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

{"title":"A New Concept for Cervical Expansion Screws Using Shape Memory Alloy: A Feasibility Study.","authors":"Ronny Grunert, Dirk Winkler, Nikolas Knoop, Martin Weidling, Cornelia Matzke, Sebastian Scholz, Juergen Meixensberger, Felix Arlt","doi":"10.1055/a-2206-2578","DOIUrl":"10.1055/a-2206-2578","url":null,"abstract":"<p><strong>Background: </strong> In general, sufficient anchoring of screws in the bone material ensures the intended primary stability.</p><p><strong>Methods: </strong> Shape memory materials offer the option of using temperature-associated deformation energy in a targeted manner to compensate the special situation of osteoporotic bones or the potential lack of anchoring. An expansion screw was developed for these purposes. Using finite element analysis (FEA), the variability of screw configuration and actuator was assessed from shape memory. In particular, the dimensioning of the screw slot, the actuator length, and the actuator diameter as well as the angle of attack in relation to the intended force development were considered.</p><p><strong>Results: </strong> As a result of the FEA, a special configuration of expansion screw and shape memory element could be found. Accordingly, with an optimal screw diameter of 4 mm, an actuator diameter of 0.8 mm, a screw slot of 7.8 mm in length, and an angle of attack of 25 degrees, the best compromise between individual components and high efficiency in favor of maximum strength can be predicted.</p><p><strong>Conclusion: </strong> Shape memory material offers the possibility of using completely new forms of power development. By skillfully modifying the mechanical and shape memory elements, their interaction results in a calculated development of force in favor of a high primary stability of the screw material used. Activation by means of body temperature is a very elegant way of initializing the intended locking and screw strength.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"128-134"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71521835","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":"Technical Standards in Neurosurgery in Germany around 1950.","authors":"Peter A Winkler","doi":"10.1055/a-2558-3355","DOIUrl":"https://doi.org/10.1055/a-2558-3355","url":null,"abstract":"<p><p>The technical state of neurosurgery in Germany around 1950 was characterized by the limitations imposed by the postwar period in a war-damaged, challenging environment. Neurosurgeons from that era had to rely on their skills, knowledge, and improvisational skills when performing complex procedures with limited resources. The development of neurosurgery was also shaped by the division of the country with the establishment of different neurosurgical schools in East and West Germany. Despite these great challenges, German neurosurgery made significant contributions to the development of the field during this time. Significant and important advances were made in hemostatic techniques, anesthesiology, and the development of new surgical instruments. Limitations in resources and technology posed enormous challenges. Craniotomy, which is presented as an example, represents the long and complex path of development of our specialty.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":"86 S 01","pages":"S33-S42"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119846","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":"Craniotomy versus Decompressive Craniectomy in Acute Subdural Hematoma Management: A Systematic Review and Meta-Analysis.","authors":"Mohammed Maan Al-Salihi, Maryam Sabah Al-Jebur, Yezan Al-Salihi, Elias Dumour, Ahmed Saleh, Mhran Daie, Firas Hammadi, Ali Ayyad","doi":"10.1055/s-0044-1791539","DOIUrl":"10.1055/s-0044-1791539","url":null,"abstract":"<p><strong>Background: </strong> This study aimed to compare the clinical outcomes of decompressive craniectomy (DC) and craniotomy in treating acute subdural hematoma (ASDH) to provide a more precise assessment of the procedures' outcomes.</p><p><strong>Methods: </strong> We searched for relevant articles in PubMed, Web of Science, Embase, Scopus, and Cochrane till August 2023, including cohort studies and randomized controlled trials comparing craniotomy and DC for ASDH. The analysis was conducted using \"Review Manager\" software, using the risk ratio along with a 95% confidence interval (CI) for categorical data, whereas continuous data were analyzed using the mean difference (MD) and 95% CI.</p><p><strong>Results: </strong> Our analysis included 13 studies with a total of 4,689 patients, of whom 1,910 (40.7%) underwent DC and 2,779 (59.3%) underwent craniotomy. The results revealed a statistically significant difference in favor of craniotomy concerning good recovery in delayed GOS (risk ratio [RR] = 1.42; 95% CI [1.12, 1.81]), postoperative mortality (RR = 0.81; 95% CI [0.71, 0.94]), mortality at last follow-up (RR = 0.75; 95% CI [0.62, 0.91]), and hospital stay (MD = -3.71; 95%CI [-5.82, -1.60]). A nonsignificant difference (RR = 1.06; 95% CI [0.52, 2.17]; <i>p</i> = 0.87) was found between the two interventions concerning seizures.</p><p><strong>Conclusion: </strong> Despite craniotomy's favorable clinical outcomes and mortality rates, the significant baseline differences between DC and craniotomy make these data inconclusive. To establish solid evidence regarding the use of DC versus craniotomy in ASDH, it is necessary to conduct well-controlled randomized studies with large sample sizes.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"182-195"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391155","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":"Participation of Neurosurgery in the Basic Neurosciences as Documented in the Annual Volumes of the Zentralblatt für Neurochirurgie around 1950.","authors":"Uwe H Wiese","doi":"10.1055/a-2558-3368","DOIUrl":"https://doi.org/10.1055/a-2558-3368","url":null,"abstract":"<p><p>The proportion of basic neuroscientific contributions in the <i>Zentralblatt für Neurochirurgie</i> in volumes 9, 10, and 11, which had been published from 1949 to 1951, thus available to the specialist public nationally and internationally during the founding phase of the German Society of Neurosurgery (Deutsche Gesellschaft für Neurochirurgie/DGNC), was examined. The results of the study indicate a high level of basic neuroscientific contributions, therefore reflecting a strong interest in the corresponding fundamentals of clinical neurosurgery.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":"86 S 01","pages":"S43-S48"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119845","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":"International Relations of German Neurosurgeons after 1945 and the Evolution of the European Association of Neurosurgical Societies.","authors":"Hartmut Collmann, Ulrike Eisenberg, Wolf-Ingo Steudel, Jürgen Piek","doi":"10.1055/a-2558-3403","DOIUrl":"https://doi.org/10.1055/a-2558-3403","url":null,"abstract":"<p><p>International relationships of early German neurosurgeons had a long tradition. These connections had been cut off after World War II and could initially be re-established only at a personal level. In this context, Klaus Joachim Zülch, Kurt Schürmann, Hans Werner Pia, Friedrich Loew, and Arist Stender played a significant role. It took nearly two decades to establish good connections at an institutional level. During this process, major support came from France and should be considered as part of a growing cooperation of European states in various fields. The 1959 meeting of French, Swiss, and German neurosurgeons in Zürich was a crucial event, which ultimately led to the foundation of the European Association of Neurosurgical Societies.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":"86 S 01","pages":"S59-S64"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119709","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":"Artificial Intelligence Prediction Model of Occurrence of Cerebral Vasospasms Based on Machine Learning.","authors":"Konstantinos Lintas, Stefan Rohde, Anna Mpoukouvala, Boris El Hamalawi, Robert Sarge, Oliver Marcus Mueller","doi":"10.1055/a-2402-6136","DOIUrl":"10.1055/a-2402-6136","url":null,"abstract":"<p><strong>Background: </strong> Symptomatic cerebral vasospasms are deleterious complication of the rupture of a cerebral aneurysm and potentially lethal. The existing scales used to classify the initial presentation of a subarachnoid hemorrhage (SAH) offer a blink of the outcome and the possibility of occurrence of symptomatic cerebral vasospasms. Altogether, neither are they sufficient to predict outcome or occurrence of events reliably nor do they offer a united front. This study tests the common grading scales and factors that otherwise affect the outcome, in an artificial intelligence (AI) based algorithm to create a reliable prediction model for the occurrence of cerebral vasospasms.</p><p><strong>Methods: </strong> Applying the R environment, an easy-to-operate command line was programmed to prognosticate the occurrence of vasospasms. Eighty-seven patients with aneurysmal SAH during a 24-month period of time were included for study purposes. The holdout and cross-validation methods were used to evaluate the algorithm (65 patients constituted the validation set and 22 patients constituted the test set). The Support Vector Machines (ksvm) classification method provided a high accuracy. The medical dataset included demographic data, the Hunt and Hess scale (H&H), Fisher grade, Barrow Neurological Institute (BNI) scale, length of intervention for aneurysmal repair, etc. RESULTS:  Our prediction model based on the AI algorithm demonstrated an accuracy of 61 to 86% for the event of symptomatic vasospasms. For subgroup analysis, 28.8% (<i>n</i> = 13) patients in the surgical cohort developed symptomatic vasospasm. Of these, 50% (<i>n</i> = 7) were admitted with Fisher scale grade 4, 37.5% (<i>n</i> = 5) with H&H 5, and 28.5% (<i>n</i> = 4) with BNI 5. In the endovascular cohort, vasospasms occurred in 31.8% (<i>n</i> = 14) patients. Of these, 69% (<i>n</i> = 9) patients were admitted with Fisher grade 4, 23% (<i>n</i> = 3) patients with H&H 5, and 7% (<i>n</i> = 1) patients with BNI 5.</p><p><strong>Conclusion: </strong> From our data, we may believe that the algorithm presented can help in identifying patients with SAH who are at \"high\" or \"low\" risk of developing symptomatic vasospasms. This risk balancing might further allow the treating physician to go for an earlier intervention trying to prevent permanent sequelae. Certainly, accuracy will improve with a higher caseload and more statistical coefficients.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"196-204"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046763","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 Evolution of the Deutsche Gesellschaft für Neurochirurgie (German Society of Neurosurgery).","authors":"Hartmut Collmann, Jutta Krüger","doi":"10.1055/a-2558-3263","DOIUrl":"https://doi.org/10.1055/a-2558-3263","url":null,"abstract":"<p><p>In Germany, an independent society of neurosurgical specialists was devised in 1937 and from the beginning it was contemplated as a European association. National Socialist's politics and the looming next World War shelved these plans. Only in 1948, at the first postwar meeting of German neurosurgeons, appropriate preparations toward a national neurosurgical society were made under the leadership of Wilhelm Tönnis. In 1949, seven founding members, almost all of them being former trainees of Tönnis, established this new medical society and named it \"Deutsche Gesellschaft für Neurochirurgie,\" and also took care for registration after the third postwar meeting in Bonn. A total of 256 applicants signed in a list for membership, a minority of them being surgically active. Of 21 female applicants, none worked as neurosurgeons thereafter. All seven founding members were residents of the three western occupation zones, reflecting the upcoming Cold War, and de facto segregated those neurosurgeons living and working in East Germany under Soviet military control.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":"86 S 01","pages":"S4-S8"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119847","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":"Robotic Frameless Stereotactic Aspiration with Thrombolysis for Primary Pontine Hemorrhage: A Therapeutic Evaluation of a Retrospective Cohort Study.","authors":"Chongxi Xu, Wenbo He, Tong Yi, Hongtian Zhang, Jianguo Xu, Junpeng Ma","doi":"10.1055/a-2235-5453","DOIUrl":"10.1055/a-2235-5453","url":null,"abstract":"<p><strong>Background: </strong> There is still no consensus on whether primary pontine hemorrhage (PPH) should be managed conservatively or treated promptly via surgical evacuation of the hematoma. The purpose of this study was to assess the therapeutic effect of robotic frameless stereotactic aspiration with thrombolysis in the treatment of PPH.</p><p><strong>Methods: </strong> A total of 39 patients with PPH treated between January 2012 and November 2016 were included in the study. Sixteen patients underwent frameless stereotactic surgical treatment (ST group) and 23 patients underwent conservative treatment (CT group). Clinical and radiologic parameters were assessed, and the patient outcomes were analyzed over a 6-month follow-up period.</p><p><strong>Results: </strong> Surgical treatment did not result in any intracranial infections, or complications. Baseline characteristics did not significantly differ between the two groups. At discharge, the average Glasgow Coma Scale (GCS) score and the overall Glasgow Outcome Scale (GOS) score were significantly higher in the ST group compared to the CT group (<i>p</i> < 0.05). The mortality rate (GOS score 1) was significantly lower in the ST group (18.75%, 3/16) than in the CT group (52.17%, 12/23). For patients with hematoma volumes of 5 to 10 mL or GCS scores of 6 to 8, following treatment, the ST group exhibited markedly higher GOS scores in comparison to the CT group.</p><p><strong>Conclusion: </strong> Our study suggests that robotic frameless stereotactic aspiration with thrombolysis is a safe and efficient method for the treatment of PPH. Patients with hematomas of 5 to 10 mL or GCS scores of 6 to 8 could benefit from surgery.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"111-119"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048918","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":"Neurosurgery in Germany Around 1950. On the 75th Anniversary of the German Society of Neurosurgery (DGNC).","authors":"Ulrike Eisenberg, Hartmut Collmann","doi":"10.1055/a-2558-3445","DOIUrl":"https://doi.org/10.1055/a-2558-3445","url":null,"abstract":"","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":"86 S 01","pages":"S1"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119711","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":"Establishing Safe Surgical Parameters for Placement of C2 Pedicle Screws: A Retrospective Study.","authors":"Bekir Tunç, Denizhan Divanlıoğlu, Göksal Günerhan, Egemen Işıtan, Emin Çağıl, Ali Dalgıç","doi":"10.1055/a-2235-5381","DOIUrl":"10.1055/a-2235-5381","url":null,"abstract":"<p><strong>Background: </strong> The study aimed to evaluate the safety and feasibility of transpedicular instrumentation for the C2 vertebra and to establish the precise anatomical parameters and boundaries within which this procedure can be safely and effectively performed.</p><p><strong>Methods: </strong> This retrospective study analyzed 66 patients who underwent C2 transpedicular screw fixation. Preoperative and postoperative axial, sagittal, and coronal computed tomography (CT) scans were examined. Anatomical measurements were taken to determine the horizontal and vertical distances from the C2 pedicle projection to the vertebral foramen using CT images. Based on the anatomical location of the vertebral artery within the C2 vertebral foramen, the patients were divided into four subgroups using the horizontal pedicle width (HPW) and vertical pedicle width (VPW) of the C2 spine.</p><p><strong>Results: </strong> The average age of the patients included in the study was 46.48 years. The patient population comprised 32 (48.5%) males and 34 (51.5%) females. Based on the anatomical measurements, the distribution of C2 vertebra types was as follows: type 1 accounted for 68.9%, type 2 for 3.8%, type 3 for 16.7%, and type 4 for 10.6%. Significantly narrower pedicle widths were observed in types 2 and 4 compared to other vertebra types. Type 2 had the largest medial angle (MA), while type 4 had the narrowest MA. In terms of the sagittal plane, type 4 exhibited the widest MA and type 3 had the narrowest MA, but these differences were not statistically significant. Among the cases, 12 (18.1%) involved the vertebral foramen, with 1 case (8.3%) showing screw-related vertebral artery injury (0.75% of all screws). No vertebral artery injuries were observed with the other transpedicular screws.</p><p><strong>Conclusion: </strong> Preoperative anatomical measurements for patients undergoing transpedicular instrumentation on the C2 vertebra should include planning CT images on three planes: axial, sagittal, and coronal.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"162-168"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048915","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}