Operative neurosurgery (Hagerstown, Md.)最新文献

{"title":"Commentary: Minimally Invasive Tubular Extraforaminal Lumbar Interbody Fusion for Revision Surgery at L4/5: 2-Dimensional Operative Video.","authors":"Serhat Aydin, Ella G O'Rourke, Qazi Zeeshan","doi":"10.1227/ons.0000000000002102","DOIUrl":"10.1227/ons.0000000000002102","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"1007-1008"},"PeriodicalIF":1.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221583","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 Endonasal Transorbital Extracapsular Resection of an Intraorbital Intraconal Capillary Hemangioma: 3-Dimensional Operative Video.","authors":"Mohammad Bilal Alsavaf, Moataz D Abouammo, Ludovica Pasquini, Guilherme Mansur, Federico Valeri, Chandrima Biswas, Rodrigo Gehrke, Kyle C Wu, Ricardo L Carrau, Daniel M Prevedello","doi":"10.1227/ons.0000000000001979","DOIUrl":"10.1227/ons.0000000000001979","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"999"},"PeriodicalIF":1.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230550","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":"Sex and Age Differences in Transcription Factor and Hormonal Immunostaining in Patients With Nonfunctioning Pituitary Adenomas.","authors":"Amara Emeh, Erica Gillespie, David J Cote, Apurva Prasad, William Zeng, Ishan Shah, Robert G Briggs, Racheal Peterson, Jonathan Sisti, Mark Shiroishi, John D Carmichael, Kyle Hurth, Gabriel Zada","doi":"10.1227/ons.0000000000001903","DOIUrl":"10.1227/ons.0000000000001903","url":null,"abstract":"<p><strong>Background and objectives: </strong>Nonfunctioning pituitary adenomas (NFPAs) have historically been characterized histologically based on hormonal immunostaining. The 2017 World Health Organization guidelines for pituitary neuroendocrine tumors further delineated NFPA classification based on biologically relevant transcription factors (TFs), including T-PIT, PIT-1, and steroidogenic factor 1 (SF-1). We sought to evaluate differences in NFPA immunohistochemistry (IHC) associated with biological sex and age according to new TF immunostaining criteria.</p><p><strong>Methods: </strong>A retrospective review of data from a single institution was conducted to identify patients who had undergone NFPA resection from 2012 to 2023. Patients grouped based on their biological sex and then further divided into age categories. Univariable statistics were used to identify associations between patient demographics and NFPA IHC.</p><p><strong>Results: </strong>A total of 416 patients were included in the IHC-hormone analysis, and 154 patients were included in the IHC-TF analysis. Men were significantly less likely to have NFPAs with positive immunostaining for T-PIT (odds ratio [OR] = 0.15, 95% CI: 0.06-0.37) or adrenocorticotropic hormone (OR = 0.38, 95% CI: 0.22-0.64) and significantly more likely to have NFPAs stain positive for SF-1 (OR = 4.87, 95% CI: 2.24-10.6), follicle-stimulating hormone (FSH) (OR = 2.46, 95% CI: 1.64-3.69), luteinizing hormone (OR = 2.28, 95% CI: 1.26-4.13), thyroid-stimulating hormone (OR = 2.56, 95% CI: 1.05-6.26), or the alpha subunit (OR = 2.01, 95% CI: 1.36-2.97). Compared with the youngest age group, women in the oldest age group were more likely to have an NFPA stain positive for SF-1 (OR = 6.88, 95% CI: 1.86-25.4), FSH (OR = 2.32, 95% CI: 1.02-5.27), or the alpha subunit (OR = 2.14, 95% CI: 1.02-4.47). Similarly, men in the oldest age group were more likely to have an NFPA staining positive for FSH (OR = 4.16, 95% CI: 1.90-9.11) and the alpha subunit (OR = 2.36, 95% CI: 1.10-5.05); they were less likely to have positive immunostaining for adrenocorticotropic hormone (OR = 0.19, 95% CI: 0.04-0.79). There were no age-related differences in TF staining for male patients.</p><p><strong>Conclusion: </strong>This study demonstrates that sex and age are important demographic factors associated with immunostaining patterns and TF lineage subtypes for NFPAs. Underlying endocrine factors dictated by age and sex may represent a role in tumorigenesis or progression of NFPAs.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"906-917"},"PeriodicalIF":1.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986189","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":"Minimally Invasive Tubular Extraforaminal Lumbar Interbody Fusion for Revision Surgery at L4/5: 2-Dimensional Operative Video.","authors":"Noah Willett, Chibuikem A Ikwuegbuenyi, Jacopo Giordana, Natasha Kharas, Mousa K Hamad, Roger Härtl","doi":"10.1227/ons.0000000000001999","DOIUrl":"10.1227/ons.0000000000001999","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"1006"},"PeriodicalIF":1.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518324","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":"Sphereplasty With 3D-Printed Porous Titanium Microspheres for Thoracolumbar Vertebral Compression Fractures: 2-Dimensional Operative Video.","authors":"Giuseppe M V Barbagallo, Giacomo Cammarata, Erica Grasso, Francesco Certo","doi":"10.1227/ons.0000000000001969","DOIUrl":"10.1227/ons.0000000000001969","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"994-995"},"PeriodicalIF":1.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Image-to-Patient Registration Performance of a Novel Augmented Reality-Based and a State-of-the-Art Infrared Optical Neuronavigation System.","authors":"Tessa M Kos, Wouter D Maathuis, Peter W A Willems, Lambertus W Bartels, Pierre A Robe, Tristan P C van Doormaal","doi":"10.1227/ons.0000000000002218","DOIUrl":"https://doi.org/10.1227/ons.0000000000002218","url":null,"abstract":"<p><strong>Background and objectives: </strong>Augmented reality-based neuronavigation systems (AR-NS) have been proposed as a potential addition to regular neuronavigation systems, such as optical or electromagnetic systems. Accurate image-to-patient registration is a prerequisite for clinical acceptance and implementation of AR-NS in neurosurgical workflows. In this study, the registration performance of a novel AR-NS using a head-mounted display with an integrated red-green-blue camera was compared with that of a state-of-the-art infrared optical neuronavigation system. The performance was evaluated in controlled phantom experiments and in a clinical setting, focusing on registration error, localization precision, and registration time.</p><p><strong>Methods: </strong>Phantom experiments were performed using a human head model equipped with 8 fiducial markers under controlled conditions. Subsequently, adult patients who were undergoing cranial neurosurgery with preoperative T1-weighted contrast-enhanced MRI were included in the clinical study. In both phantom and clinical settings, the target registration error (TRE) and fiducial registration error were assessed using 7 registration fiducials and one independent target fiducial. The registration time was also recorded. Paired t-tests were used for the statistical analysis.</p><p><strong>Results: </strong>Data from 37 patients were included for analysis. In phantom experiments, sub-3-mm TRE and sub-1-mm point localization were achieved with both systems (P = .63). In the clinical setting, mean TRE values for AR-NS and infrared optical neuronavigation system were 5.5 ± 3.0 mm [95% CI: 4.8, 6.2] and 4.0 ± 2.0 mm [95% CI: 3.4, 4.7], respectively. The mean TRE difference was 1.2 ± 3.6 mm [95% CI: 0.1, 2.4], P = .047.</p><p><strong>Conclusion: </strong>Comparable registration performance was observed in the phantom measurements. A statistically significant difference in the registration performance of the 2 systems was observed in the patient measurements. The difference between the phantom and clinical findings highlights that similar registration performance can be achieved by the 2 systems under controlled circumstances, but the effect of clinical variables on the registration performance requires further investigation.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221308","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":"Neoadjuvant Treatment of BRAFV600E Papillary Craniopharyngiomas: A Case Series.","authors":"Amy J Wang, Ye Rim Chang, Lucas R Martinez, Iris P van Mullem, Qilin Zhang, Helen A Shih, Laura E Dichtel, Isabel C Arrillaga-Romany, George A Scangas, William E Butler, Otto Rapalino, Karen K Miller, William T Curry, Fred G Barker, Priscilla K Brastianos, Pamela S Jones","doi":"10.1227/ons.0000000000002222","DOIUrl":"https://doi.org/10.1227/ons.0000000000002222","url":null,"abstract":"<p><strong>Background and objectives: </strong>Craniopharyngiomas are locally invasive and frequently recurrent tumors of the sellar/suprasellar region. Historically, the mainstay of treatment has been surgical resection. The papillary type of craniopharyngiomas (PCP) frequently harbors a BRAFV600E mutation, rendering them amenable to targeted therapies. We present our institution's initial experience of using a minimally invasive endoscopic transventricular approach for biopsy, followed by neoadjuvant targeted BRAF/MEK inhibition.</p><p><strong>Methods: </strong>We retrospectively reviewed 5 cases of patients with BRAFV600E-mutated PCP diagnosed by endoscopic transventricular biopsy between July 2018 and August 2023, who then received BRAF/MEK inhibitor therapy. Patient characteristics, symptoms, tumor volumes, and treatment outcomes were collected from the electronic medical record. Tumor volumes were collected from radiology reports.</p><p><strong>Results: </strong>All 5 patients underwent endoscopic transventricular biopsy of a third ventricular tumor. The mean tumor volume postbiopsy was 23.8 ± 19.1 cm3 (range, 11.5-57.3 cm3). After confirmation of BRAFV600E mutation by biopsy, all patients received at least 1 cycle of BRAF/MEK inhibitor therapy (median, 5 cycles; range, 1-16 cycles). Two patients elected to undergo radiation treatment after 5 cycles of therapy. No patients experienced decline in endocrine function; notably, none of them developed arginine-vasopressin deficiency. Two patients with abnormal visual findings at baseline experienced improvement after treatment. At the last follow-up (mean, 5.1 ± 2.3 years after treatment initiation; range, 2.1-7.8 years), the mean tumor volume was 0.5 ± 0.4 cm3 (range, 0.07-1.2 cm3), corresponding to a mean reduction of 97.8% ± 1.2% (range, 96.2%-99.6%).</p><p><strong>Conclusion: </strong>When anatomically feasible, endoscopic transventricular biopsy appears to be a safe method for confirming BRAFV600E-mutated PCP. In our cohort, neoadjuvant BRAF/MEK inhibitor therapy after biopsy resulted in substantial, durable tumor shrinkage, visual improvement, and endocrine stability, without permanent treatment-related morbidity or need for more surgical management. The long-term follow-up reported here supports this novel, minimally invasive management pathway for BRAFV600E-mutated PCP.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187604","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":"Transcochlear Approach for an Aggressive Recurrent Posterior Petrous Meningioma: 2-Dimensional Operative Video.","authors":"Edoardo Agosti, Yousef Odeibat, Karen Mapelli, Guilherme Gago, Jean-Michel Bourque, Mathieu Trudel, Pierre-Olivier Champagne","doi":"10.1227/ons.0000000000002187","DOIUrl":"https://doi.org/10.1227/ons.0000000000002187","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171568","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":"Predictors of Insufficient Awakening During Awake Surgery: A Single-Center Retrospective Study.","authors":"Shigeki Takada, Etsuko Yamamoto Hattori, Hiroyuki Ikeda, Noritaka Sano, Masahiro Sawada, Masahiro Tanji, Yohei Mineharu, Takayuki Kikuchi, Yoshiki Arakawa","doi":"10.1227/ons.0000000000002221","DOIUrl":"https://doi.org/10.1227/ons.0000000000002221","url":null,"abstract":"<p><strong>Background and objectives: </strong>Awake surgery (AS) is widely performed for the resection of brain tumors and for epilepsy surgery. However, a non-negligible proportion of patients experience insufficient intraoperative awakening, leading to inadequate neurological monitoring. This retrospective study investigated predictive factors associated with insufficient intraoperative awakening.</p><p><strong>Methods: </strong>We retrospectively reviewed 78 consecutive AS procedures for brain tumors and epilepsy performed at our institution between 2021 and 2024. Previously reported predictive factors for AS failure and contraindications for AS were evaluated, along with the presence of basal ganglionic involvement (BGI), defined as a high-intensity area on fluid-attenuated inversion recovery imaging involving the striatum and globus pallidus.</p><p><strong>Results: </strong>Insufficient intraoperative awakening occurred in 13 cases (16.7%). Age (odds ratio [OR] per year, 1.04; 95% CI, 1.00-1.08), aphasia (OR, 4.18; 95% CI, 1.23-15.5), midline shift (OR, 7.85; 95% CI, 2.22-30.6), and BGI (OR, 118; 95% CI, 18.7-2352.2) were identified as factors associated with insufficient awakening using univariate logistic regression analysis. In multivariate logistic regression analysis, BGI remained independently associated with insufficient awakening (OR, 104.7; 95% CI, 16.4-2098.1). Preoperative corticosteroids were administered to 11 patients with glioblastoma to reduce peritumoral edema. Among 7 patients with glioblastoma and BGI at admission, BGI resolved preoperatively in 2 patients after corticosteroid therapy, and AS was successfully performed in both cases. Betamethasone was predominantly used, at a median dose of 4 mg/day and median preoperative treatment duration of 14 days. In both cases with resolved BGI, betamethasone was administered at 8 mg/day for more than 10 days.</p><p><strong>Conclusion: </strong>BGI may be one of the independent predictors of insufficient intraoperative awakening across a broader AS population. Preoperative administration of an adequate course of betamethasone may facilitate sufficient intraoperative awakening in patients with glioblastoma and BGI. Further multicenter studies are warranted.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169739","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":"Validation of Magnetic Resonance Brain Thermometry and Bioheat Modeling of Brain Temperature Using Direct Measurements With an Implanted Fiber Optic Probe.","authors":"Beini Hu, Benjamin B Risk, Nicholas M Boulis, Fadi Nahab, Jason W Allen, Andrei G Fedorov, Candace C Fleischer","doi":"10.1227/ons.0000000000002219","DOIUrl":"https://doi.org/10.1227/ons.0000000000002219","url":null,"abstract":"<p><strong>Background and objectives: </strong>Brain temperature is a promising marker of prognosis after injury. Although magnetic resonance (MR) thermometry and biophysical modeling can approximate absolute temperature, limited validation has been performed with direct measurements in a large animal model. The goal of this pilot study was to compare brain temperature measured using MR chemical shift thermometry (CST) and biophysical modeling with that measured using a fiber optic probe in a porcine model.</p><p><strong>Methods: </strong>MR data were acquired from a Yorkshire pig using a 3 T whole body MR scanner, with simultaneous monitoring of brain and body temperature using a fiber optic probe surgically implanted in the left thalamus and a rectal temperature probe, respectively. MR spectroscopy was acquired for CST. T1-weighted images and MR angiography and venography were acquired for biophysical modeling. Temperature was calculated using the chemical shift difference between water and N-acetylaspartate. Using MR input data of tissue and vessel structures, along with bioheat equations, whole brain temperatures were predicted. Brain temperatures measured using CST, biophysical modeling, and direct measurements from the fiber optic probe, along with rectal temperatures, were compared.</p><p><strong>Results: </strong>Brain temperature measured using CST was 39.9°C, whereas that measured using the implanted probe was 40.6°C in the left thalamus. Modeled brain temperature, averaged across all voxels in the left thalamus, was 40.1 ± 0.2°C. The difference between brain temperatures measured using CST and modeled temperature was -0.2°C. Brain temperatures from all 3 methods were equal to or higher than the mean rectal temperature during CST (39.9°C, range = 39.6-40.2°C). The difference between brain temperatures measured using the implanted probe and CST was 0.7°C, whereas the difference between probe-measured and modeled temperature was 0.5°C, on the same order as CST (±0.8°C) and probe accuracy (±0.3°C).</p><p><strong>Conclusion: </strong>Brain temperature quantification using CST and biophysical modeling showed strong agreement with ground truth measurements using a fiber optic probe, providing initial validation of both methods to quantify absolute brain temperature.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140384","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}