Operative neurosurgery (Hagerstown, Md.)最新文献

{"title":"Letter: Clinical and Radiographic Outcomes of Atlantoaxial or Occipitocervical Fixation and Fusion in Patients With Cervical Myelopathy due to Idiopathic Retro-Odontoid Pseudotumor.","authors":"Atul Goel","doi":"10.1227/ons.0000000000001636","DOIUrl":"https://doi.org/10.1227/ons.0000000000001636","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112124","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":"In Reply: Clinical and Radiographic Outcomes of Atlantoaxial or Occipitocervical Fixation and Fusion in Patients With Cervical Myelopathy due to Idiopathic Retro-Odontoid Pseudotumor.","authors":"Xin Zhou, Huasheng Jiang","doi":"10.1227/ons.0000000000001637","DOIUrl":"https://doi.org/10.1227/ons.0000000000001637","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112123","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":"Transorbital Endoscopic Approach for Resection of an Intraorbital Lesion: 2-Dimensional Operative Video.","authors":"Jesse D Lawrence, Kyle Godfrey, Theodore H Schwartz","doi":"10.1227/ons.0000000000001634","DOIUrl":"https://doi.org/10.1227/ons.0000000000001634","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113171","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":"A Comparative Study of Spinous Process Splitting Laminectomy and Laminoplasty for Thoracolumbar Intradural Spinal Tumor Surgery.","authors":"Ho Sung Myeong, Woojin Kim, Jungbo Sim, Hangeul Park, Chang-Hyun Lee, Jun-Hoe Kim, Chi Heon Kim","doi":"10.1227/ons.0000000000001621","DOIUrl":"https://doi.org/10.1227/ons.0000000000001621","url":null,"abstract":"<p><strong>Background and objectives: </strong>In intradural spinal tumor surgery, laminoplasty (LP) aims to better preserve posterior spinal structures compared with laminectomy, potentially reducing complications such as deformity and cerebrospinal fluid leakage. Spinous process splitting laminectomy (SPSL), a modified form of laminectomy, also maintains the integrity of posterior spinal elements. However, there is concern regarding postoperative fluid collection at the laminectomy site. This study aimed to compare the postoperative outcomes between the two techniques.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent thoracolumbar intradural tumor surgery performed by a single experienced surgeon. Patients with instrumentation, hemilaminectomy, or reoperation for the same lesion were excluded. The volume of postoperative fluid collections and the degree of thecal sac compression caused by these collections on sagittal MRI were evaluated. Postoperative complications, along with other surgical and clinical outcomes were compared between groups. In addition, risk factors of cord compression were analyzed.</p><p><strong>Results: </strong>A total of 149 patients underwent SPSL (n = 78) or LP (n = 71), with similar baseline characteristics. The mean volume of postoperative fluid collection per level was significantly larger in the SPSL group than in the LP group (P < .01, 95% CI [1.087, 2.858]). However, because the fluid passively accumulated in the dead space at the laminectomy site, the degree of thecal sac compression did not differ significantly (P = .536). Complication rates and neurological outcomes were comparable, although one SPSL patient required reoperation for symptomatic epidural hematoma and one LP patient for cerebrospinal fluid leakage. Changes in sagittal alignment parameters did not differ between groups. Fluid collection volume was not a risk factor of cord compression, but older age was (P = .01, 95% CI [1.01, 1.09]).</p><p><strong>Conclusion: </strong>SPSL and LP demonstrated similar clinical and radiological outcomes. Although SPSL technique resulted in a larger volume of postoperative passive fluid collections at the laminectomy site, it did not lead to worse outcomes.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113328","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":"Endoscopic Super Extended Endonasal Approach: Transplanum Transtubercullum With Pituitary Hemitransposition and Tailored Transclival Approach for the Resection of a Giant Craniopharyngioma: 2-Dimensional Operative Video.","authors":"Diego Méndez-Rosito, Jesus Abraham Ibarra-Ramos, Isai García-López, Cristian Alberto Pérez-Carrillo, Eli Hernandez-Chávez, Sheila Maria Del Mar Borrayo-Dorado, Ivan Alejandro Méndez-Guerrero, Farina Arreguín-González, Nadin J Abdala-Vargas","doi":"10.1227/ons.0000000000001630","DOIUrl":"https://doi.org/10.1227/ons.0000000000001630","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113329","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":"Update and Evaluation of a Preoperative Scoring System to Predict Long-Term Outcomes After Microvascular Decompression in Trigeminal Neuralgia.","authors":"Margaret Tugend, Colby T Joncas, Yue-Fang Chang, Yanis Jaoui, Raymond F Sekula","doi":"10.1227/ons.0000000000001599","DOIUrl":"https://doi.org/10.1227/ons.0000000000001599","url":null,"abstract":"<p><strong>Background and objectives: </strong>Scoring systems attempting to predict long-term pain relief after microvascular decompression (MVD) for trigeminal neuralgia (TN) have been published previously. We compare the Panczykowski scoring system and a new scoring system, developed in response to published criticisms of previous scoring systems, in a larger cohort with longer term follow-up.</p><p><strong>Methods: </strong>In this retrospective cohort study, records from 410 patients undergoing MVD for TN were reviewed. Pain freedom after MVD was recorded, and Panczykowski scores (scoring system A) were calculated. Univariate logistic regression models were used to determine the relationship between clinical characteristics and pain freedom at follow-up. The predictive value of a tentative new scoring system was examined (scoring system B) and compared with scoring system A.</p><p><strong>Results: </strong>At a mean follow-up of 63 months, 282 patients (68.8%) were pain free without medications. Univariable analysis showed that age >45 years(χ2 = 6.26, df = 1, P = .012), TN type (χ2 = 53.16, df = 1, P < .0001), response to carbamazepine (χ2 = 6.65, df = 1, P = .010), and neurovascular compression (χ2 = 25.93, df = 1, P < .0001) all significantly predicted postoperative pain freedom without medication. Using scoring system A, a patient with a preoperative score of 3, 4, or 5 was, respectively, 2.05 (P = .114), 5.76 (95% CI 2.46-13.50, P < .0001), and 10.52 (95% CI 4.66-23.79, P < .0001) times more likely to attain long-term pain freedom without medication than a patient with a score of 0 or 1. Using scoring system B, a patient with a score of 3 or 4 was, respectively, 3.59 (95% CI 1.42-9.08, P = .007) and 8.68 (95% CI 3.42-22.05, P < .0001) times more likely to attain long-term pain freedom without medication than a patient with a score of 0 or 1.</p><p><strong>Conclusion: </strong>In a larger cohort of patients with longer term follow-up, both scoring systems A and B reliably predict long-term pain freedom after MVD for TN in this patient population and may be beneficial in selecting patients most likely to benefit from surgery.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113173","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":"Quantitative MRI Tractography of White Matter Tracts After Tumor Craniotomy Surgery: Comparative Analysis Between Tubular Retractor and Open Craniotomy Surgery.","authors":"Cynthia Alms, Chikezie I Eseonu","doi":"10.1227/ons.0000000000001622","DOIUrl":"https://doi.org/10.1227/ons.0000000000001622","url":null,"abstract":"<p><strong>Background and objectives: </strong>Tubular retraction has been a technique used to minimize the extent of cerebral retraction injury; however, only qualitative imaging assessments exist in the literature comparing this technique with open craniotomies using spatula retraction. This study uses quantitative MRI tractography to analyze the extent of cerebral retraction injury using tubular retraction (TR) compared with open craniotomies (OC).</p><p><strong>Methods: </strong>This study performed a retrospective analysis of a cohort of 20 patients who underwent cranial tumor surgery for deep-seated brain tumors. Ten patients who underwent surgery with TR were case-control matched with 10 patients who underwent an OC with spatula retraction. Quantitative metrics evaluating white matter tract integrity (fractional anisotropy (FA), geodesic anisotropy (GA), mean diffusivity, radial diffusivity, axial diffusivity, and tract volume), extent of resection, and neurological outcome were compared between the groups.</p><p><strong>Results: </strong>Twenty patients underwent cranial surgery for deep-seated brain lesions. Preoperative neurological and tumor characteristics were comparable between the 2 cohorts. Postoperative extent of resection was found to be 90.4% in the TR group and 94.8% in the OC group (P = .395). Significant improvement was seen in the change in Karnofsky Performance Score from preoperative to postoperative status in the TR group, an 11-point increase, compared with the OC group, no change in score (P = .035). Quantitative metrics evaluating overall axonal status (FA) and compression (GA) showed significant signs of improvement in the TR group, with an FA of 0.322 vs 0.029 in the OC group (P = .011). GA was found to increase in the TR group (0.441) and decrease in the OC group (0.411, P = .0.012). Diffusivity metrics, evaluating axonal integrity were comparable between the 2 groups.</p><p><strong>Conclusion: </strong>Tubular retraction surgery provides a viable surgical option for deep-seated tumors that provides comparable extent of resection outcomes while mitigating the effects of some components of retraction injury.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112804","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":"Letter: Omentomyelopexy for the Treatment of a Persistent Lumbar Pseudomeningocele: A Case Report With Technical Note.","authors":"Brahim Kammoun, Mehdi Borni, Ghassen Souissi, Fatma Kolsi, Basma Souissi, Hela Ben Jemaa, Mohamed Zaher Boudawara","doi":"10.1227/ons.0000000000001612","DOIUrl":"https://doi.org/10.1227/ons.0000000000001612","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112134","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":"Nerve Transfers for Elbow Reconstruction in Upper and Extended Upper-Type Brachial Plexus Injuries: A Case Series.","authors":"Emmanuel P Estrella,&nbsp;Tristram D Montales","doi":"10.1227/ons.0000000000000369","DOIUrl":"https://doi.org/10.1227/ons.0000000000000369","url":null,"abstract":"<p><strong>Background: </strong>Nerve transfers for elbow flexion in brachial plexus injuries have been used with increasing frequency because of the higher rate of success and acceptable morbidity. This is especially true in upper and extended upper-type brachial plexus injuries.</p><p><strong>Objective: </strong>To present the clinical outcomes of nerve transfers for elbow flexion in patients with upper and extended upper-type brachial plexus injuries.</p><p><strong>Methods: </strong>A retrospective cohort review was done on all patients with upper and extended upper-type brachial plexus injuries from 2006 to 2017, who underwent nerve transfers for the restoration of elbow flexion. Outcome variables include Filipino version of the disability of the arm, shoulder, and hand (FIL-DASH) score, elbow flexion strength and range of motion, and pain. All statistical significance was set at P &lt; .05.</p><p><strong>Results: </strong>Fifty-six patients with nerve transfers to restore elbow flexion were included. There was a significant improvement in FIL-DASH scores in 28 patients after the nerve transfer procedure. Patients with C56 nerve root injuries and those with more than 2 years' follow-up have a higher percentage of regaining ≥M4 elbow flexion strength. Those with double nerve transfers had a higher percentage of ≥M4 elbow flexion strength, greater range of elbow flexion, and better FIL-DASH scores compared with single nerve transfers, but this did not reach statistical significance.</p><p><strong>Conclusion: </strong>Nerve transfer procedures improve FIL-DASH scores in upper and upper-type brachial plexus injuries. After nerve transfer, stronger elbow flexion can be expected in patients with C56 injuries, and those with longer follow-up.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"367-373"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33502880","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":"Diaphragmatic Hernia With Incarcerated Spleen as a Complication After Lateral Anterior Column Realignment.","authors":"Aria M Jamshidi,&nbsp;Joel R Martin,&nbsp;Onur C Kutlu,&nbsp;Michael Y Wang","doi":"10.1227/ons.0000000000000371","DOIUrl":"https://doi.org/10.1227/ons.0000000000000371","url":null,"abstract":"<p><strong>Background: </strong>The creation of sagittal balance of the spine is critical in the treatment adult spinal deformity. Anterior column release (ACR) has gained traction as a minimally invasive alternative to pedicle subtraction osteotomy. By releasing the anterior longitudinal ligament, the anterior column can be lengthened and physiologic lordosis restored. Risks such as transient psoas weakness and thigh numbness have been well documented in the literature; however, diaphragmatic hernia has never been reported.</p><p><strong>Objective: </strong>To highlight the difficulties encountered in diagnosing, managing, and treating iatrogenic diaphragmatic hernia in the setting of ACR and stress the relevant retropleural, retroperitoneal, and diaphragmatic structures during the surgical approach.</p><p><strong>Methods: </strong>In this technical note, we discuss the relevant anatomy in a direct lateral approach to the thoracolumbar junction and the management of an iatrogenic diaphragmatic hernia, which occurred in a patient who underwent a L1 ACR.</p><p><strong>Results: </strong>Three months after surgery, our patient was assessed in clinic and endorsed significant improvements in her pain and mobility. Her 3-month postoperative scoliosis x-rays demonstrated a significant improvement in her sagittal alignment, and she experienced no further negative sequelae from the iatrogenic hernia.</p><p><strong>Conclusion: </strong>Iatrogenic diaphragmatic hernia with an intrathoracic spleen after direct lateral ACR is a risk spine surgeons should be aware of and address promptly.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"389-395"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33503611","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}