Neurochirurgie最新文献

{"title":"Vagus nerve stimulation lead durability: Insights from an extensive monocentric single-operator adult series","authors":"Sami Barrit ,&nbsp;Marc Zanello ,&nbsp;Romain Carron","doi":"10.1016/j.neuchi.2025.101631","DOIUrl":"10.1016/j.neuchi.2025.101631","url":null,"abstract":"<div><h3>Background</h3><div>Vagus nerve stimulation (VNS) is an established surgical option for neuromodulation. Lead failure is a significant complication mainly reported in children.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of all VNS-related surgeries for refractory epilepsy in adults performed by a single experienced surgeon at a French national referral center from November 2011 to March 2023. We analyzed lead survival using Kaplan-Meier estimators and calculated failure rates.</div></div><div><h3>Results</h3><div>The study included 267 patients (144 females, mean age 36.56 years) with a mean follow-up of 4.32 years. Of 235 leads implanted, accumulating 1355 device years, four lead failures (1.74%) were identified. The cumulative 5-year and 10-year lead survival probabilities were 98.14% (95% CI: 96.06%–100%) and 97.33% (95% CI: 94.75%–100%), respectively. The lead failure rate was 0.00295 events per device-year. All lead failures were associated with abnormally high impedance (&gt;10,000 ohms).</div></div><div><h3>Conclusions</h3><div>This study characterizes technical VNS lead durability, with a failure rate comparable to other neuromodulation devices. Lead longevity is influenced by technical specifications, surgical techniques, and patient-related factors. To optimize lead durability, surgeons should consider the latest technical developments, adhere to best practices, and provide proper patient counseling. Future research should focus on refining lead design and implantation techniques to further improve long-term outcomes.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 1","pages":"Article 101631"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932247","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":"Empathy burnout among neurosurgeons","authors":"Saad Javed ,&nbsp;Shajia Khan ,&nbsp;Ismail Bozkurt ,&nbsp;Ismail Bozkurt ,&nbsp;Bipin Chaurasia","doi":"10.1016/j.neuchi.2024.101623","DOIUrl":"10.1016/j.neuchi.2024.101623","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 1","pages":"Article 101623"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873138","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":"Emergence of green neurosurgery in France","authors":"Irène Ollivier ,&nbsp;Martin Dupuy ,&nbsp;Paul Fréchon ,&nbsp;Tuan Le Van ,&nbsp;Violaine Delabar ,&nbsp;Mathilde Duran ,&nbsp;Ophélie Granjon ,&nbsp;Emilie Burger ,&nbsp;Audrey Reich ,&nbsp;Benjamin Nicot ,&nbsp;Romain Manet ,&nbsp;Johan Pallud","doi":"10.1016/j.neuchi.2025.101628","DOIUrl":"10.1016/j.neuchi.2025.101628","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 1","pages":"Article 101628"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015594","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":"Seizure outcomes and associated factors in adults with unilateral mesial temporal lobe epilepsy undergoing surgery","authors":"Mariana Torres-Bustamante ,&nbsp;Manuel Vicente Jaramillo-Canastero ,&nbsp;José Fernando Zapata-Berruecos ,&nbsp;Julián Carvajal-Castrillón ,&nbsp;Lucas Lozano-García ,&nbsp;Juan Felipe Álvarez ,&nbsp;Héctor Jaramillo-Betancur","doi":"10.1016/j.neuchi.2024.101622","DOIUrl":"10.1016/j.neuchi.2024.101622","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 1","pages":"Article 101622"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","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}

{"title":"Epidemiological analysis of adult-type diffuse lower-grade gliomas and incidence and prevalence estimates of diffuse IDH-mutant gliomas in France","authors":"Luc Bauchet ,&nbsp;Valérie Rigau ,&nbsp;Bertrand Mathon ,&nbsp;Amélie Darlix ,&nbsp;With the participation of the Société Française de Neurochirurgie (SFNC), Club de Neuro-oncologie of SFNC, Société Française de Neuropathologie (SFNP), Association des Neuro-Oncologues d’Expression Française (ANOCEF)","doi":"10.1016/j.neuchi.2024.101627","DOIUrl":"10.1016/j.neuchi.2024.101627","url":null,"abstract":"<div><h3>Background</h3><div>The recent advent of anti-IDH therapies and changes in the WHO classification of gliomas implies estimating the number of patients who could benefit (or not) from anti-IDH treatment. As published data on the current incidence of different subtypes of IDH-mutant gliomas (based on the latest histomolecular WHO classification) are lacking in many countries. The present analysis aims to review the main factors impacting the incidence of gliomas and lower-grade gliomas and to estimate the incidence and prevalence of IDH-mutant gliomas in France.</div></div><div><h3>Methods</h3><div>Our analysis was based on data from the French Brain Tumor DataBase and literature.</div></div><div><h3>Results</h3><div>Case definition, recording methods, histological classifications, age, sex, ethnicity, ancestry, environment, genetics, etc., impact the incidence of gliomas overall and lower-grade gliomas. In France, for the year 2024, the incidence estimates of all gliomas and all adult-type diffuse IDH-mutant gliomas are 6.6/100,000 and 1/100,000 person-years, respectively. The incidence estimates of grades 2, 3, and 4 diffuse IDH-mutant gliomas are 0.5, 0.3, 0.2 per 100,000 person-years, respectively. Of note, the incidence estimate of grade 3 diffuse IDH-mutant glioma versus grade 2 or 4 is slightly more difficult to assess due to the possible variability in histological criteria to define tumor grade. The prevalence of diffuse IDH-mutant grade 2 glioma would be more than 6.57/100,000 persons.</div></div><div><h3>Discussion/Conclusion</h3><div>Our epidemiological analysis provides estimates of potential number of patients, but large prospective real-world studies are required to determine the positioning of anti-IDH treatments among all therapeutic strategies [surgery(ies), chemotherapy(ies), radiotherapy(ies), clinical/radiological follow-up, etc.].</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 3","pages":"Article 101627"},"PeriodicalIF":1.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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 ,&nbsp;Francesco Travaglini ,&nbsp;Matteo De Simone ,&nbsp;Morgane Evin ,&nbsp;Kaissar Farah ,&nbsp;Stéphane Fuentes","doi":"10.1016/j.neuchi.2024.101624","DOIUrl":"10.1016/j.neuchi.2024.101624","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>To map the current use of the DVR in spine surgery, identify gaps, address its limits and future perspectives.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 3","pages":"Article 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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcome of meningomyelocele and short-term prognostic factors: A retrospective cohort study","authors":"Atakan Besnek ,&nbsp;Mehmet Kılıç ,&nbsp;Halil Aslan ,&nbsp;İhsan Yıldırım ,&nbsp;Barış Erdoğan","doi":"10.1016/j.neuchi.2024.101626","DOIUrl":"10.1016/j.neuchi.2024.101626","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 &lt; 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 &lt; 0.001), experienced motor deficits (p &lt; 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 &lt; 0.001) and motor deficits (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"Article 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 ,&nbsp;Lesueur Paul ,&nbsp;Mazen Kallel ,&nbsp;Gregoire Braux ,&nbsp;Arthur Leclerc ,&nbsp;Evelyne Emery","doi":"10.1016/j.neuchi.2024.101621","DOIUrl":"10.1016/j.neuchi.2024.101621","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"Article 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}

{"title":"Is endoscopic optic nerve decompression useful in cases of optic neuropathy secondary to pachymeningitis?","authors":"Jonathan G.F. Smith,&nbsp;Caroline P. Smith,&nbsp;Philip Weir,&nbsp;Brendan C. Hanna","doi":"10.1016/j.neuchi.2024.101618","DOIUrl":"10.1016/j.neuchi.2024.101618","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>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-.</div><div>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.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"Article 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}

{"title":"Sustaining surgeon longevity in spine surgery: A narrative review","authors":"Vimal Raj Nitish Gunness ,&nbsp;Sara Chakir ,&nbsp;Omar Aljeeran ,&nbsp;Paolo Rizzo ,&nbsp;Said Taha","doi":"10.1016/j.neuchi.2024.101619","DOIUrl":"10.1016/j.neuchi.2024.101619","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"Article 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}