Journal of neurological surgery. Part A, Central European neurosurgery最新文献

{"title":"Neurosurgery Residency Training and beyond in Turkey: A National Survey Study.","authors":"Taha Şükrü Korkmaz, Semih Can Çetintaş, Süleyman Akkaya, Süreyya Toklu","doi":"10.1055/a-2558-5909","DOIUrl":"10.1055/a-2558-5909","url":null,"abstract":"<p><p>Training neurosurgery specialists is a challenging and demanding process. This national survey study was conducted to evaluate the infrastructure of neurosurgery residency programs and training clinics in Turkey and to assess how these factors impact specialist practice.A national survey consisting of 32 questions was distributed to neurosurgeons who had been practicing as specialists for at least two years. The survey was divided into four sections: demographic information, residency training process, hospital where they currently work as specialists, and microsurgical experience. Statistical analyses, including chi-square and logistic regression, were conducted to examine factors influencing surgical performance in specialist practice.Regression analyses indicated that performing skin-to-skin surgeries during residency significantly and most effectively increased the likelihood of performing these procedures as a specialist. Additionally, working in anatomy laboratories, attending hands-on cadaver courses, and increased years of practice were all positively associated with surgical performance. It was also found that participants who graduated within the last 5 years were statistically significantly less likely to have attended hands-on courses or visited another clinic for observerships/fellowships compared with those who graduated more than 5 years ago.Findings suggest that neurosurgical training in Turkey is affected by disparities in clinical infrastructure and hands-on experience. Standardizing residency experiences and ensuring access to necessary equipment and training resources could enhance neurosurgical competency and consistency in specialist practice.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657552","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":"Effect of Kyphoplasty on Pain Control and Vertebral Restoration.","authors":"Mustafa C Kilinc, Baran C Alpergin, Omer M Ozpiskin, Eray S Aktan, Ihsan Dogan","doi":"10.1055/a-2479-5392","DOIUrl":"10.1055/a-2479-5392","url":null,"abstract":"<p><strong>Background and aim: </strong> Numerous studies have been conducted regarding vertebral restoration, development of kyphotic deformity, and pain control following balloon kyphoplasty. However, there is no consensus regarding the ideal time to perform kyphoplasty. Herein, we aimed to compare the results of treatment of different vertebral levels following early or late kyphoplasty.</p><p><strong>Patients and methods: </strong> Between 2017 and 2022, 283 patients with single-level osteoporotic vertebral fractures were retrospectively reviewed. Patients in whom visual analog scale (VAS) values were recorded, and osteoporosis tests performed were included in the study. Traumatic single-level fractures in patients with osteoporosis who were aged > 60 years were included. Patients with a history of malignancy, previous spinal surgery, or neurological deficits were excluded. A total of 100 patients met the inclusion criteria. A total of 50 patients underwent kyphoplasty within 3 days of sustaining the fracture (Group 1), and 50 patients underwent kyphoplasty more than 3 days after sustaining the fracture (Group 2). Groups A, B, and C included fractures at the T7-T11 levels, T12-L1 levels (thoracolumbar junction), and L2-L5 levels, respectively. These groups were compared among themselves. Bilateral balloon kyphoplasty was performed under sedation in the prone position. Preoperative and postoperative VAS scores, anterior vertebral heights, and kyphotic angles (KAs) were measured and recorded. The vertebral segments that underwent early and late kyphoplasty were also compared among themselves.</p><p><strong>Results: </strong> In all the patients who underwent early or late kyphoplasty, there was a significant decrease in the KA and a significant increase in vertebral heights during the early postoperative period (<i>p</i> < 0.001). There was no significant change in the vertebral heights and KA between the early and late postoperative periods (<i>p</i> = 0.780). Early kyphoplasty demonstrated better pain control with a greater improvement in VAS score (<i>p</i> < 0.001) than late kyphoplasty.</p><p><strong>Conclusion: </strong> Kyphoplasty plays an important role in reducing pain and ensuring early mobilization in older patients. In our study, the improvements in both symptoms and radiological features are concrete evidence in favor of performing early kyphoplasty.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687154","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":"Spinal Schwannomas: A Proposal for a New Classification to Aid Surgical Planning.","authors":"Serdar Onur Aydın, Mustafa Umut Etli, Caner Sarıkaya, Reha Can Köylü, Eyüp Varol, Ali Fatih Ramazanoğlu, Cumhur Kaan Yaltırık, Luay Şerifoğlu, Ali Erhan Kayalar, Sait Naderi","doi":"10.1055/a-2053-2901","DOIUrl":"10.1055/a-2053-2901","url":null,"abstract":"<p><strong>Background: </strong> The current standard of care for spinal schwannoma, which is the most common nerve sheath tumor, is total microsurgical resection. The localization, size, and relationship with the surrounding structures of these tumors are crucial in terms of preoperative planning. A new classification method for surgical planning of spinal schwannomas is presented in this study.</p><p><strong>Methods: </strong> All patients who underwent surgery for spinal schwannoma between 2008 and 2021 were reviewed retrospectively, along with radiologic images, clinical presentation, surgical approach, and postoperative neurologic status.</p><p><strong>Results: </strong> A total of 114 patients (57 males and 57 females) were included in the study. Tumor localizations were cervical in 24 patients, cervicothoracic in 1 patient, thoracic in 15 patients, thoracolumbar in 8 patients, lumbar in 56 patients, lumbosacral in 2 patients, and sacral in 8 patients. All tumors were divided into seven types according to our classification method. Type 1 and 2 groups were operated on with a posterior midline approach only, type 3 tumors were operated on with a posterior midline approach and an extraforaminal approach, and type 4 tumors were operated on with only an extraforaminal approach. While the extraforaminal approach was sufficient in patients with type 5 tumors, partial facetectomy was required in 2 patients. A combined surgery including hemilaminectomy and extraforaminal approach was performed in the type 6 group. A posterior midline approach with partial sacrectomy/corpectomy was performed in the type 7 group.</p><p><strong>Conclusion: </strong> Effective treatment of spinal schwannoma depends on preoperative planning, which includes correctly classifying tumors. In this study, we present a categorization scheme that covers bone erosion and tumor volume for all spinal localizations.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9097473","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":"Prevertebral Soft-Tissue Swelling Following One-Level Anterior Cervical Diskectomy and Fusion: An Analysis Based on Surgical Level.","authors":"Ryo Kanematsu, Toshiyuki Takahashi, Manabu Minami, Junya Hanakita","doi":"10.1055/a-2389-5283","DOIUrl":"10.1055/a-2389-5283","url":null,"abstract":"<p><strong>Background: </strong> The purposes of this study were to identify the primary level at which prevertebral tissue swelling (PSTS) occurs following one-level anterior cervical diskectomy and fusion (ACDF) based on surgical level, and to quantify the degree to which it occurs. Although PSTS peaks at day 2 or 3 after ACDF, with swelling noted to be prominent at the C2-C4 levels, the way in which the features of PSTS vary according to surgical level has not been examined.</p><p><strong>Methods: </strong> Thirty-seven patients who underwent one-level ACDF were reviewed and classified into retropharyngeal and retrotracheal groups based on surgical level. PSTS occurring at C2-C6 and the width of the airway (WA) at C2-C4 were assessed using plain radiographs before surgery and at 1, 3, 5, and 7 days postoperatively.</p><p><strong>Results: </strong> The retropharyngeal group comprised 10 patients, while the retrotracheal group comprised 27 patients. The retropharyngeal group had the most severe PSTS on day 3 after surgery. C4 showed PSTS peaked on day 3, with a value of 3.26 times the preoperative prevertebral tissue thickness. The WA at C4 was narrowest on day 1, with a value of 0.74 times and remained narrow until day 3. The retrotracheal group showed the most severe PSTS on day 1 at the C3 level: 2.81 times. The WA at C4 was narrowest on day 1 with a value of 0.78 times and increased thereafter.</p><p><strong>Conclusions: </strong> PSTS following one-level ACDF for both retropharyngeal and retrotracheal lesions was greatest at the C3 and C4 levels, with peaks on the third day after operation for the former and the first day for the latter. The WA at C4 was narrowest from day 1 in both groups. In the retropharyngeal group, narrowing remained until day 3.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995916","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":"Management of Subarachnoid-Pleural Fistula Following Anterior Transthoracic Approach for the Ossification of Posterior Longitudinal Ligament in the Thoracic Spine.","authors":"Ryo Kanematsu, Junya Hanakita, Manabu Minami, Toshiyuki Takahashi","doi":"10.1055/a-2479-5581","DOIUrl":"10.1055/a-2479-5581","url":null,"abstract":"<p><strong>Background: </strong> Subarachnoid-pleural fistula (SAPF) is an abnormal communication between the subarachnoid and pleural spaces that can arise from blunt or penetrating trauma or as a complication of spinal surgery via the transthoracic approach. Uncontrolled cerebrospinal fluid (CSF) leakage after transthoracic spinal surgery could be more problematic than that after spinal surgery via the conventional posterior approach because of the negative pressure in the pleural cavity.</p><p><strong>Case description: </strong> The authors reported SAPF management using chest and lumbar drainage in five patients with several troublesome complications, such as intracranial subdural hematoma or severe respiratory dysfunction. Chest drainage was managed for 2 to 3 days by continuous low negative pressure, whereas lumbar spinal drainage was managed for 5 to 7 days, aiming at an output volume of 150 to 200 ml/day and higher than that of chest drainage. Additionally, when changes in the accumulated pleural fluid were seen by standing chest X-ray immediately before the operation and 1 month after the operation, the pleural effusions in four of the five patients were assimilated 1 month postoperatively.</p><p><strong>Conclusion: </strong> Compared with CSF management following standard posterior spinal surgery, management after the anterior transthoracic approach could be more troublesome because of the intrapleural negative pressure. When the chest and lumbar drainage are used, it is important to consider that overdrainage of CSF could potentially cause severe respiratory dysfunction and intracranial subdural hematoma.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682019","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":"Intraventricular Neurocysticercosis: Comparative Analysis of Different Localizations. Clinical Course and Treatment. A Systematic Review.","authors":"Zoran Milenković, Stefan Momčilović, Aleksandra Ignjatović, Aleksandra Aracki-Trenkić, Tanja Džopalić, Nataša Vidović, Zorica Jović, Suzana Tasić-Otašević","doi":"10.1055/a-2122-7391","DOIUrl":"10.1055/a-2122-7391","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt; Neurocysticercosis (NCC) is significant due to its high prevalence and considerable morbidity and mortality. Intraventricular NCC (IVNCC) is less common than parenchymal NCC. It may have a rapidly progressive course and it requires a corresponding therapeutic response. Despite the extensive literature dealing with NCC and intraventricular cystic lesions, there are no systematic reviews on the clinical course and treatment of the infestation. Our main objective was to analyze the clinical type of the disease and the management of each ventricle separately based on case reports or series with individual data on the course and treatment of the disease. We used the data on the signs and symptoms and treatment of patients from published series on IVNCC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt; We performed a search in the Medline database. Google Scholar was also randomly searched. We extracted the following data from the eligible studies: age and gender, symptoms, clinical signs, diagnostic examinations and findings, localization, treatment, follow-up period, outcome, and publication year. In this study, all the data are presented in the form of absolute and relative numbers. The frequency of signs and symptoms, treatment, and outcomes of the observed groups were assessed using the chi-squared test and the Fisher exact test. A &lt;i&gt;p&lt;/i&gt; value of &lt;0.05 was considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt; We selected 160 cases of IVNCC and divided them according to their localization into five categories. Hydrocephalus was observed in 134 cases (83.4%). Patients with isolated IVNCC were younger (&lt;i&gt;p&lt;/i&gt; = 0.0264) and had a higher percentage of vesicular cysts (&lt;i&gt;p&lt;/i&gt; &lt; 0.00001). In mixed IVNCC, degenerative and multiple confluent cysts predominate (&lt;i&gt;p&lt;/i&gt; = 0.00068). Individuals with fourth- and third-ventricular cysts (potentially an obstructive form) are younger than those with lateral ventricular cysts (potentially a less obstructive form; &lt;i&gt;p&lt;/i&gt; = 0.0083). The majority of patients had individual symptoms for a longer period before acute onset of the disease (&lt;i&gt;p&lt;/i&gt; &lt; 0.00001). The predominant clinical manifestation was headache (88.7%); the proportion within the groups ranged from 100 to 75% without statistical significance (&lt;i&gt;p&lt;/i&gt; = 0.074214). The same was true for patients with symptoms of vomiting or nausea, who had a lower and roughly balanced percentage of 67.7 to 44.4% (&lt;i&gt;p&lt;/i&gt; = 0.34702). Altered level of consciousness (range: 21-60%) and focal neurologic deficit (range: 51.2-15%) are the only clinical categories with a statistical significance (&lt;i&gt;p&lt;/i&gt; &lt; 0.001 and 0.023948). Other signs and symptoms were less frequent and statistically irrelevant. Surgical resection of the cyst including the parasite was the of treatment of choice, varying from 55.5 to 87.5% (&lt;i&gt;p&lt;/i&gt; = 0.02395); endoscopy (48.2%) and craniotomy (24.4%), each individually, showed statistical significance (&lt;i&gt;p&lt;/i&gt; = ","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9752123","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 Outcomes of Additional Posterior Lumbar Interbody Fusion for Adjacent Segment Disease after Posterior Lumbar Interbody Fusion Assessed with the Zurich Claudication Questionnaire.","authors":"Hironobu Sakaura, Takahito Fujimori, Tsuyoshi Sugiura, Shutaro Yamada, Sadaaki Kanayama, Daisuke Ikegami","doi":"10.1055/s-0044-1791975","DOIUrl":"https://doi.org/10.1055/s-0044-1791975","url":null,"abstract":"<p><strong>Study design: </strong> A retrospective analysis of prospectively collected data.</p><p><strong>Background: </strong> The Zurich Claudication Questionnaire (ZCQ) has been recently reported to be the most responsive assessment tool for lumbar spinal stenosis among the ZCQ, the Oswestry Disability Index, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, the visual analog scale, the 8-Item Short Form Health Survey, and the EuroQol 5 dimensions 5 level. There has been no study comparing surgical outcomes of additional posterior lumbar interbody fusion (PLIF) for adjacent segment disease (ASD) after previous PLIF with those of primary PLIF.</p><p><strong>Objective: </strong> We compared the clinical outcomes of additional PLIF for unstable ASD after previous PLIF with those of primary PLIF assessed with the ZCQ to examine whether surgical outcomes of additional PLIF for ASD following previous PLIF are inferior to those of primary PLIF.</p><p><strong>Methods: </strong> Thirteen consecutive patients undergoing additional single-level PLIF for unstable ASD after previous PLIF (A group) and 61 consecutive patients undergoing primary single-level PLIF (P group) were included in the study. Clinical outcomes were assessed with the ZCQ before PLIF surgery and at 2 years postoperatively. Achievement rates of the minimum clinically important difference (MCID) of each domain (symptom severity [SS] and physical function [PF]) on the ZCQ were evaluated in each group.</p><p><strong>Results: </strong> In the A group, the mean SS and PF before additional PLIF were 3.615 and 3.1, respectively, which significantly improved to 2.231 and 2.0, respectively, at 2 years after surgery. In the P group, the mean SS and PF before primary PLIF were 3.438 and 2.5, respectively, which also significantly improved to 2.194 and 1.6, respectively, at 2 years postoperatively. PF before additional PLIF in the A group was significantly inferior to that in the P group, but SS both before and after PLIF and PF at 2 years postoperatively showed no significant differences between the two groups. The achievement rates of the MCID of SS and PF were 92.3 and 76.9%, respectively, in the A group and 59.0 and 59.0%, respectively, in the P group. The MCID achievement rates of SS was significantly higher in the A group than in the P group.</p><p><strong>Conclusion: </strong> Assessed with the ZCQ at 2 years after surgery, the clinical outcomes of additional single-level PLIF for unstable ASD after previous PLIF were equivalent to those of primary single-level PLIF.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258289","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":"Bilateral Rod Loosening and Sequential Distal Migration after Thoracolumbar Junction Fracture Stabilization.","authors":"Andreas K Demetriades, Himanshu Shekhar","doi":"10.1055/a-2088-3039","DOIUrl":"10.1055/a-2088-3039","url":null,"abstract":"<p><p>Distal rod migration remains uncommon and has been reported in a variety of anatomical locations, including the retroperitoneal region, knee, and pelvis. It is postulated that spinal fixation without fusion might allow the mechanical system some vulnerability to motion effects of the spine. Bilateral distal rod migration is rarer still. We report the interesting scenario of sequential and delayed bilateral rod migration 17 months after thoracolumbar fracture stabilization.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9793729","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":"Otogenic Brain Abscess and Concomitant Acute COVID-19 Infection: Case Report and Review of the Literature.","authors":"Artem Rafaelian, Sae-Yeon Won, Svorad Trnovec, Bedjan Behmanesh, Susanne Barz, Christoph Busjahn, Daniel A Reuter, Lichun Zhang, Robert Mlynski, Thomas Freiman, Florian Gessler, Daniel Dubinski","doi":"10.1055/a-2479-5462","DOIUrl":"10.1055/a-2479-5462","url":null,"abstract":"<p><strong>Background: </strong> 2019 coronavirus disease (COVID-19) has attracted global attention primarily because of the severe acute respiratory symptoms associated with it. However, nearly one third of the patients also present with neurological symptoms. This report describes a case of a previously healthy woman with acute COVID-19 infection, who developed acute facial nerve palsy and rapid progression to coma due to otogenic brain abscess.</p><p><strong>Case description: </strong> A 63-year-old woman with acute COVID-19 infection exhibited acute facial nerve paresis, high fever, and purulent secretion from her left ear within 48 hours after COVID-19 onset. Cranial computed tomography scan confirmed acute mastoiditis, precipitating an urgent mastoidectomy. A postoperative contrast-enhanced magnetic resonance imaging on the same day revealed a subdural empyema, which prompted an urgent craniotomy and decompression. Intraoperative microbiological swabs confirmed a <i>Streptococcus pyogenes</i> infection; however, reverse transcription polymerase chain reaction was negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). After immediate intravenous antibiotic treatment, extubation was achieved 4 days after operation, and the patient was discharged without neurological deficits 19 days after postoperatively.</p><p><strong>Conclusion: </strong> This finding adds a layer of insight into the specific nature of the infection, suggesting a potential absence of SARS-CoV-2 involvement in otogenic subdural empyema. However, the impact of SARS-CoV-2 in otogenic brain abscess cannot be excluded to date and should be further prospectively investigated. The complete recovery of neurological status emphasizes the importance of prompt and interdisciplinary interventions in managing rare and severe complications associated with COVID-19.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682028","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":"Impact of Suturing Techniques on Microvascular Anastomosis Maturation.","authors":"Jiri Dostal, Pavel Klein, Tereza Blassova, Vladimir Priban","doi":"10.1055/a-2389-7761","DOIUrl":"10.1055/a-2389-7761","url":null,"abstract":"<p><strong>Background: </strong> Microvascular anastomosis using interrupted suture is a widely accepted standard technique. Continuous suture is less common due to the presumption that its firmness can negatively affect anastomosis maturation. The purpose of this study was to determine whether the use of continuous suture allows maturation of the microanastomosis site.</p><p><strong>Methods: </strong> A rat common carotid artery (CCA) end-to-end microanastomosis model was utilized, with 19 Long-Evans rats in the interrupted suture group and 13 in the continuous suture group. Immediate blood flow of the operated and contralateral intact CCAs was compared before clamping, at the completion of the anastomosis and after 14 days. Quantitative transit time flowmetry measurement and histologic examination were employed.</p><p><strong>Results: </strong> Initial blood flow in both intact CCAs was similar across all animals (<i>p</i> = 0.004). In the interrupted suture group, the median anastomosis blood flow was 88.9% of the contralateral CCA blood flow, with a median suture time of 46 minutes. After 2 weeks, blood flow increased to 96.1%. In the continuous suture group, the median anastomosis blood flow was 88.3% of the contralateral CCA blood flow, with a median suture time of 30 minutes. After 2 weeks, blood flow increased to 100.0%. The reduction in suture time achieved with continuous suture was 34.8% (<i>p</i> < 0.001). Histologic examination confirmed scar maturity.</p><p><strong>Conclusions: </strong> The maturation rates of continuous and interrupted suture microanastomosis were comparable in our study, implying that concerns about the suture restricting maturation may be unwarranted. Additional finding is the potential for a reduction in microanastomosis time when using the continuous suture technique.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995914","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}