Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"The left lateral decubitus position as a safe and effective alternative for posterior lumbar fixation in Pregnancy: A technical Note","authors":"Oualid Mohammed Hmamouche,&nbsp;Marouane Hammoud,&nbsp;Faycal Lakhdar,&nbsp;Mohammed Benzagmout,&nbsp;Khalid Chakour,&nbsp;Mohammed El Faiz Chaoui","doi":"10.1016/j.inat.2025.102187","DOIUrl":"10.1016/j.inat.2025.102187","url":null,"abstract":"<div><h3>Background</h3><div>Spinal trauma during pregnancy is rare and technically challenging due to maternal–fetal risks. Positioning for posterior fixation in advanced gestation is problematic because prone positioning risks aortocaval compression.</div><div><strong>Case/Technique:</strong> We report emergency posterior fixation for a burst fracture of L1 in a 40-year-old woman at 24 weeks’ gestation. Short-segment fixation was performed from D12 to L2 in the left lateral decubitus position to avoid vena cava compression. Free-hand pedicle screws were placed using anatomical landmarks and tactile feedback, with limited laminectomy and single-shot fluoroscopy under abdominal shielding.</div><div><strong>Outcome:</strong> Recovery was uneventful. Urinary retention resolved within 6 days. The patient delivered vaginally at term, and 36-month follow-up confirmed stable fixation without maternal or neonatal complications.</div></div><div><h3>Conclusion</h3><div>The left lateral decubitus position is a feasible and safe alternative to prone positioning for lumbar fixation in advanced pregnancy. Multidisciplinary collaboration, radiation minimization, and precise free-hand technique are essential for achieving favorable outcomes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102187"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939479","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":"Safety and outcomes of hematoma evacuation surgery for intracerebral hemorrhage during antithrombotic therapy","authors":"Shigeo Yamashiro ,&nbsp;Ken Uekawa ,&nbsp;Toshihiro Amadatsu ,&nbsp;Ryuta Ueda ,&nbsp;An Murai ,&nbsp;Masayoshi Fukuoka ,&nbsp;Masatomo Kaji ,&nbsp;Akitake Mukasa","doi":"10.1016/j.inat.2025.102193","DOIUrl":"10.1016/j.inat.2025.102193","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the safety and efficacy of hematoma evacuation surgery for intracerebral hemorrhage in patients receiving antithrombotic therapy.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study at a single institution, including 111 patients who underwent hematoma evacuation for spontaneous intracerebral hemorrhage. Patients were divided into an antithrombotic group and a normal group for comparison. Propensity score matching was performed based on hematoma location and volume to compare matched pairs from both groups. Within the antithrombotic group, patients were categorized into endoscopic surgery and craniotomy groups for further comparison.</div></div><div><h3>Results</h3><div>The antithrombotic group (n = 37) was older and had a higher prevalence of comorbidities compared to the normal group (n = 74). Hematoma volume was significantly greater in the antithrombotic group (86.7 vs 68.9 ml, p = 0.013). No significant differences were observed in terms of surgery duration, hematoma removal rate, intraoperative bleeding, or adverse events. There were significantly more poor outcomes in the antithrombotic group, with no difference in the proportion of good outcomes between two groups. Propensity score analysis revealed no significant differences in surgical outcomes between matched groups (n = 27, each). The endoscopic surgery (n = 31) had a shorter surgery duration compared to the craniotomy (n = 6), with no differences in hemorrhage volume, removal rate, intraoperative bleeding, adverse events, or outcomes. The antiplatelet group (n = 24) tended to have greater hemorrhage volume and lower removal rates comparatively.</div></div><div><h3>Conclusions</h3><div>These findings suggest that hematoma evacuation can be safely performed in patients on antithrombotic therapy with appropriate perioperative management. Endoscopic surgery offers a less invasive alternative with similar outcomes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102193"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077467","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":"Surgical outcomes and challenges in spinal cord tumor resection: a comparative study of elderly vs. young patients","authors":"Ali Tarik Abdul Wahid","doi":"10.1016/j.inat.2025.102155","DOIUrl":"10.1016/j.inat.2025.102155","url":null,"abstract":"<div><h3>Background</h3><div>Primary spinal cord tumors present significant diagnostic and clinical challenges, particularly in elderly patients, due to their impact on the neural axis and the complexity of treatment. This study aims to compare surgical outcomes, complications, and long-term functional recovery between elderly vs younger patients undergoing spinal cord tumor resection.</div></div><div><h3>Methods</h3><div>A chart review of 100 patients at Baghdad Medical City from 2021 through 2023 divided them into two groups: young adults (18–60 years) and elderly (60 + years). Preoperative, intraoperative, and postoperative parameters, including demographics, surgical duration, blood loss, complications, hospital stay, postoperative assessment, and recovery outcomes, were collected from medical records.</div></div><div><h3>Results</h3><div>Elderly patients had significantly longer surgeries (160 ± 40 vs. 120 ± 30 min) and greater blood loss (300 ± 90 vs. 250 ± 80 mL) than young adults for both intramural and extramural spinal cord tumors. Complications in the elderly group (30 % vs. 10 %), with 24 % requiring blood transfusions compared to 8 %. Postoperatively, elderly patients had longer hospital stays (7 ± 4 vs. 5 ± 2 days) and higher pain scores (6 ± 2 vs. 4 ± 2). Mobility recovery was slower in elderly patients, averaging 14 ± 5 versus 8 ± 3 days for younger patients. Elderly patients experienced a higher rate of postoperative delirium (10 % vs. none).</div></div><div><h3>Conclusion</h3><div>Elderly patients undergoing spinal cord tumor resection face higher risks of intraoperative complications, blood loss, and prolonged recovery. This underscores the need for age-adjusted surgical techniques and postoperative care to improve outcomes for elderly patients with spinal cord tumors.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102155"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799062","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":"Rapid antimicrobial-impregnated 3D-printed negative mould technique for PMMA cranioplasty in emergent management of syndrome of the trephined","authors":"Talhah Chaudri ,&nbsp;Nicholas Gikas ,&nbsp;Antonio Belli ,&nbsp;Mark Svolkinas ,&nbsp;Emilia Hargreaves ,&nbsp;Andrew R. Stevens ,&nbsp;David J. Davies","doi":"10.1016/j.inat.2025.102164","DOIUrl":"10.1016/j.inat.2025.102164","url":null,"abstract":"<div><h3>Background</h3><div>Syndrome of the trephined is a rare but significant complication which can develop after large craniectomy, characterised by neurological deterioration that typically improves after cranioplasty. Advanced cases can lead to severe neurological impairment, such as impaired consciousness or respiratory failure, requiring urgent surgical intervention. Standard supply chains for custom implants, such as those fashioned from titanium or PEEK, often have prohibitively long turnaround times, unsuitable for emergency cases. The authors present a case of a patient experiencing recurrent apnoeic episodes as a manifestation of the syndrome of the trephined, who underwent an emergent, customised bi-frontal cranioplasty produced using in-house computer-aided design and 3D printing techniques.</div></div><div><h3>Observation</h3><div>A 29-year-old patient who suffered a severe traumatic brain injury developed apnoeic episodes post-decompressive craniectomy. Imaging demonstrated significant sinking of the skin flap and distortion of the brainstem, suggestive of syndrome of the trephined. In order to expedite cranioplasty and mitigate the risk of further deterioration, an inlay PMMA graft was rapidly designed and fabricated on-site. The technique involved creation of a MED-610 acrylic positive model from pre-operative imaging, followed by a negative silicone mould, into which a vancomycin- and gentamicin-impregnated PMMA mixture was poured and allowed to cure. The graft was secured with plates and hitch sutures used to relieve brain slump. The production process took approximately 48 h at a fraction of the cost of commercially-available alternatives. The procedure had minimal complications. A favourable cosmetic outcome was achieved, and within days the patient’s apnoeic episodes resolved, allowing ventilation to be weaned.</div></div><div><h3>Conclusion</h3><div>This case illustrates the potential for in-house CAD and 3D printing techniques to significantly reduce turnaround time for cranioplasty in urgent cases. Prefabrication of PMMA grafts reduces operative time and the risk of thermal injury and helps to achieve a good anatomical fit. Use of PMMA cement also allows incorporation of antimicrobial agents, possibly reducing the risk of surgical site infection and the risk of bone flap removal and recurrence of neurological deficits.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102164"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799095","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":"Surgical biopsy techniques in neurosurgery: A four-year population-based study of frameless and frame-based procedures","authors":"Hanna Barchéus ,&nbsp;Alba Corell ,&nbsp;Malin Blomstrand ,&nbsp;Thomas Olsson Bontell ,&nbsp;Helena Carén ,&nbsp;Anneli Ozanne ,&nbsp;Asgeir S. Jakola ,&nbsp;Anja Smits ,&nbsp;Johan Ljungqvist","doi":"10.1016/j.inat.2025.102158","DOIUrl":"10.1016/j.inat.2025.102158","url":null,"abstract":"<div><h3>Background</h3><div>Suspected malignant lesions in the brain unamenable for resection are most often biopsied to establish the histomolecular diagnosis, guiding further treatment. Herein, we compare the postoperative outcomes in terms of safety and diagnostic yield between traditional and more recent biopsy techniques utilized at our facility.</div></div><div><h3>Methods</h3><div>Population-based patient data was collected from 2020 to 2023. Patients were subdivided depending on chosen surgical strategy. Data included clinical, radiological and surgical variables, in addition to histopathological diagnosis and post-operative treatment strategy.</div></div><div><h3>Results</h3><div>We identified 161 adult patients undergoing 163 biopsies; 101 robot-assisted biopsies, 35 frameless skull-mounted trajectory guided biopsies, 15 biopsies obtained via craniotomies, and 12 frame-based stereotactic biopsies. There was no significant difference in diagnostic yield between methods, ranging from 94.3 % in skull-mounted biopsies to 83.3 % in stereotactic biopsies. Glioblastomas were the most common diagnosis (55.2 %), but a plethora of malignancies were identified. The histopathological diagnosis was inconclusive in 19 patients (11.7 % of study population). Robot-assisted and skull-mounted procedures resulted in significantly shorter operating time compared to craniotomies (p &lt; 0.001). There was no statistically significant difference in rate of complications between methods. Small postoperative hemorrhages were detected in 28.2 % of cases (median 6 mm), none required intervention. Subsequent oncologic treatment was administered to 91.7 % of patients with a conclusive histopathological diagnosis, compared to 73.7 % with an inconclusive diagnosis.</div></div><div><h3>Conclusion</h3><div>Both frameless and frame-based methods demonstrated comparable safety and efficacy. Robot-assisted biopsy was the predominant method. Our findings further illustrate the large variety of histopathological diagnoses in patients presenting with radiologically suspected brain tumor, underscoring the importance of a biopsy to obtain a conclusive tissue diagnosis to guide treatment.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102158"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939392","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":"Global, regional, and national burden of intracerebral hemorrhage, 1990–2021: an analysis of data from the global burden of disease study 2021","authors":"Haiyang Ma ,&nbsp;Weicheng Peng ,&nbsp;Sheng Xu ,&nbsp;Xupeng Peng ,&nbsp;Shuaibin Lu ,&nbsp;Rui Zhao ,&nbsp;Beibei Mao ,&nbsp;Guangtong Zhu ,&nbsp;Zhiqiang Hu","doi":"10.1016/j.inat.2026.102241","DOIUrl":"10.1016/j.inat.2026.102241","url":null,"abstract":"<div><h3>Background</h3><div>Intracerebral hemorrhage (ICH) represents one of the most lethal subtypes of stroke, with a disproportionately high burden of mortality and disability relative to its lower incidence compared to ischemic stroke. However, comprehensive evaluations of the global burden and projected trends of ICH based on GBD 2021 data remain limited. This study aims to analyze the burden of ICH at global, regional, and national levels, stratified by age, sex, and Sociodemographic Index (SDI).</div></div><div><h3>Methods</h3><div>Data on the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of ICH and its related risk factors from 1990 to 2021 were extracted from the GBD 2021 project. To quantify temporal patterns and assess trends in age-standardized rates of ICH prevalence (ASPR), incidence (ASIR), mortality (ASDR), and disability-adjusted life years (DALYs), estimated annual percentage changes (EAPCs) were computed over the study period. Analyses were stratified by sex, 20 age groups, 21 GBD regions, 204 countries and territories, and five SDI quintiles.</div></div><div><h3>Results</h3><div>Globally, ICH accounted for an estimated 16.6 million prevalent cases, 3.44 million incident cases, 3.31 million deaths, and 79.5 million DALYs in 2021—each showing a substantial increase compared to 1990. Despite this rise in absolute numbers, the corresponding age-standardized rates, including ASPR, ASIR, ASDR, and age-standardized DALY rate, all declined over the same period. Regionally, a significant inverse correlation was found between the SDI and ICH burden. Burden increased with age, peaking at 70–74 years, and was consistently higher in males. Leading risk factors included hypertension, air pollution, smoking, and high sodium intake.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102241"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421117","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":"Outcomes of mechanical thrombectomy at a remote hospital lacking a neuroendovascular therapy specialist and mechanical thrombectomy practitioner in Japan","authors":"Shota Yoshimura ,&nbsp;Susumu Yamaguchi ,&nbsp;Hikaru Nakamura ,&nbsp;Kosuke Hirayama ,&nbsp;Yukishige Hayashi ,&nbsp;Takayuki Matsuo","doi":"10.1016/j.inat.2026.102230","DOIUrl":"10.1016/j.inat.2026.102230","url":null,"abstract":"<div><h3>Purpose</h3><div>Randomized controlled trials assessing mechanical thrombectomy (MT) efficacy for acute large-vessel occlusion have primarily been conducted at high-volume stroke centers with extensive experience. In this study, we evaluated MT outcomes performed at a remote hospital lacking a neuroendovascular therapy specialist and MT practitioner in Japan.</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study included 68 patients who underwent MT between April 2018 and March 2025. Patients were categorized into specialist-treated and general neurosurgeon-treated groups for comparison of clinical characteristics and outcomes. General neurosurgeons were defined as those without specialist or practitioner certification who had performed at least 15 MT procedures and five years of experience. Inverse probability weighting was applied to adjust for selection bias.</div></div><div><h3>Results</h3><div>Rates of successful recanalization (TICI 2b or 3), favorable functional outcome (mRS 0–2 at three months) and symptomatic intracranial hemorrhage (SICH) did not differ significantly between the two groups. The general neurosurgeon group had a significantly longer puncture-to-first-pass time and lower successful recanalization rate in large vessel occlusion due to intracranial atherosclerotic disease. However, the general neurosurgeon group required significantly fewer passes and achieved a higher rate of first-pass complete recanalization. In the general neurosurgeon group, successful recanalization was observed in 81%, favorable functional outcome in 63%, and SICH in 0%.</div></div><div><h3>Conclusion</h3><div>MT performed by general neurosurgeons as defined in this study should only be considered under carefully selected circumstances including remote hospitals with limited access to thrombectomy-capable stroke centers and should not be interpreted as a general recommendation.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102230"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421168","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":"Neuroendoscope-assisted peripheral nerve decompression for refractory chemotherapy-induced peripheral neuropathy: A case report and literature review","authors":"Jisheng Xu,&nbsp;Kunceng Xie,&nbsp;Qi Liu","doi":"10.1016/j.inat.2026.102228","DOIUrl":"10.1016/j.inat.2026.102228","url":null,"abstract":"<div><div>Chemotherapy-induced peripheral neuropathy(CIPN) is a common adverse reaction to many first- and second-line chemotherapy medications, often manifesting as sensory and motor impairment, impacting the patient’s daily activities and quality of life. While pharmacological management remains standard, outcomes in severe cases are frequently unsatisfactory. This report details a 62-year-old male with progressive lower limb numbness and gait disturbance following gastric cancer chemotherapy. After electrophysiological confirmation of peripheral neuropathy, the patient was scheduled to undergo peripheral neurolysis, resulting in significant functional improvement after the operation. This case supports the consideration of surgical intervention for refractory CIPN and underscores the importance of individualized treatment strategies. Diagnosis and treatment are reported.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102228"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419825","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":"Hemorrhagic pseudo-cystic transformation of a sequestered lumbar disc fragment mimicking a synovial cyst","authors":"Alaa Eldin Elsharkawy,&nbsp;Evariste Gafumbegete,&nbsp;Peter Douglas Klassen","doi":"10.1016/j.inat.2026.102235","DOIUrl":"10.1016/j.inat.2026.102235","url":null,"abstract":"<div><div>Background: Lumbar synovial cysts are most common in older adults, especially females, often associated with degenerative spine changes like facet joint arthritis and instability. Rarely, sequestered disc fragments may undergo hemorrhagic pseudo-cystic transformation and mimic synovial cysts on imaging.</div></div><div><h3>Case presentation</h3><div>A 74-year-old female patient presented to the emergency department with acute lumbar pain radiating to the left groin and thigh. Magnetic resonance imaging showed a well-defined lesion adjacent to the left L2/3 facet joint, initially interpreted as a hemorrhagic synovial cyst with compression of the affected nerve root. At surgery, the lesion consisted of a dark, organized hemorrhagic mass. There was no cyst wall and no synovial connection. Histopathological examination, independently confirmed by three pathologists, demonstrated degenerated nucleus pulposus tissue with hemorrhage and granulation tissue, consistent with a sequestered disc fragment with secondary hemorrhagic transformation.</div></div><div><h3>Conclusion</h3><div>Hemorrhagic pseudo-cystic transformation of sequestered disc material may mimic synovial cysts radiologically and intraoperatively. Histopathological confirmation is essential for accurate diagnosis and appropriate prognostic interpretation.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102235"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419826","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":"Supercharge end-to-side anterior interosseous to motor ulnar nerve transfer under robotic exoscopic visualization: Proof-of-concept illustrative case","authors":"Elena d’Avella ,&nbsp;Sara Lombardi ,&nbsp;Luigi Pintore ,&nbsp;Francesca Sarti ,&nbsp;Domenico La Torre ,&nbsp;Domenico Solari ,&nbsp;Luigi Maria Cavallo","doi":"10.1016/j.inat.2026.102199","DOIUrl":"10.1016/j.inat.2026.102199","url":null,"abstract":"<div><div>Herein, we report the first case of a supercharge end-to-side anterior interosseous to motor ulnar nerve transfer performed under exoscopic visualization, providing new insights that may help better define the role of high-definition robotic exoscopes in nerve transfer. The rationale for this procedure was based on the poor outcomes associated with nerve decompression at the elbow in cases of severe cubital tunnel syndrome. The end-to-side anterior interosseous to motor ulnar nerve transfer can promote reinnervation of the intrinsic muscles of the hand through both direct donor axon reinnervation and regeneration of native axons. In presenting this illustrative case, we observed specific benefits that the exoscope (Modus X, Synaptive, Canada) offers for this nerve transfer procedure: it facilitates identification and neurolysis of the motor fascicle bundle of the ulnar nerve; it allows rapid switching between micro and macro visualization and during microsuturing, it eliminates the need for frequent zoom and focus adjustments required by the microscope. Further studies are needed to clarify the benefits of the exoscope compared to established visualization tools and to determine the surgical settings in which it is best indicated.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102199"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188877","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}