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

{"title":"A New Management Strategy for Hemimasticatory Spasm.","authors":"Zhongding Zhang, Datan Lu, Tingting Ying, Shiting Li, Hua Zhao","doi":"10.1055/a-2479-5625","DOIUrl":"10.1055/a-2479-5625","url":null,"abstract":"<p><strong>Background: </strong> Hemimasticatory spasm (HMS) is an uncommon movement disorder of the trigeminal motor rootlet characterized by unilateral, involuntary, and paroxysmal contractions of the muscles of mastication. The mechanisms for HMS are still unclear, and an efficient treatment strategy still needs to be developed. This study aims to investigate the clinical features and surgical treatment of HMS.</p><p><strong>Methods: </strong> Twelve patients with HMS were included in our study. The patient data regarding clinical characteristics, neuroimaging presentations, intraoperative findings, and treatment outcomes were analyzed retrospectively. Highly selective trigeminal motor root rhizotomy (HSTR) combined with microvascular compression was performed in nine cases with neurovascular conflict, whereas three patients without vascular compression underwent HSTR only.</p><p><strong>Results: </strong> Intraoperative findings showed that there were two patients with six branches, two patients with five branches, and the remaining patients with three to four branches of the trigeminal motor roots. Seven patients had two motor branches severed, three patients had one motor branch severed, and two patients each had three motor branches severed. Nine patients recovered uneventfully and showed no signs of spasms, and the remaining two patients experienced complete disappearance of symptoms within 3 months after surgery. In one patient, the symptoms disappeared immediately after surgery but recurred 2 years later.</p><p><strong>Conclusion: </strong> The surgical procedures of HSTR can significantly alleviate the clinical symptoms of patients with HMS without serious complications.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682048","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":"Alternative Bypass Technique Using Radial Artery Graft between V3 Segment of Vertebral Artery and Middle Cerebral Artery: Technical Note.","authors":"Yasuhiro Ito, Katsuhiko Maruichi, Naoki Nakayama, Hiroyuki Kobayashi, Ryota Tatezawa, Shinitirou Shinada, Shunsuke Terasaka","doi":"10.1055/s-0043-1775989","DOIUrl":"10.1055/s-0043-1775989","url":null,"abstract":"<p><strong>Background: </strong> There are some cases where a radial artery (RA) graft is needed for a high-flow extracranial to intracranial (EC-IC) bypass as the external carotid artery (ECA) cannot be utilized as a donor artery. In this report, we describe two cases of extracranial vertebral artery (VA) to middle cerebral artery (MCA) high-flow bypass using an RA graft with an artificial vessel as an alternative bypass technique.</p><p><strong>Methods: </strong> The patient was placed supine with a head rotation of 80 degrees. After frontotemporal craniotomy, another C: -shaped skin incision was made at the retroauricular region and the V3 portion of the VA was exposed at the suboccipital triangle. Prior to attempting the high-flow bypass, the superficial temporal artery (STA) was anastomosed to the M4 portion of the MCA as an insurance bypass. The RA graft was anastomosed to the V3 portion of the VA that traveled under the periosteum at the supra-auricular region through an artificial vessel. After RA-M2 anastomosis, an alternative EC-IC bypass, the V3-RA-M2 bypass, was achieved.</p><p><strong>Results: </strong> Postoperative angiography demonstrated successful graft patency and no perioperative complications were observed in both cases.</p><p><strong>Conclusions: </strong> In the cases where a high-flow bypass is required, the V3 portion of the VA is a suitable alternative proximal anastomosis site when the ECA is not a candidate donor. Furthermore, an artificial vessel shows satisfactory protection against graft complications.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"99-104"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41203561","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":"Subdural Hematoma due to Dural Metastasis: A Systematic Review on Frequency, Clinical Characteristics, and Neurosurgical Management.","authors":"Bhavya Pahwa, Anish Tayal, Atulya Chandra, Joe M Das","doi":"10.1055/s-0044-1782141","DOIUrl":"10.1055/s-0044-1782141","url":null,"abstract":"<p><strong>Background: </strong> Subdural hematoma (SDH) occasionally accompanies dural metastasis and is associated with high recurrence rate, significantly impacting patient morbidity and mortality. This systematic review aims to evaluate the characteristics, management options, and outcomes of patients with SDH associated with dural metastasis.</p><p><strong>Methods: </strong> A comprehensive search of the PubMed and Cochrane databases was conducted for English-language studies published from inception to March 20, 2023, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The authors reviewed cases of histopathologically confirmed SDH with non-central nervous system (non-CNS) tumor metastasis, focusing on therapeutic management of SDH. Statistical analysis was performed using SPSS software, with a significance level set at 0.05.</p><p><strong>Results: </strong> This review included 32 studies comprising 37 patients with 43 SDH cases associated with dural metastasis. Chronic SDH was the most frequently observed presentation (<i>n</i> = 28, 65.12%). The systemic malignancies most commonly associated with SDH due to dural metastasis were prostate carcinoma (<i>n</i> = 9, 24.32%) and gastric carcinoma (<i>n</i> = 5, 13.51%). A statistically significant association was found between metastatic melanoma and subacute SDH (<i>p</i> = 0.010). The majority of patients were treated with burr holes (<i>n</i> = 15, 40.54%) or craniotomies (<i>n</i> = 14, 37.84%), with no statistically significant difference in mortality rates between the two techniques (<i>p</i> = 0.390). Adjuvant therapy was administered to a limited number of patients (<i>n</i> = 5, 13.51%), including chemotherapy (<i>n</i> = 2, 5.41%), whole brain radiotherapy (<i>n</i> = 1, 2.70%), a combination of chemotherapy and whole brain radiotherapy (<i>n</i> = 1, 2.70%), and transcatheter arterial chemoembolization (<i>n</i> = 1, 2.70%). The overall recurrence rate was 45.95% (<i>n</i> = 17), with burr holes being the most common management approach (<i>n</i> = 4, 10.81%). Within a median of 8 days, 67.57% (<i>n</i> = 25) of patients succumbed, primarily due to rebleeding (<i>n</i> = 3, 8.11%), disseminated intravascular coagulation (<i>n</i> = 3, 8.11%), and pneumonia (<i>n</i> = 3, 8.11%).</p><p><strong>Conclusion: </strong> This review highlights the need for improving existing neurosurgical options and exploring novel treatment methods. It also emphasizes the importance of dural biopsy in patients with suspected metastasis to rule out a neoplastic etiology.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"73-84"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028254","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":"Brain Abscess: A Comparison of Surgical Outcomes between Conventional Burr Hole Aspiration and Endoscope-Assisted Evacuation.","authors":"Md Farhad Ahmed, Sumon Rana, Kanij Fatema Ishrat Zahan, Shirazum Munira, Mohammad Shafiqul Islam, Monzurul Haque, Bhavya Pahwa, Levent Aydin, Giuseppe Emmanuele Umana, Bipin Chaurasia","doi":"10.1055/a-2175-3018","DOIUrl":"10.1055/a-2175-3018","url":null,"abstract":"<p><strong>Background: </strong> Brain abscesses are a major health problem with significant morbidity and mortality rates. The objective of this study was to compare the surgical efficacy of endoscope-assisted evacuation of a brain abscess with that of single burr hole aspiration in a tertiary health care center.</p><p><strong>Methods: </strong> This single-center nonrandomized clinical study was conducted during the period from July 2020 to December 2021. Male and female patients younger than 30 years who presented with brain abscess were enrolled in this study. They were divided into two groups and treated with two different techniques: conventional burr hole aspiration group and endoscope-assisted evacuation group.</p><p><strong>Results: </strong> Thirty patients were enrolled in this study. The mean age was 13.0 ± 6.3 years in the burr hole group and 13.1 ± 6.4 years in the endoscope-assisted group. There was ≥75.0% evacuation of brain abscess on postoperative day 1 in 13 (92.9%) patients in the endoscope-assisted group and in 5 (33.3%) patients in the burr hole group. The mortality rate was 6.7% in both groups. The mean residual volume on postoperative day 30 was 0.75 mL in the endoscope-assisted group and 1.75 mL in the burr hole aspiration group. No patients treated with endoscope-assisted evacuation required a repeat surgery, whereas five patients (33.3%) treated with the conventional burr hole method required a repeat surgery.</p><p><strong>Conclusions: </strong> This study showed that the endoscope-assisted procedure has a better rate of abscess evacuation, lower residual risk, and less chance of repeat surgeries than the conventional burr hole procedure.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"12-16"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10285692","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":"Ventriculoperitoneal Shunt Surgery in Pediatrics: Does Preoperative Skin Antisepsis with Chlorhexidine/Alcohol Reduce Postoperative Shunt Infection Rate?","authors":"Ahmed Shawky Ammar, Hossam Elnoamany, Hany Elkholy","doi":"10.1055/a-2265-9325","DOIUrl":"10.1055/a-2265-9325","url":null,"abstract":"<p><strong>Background: </strong> In pediatrics, shunt infection is considered the most common complication of ventriculoperitoneal (VP) shunt insertion and the main cause of shunt failure. Careful surgical technique and hygienic skin preparations are highly important for prevention of shunt infections. Our objective was to assess the significance of using preoperative chlorhexidine/alcohol as a skin antiseptic in reducing the infection rate in pediatric VP shunts surgery.</p><p><strong>Methods: </strong> We conducted a retrospective, case control study of 80 pediatric patients with active hydrocephalus. The control group (a single step of preoperative skin antisepsis using povidone-iodine and isopropyl alcohol) comprised 40 patients who underwent a shunt surgery between January 2019 and June 2020 and the study group (two steps of preoperative skin antisepsis using 2% chlorhexidine gluconate in 70% isopropyl alcohol as a first step followed by povidone-iodine as a second step) comprised 40 patients who underwent a shunt surgery between July 2020 and January 2022.</p><p><strong>Results: </strong> Shunt infection was encountered in 11 (13.7%) patients. It was significantly higher in preterm babies (<i>p</i> = 0.010), patients with a previous shunt revision (<i>p</i> < 0.001), and those with a previous shunt infection (<i>p</i> < 0.001). The incidence of infection was 22.5% in the control group and 5% in study group, with a statistically significant difference (<i>p</i> = 0.023).</p><p><strong>Conclusions: </strong> Two steps of preoperative skin antisepsis, first using chlorhexidine/alcohol and then povidone-iodine scrub solution, may significantly reduce the infection rate in pediatric VP shunt surgeries.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"65-72"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139712417","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 Enigma of Basilar Artery Dissections Secondary to Vasospasm Following Subarachnoid Hemorrhage. Exploration of the Unknown Effect of Superior Cervical Ganglia: A Preliminary Experimental Study.","authors":"Mete Zeynal, Mehmet Hakan Sahin, Ayhan Kanat, Mehmet Kursat Karadag, Sare Sipal, Saban Ergene, Mehmet Dumlu Aydin","doi":"10.1055/a-2104-1520","DOIUrl":"10.1055/a-2104-1520","url":null,"abstract":"<p><strong>Background: </strong> Life-threatening basilar artery dissection (BAD) can be seen following subarachnoid hemorrhage (SAH), but it is not clear whether SAH causes dissection, or not. This study aims to investigate the relationship between degenerative changes in the superior cervical ganglia and the dissection rate of the basilar artery.</p><p><strong>Method: </strong> In this study, after 3 weeks of experimental SAH, animals were decapitated. Eighteen rabbits were divided into three groups according to their vasospasm indices. The basilar arteries were examined by anatomical and histopathologic methods.</p><p><strong>Results: </strong> Basilar dissection with high vasospasm index (VSI) value (VSI > 3) was detected in six animals (group I); severe basilar edema and moderate VSI value (>2.4) were detected in seven rabbits (group II); and slight VSI value (<1.5) was detected in five subjects (group III). The degenerated neuron densities of the superior cervical ganglia were 12 ± 4 n/mm³ in group I, 41 ± 8 n/mm³ in group II, and 276 ± 78 n/mm³ in group III. The dissected surface values/lumen values were calculated as (42 ± 1)/(64 ± 11) in G-I, (21 ± 6)/(89 ± 17) in group II, and (3 ± 1)/(102 ± 24) in group III. If we look at these ratios as a percentage, it was 62% in group I, 23% in group II, and 5% in group III.</p><p><strong>Conclusion: </strong> Inverse relationship between the degenerated neuron densities of the superior cervical ganglia and the dissected surface values of the basilar artery was observed. Common knowledge is that BAD may lead to SAH; however, this study indicates that SAH is the cause of BAD.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"56-64"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9561997","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":"Radiosurgery as a Stand-Alone Treatment Option for Cerebral Dural Arteriovenous Fistulas: The Vienna Series.","authors":"Beate Kranawetter, Anna Cho, Dorian Hirschmann, Philipp Göbl, Christian Dorfer, Karl Rössler, Philippe Dodier, Wei-Te Wang, Brigitte Gatterbauer, Andreas Gruber, Klaus Kitz, Josa M Frischer","doi":"10.1055/a-2235-5256","DOIUrl":"10.1055/a-2235-5256","url":null,"abstract":"<p><strong>Background: </strong> Gamma Knife radiosurgery (GKRS) has been demonstrated to be an effective and safe treatment method for dural arteriovenous fistulas (DAVFs). However, only few studies, mostly with limited patient numbers, have evaluated radiosurgery as a sole and upfront treatment option for DAVFs.</p><p><strong>Methods: </strong> Thirty-three DAVF patients treated with GKRS as a stand-alone management at our institution between January 1992 and January 2020 were included in this study. Obliteration rates, time to obliteration, neurologic outcome, and complications were evaluated retrospectively.</p><p><strong>Results: </strong> Complete overall obliteration was achieved in 20/28 (71%) patients. The postradiosurgery actuarial rates of obliteration at 2, 5, and 10 years were 53, 71, and 85%, respectively. No difference in time to obliteration between carotid-cavernous fistulas (CCFs; 14/28, 50%, 17 months; 95% confidence interval [CI]: 7.4-27.2) and non-CCFs (NCCFs; 14/28, 50%, 37 months; 95% CI: 34.7-38.5; <i>p</i> = 0.111) were found. Overall, the neurologic outcome in our series was highly favorable at the time of the last follow-up. A complete resolution of symptoms was seen in two-thirds (20/30, 67%) of patients. One patient with multiple DAVFs suffered from an intracranial hemorrhage of the <i>untreated</i> lesion and died during the follow-up period, resulting in a yearly bleeding risk of 0.5%. No complications after radiosurgery were observed in our series.</p><p><strong>Conclusion: </strong> Our results show that GKRS is a safe and effective stand-alone management option for selected DAVF patients.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"48-55"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048916","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":"Pineal Apoplexy: Highlighting the Causes, Treatment, and Outcome.","authors":"Oday Atallah, Bipin Chaurasia, Amr Badary, Lucio De Maria, Yasser F Almealawy, Wireko Andrew Awuah, Wahab Moustafa, Anil Ergen, Marco Maria Fontanella","doi":"10.1055/s-0044-1786538","DOIUrl":"10.1055/s-0044-1786538","url":null,"abstract":"<p><strong>Background: </strong> Pineal apoplexy, alternatively referred to as pineal hemorrhage or pineal gland hemorrhagic stroke, is an infrequent pathologic condition characterized by bleeding within the pineal gland. In this review, we encompass the primary factors contributing to this uncommon ailment.</p><p><strong>Methods: </strong> The retrieval of pertinent research, including patients with pineal apoplexy, was conducted through PubMed, Google Scholar, and Scopus databases. This study exclusively incorporated comprehensive articles written in the English language. The search encompassed the MeSH terms \"pineal apoplexy\" and \"pineal hemorrhage.\"</p><p><strong>Results: </strong> A total of 41 articles were identified, encompassing a collective sample size of 57 patients. The median age of the patients in the study was 30 years, with a range spanning from 1 to 73 years. There were 27 males, representing 47.4% of the participants. The study identified the most often reported symptoms as headache (49; 86%), nausea/vomiting (19; 33.3%), and Parinaud's syndrome (16; 28.1%). The treatment options encompass several approaches, including open resection, shunting, ventriculostomy, endoscopic aspiration, and conservative care. In the conducted study, a notable number of patients, amounting to 45 cases (78.9%), indicated an amelioration of their symptoms upon their discharge.</p><p><strong>Conclusion: </strong> Data from a cohort of 57 cases provide insights into symptoms, lesions, treatments, and outcomes. Management approaches range from conservative measures to surgical interventions, with prognosis hinged on timely intervention. This investigation serves as a valuable resource for clinicians and researchers, underscoring the need for early diagnosis before permanent neurologic dysfunction happens and tailored treatments for optimal outcomes in pineal apoplexy cases.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"85-98"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093751","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":"Elevated HSPB1 Expression Is Associated with a Poor Prognosis in Glioblastoma Multiforme Patients.","authors":"Zhihua Wang, Zhaohua Fang, Yongping Gui, Bin Xi, Zhiping Xie","doi":"10.1055/s-0043-1777761","DOIUrl":"10.1055/s-0043-1777761","url":null,"abstract":"<p><strong>Background: </strong> Glioblastoma multiforme (GBM) is a highly aggressive form of brain cancer. This study investigated the clinical predictive value of heat shock protein β1 (HSPB1) in patients with GBM.</p><p><strong>Methods: </strong> A correlation was established between HSPB1 expression and GBM progression using data from The Cancer Genome Atlas (TCGA) dataset, Chinese Glioma Genome Atlas dataset, Gene Expression Omnibus dataset, and Human Protein Atlas database. A survival analysis was conducted and an HSPB1-based nomogram was constructed to evaluate the prognostic value of HSPB1 in patients with GBM.</p><p><strong>Results: </strong> Based on TCGA data mining, we discovered that HSPB1 was significantly elevated in patients with GBM and may reflect their response to immunotherapy. In survival analysis, it appeared to have a predictive role in the prognosis of patients with GBM. Five signaling pathways were significantly enriched in the high HSPB1 expression phenotype according to the gene set enrichment analysis. In addition, a significant association was found between HSPB1 expression and immune checkpoints, tumor immune infiltration, tumor immune microenvironment, and immune cell markers in glioma. Overall, our results suggest that HSPB1 may regulate the function of immune cells, serve as a new immunotherapy target, and predict the response to immunotherapy in patients with GBM.</p><p><strong>Conclusion: </strong> HSPB1 appears to serve as a potential predictor of the clinical prognosis and response to immunotherapy in patients with GBM. It may be possible to identify patients who are likely to benefit from immunotherapy by assessing the expression level of HSPB1.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"17-29"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498290","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":"Comparing Three-dimensional and Two-dimensional Preoperative Planning for Lumbar Transpedicular Screw Placement: A Retrospective Study.","authors":"Hüseyin Doğu, Anas Abdallah, Ali O Muçuoğlu, Nail Demirel, N Mehmet Elmadağ","doi":"10.1055/a-2175-3215","DOIUrl":"10.1055/a-2175-3215","url":null,"abstract":"<p><strong>Background: </strong> Transpedicular screw (TPS) misplacement is still a nightmare for spine surgeons. Preoperative planning is one of the methods that a surgeon could use to minimize this complication. This study aims to compare the efficacy of three-dimensional (3D) and two-dimensional (2D) preoperative planning in posterior lumbar TPSs placement performed using the freehand technique.</p><p><strong>Patients and methods: </strong> Patients who underwent posterior TPSs placement for degenerative lumbar spondylolisthesis or spinal stenosis using the freehand technique between November 2021 and October 2022 were evaluated retrospectively. In total, 33 and 30 patients who met the inclusion criteria were consecutively operated on with preoperative 2D and 3D planning, respectively. The patients were divided into the 2D preoperative planning group (2DG) and 3D preoperative planning group (3DG) and the two groups were compared.</p><p><strong>Results: </strong> Sixty-three patients were operated during the study period. There was no significant difference between the groups regarding blood transfusion, operation time, and radiation exposure. Although the accuracy of TPSs positioning was 94.2 and 96.5% in the 2DG and 3DG, respectively, the difference between the groups was not statistically significant. The upper facet joint violation rate was 12.8% (<i>n</i> = 20) in the 2DG versus 3.5% (<i>n</i> = 5) in the 3DG (<i>p</i> = 0.006). All L4 TPSs were inserted with their standard entry points without any modification (<i>p</i> < 0.0001; relative/risk ratio = 0.64). The modification rate was higher in L1, L2, and L5 TPSs (<i>p</i> < 0.0001; <i>χ</i> ² = 24.7).</p><p><strong>Conclusion: </strong> For patients with degenerative lumbar diseases, 3D preoperative planning in posterior lumbar instrumentation surgeries performed with the freehand technique decreased the upper facet joint violation rate.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"1-11"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10670382","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}