NeurochirurgiePub Date : 2024-12-18DOI: 10.1016/j.neuchi.2024.101624
Anis Choucha, Francesco Travaglini, Matteo De Simone, Morgane Evin, Kaissar Farah, Stephan Fuentes
{"title":"The Da Vinci Robot, a Promising Yet Underused Minimally Invasive Tool for Spine Surgery: a Scoping Review of its Current Role and Limits.","authors":"Anis Choucha, Francesco Travaglini, Matteo De Simone, Morgane Evin, Kaissar Farah, Stephan Fuentes","doi":"10.1016/j.neuchi.2024.101624","DOIUrl":"https://doi.org/10.1016/j.neuchi.2024.101624","url":null,"abstract":"<p><strong>Background: </strong>The Da Vinci robot ® (DVR), released in the early 2000s, provided a set of innovation aiming at pushing minimally invasive surgery forward. Its stereoscopic magnified visualization camera, motions that exceed the natural range of the human hand, or tremor reduction enhanced the surgeon's skills and added value in many surgical fields.</p><p><strong>Objective: </strong>To map the current use of the DVR in spine surgery, identify gaps, address its limits and future perspectives.</p><p><strong>Methods: </strong>We conducted a scoping review upon PRISMA guidelines through Pubmed from inception to July 2024, including english-written articles describing clinical use of the DVR on procedures related to spinal conditions. We collected a broad range of data, from journals publishing those articles, to the study design, the purpose of the study, the sample size or conclusions. We then provided a narrative review on the scope of indications and results of those studies.</p><p><strong>Results: </strong>Seventeen studies including a total of forty-nine patients were included. Those included procedures in the craniocervical junction for 4 patients, thoracic spine for 5 cases, 29 patients involved the lumbar and lumbosacral segment, and 11 on the sacral region. Pathologies included degenerative diseases with 25 cases (14 ALIF and 11 OLIF), tumors as paraspinal schwannomas and odontoid lesions, but also basilar invagination of the odontoid process, Tarlov cyst, and sacral fracture.</p><p><strong>Conclusion: </strong>The DVR presents as a valuable tool for minimally invasive surgery in selected cases. Further studies including cost effectiveness, leaning curve, and control trial are needed.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":" ","pages":"101624"},"PeriodicalIF":1.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873108","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}
NeurochirurgiePub Date : 2024-12-18DOI: 10.1016/j.neuchi.2024.101626
Atakan Besnek, Mehmet Kılıç, Halil Aslan, İhsan Yıldırım, Barış Erdoğan
{"title":"Surgical outcome of meningomyelocele and short-term prognostic factors: A retrospective cohort study.","authors":"Atakan Besnek, Mehmet Kılıç, Halil Aslan, İhsan Yıldırım, Barış Erdoğan","doi":"10.1016/j.neuchi.2024.101626","DOIUrl":"10.1016/j.neuchi.2024.101626","url":null,"abstract":"<p><strong>Introduction: </strong>Meningomyelocele is the most common congenital anomaly. It is associated with significant complications and can result in morbidity and mortality. The present study aims to identify short-term prognostic markers by investigating the characteristics of patients with meningomyelocele during hospitalization.</p><p><strong>Methods: </strong>This is a retrospective study for patients with meningomyelocele who underwent surgery between 2019 and 2022. Preoperative and postoperative characteristics of the patients were statistically analyzed.</p><p><strong>Results: </strong>Of the total of 161 patients included in the study, 137 (85.1%) were female and 24 (14.9%) were male. Examination of the relationship between the preoperative characteristics of the patients and mortality showed a significant correlation with Apgar scores at the first and fifth minutes (p < 0.01). Comparison of the preoperative and postoperative characteristics of the patients showed that those with necrosis at the wound site had significantly lower 1-min and 5-min Apgar scores (p < 0.001), experienced motor deficits (p < 0.001), and underwent a delayed surgery (p = 0.048). Analysis of patients requiring postoperative ventriculoperitoneal (VP) shunt placement showed significant associations with low 1-min and 5-min Apgar scores (p < 0.001) and motor deficits (p < 0.001).</p><p><strong>Conclusions: </strong>The present study demonstrated that low Apgar scores, surgical timing, defect size, and neurological deficits were associated with the length of hospital stay and prognosis. Postoperative complications significantly prolonged the follow-up period of patients. We found that the Apgar score has a significant effect on both complications and mortality.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":" ","pages":"101626"},"PeriodicalIF":1.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873106","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":"Trigeminal malignant peripheral nerve-sheath tumor: Systematic review, and case report treated by proton-beam therapy.","authors":"Mathieu Lozouet, Lesueur Paul, Mazen Kallel, Gregoire Braux, Arthur Leclerc, Evelyne Emery","doi":"10.1016/j.neuchi.2024.101621","DOIUrl":"https://doi.org/10.1016/j.neuchi.2024.101621","url":null,"abstract":"<p><strong>Background: </strong>Malignant peripheral nerve-sheath tumor (MPNST) is rare, occurring in approximately 0.001% of the general population. Cases involving cranial nerves, and particularly the trigeminal nerve (V), are exceptionally rare, with only 36 cases reported in a literature review in 2013. Standardized treatment and follow-up protocols are lacking. Here, we present a case of MPNST of the trigeminal nerve, provide a review of all cases described in the literature, and discuss treatment, surgical approach, recurrence rate, follow-up time and prognosis.</p><p><strong>Methods: </strong>Based on PRISMA guidelines, we reviewed all cases of trigeminal MPNST published between 1950 and September 2023. We analyzed risk factors for recurrence. And we report the case of a patient with trigeminal MPNST admitted to our hospital.</p><p><strong>Results: </strong>The literature review retrieved 39 relevant studies, reporting 48 cases. Patient age ranged from 4 to 71 years, for a mean 44.4 ± 17 years. The male:female ratio was 3.8:1. Most cases developed sporadically; 1 patient had neurofibromatosis type 1 and 1 had type 2. Surgery was the first-line treatment (85%), and radiotherapy was often included as adjuvant (65%). During a mean follow-up of 23.1 ± 24.4 months, fatal outcomes occurred in approximately 30% of patients. Only 1 case of systemic metastasis was reported. The only prognostic factor significantly associated with a lower rate of recurrence was complete surgical resection (p = 0.0035).</p><p><strong>Conclusion: </strong>Cranial nerve MPNST is extremely rare, and trigeminal MPNST is even rarer. Treatment corresponds to current recommendations for intracranial MPNST, in which radical resection with adjuvant radiotherapy under stereotactic conditions results in the best outcome. Because of the high risk of recurrence, especially in case of incomplete resection, close follow-up is mandatory. Proton-beam therapy could be an interesting alternative adjuvant therapy after surgery.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"101621"},"PeriodicalIF":1.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814935","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}
NeurochirurgiePub Date : 2024-12-07DOI: 10.1016/j.neuchi.2024.101618
Jonathan G F Smith, Caroline P Smith, Philip Weir, Brendan C Hanna
{"title":"Is endoscopic optic nerve decompression useful in cases of optic neuropathy secondary to pachymeningitis?","authors":"Jonathan G F Smith, Caroline P Smith, Philip Weir, Brendan C Hanna","doi":"10.1016/j.neuchi.2024.101618","DOIUrl":"https://doi.org/10.1016/j.neuchi.2024.101618","url":null,"abstract":"<p><p>This case reports the outcome of endoscopic optic nerve decompression in a rare case of idiopathic pachymeningitis in a patient solely reliant on the affected eye. A 70 year old man with complete blindness in his left eye presented with deterioration of vision in his right eye. An MRI head and orbits was suggestive of idiopathic pachymeningitis extending into the right orbital apex, causing a compressive optic neuropathy. He subsequently underwent endoscopic optic nerve compression. Visual acuity and colour vision were measured pre-operatively, and at 6 weeks and one year post operatively. Pre-operative visual acuity was measured at 6/9, compared to 6/9 at 6 weeks post operatively and 6/60 at one year. Colour vision was measured at 0/17 pre-operatively and did not improve post-. We report a rare case of optic neuropathy secondary to pachymeningitis, in which endoscopic nerve decompression did not offer the expected benefit of halting visual deterioration.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"101618"},"PeriodicalIF":1.5,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795972","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}
NeurochirurgiePub Date : 2024-12-05DOI: 10.1016/j.neuchi.2024.101620
Jean-Baptiste Odent, Xavier Castel, Thais Dutra Vieira, Estelle Ben Brahim, Vincent Fière, Henri d'Astorg, Marc Szadkowski
{"title":"Beyond traditional surgery for far lateral lumbar herniation: transforaminal full endoscopic discectomy.","authors":"Jean-Baptiste Odent, Xavier Castel, Thais Dutra Vieira, Estelle Ben Brahim, Vincent Fière, Henri d'Astorg, Marc Szadkowski","doi":"10.1016/j.neuchi.2024.101620","DOIUrl":"10.1016/j.neuchi.2024.101620","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the clinical outcomes of transforaminal full-endoscopic lumbar discectomy (FELD) for treating lateral lumbar disc herniation.</p><p><strong>Methods: </strong>A retrospective single-center study was conducted at Centre Orthopédique Santy, Lyon, France, including 58 adult patients with foraminal or extraforaminal lumbar disc herniations who underwent surgery between October 2020 and January 2023. Inclusion criteria were patients with significant functional impairment due to unilateral radicular pain unresponsive to conservative treatment for over six weeks. Data on demographics, clinical characteristics, and outcomes were collected, evaluated preoperatively and at 12 months postoperatively using Visual Analog Scale (VAS) for pain, Oswestry Disability Index (ODI), and Macnab criteria.</p><p><strong>Results: </strong>The cohort had a mean age of 56.5 years and consisted predominantly of males, with 35 men (60%). Most herniations were at the L4-L5 level (29 patients, 50%). Significant improvements were observed in lumbar VAS (mean reduction of 1.9 points, p < 0.001), radicular VAS (mean reduction of 4.9 points, p < 0.001), and ODI (mean reduction of 41.9 points, p < 0.001) scores. Patient satisfaction was high, with 91% (53 patients) reporting excellent or good outcomes. The reoperation rate was 6.9% (4 patients). Linear regression analysis indicated that longer symptom duration and higher preoperative radicular VAS scores predicted greater satisfaction.</p><p><strong>Conclusions: </strong>Transforaminal FELD is a safe and effective technique for treating lateral lumbar disc herniation, offering high patient satisfaction. Symptom duration and preoperative radicular VAS scores are key predictors of positive outcomes. Further studies with larger sample sizes and longer follow-up periods are necessary to confirm these findings.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":" ","pages":"101620"},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792808","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}
NeurochirurgiePub Date : 2024-12-05DOI: 10.1016/j.neuchi.2024.101622
Mariana Torres-Bustamante, Manuel Vicente Jaramillo-Canastero, José Fernando Zapata-Berruecos, Julián Carvajal-Castrillón, Lucas Lozano-García, Juan Felipe Álvarez, Héctor Jaramillo-Betancur
{"title":"Seizure outcomes and associated factors in adults with unilateral mesial temporal lobe epilepsy undergoing surgery.","authors":"Mariana Torres-Bustamante, Manuel Vicente Jaramillo-Canastero, José Fernando Zapata-Berruecos, Julián Carvajal-Castrillón, Lucas Lozano-García, Juan Felipe Álvarez, Héctor Jaramillo-Betancur","doi":"10.1016/j.neuchi.2024.101622","DOIUrl":"10.1016/j.neuchi.2024.101622","url":null,"abstract":"<p><strong>Objective: </strong>To analyze postoperative seizure outcomes and factors associated with unfavorable seizure control (Engel III-IV) in adults with drug-resistant unilateral mesial temporal epilepsy who underwent temporal lobectomy.</p><p><strong>Methods: </strong>This was an observational, longitudinal, and retrospective study. A descriptive analysis of sociodemographic, clinical, and paraclinical characteristics was performed. The incidence rate of inadequate seizure control was calculated, and a Kaplan-Meier curve was reported. Cox regression analysis was conducted to identify factors associated with unfavorable outcomes.</p><p><strong>Results: </strong>A total of 285 patients were included, 56.4% were women, and 49.12% underwent standard temporal lobectomy. Engel I were achieved in 70.87% of patients, while 6.31% experienced postsurgical complications. The estimated incidence rate of unfavorable outcomes was 3.87 cases per 100 person-years (95% CI: 3.51-4.27). Cox regression analysis indicated that patients with a temporal functional deficit zone, as identified by neuropsychological testing, had a 55.34% lower risk of an unfavorable outcome (adjusted HR: 0.4466, 95% CI: 0.236-0.854) compared to those with non-conclusive or extratemporal deficits. Concordance between video-electroencephalogram and brain magnetic resonance imaging findings in patients with right-sided lesions was also a protective factor (adjusted HR: 0.1868, 95% CI: 0.06-0.578). Discontinuation of anti-seizure treatment significantly increased the risk of an unfavorable outcome (adjusted HR: 6.718, 95% CI: 3.309-13.64).</p><p><strong>Conclusion: </strong>Temporal lobe epilepsy surgery can achieve long-term seizure control in a significant proportion of patients. Neuropsychological assessment and concordance between MRI and video-EEG are essential presurgical factors for favorable outcomes. Additionally, patients should continue with antiepileptic treatment post-surgery to prevent seizure recurrence.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":" ","pages":"101622"},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792809","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}
NeurochirurgiePub Date : 2024-11-28DOI: 10.1016/j.neuchi.2024.101619
Vimal Raj Nitish Gunness, Sara Chakir, Omar Aljeeran, Paolo Rizzo, Said Taha
{"title":"Sustaining surgeon longevity in spine surgery: A narrative review.","authors":"Vimal Raj Nitish Gunness, Sara Chakir, Omar Aljeeran, Paolo Rizzo, Said Taha","doi":"10.1016/j.neuchi.2024.101619","DOIUrl":"10.1016/j.neuchi.2024.101619","url":null,"abstract":"<p><p>Spine surgery is a physically and mentally demanding surgical specialty. This paper focuses on raising awareness about ergonomic challenges that threaten spine surgeon longevity. Sustaining a fulfilling career in spine surgery requires a multifaceted approach that prioritizes physical well-being and mental health. By proactively addressing them through education, technology, and support systems, we can foster a future where spine surgeons enjoy long, healthy careers and continue to provide top-quality care.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":" ","pages":"101619"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774478","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}
NeurochirurgiePub Date : 2024-11-16DOI: 10.1016/j.neuchi.2024.101610
Jean Raymond , Tim E. Darsaut
{"title":"Lies, damned lies, and statistical populations","authors":"Jean Raymond , Tim E. Darsaut","doi":"10.1016/j.neuchi.2024.101610","DOIUrl":"10.1016/j.neuchi.2024.101610","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 1","pages":"Article 101610"},"PeriodicalIF":1.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645067","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}
NeurochirurgiePub Date : 2024-11-16DOI: 10.1016/j.neuchi.2024.101615
Peixi Liu , Qingzhu An , Yuan Shi , Wei Zhu
{"title":"Staged ECA-RA-MCA bypass and interventional trapping: application of hybrid vascular reconstruction of ruptured complex tandem aneurysms","authors":"Peixi Liu , Qingzhu An , Yuan Shi , Wei Zhu","doi":"10.1016/j.neuchi.2024.101615","DOIUrl":"10.1016/j.neuchi.2024.101615","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 1","pages":"Article 101615"},"PeriodicalIF":1.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645118","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}
NeurochirurgiePub Date : 2024-11-14DOI: 10.1016/j.neuchi.2024.101614
Yoo Sung Jeon , Jeong-Jin Park , Hong Gee Roh , Young Il Chun
{"title":"Natural course of the acute unruptured intracranial vertebral artery dissections which show pearl-and-string sign","authors":"Yoo Sung Jeon , Jeong-Jin Park , Hong Gee Roh , Young Il Chun","doi":"10.1016/j.neuchi.2024.101614","DOIUrl":"10.1016/j.neuchi.2024.101614","url":null,"abstract":"<div><h3>Introduction</h3><div>Ruptured vertebral artery dissections frequently exhibit pearl-and-string signs, a characteristic also observed in many unruptured dissections. This study examines the natural course of 50 unruptured acute vertebral artery dissections presenting with pearl-and-string signs and compares them to 10 ruptured dissections of the same morphological pattern.</div></div><div><h3>Methods</h3><div>We reviewed 633 radiology reports of head and neck imaging studies that included the keyword ‘dissection’. From these, 60 cases displaying pearl-and-string signs were identified from a total of 322 vertebral artery dissections. These cases were classified based on morphological characteristics, including fusiform versus bulbous dilatation, symmetry, degree of expansion, and the severity of stenosis at both ends of the dilation. The relationships between these factors and favorable anatomical recovery were then analyzed.</div></div><div><h3>Results</h3><div>Headaches were linked to subarachnoid hemorrhages in 10 cases with bulbous dilatations. In contrast, 50 unruptured cases had fusiform dilatations, with no subsequent hemorrhages except for two cases treated preventively. Most unruptured dissections (78.4%) improved on follow-up: 48.6% fully recovered, 29.7% retained smooth dilatation, 10.8% developed irregular stenotic segments, 8.1% became occluded, and 2.7% transformed into a saccular lesion. Smaller or hypoplastic vertebral arteries were more likely to occlude (p = 0.017). Mild distal stenosis was associated with improvement (p = 0.001).</div></div><div><h3>Conclusion</h3><div>Acute unruptured intracranial vertebral artery dissections with ‘pearl-and-string’ signs had benign courses, with most recovering spontaneously and no subsequent hemorrhages. Regular imaging follow-ups at one- to three-month intervals are recommended over immediate intervention.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 1","pages":"Article 101614"},"PeriodicalIF":1.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640290","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}