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

{"title":"Patient-Specific Highly Realistic Spine Surgery Phantom Trainers.","authors":"Azad Malikov, Tural Rahimli, Rovshan Khalilzada, Sabir Etibarli, Ozgur Ocal","doi":"10.1055/a-2576-7222","DOIUrl":"10.1055/a-2576-7222","url":null,"abstract":"<p><p>A realistic phantom created from a three-dimensional (3D)-reconstructed digital patient model would enable researchers to investigate the morphological aspects of the pathological spine, thereby resolving the issue of scarce cadaveric specimens. We designed a patient-specific, human-like, reliable, and cost-effective prototype of the examined pathological spine through open-source editing software analysis, a desktop 3D printer, and alginate material. We aimed to validate that the major surgical steps and anatomy replicated the real surgery as it would be conducted in actual patients.We cover the fundamental principles and procedures involved in 3D printing, from spine imaging to phantom manufacturing. Three representative simulation cases were included in the study. All phantoms were sequentially evaluated by surgeons for fidelity. Following each surgery, participants were given a survey that included 20 questions regarding the fidelity of the training phantom.We validated this simulation model by analyzing neurosurgeons' performance on the phantom trainer. Based on a 20-item survey to test content validity and reliability, there was little variation among participants' ratings, and the feedback was consistently positive. The gross appearance of the phantom was analogous to the cadaveric specimen and the phantoms demonstrated an excellent ability to imitate the intraoperative condition. The plastic material expenditure ranged from 170 to 470 g, and the alginate expenditure was 450 g. The total cost of acrylonitrile butadiene styrene (ABS) varied from $5.1 to $17.6 ($0.03 per gram of ABS), whereas the total cost of alginate was $14.3. The average cost of our phantoms was approximately $25.7, and the 3D printer used in this study costs approximately $200.The basic properties of this phantom were similar to cadaveric tissue during manipulation. We believe our phantoms have the potential to improve skills and minimize risk for patients when integrated into trainee education.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"23-31"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811659","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><p>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.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.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.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":"32-38"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","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":"Partial Detachment of the Gluteus Maximus Muscle to Expose the Proximal Third of the Sciatic Nerve in the Infragluteal Approach: An Alternative Technique to Minimize Iatrogenic Muscle Deafferentation Damage.","authors":"Filippo Gagliardi, Pierfrancesco De Domenico, Marco Ometti, Carlo Mandelli, Elena Virginia Colombo, Pietro Mortini","doi":"10.1055/a-2649-7736","DOIUrl":"10.1055/a-2649-7736","url":null,"abstract":"<p><p>Exposing the proximal extrapelvic sciatic nerve usually requires a partial transsection of the gluteus maximus muscle. The authors describe a modified infragluteal technique for mobilizing the gluteus maximus muscle, with only partial detachment of the muscle aponeurosis attaching to the femur.An illustrative case is reported to demonstrate the surgical feasibility of the approach. The present technique offers good operability, with only a slight decrease in the angle of the surgical corridor compared with the standard infragluteal and transgluteal techniques, while preventing muscle damage resulting from muscle deafferentation.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"58-62"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130778","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":"Diagnostic Value of Enhanced Computed Tomography and Magnetic Resonance Imaging in Intracranial Infections after Craniocerebral Surgery.","authors":"Wen Su, Honghui Luo, Lieyin Xu, Ge Cheng, Xiaotian Li, Bin Lin, Zhipeng Zhou","doi":"10.1055/a-2558-5497","DOIUrl":"10.1055/a-2558-5497","url":null,"abstract":"<p><p>This study investigated the diagnostic value of enhanced computed tomography (CT) and magnetic resonance imaging (MRI) in postoperative intracranial infections in patients undergoing craniocerebral surgery.A total of 130 patients suspected of developing intracranial infection after cranial surgery were included in the study. All patients underwent MRI and CT examinations. The results of cerebrospinal fluid (CSF) culture were observed. The diagnostic efficacy of CT and MRI for intracranial infections was compared. In addition, univariate and multivariate logistic regression analyses were conducted to identify the factors influencing intracranial infections after surgery.By CSF culture, 45 intracranial infections were finally diagnosed in 130 patients with suspected intracranial infections, including 20 cases of <i>Staphylococcus aureus</i> infections (44.44%), 14 cases of <i>Staphylococcus haemolyticus</i> infections (31.11%), and 11 cases of <i>Staphylococcus epidermidis</i> infections (24.44%). The sensitivity, specificity, and accuracy of CT in diagnosing intracranial infections were 51.11, 89.41, and 76.15%, respectively. In comparison, MRI demonstrated a sensitivity of 77.78%, specificity of 92.94%, and accuracy of 87.69% in diagnosing intracranial infections. Logistic multifactorial regression analysis showed that surgical approach, surgical time, CSF leakage, and ventricular drainage were independent risk factors of postoperative intracranial infections (odds ratio > 1, <i>p</i> < 0.05).MRI has a higher diagnostic accuracy for intracranial infections compared with CT. Various factors contribute to the development of intracranial infections following cranial surgery, which warrants careful attention and timely targeted interventions to reduce the risk of such infections.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"11-17"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512054","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":"Meningioma and Cerebral Spindle Cell Sarcoma as Two Different Metachronous Tumor Entities Secondary to Medulloblastoma Treatment in Childhood: Case Report and Review of the Literature.","authors":"Anna Jung, Michael Brodhun, Andreas Lemmer, Rüdiger Gerlach","doi":"10.1055/a-2618-6807","DOIUrl":"10.1055/a-2618-6807","url":null,"abstract":"<p><p>The authors report on a 21-year-old clinically asymptomatic female patient, who was admitted with two supratentorial intradural lesions in her follow-up magnetic resonance imaging 17 years after treatment of a posterior fossa medulloblastoma. Sequential surgical removal was performed. The left parietal tumor with dural involvement was diagnosed as a transitional meningioma WHO (World Health Organization) grade 1. The right temporal lesion, which had also close relationship to the dura, was diagnosed as a spindle cell sarcoma. We therefore report a metachronous tumor development of a benign and a malignant intradural sarcomatous tumor as secondary neoplasms following childhood medulloblastoma treatment.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"63-68"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127904","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 Revision Posterior Lumbar Interbody Fusion for Late Deterioration after Laminotomy Assessed with the Zurich Claudication Questionnaire.","authors":"Hironobu Sakaura, Takahito Fujimori, Tsuyoshi Sugiura, Shutaro Yamada, Sadaaki Kanayama, Daisuke Ikegami","doi":"10.1055/a-2479-4972","DOIUrl":"10.1055/a-2479-4972","url":null,"abstract":"<p><p>A retrospective analysis of prospectively collected data.There have been a few studies comparing surgical outcomes between revision lumbar fusion surgery and the same primary surgery.Using the Zurich Claudication Questionnaire (ZCQ), we compared clinical outcomes of revision posterior lumbar interbody fusion (PLIF) for late deterioration after laminotomy with those of primary PLIF to examine whether surgical outcomes of revision PLIF for late deterioration after laminotomy are inferior to those of primary PLIF.Sixteen consecutive patients undergoing revision single-level PLIF for late deterioration after single-level laminotomy (R group) and 61 consecutive patients undergoing primary single-level PLIF during the same period (P group) were enrolled. Before PLIF surgery and at 2 years postoperatively, clinical outcomes were assessed using the ZCQ. Achievement rates of the minimum clinically important difference (MCID) of each domain (Symptom severity [SS] and Physical function [PF]) on the ZCQ were calculated in each group.In the R group, mean SS and PF before revision PLIF and at 2 years after surgery were 3.429 and 2.8, and 1.946 and 1.6, respectively. In the P group, mean SS and PF before primary PLIF and at postoperative 2 years were 3.438 and 2.5, and 2.194 and 1.6, respectively. Both SS and PF significantly improved at postoperative 2 years in both groups, and SS both before and after PLIF and PF at 2 years postoperatively showed no significant differences between the two groups. Achievement rates of the MCID of SS and PF were 81.3 and 68.8% in the R group, and 59.0 and 59.0% in the P group, respectively. None of the MCID achievement rates of SS and PF showed significant differences between the two groups.Clinical outcomes of revision PLIF for late deterioration after laminotomy were equivalent to those of primary PLIF assessed with the ZCQ at 2 years after PLIF surgery.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"532-536"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682051","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":"Report of the Outcome of 6-year Blood Blister-Like Aneurysm Treatment Using Clipping Technique: A Single-Center Experience.","authors":"Iman Ahrari, Abdelkarim Rahmanian, Meisam Eqbal, Mahsa Ghavipisheh, Ali Namjoo-Moghadam, Sobhan Ahrari, Ehsan Mohammad Hosseini, Mohammad Jamali","doi":"10.1055/a-2568-4665","DOIUrl":"10.1055/a-2568-4665","url":null,"abstract":"<p><p>Blood blister-like aneurysms (BBA) are rare vascular lesions with challenging treatment. While direct surgery has been the primary technique for treating BBA, there has been a shift toward endovascular methods in recent years. This article presents a retrospective case series of patients treated with direct surgery at our center over a 6-year period.Patients who underwent surgery for BBA from 2014 to 2019 were evaluated. Data on surgical procedures, complications, and clinical outcomes were obtained from patients' medical records. Additionally, patients were contacted to provide updates on their treatment outcomes.A total of 17 patients were treated for BBA during the study period. All cases presented with subarachnoid hemorrhage and were treated using the clipping method. Intraoperative rupture occurred in 11 patients. Additionally, internal carotid artery sacrificing was done in five patients due to avulsion during surgery. Of these 17 patients, 11 (64.7%) had favorable outcomes following surgery, while the mortality rate was 29.4% (5 patients).The rate of favorable outcomes and mortality associated with the direct surgery technique at our center was comparable to results from other centers. Further studies are required to determine the optimal method for treating BBA.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"509-515"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742958","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":"Chromosomal Abnormalities and Hydrocephalus: Could There Be an Association between Klinefelter's Syndrome and Idiopathic Normal-Pressure Hydrocephalus?","authors":"Alessandro Pesce, Graziano Taddei, Mauro Palmieri, Silvia Ciarlo, Rita Carnevale, Stefania Elia, Angelo Pompucci, Gianpaolo Petrella","doi":"10.1055/s-0045-1810046","DOIUrl":"10.1055/s-0045-1810046","url":null,"abstract":"<p><p>Idiopathic normal-pressure hydrocephalus shows a typical clinical triad consisting of gait disturbance, dementia, and urinary incontinence, often combined with ventriculomegaly. Fortunately, these clinical manifestations are potentially reversible by adequate surgical treatment. Men affected by Klinefelter's syndrome can present cognitive problems. These include impairments in both verbal and nonverbal memory and in executive functions, which could be related to idiopathic normal-pressure hydrocephalus in these patients. In this study, we describe the case of a 62-year-old-man genetically diagnosed with Klinefelter's syndrome with a history of gait ataxia resulting in recurrent falls. Direct associations between idiopathic normal-pressure hydrocephalus and Klinefelter's syndrome and clinical pathophysiologic and potential molecular implications are discussed.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"591-595"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789339","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":"Shifting the Culture: How Crew Resource Management Can Enhance Team Dynamics in Neurosurgery.","authors":"Marcel Alexander Kamp, Christiane von Sass, Felix Mühlensiepen, Christian Senft, Nazife Dinc","doi":"10.1055/a-2590-6245","DOIUrl":"10.1055/a-2590-6245","url":null,"abstract":"","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"602-606"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506005","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><p>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.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.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.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":"583-590"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","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}