Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko最新文献

{"title":"[Minimally invasive surgery for invaginated CII odontoid process].","authors":"A N Shkarubo, I V Chernov, D N Andreev, N A Konovalov, M E Sinelnikov","doi":"10.17116/neiro2023870315","DOIUrl":"10.17116/neiro2023870315","url":null,"abstract":"<p><p>Odontoidectomy is indicated for anterior compression of the brainstem by invaginated odontoid process. This procedure can currently be performed via transoral microsurgical and transnasal endoscopic access.</p><p><strong>Objective: </strong>To analyze the results of endoscopic transnasal odontoidectomy.</p><p><strong>Material and methods: </strong>We assessed treatment outcomes in 10 patients with anterior compression of the brainstem by invaginated odontoid process. All patients underwent endoscopic transnasal odontoidectomy.</p><p><strong>Results: </strong>Brainstem decompression was achieved in all cases.</p><p><strong>Conclusion: </strong>Currently, endoscopic transnasal approach is gradually replacing the transoral one in some patients requiring anterior odontoidectomy. Analysis of literature data reflects the development of this technique taking into account various features of surgical treatment including optimization of dimensions of surgical field, attempts to perform C1-sparing surgeries and analysis of sufficient size of trepanation. Nasopalatine and nasoclival lines are used to select optimal access. Nevertheless, the choice of access depends on equipment of the hospital and surgical experience in most cases.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9657026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expression of estrogen and progesterone receptors in vestibular schwannomas].","authors":"S R Ilyalov, M V Ryzhova, M V Galkin, S M Banov, A V Golanov, D Yu Usachev","doi":"10.17116/neiro20238701144","DOIUrl":"10.17116/neiro20238701144","url":null,"abstract":"<p><strong>Introduction: </strong>Stereotactic radiosurgery is one of the main treatments for vestibular schwannomas (VS). Their feature is frequent post-radiation pseudoprogression. This may be due to hormonal status of patients.</p><p><strong>Objective: </strong>To analyze expression of progesterone and estrogen receptors in women and men with VS.</p><p><strong>Material and methods: </strong>Immunohistochemical analysis of expression of progesterone (PR) and estrogen receptors (ER) after biopsy was performed in 240 patients with VS between 2018 and 2021. ER/PR expression was assessed in men (<i>n</i>=120) and women (<i>n</i>=120) in 3 age subgroups: young age (18-44 years), middle age (45-59 years) and old age (60-79 years). Each subgroup included 40 patients. Statistical analysis was performed using the Mann-Whitney test and MedCalc software.</p><p><strong>Results: </strong>ER expression is not typical for VS (men - 1 (0.01%), women - 3 (2.5%)). At the same time, PR expression was found in 29 (24.2%) men and 21 (17.5%) women. We found no significant difference in expression of ER and PR between men and women. However, variability in PR expression was revealed, i.e. predominance of this indicator in young women (<i>p</i>=0.0463) and middle-aged men (<i>p</i>=0.0110). Expression of PR was similar in elderly patients (<i>p</i>=0.2382).</p><p><strong>Conclusion: </strong>The established incidence of PR expression may be one of the probable causes affecting development and duration of VS pseudoprogression after radiosurgery without clear relationship between sex and age. Further prospective research is needed to predict the risks of pseudoprogression.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10702677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[En-bloc resection of giant neuroma of thoracic spine via transthoracic extrapleural access: a case report and literature review].","authors":"I Yu Lisitsky, A V Lychagin, A Yu Zarov, A L Korkunov, V G Cherepanov, I A Vyzankin","doi":"10.17116/neiro20238701184","DOIUrl":"10.17116/neiro20238701184","url":null,"abstract":"<p><p>The authors describe surgical treatment of a patient with giant neuroma of thoracic spine. The patient underwent en-bloc resection of tumor via transthoracic extrapleural access. Technical nuances of surgery and operational capabilities of transthoracic extrapleural access for resection of neurogenic tumors of posterior mediastinum are demonstrated. Capabilities of transthoracic extrapleural access are comparable to thoracotomy. The first experience of transthoracic extrapleural access showed its effectiveness in resection of giant neuromas of thoracic spine. Indisputable advantage of this access is less surgical injury compared to thoracotomy. A brief literature review is presented.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10702678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Revision surgery after previous spinal decompression and fusion for lumbar spinal stenosis].","authors":"V B Lebedev, D S Epifanov, I I Osipov, A I Esin, B R Kinzyagulov, A A Zuev","doi":"10.17116/neiro20238701170","DOIUrl":"10.17116/neiro20238701170","url":null,"abstract":"<p><p>Nowadays, vertebral stenosis is the most common indication for surgical treatment in patients over 65 years old in spine surgery. According to the literature, there are conflicting data on the incidence and indications for revision surgery after previous spinal decompression and fusion for lumbar spinal stenosis.</p><p><strong>Objective: </strong>To evaluate the incidence and indications for revision surgery after previous spinal decompression and fusion for lumbar spinal stenosis.</p><p><strong>Material and methods: </strong>A retrospective single-center study enrolled 1233 patients with lumbar spine stenosis who underwent spinal decompression and fusion surgery between 2014 and 2018. The number and causes of readmission were evaluated.</p><p><strong>Results: </strong>There were 164 readmissions. Revision surgery at the same level was performed in 63 patients (38.4%), at the higher level - 72 (43.9%), at the lower level - in 29 (17.7%) patients. The most common indication for readmission was spondyloarthrosis with facet joint syndrome (94 (57.3%) patients). The second common complication was pseudoarthrosis (26 (15.9%) patients). These ones comprised 2.1% of all patients with lumbar spine stenosis.</p><p><strong>Conclusion: </strong>The most common indication for readmission was adjacent segment degeneration. The most severe complications requiring complex and even multiple stage revision surgery were pseudoarthrosis and postoperative spondylodiscitis. Causes of readmission are significantly changing at different periods after surgery.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10708064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[pConus device for endovascular treatment of basilar bifurcation aneurysms].","authors":"I O Kurzakova, S B Yakovlev","doi":"10.17116/neiro20238704183","DOIUrl":"10.17116/neiro20238704183","url":null,"abstract":"<p><p>Aneurysm occlusion with microcoils is an effective and safe procedure. However, bifurcation aneurysms usually have a wide neck, and their occlusion is still a difficult objective.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of bifurcation stents in the treatment of basilar bifurcation aneurysms.</p><p><strong>Material and methods: </strong>A retrospective analysis included 34 patients with basilar bifurcation aneurysms between 2016 and 2022. The pConus bifurcation stent was used as a stent-assistance for endovascular occlusion of aneurysms with microcoils. We analyzed technical features of stent implantation and clinical results of endovascular treatment. Mean aneurysm dimension was 8.4 mm, neck size - 4.6 mm. Preoperative MSR score 0-2 was observed in 94.7% of patients, 3-5 scores - in 5.3% of patients.</p><p><strong>Results: </strong>There were no significant changes in functional status early after surgery (MSR grading system). Total aneurysm occlusion was achieved in 67.6% of patients, subtotal - 17.6% of cases, partial - 14.8%. There were no technical or early postoperative clinical complications. Six months after surgery, total occlusion was observed in 77.8% of patients, subtotal occlusion - 14.8%, partial occlusion - 4%. MSR score 0-2 was observed between 3 and 12 months after surgery. One patient died from other cause rather aneurysm. Redo intervention due to aneurysm recanalization was performed in 1 patient.</p><p><strong>Conclusion: </strong>The pConus bifurcation stent is effective and safe in endovascular treatment of basilar bifurcation aneurysms of the most complex configuration. There was a minimal risk of aneurysm recanalization in long-term postoperative period.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Total DNA methylation profile in assessing the MGMT gene promoter status in malignant gliomas].","authors":"E I Petrova, S A Galstyan, E N Telysheva, M V Ryzhova","doi":"10.17116/neiro20238706152","DOIUrl":"10.17116/neiro20238706152","url":null,"abstract":"<p><p>Methylation of the O-6-methylguanine-DNA methyltransferase (<i>MGMT</i>) gene promoter is currently the most important prognostic biomarker in therapy of IDH-wild-type glioblastoma. One can obtain information about this methylation from total DNA methylation profile.</p><p><strong>Objective: </strong>To analyze the DNA methylation signal intensity in the <i>MGMT</i> gene in samples of malignant gliomas and identify the most significant genomic positions for calculating the <i>MGMT</i> gene promoter status for further improvement of diagnostics and prediction of therapeutic options in patients with malignant gliomas.</p><p><strong>Material and methods: </strong>The study is based on 43 samples (frozen tissue or paraffin blocks) from patients with malignant gliomas. Tumor DNA samples were prepared using the Illumina Infinium MethylationEPIC BeadChip Kit and the Illumina Next-Seq 550 Sequencing System platform. DNA methylation profiles were analyzed using computational algorithms in the R language, specialized libraries minfi and mgmtstp27, as well as basic statistical functions in the Rstudio environment.</p><p><strong>Results: </strong>We established the <i>MGMT</i> gene promoter status in 43 samples of malignant gliomas considering total DNA methylation profile. In 24 samples (55%), the <i>MGMT</i> gene promoter was methylated. We compared methylation signal in certain CpG islands in groups with methylated and unmethylated <i>MGMT</i> gene promoters and identified the most significant positions for further improvement of data analysis algorithm.</p><p><strong>Conclusion: </strong>These data demonstrate the possibilities and prospects for further improvement of algorithm for analysis of the <i>MGMT</i> gene promoter status based on total DNA methylation profile in patients with malignant gliomas as an alternative to methyl-specific PCR. Our results are consistent with data of other neuro-oncology researchers. Indeed, computational methods like MGMT-STP27 are quite powerful and can be used in scientific and clinical practice to assess prognosis and make decisions about chemotherapy with alkylating agents.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valery Ivanovich Danilov. By the 75th anniversary","authors":"","doi":"10.17116/neiro202387051117","DOIUrl":"https://doi.org/10.17116/neiro202387051117","url":null,"abstract":"","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136305551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Bone defect closure after resection of sphenoorbital meningioma].","authors":"N V Lasunin, A N Abdullaev, V A Cherekaev, D N Okishev, N N Grigorieva, A V Kozlov","doi":"10.17116/neiro20238701196","DOIUrl":"10.17116/neiro20238701196","url":null,"abstract":"<p><p>Sphenoorbital meningiomas (SOM) are a subgroup of skull base tumors with soft tissue component in the orbit and anterior and/or middle cranial fossa. According to different authors, SOMs account for 2-12% of all intracranial meningiomas. Reconstruction of bone defects after resection of SOM has own nuances. Along with cranial vault repair, patients encounter with cosmetic defects following facial skull lesion, ophthalmic symptoms due to orbital defects, dental and functional problems associated with opening of the mouth in case of damage to maxilla and mandible. Predominant infiltrative growth of tumor and common large bone defects involving various anatomical regions require multiple implants or implants with complex shape. Moreover, contact of implantation area with nasal cavity and paranasal sinuses requires additional impermeability of soft tissue reconstruction and inertness of materials.</p><p><strong>Objective: </strong>To summarize available modern data on bone defect closure after resection of SOM.</p><p><strong>Material and methods: </strong>The authors reviewed available data on bone defect closure after resection of SOM. Effectiveness of modern methods of reconstruction and safety of materials were assessed.</p><p><strong>Results: </strong>We analyzed 96 available references. Technical features of tumor resection, materials used for bone defect closure and modern possibilities of 3D technologies in reconstructive surgery were described. The authors proposed the algorithms for selecting the materials for bone defect closure after resection of SOM.</p><p><strong>Conclusion: </strong>Improvement of surgical technique and development of new materials and technologies significantly improve cosmetic and functional results. A large percentage of negative ophthalmologic outcomes and high risk of complications in SOM surgery require further studies and elaboration of modern techniques.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10708062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Autologous bone implant for reconstructive surgery after decompressive craniectomy in children].","authors":"Zh B Semenova, A I Salimon, A M Korsunsky, A V Melnikov, Yu A Sadykova, A V Marshintsev, E S Statnik, V I Lukyanov","doi":"10.17116/neiro20238704158","DOIUrl":"10.17116/neiro20238704158","url":null,"abstract":"<p><p>The concept of post-traumatic skull defect closure is based on restoration of anatomical relationships for the maximum possible recovery of brain function, i.e. it is considered as a stage of surgical rehabilitation. The choice of implants in pediatric patients is limited. In this regard, the «gold standard» is still autologous bone implant.</p><p><strong>Material and methods: </strong>We propose a method for storage and sterilization of autologous bone implant. The last one implies keeping at a temperature of -80 ˚C with sterilization in a vacuum chamber filled with hydrogen peroxide vapors of biocidal plasma medium. Sterilization is provided by 45-minute cycle immediately before surgery. We report skull defect closure using autologous bone implants in 79 patients. Evaluation of effectiveness of storage and sterilization of autologous bone implant included analysis of mechanical properties of bone after sterilization, intra-operative microbiological monitoring, incidence of infections in early postoperative period, follow-up with assessment of resorption.</p><p><strong>Results: </strong>Early infectious complications occurred in 2 patients (2.5%). Complete resorption with redo surgery occurred in 6 (10.1%) cases. Sterilization in low-temperature plasma of hydrogen peroxide changes mechanical properties of the bone, increases durability under compressive stresses and decreases durability under tensile conditions. This does not affect functional tasks of autologous bone. The proposed method of storage and sterilization is accompanied by low risk of infections and resorption. Storage of autologous bone implant at a temperature of -80 ˚C with subsequent sterilization in low-temperature plasma of hydrogen peroxide can be considered as a safe and effective method for skull defect closure in children after decompressive surgery.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Dural defect closure after resection of cranioorbital meningiomas].","authors":"N V Lasunin, A N Abdullaev, V A Cherekaev, D N Okishev, N N Grigorieva, A V Kozlov","doi":"10.17116/neiro20238702176","DOIUrl":"10.17116/neiro20238702176","url":null,"abstract":"<p><p>Dural defect closure after resection of cranioorbital meningiomas has its own specifics. Extended malignant lesions and common large bone defects involving various anatomical regions require multiple implants or implants with complex geometry. The features of this stage of reconstruction were described in the previous issue of the Burdenko Journal of Neurosurgery. At the same time, contact of implant with nasal cavity and paranasal sinuses dictates additional requirements for tightness of soft tissue reconstruction and inertness of material. In this review, we describe modern and historically interesting methods of reconstruction of soft tissue defects following resection of cranioorbital meningioma.</p><p><strong>Objective: </strong>To summarize and analyze available literature data on reconstruction of soft tissue defects following resection of cranioorbital meningioma.</p><p><strong>Material and methods: </strong>The authors reviewed available data on reconstruction of soft tissue defects after resection of cranioorbital meningiomas. Effectiveness of reconstruction techniques and safety of materials were analyzed.</p><p><strong>Results: </strong>The authors analyzed 42 available full-text articles. Features of growth and natural course of cranioorbital meningioma, methods of soft tissue defects closure, modern materials and sealing compositions are described. Considering these data, the authors proposed the algorithms for selecting materials for dural reconstruction after resection of cranioorbital meningioma.</p><p><strong>Conclusion: </strong>Improvement of surgical technique, development of new materials and technologies increase the efficiency and safety of dural defect closure. Nevertheless, high incidence of complications associated with dura mater repair necessitates further research in this area.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9301649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}