed at our institution by one surgeon between July 2017 and June 2020. Wilcoxon Rank test was used to compare time taken to place each screw during the first 20 cases and the cases thereafter.\u0000\u0000\u0000RESULTS\u0000A total of 28 patients were included. A total of 159 screws were placed using the Mazor X robotic system. The overall mean time for screw placement was 7.8±2.3 minutes and there was a significant reduction in the mean time for screw placement after the 20th case or 120 screws (8.70 vs. 5.42 min, P=0.008). No postoperative neurologic deficit or new radiculopathy was noted to occur secondary to hardware placement. No revision surgery was required for replacement or removal of a mispositioned screw.\u0000\u0000\u0000CONCLUSIONS\u0000From this single-center, single-surgeon series we conclude that robot-assisted spine surgery can be safely and efficiently integrated into the operating room workflow, which improves after a learning curve of approximately 20 operative interventions. We found robot-assisted spinal instrumentation to be reliable, safe, effective and highly precise.","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140790389","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":"The detrimental effects of residents' over-reliance on neuronavigation technology on their knowledge of neuroanatomical structures.","authors":"Oday Atallah, Bipin Chaurasia","doi":"10.23736/S0390-5616.23.06119-2","DOIUrl":"10.23736/S0390-5616.23.06119-2","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286249","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":"The gender impact in the era of COVID-19: an Italian neurosurgical perspective.","authors":"Teresa Somma, Ilaria Bove, Karol Migliorati, Maria R Scala, Tamara Ius, Giada Garufi, Laura Santi, Paolo Cappabianca","doi":"10.23736/S0390-5616.21.05330-3","DOIUrl":"10.23736/S0390-5616.21.05330-3","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to understand the impact of SARS-COV-2 disease on neurosurgeons and our profession; specifically, to trace the role of women, in particular young neurosurgeons, in addressing this health emergency.</p><p><strong>Methods: </strong>This cross-sectional study evaluated the impact of SARS-COV-2 disease on Italian neurosurgeons stratified by gender (44 [49.9%] males and 49 [52.1%] females) enrolled through a questionnaire-based online survey.</p><p><strong>Results: </strong>Ninety-three Italian neurosurgeons were included in this study. The percentage of female participants was 52.1% (49) and 53% (50) were younger than 40 years. Men were significantly more affected than women by complications (14 versus 3), while there was no gender difference in the COVID-19 infection rate. Furthermore, the social impact of the pandemic was the same between men and women.</p><p><strong>Conclusions: </strong>Our analysis did not show significant differences between the two genders in the susceptibility, and mortality from COVID-19. The possible and immediate implementation of anti-COVID-19 measures and devices, associated with a lower risk of transmission in the treatment of neurosurgical pathologies, has likely, moderated and disregarded the socio-psychological \"gender gap\" of the Covid-19 pandemic.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25468247","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":"Prospective analysis of gross and fine electrode position and motor manifestations after STN-DBS and their correlation with electrode position.","authors":"Rajesh Alugolu, Swapnil Kolpakwar, Vijayasaradhi Mudumba, Abhishek Arora, Rukmini Kandadai, Rupam Borgohain","doi":"10.23736/S0390-5616.21.05461-8","DOIUrl":"10.23736/S0390-5616.21.05461-8","url":null,"abstract":"<p><strong>Background: </strong>Deep brain stimulation (DBS) has been proven to be a safe, reversible, cost-effective procedure for treatment of Parkinson's disease. Final electrode position remains a significant factor determining the outcomes of subthalamic nucleus DBS (STN-DBS). This study aims to analyze the final lead position in three-dimensional plane and its effect on gross and fine motor outcomes in cases of advanced Parkinson's disease operated for STN-DBS.</p><p><strong>Methods: </strong>Patients who underwent bilateral STN-DBS were prospectively followed for improvement in gross motor outcomes at 6 months. Improvement in dysgraphia was analyzed by Fahn-Tolosa-Marin Tremor Rating Scale Part B Score. Postoperative outcomes were correlated with final electrode position.</p><p><strong>Results: </strong>A total of 64 Patients (128 leads) were analyzed. Patients who were less than 65 years of age at time of surgery had more significant reduction in UPDRS III (P=0.02). Cases with deviation of left x less than 3 mm had significant reduction in UPDRS III (P=0.05) and speech sub-scores (P=0.05). Deviation less than 2 mm in left x was associated with reduction in gait sub-scores (P=0.04). Optimal placement of right y electrode was associated with reduction in UPDRS III (P=0.02). Significant reduction in Fahn-Tolosa-Marin Tremor Rating Scale Part B Score was noted after DBS (P=0.001).</p><p><strong>Conclusions: </strong>Subthalamic nucleus DBS thus results in significantly improved functional outcome particularly in patients with age less than 65 years. Accurate final electrode position is associated with maximum clinical benefit and improvement in dysgraphia.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39516695","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":"Endovascular neurosurgery in Europe: an International Survey and future perspectives.","authors":"Simone Peschillo, Torstein R. Meling","doi":"10.23736/S0390-5616.24.06252-0","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06252-0","url":null,"abstract":"BACKGROUND\u0000Recent advancements in neurosurgery have transformed patient care through minimally invasive procedures and led to a notable surge in endovascular treatments. However, the regulatory landscape governing these procedures across European countries varies, impacting treatment access and collaboration. This paper discusses the results of a survey on European legislation regarding endovascular neurosurgery, exploring current practices and speculating on the field's future.\u0000\u0000\u0000METHODS\u0000An e-mail survey was distributed to 41 European countries, targeting European member societies within the EANS. Thirty-seven completed questionnaires were returned, providing insights into neuroendovascular treatment legislation and restrictions.\u0000\u0000\u0000RESULTS\u0000Legislation and certification varied across the surveyed countries, with only two countries prohibiting endovascular neurosurgery. Eight countries required specific fellowship programs. Resistance from radiologists was noted in many countries.\u0000\u0000\u0000CONCLUSIONS\u0000Despite growing support for neurosurgeons performing endovascular treatments in Europe, challenges persist. Specialized care, improved access, and a broadening spectrum of treatable conditions contribute to the argument for involvement of neurosurgeons.","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788680","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":"Microsurgical clipping of unruptured intracranial aneurysms by a single surgeon's experience: why should we preserve the neurosurgical skills in our health areas?","authors":"Biagia LA Pira, Veronica Picotti, Marta Zappalà, Vincenza Maiola, Alessandro Pesce, Alessandro Frati, Antonio Santoro, Giancarlo D'Andrea","doi":"10.23736/S0390-5616.21.05366-2","DOIUrl":"10.23736/S0390-5616.21.05366-2","url":null,"abstract":"<p><strong>Background: </strong>The long-standing comparison between the endovascular and microsurgical treatment is still ongoing. While not any center avails of a neuroendovascular service, and not every aneurysm is suitable for endovascular treatment, the neurovascular technique is slowly disappearing from our territories, whereas in the current literature, the role of the neurosurgical treatment is being re-appreciated. The aim of this paper was to discuss a single surgeon's clinical and radiological results with the microsurgical management of unruptured intracranial aneurysms (UIA).</p><p><strong>Methods: </strong>We retrospectively reviewed the clinical and radiological records of patients treated for UIA, by a single surgeon, in the period ranging between 2015 and 2019. We recorded all the relevant anatomic features of the aneurysm, saliencies of the surgical treatment, such as the need for temporary clipping, intraoperative rupture, or postoperative complications. The results of the clinical and radiological follow-up examinations were recorded either.</p><p><strong>Results: </strong>Fifty-eight patient undergoing microsurgical clipping were included, harboring a total of 65 UIAs. CTA with 3D reconstructions was sufficient to reach a reliable preoperative planning in 46 patients (76%). A total of 94% of the cases were unchanged or neurologically unremarkable at follow-up. The presence of postoperative complications was associated to the neck size and predictor of a longer hospitalizations, as well as longer hospitalizations are associated to the patients' age, size of the aneurysms and surgical times.</p><p><strong>Conclusions: </strong>According to our experience, we believe that microsurgical clipping plays a critical role in the management of UIA, also on the ground of the encouraging results of the relevant literature.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39270283","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":"Large language model, AI and scientific research: why ChatGPT is only the beginning.","authors":"Pietro Zangrossi, Massimo Martini, Francesco Guerrini, Pasquale DE Bonis, Giannantonio Spena","doi":"10.23736/S0390-5616.23.06171-4","DOIUrl":"10.23736/S0390-5616.23.06171-4","url":null,"abstract":"<p><p>ChatGPT, a conversational artificial intelligence model based on the generative pre-trained transformer GPT architecture, has garnered widespread attention due to its user-friendly nature and diverse capabilities. This technology enables users of all backgrounds to effortlessly engage in human-like conversations and receive coherent and intelligible responses. Beyond casual interactions, ChatGPT offers compelling prospects for scientific research, facilitating tasks like literature review and content summarization, ultimately expediting and enhancing the academic writing process. Still, in the field of medicine and surgery, it has already shown its endless potential in many tasks (enhancing decision-making processes, aiding in surgical planning and simulation, providing real-time assistance during surgery, improving postoperative care and rehabilitation, contributing to training, education, research, and development). However, it is crucial to acknowledge the model's limitations, encompassing knowledge constraints and the potential for erroneous responses, as well as ethical and legal considerations. This paper explores the potential benefits and pitfalls of these innovative technologies in scientific research, shedding light on their transformative impact while addressing concerns surrounding their use.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139521125","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":"Frailty as a predictor of postoperative outcomes in neurosurgery: a systematic review.","authors":"Joanna M Roy, Syed F Kazim, Dylan Macciola, Dante N Rangel, Kavelin Rumalla, Zafar Karimov, Remy Link, Javed Iqbal, Muhammad A Riaz, Georgios P Skandalakis, Carmelo V Venero, Rachel B Sidebottom, Alis J Dicpinigaitis, Christian S Kassicieh, Omar Tarawneh, Matt S Conlon, Rachel Thommen, Daniel J Alvarez-Crespo, Karizma Chhabra, Sahaana Sridhar, Amanpreet Gill, John Vellek, Phuong A Nguyen, Grace Thompson, Myranda Robinson, Christian A Bowers","doi":"10.23736/S0390-5616.23.06130-1","DOIUrl":"10.23736/S0390-5616.23.06130-1","url":null,"abstract":"<p><strong>Introduction: </strong>Baseline frailty status has been utilized to predict a wide range of outcomes and guide preoperative decision making in neurosurgery. This systematic review aims to analyze existing literature on the utilization of frailty as a predictor of neurosurgical outcomes.</p><p><strong>Evidence acquisition: </strong>We conducted a systematic review following PRISMA guidelines. Studies that utilized baseline frailty status to predict outcomes after a neurosurgical intervention were included in this systematic review. Studies that utilized sarcopenia as the sole measure of frailty were excluded. PubMed, EMBASE, and Cochrane library was searched from inception to March 1^st, 2023, to identify relevant articles.</p><p><strong>Evidence synthesis: </strong>Overall, 244 studies met the inclusion criteria. The 11-factor modified frailty index (mFI-11) was the most utilized frailty measure (N.=91, 37.2%) followed by the five-factor modified Frailty Index (mFI-5) (N.=80, 32.7%). Spine surgery was the most common subspecialty (N.=131, 53.7%), followed by intracranial tumor resection (N.=57, 23.3%), and post-operative complications were the most reported outcome (N.=130, 53.2%) in neurosurgical frailty studies. The USA and the Bowers author group published the greatest number of articles within the study period (N.=176, 72.1% and N.=37, 15.2%, respectively).</p><p><strong>Conclusions: </strong>Frailty literature has grown exponentially over the years and has been incorporated into neurosurgical decision making. Although a wide range of frailty indices exist, their utility may vary according to their ability to be incorporated in the outpatient clinical setting.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158149","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":"Frailty-based prehabilitation for patients undergoing spinal deformity surgery.","authors":"Javed Iqbal, Joanna M Roy, Syed F Kazim, Christian A Bowers","doi":"10.23736/S0390-5616.23.06132-5","DOIUrl":"10.23736/S0390-5616.23.06132-5","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10291884","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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-03-19","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}