Operative neurosurgery (Hagerstown, Md.)最新文献

{"title":"Three-Dimensional Modeling and Augmented Reality and Virtual Reality Simulation of Fiber Dissection of the Cerebellum and Brainstem.","authors":"Muhammet Enes Gurses,&nbsp;Abuzer Gungor,&nbsp;Serdar Rahmanov,&nbsp;Elif Gökalp,&nbsp;Sahin Hanalioglu,&nbsp;Mustafa Berker,&nbsp;Aaron A Cohen-Gadol,&nbsp;Uğur Türe","doi":"10.1227/ons.0000000000000358","DOIUrl":"https://doi.org/10.1227/ons.0000000000000358","url":null,"abstract":"<p><strong>Background: </strong>Surgeons must understand the complex anatomy of the cerebellum and brainstem and their 3-dimensional (3D) relationships with each other for surgery to be successful. To the best of our knowledge, there have been no fiber dissection studies combined with 3D models, augmented reality (AR), and virtual reality (VR) of the structure of the cerebellum and brainstem. In this study, we created freely accessible AR and VR simulations and 3D models of the cerebellum and brainstem.</p><p><strong>Objective: </strong>To create 3D models and AR and VR simulations of cadaveric dissections of the human cerebellum and brainstem and to examine the 3D relationships of these structures.</p><p><strong>Methods: </strong>Ten cadaveric cerebellum and brainstem specimens were prepared in accordance with the Klingler's method. The cerebellum and brainstem were dissected under the operating microscope, and 2-dimensional and 3D images were captured at every stage. With a photogrammetry tool (Qlone, EyeCue Vision Technologies, Ltd.), AR and VR simulations and 3D models were created by combining several 2-dimensional pictures.</p><p><strong>Results: </strong>For the first time reported in the literature, high-resolution, easily accessible, free 3D models and AR and VR simulations of cerebellum and brainstem dissections were created.</p><p><strong>Conclusion: </strong>Fiber dissection of the cerebellum-brainstem complex and 3D models with AR and VR simulations are a useful addition to the goal of training neurosurgeons worldwide.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"345-354"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33503612","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":"Commentary: Dura Management Strategies in the Surgical Treatment of Adult Chiari Type I Malformation: A Retrospective, Multicenter, Population-Based Parallel Cohort Case Series.","authors":"Hani Chanbour,&nbsp;Jeffrey W Chen,&nbsp;Michael C Dewan,&nbsp;Scott L Zuckerman","doi":"10.1227/ons.0000000000000416","DOIUrl":"https://doi.org/10.1227/ons.0000000000000416","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e342-e343"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40364066","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":"Unilateral Approaches for Posterior Spinal Canal Decompression in Cervical Spondylotic Myelopathy-An Evaluation of Conceptual Feasibility.","authors":"Sebastian Siller,&nbsp;Laura Pannenbaecker,&nbsp;Joerg-Christian Tonn,&nbsp;Stefan Zausinger","doi":"10.1227/ons.0000000000000364","DOIUrl":"https://doi.org/10.1227/ons.0000000000000364","url":null,"abstract":"<p><strong>Background: </strong>Patients with cervical spondylotic myelopathy (CSM) can be treated with posterior approaches for spinal canal decompression.</p><p><strong>Objective: </strong>We compared the patients' outcome after 2 different unilateral and a bilateral posterior approach for decompression to elucidate feasibility and potential procedure-related differences.</p><p><strong>Methods: </strong>Medical records of 98 patients with CSM undergoing posterior decompression between 2012 and 2018 were assessed. Patients were divided into 3 groups: (1) unilateral interlaminar fenestration with over-the-top \"undercutting\" (laminotomy) for compression limited to a ligamentum flavum hypertrophy, (2) unilateral hemilaminectomy for lateralized compression with a combination of ligamentous hypertrophy and osseus stenosis, and (3) laminectomy/laminoplasty for circular osseous-ligamentous spinal canal narrowing.</p><p><strong>Results: </strong>The mean age was 73 years (m:f = 1.4:1), and most frequent symptoms (mean duration: 15 months) were ataxia (69%) and sensory changes (57%). Main location of stenoses (median Naganawa Score = 3; mean anteroposterior spinal canal diameter = 7.7 ± 2.2 mm) was C3 to C6. Thirty-one percent of the patients were assigned for a laminotomy procedure, 20% for a hemilaminectomy, and 49% for a laminectomy/laminoplasty. There were no significant differences of patients' characteristics, blood loss, and operation time between the 3 groups. Independent from the mode of surgery, the spinal canal was significantly widened (median Naganawa Score = 0; mean anteroposterior diameter = 11.4 ± 3.6 mm) and myelopathy (mJOA Score) improved ( P &lt; .001); a higher body mass index was significantly correlated with a worse mJOA improvement (r = 0.293/ P = .003). Quality of life (Short-Form 36v2 Health Survey/Neck Disability Index) and reduction of the neck pain level were similar in the 3 groups at last follow-up (mean: 28 months).</p><p><strong>Conclusion: </strong>To minimize patients' periprocedural burden in CSM with dorsal compression, individual tailoring of the posterior approach according to the underlying compressive pathology achieves sufficient decompression and comparable long-term results.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"431-438"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33502884","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":"Commentary: Endoscope-Assisted Microsurgical Resection of a Large Petroclival Meningioma Using a Retrosigmoid Approach: 2-Dimensional Operative Video.","authors":"Hailiang Tang,&nbsp;Feng Xu","doi":"10.1227/ons.0000000000000398","DOIUrl":"https://doi.org/10.1227/ons.0000000000000398","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e326-e327"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33504513","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":"Use of Antibacterial Envelopes for Prevention of Infection in Neuromodulation Implantable Pulse Generators.","authors":"Amit R Persad,&nbsp;Syed Uzair Ahmed,&nbsp;Rosalie Mercure-Cyr,&nbsp;Karen Waterhouse,&nbsp;Aleksander M Vitali","doi":"10.1227/ons.0000000000000367","DOIUrl":"https://doi.org/10.1227/ons.0000000000000367","url":null,"abstract":"<p><strong>Background: </strong>Neuromodulation unit placement carries a historic infection rate as high as 12%. Treatment of such requires surgical removal and a long course of systemic antibiotics. Antibiotic-impregnated envelopes have been effective in preventing infection in implantable cardiac devices. At our center, 1 surgeon uses these envelopes with all implanted neuromodulation units.</p><p><strong>Objective: </strong>To assess the efficacy of antibacterial envelopes in prevention of infection in neuromodulation device placement.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of consecutive implantable pulse generator (IPG) unit implantation with an antibacterial envelope at a single center between October 2014 and December 2019. We collected demographic data, including postoperative infections, reoperations, and complications, associated with the IPGs. This cohort was then compared with a historical cohort of consecutive patients undergoing surgery before envelope usage (October 2007-April 2014).</p><p><strong>Results: </strong>In the pre-envelope cohort of 151 IPGs placed in 116 patients, there were 18 culture-confirmed infections (11.9%). In the antibacterial envelope cohort of 233 IPGs placed in 185 patients, there were 5 culture-confirmed infections (2.1%). The absolute risk reduction of the antibacterial envelope was 9.85% (95% CI 4.3%-15.4%, P &lt; .01). The number needed to treat was 10.1 (95% CI 6.5-23.1, P &lt; .01) envelopes to prevent 1 IPG infection.</p><p><strong>Conclusion: </strong>We saw a reduced rate of infections in the antibacterial envelope cohort. Although this is likely multifactorial, our results suggest a benefit of antibacterial envelopes on infection after neuromodulation surgery.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"413-419"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33503613","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":"Fractured Lumbar Drain Catheter Retrieval Using an Endoscopic Transforaminal Approach to the Lumbar Spine.","authors":"Suraj Sulhan,&nbsp;Saeed S Sadrameli,&nbsp;Sean Barber,&nbsp;Paul Holman,&nbsp;Gavin Britz,&nbsp;Meng Huang","doi":"10.1227/ons.0000000000000378","DOIUrl":"https://doi.org/10.1227/ons.0000000000000378","url":null,"abstract":"<p><strong>Background and importance: </strong>Lumbar drain placement is a common neurosurgical procedure, with several surgical and medical indications extending even beyond the specialty. One complication of placement is a fractured catheter fragment. In some circumstances, catheter retrieval is necessary which is classically performed through an open approach. Here, we present the only reported case of a retained lumbar drain catheter which was retrieved using a transforaminal endoscopic approach to the lumbar spine.</p><p><strong>Clinical presentation: </strong>This is a 39 year-old woman who underwent an elective craniotomy with planned perioperative lumbar drain placement for cerebrospinal fluid diversion using a 14-gauge Tuohy needle. Placement was noted to be technically challenging, and during the final attempt on removal of the system, it was noted that the distal end of the catheter had been sheared and retained in the thecal sac. Postoperatively a computed tomography scan of the lumbar spine was obtained showing the catheter fragment which entered the thecal sac dorsally at the L3-4 level but penetrated the ventral dura traveling in the epidural space caudally and terminating in the left lateral recess of L4-5. Given its presumed epidural location near the left L4-5 lateral recess and foramen, the decision was made to attempt a left transforaminal endoscopic approach for catheter retrieval before resorting to a standard open surgery.</p><p><strong>Conclusion: </strong>As minimally invasive spine techniques for spine surgery continue to evolve, we have highlighted the versatility of the endoscope in spine surgery as it was implemented in our case, allowing for reduced perioperative morbidity associated with retained spinal catheter retrieval.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e331-e334"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33502882","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: Craniometrics and Ventricular Access: A Review of Kocher's, Kaufman's, Paine's, Menovksy's, Tubbs', Keen's, Frazier's, Dandy's, and Sanchez's Points.","authors":"Nelson A Picard","doi":"10.1227/ons.0000000000000411","DOIUrl":"https://doi.org/10.1227/ons.0000000000000411","url":null,"abstract":"To the Editor: In their recent article, “Craniometrics and Ventricular Access: A Review of Kocher’s, Kaufman’s, Paine’s, Menovksy’s, Tubbs’, Keen’s, Frazier’s, Dandy’s, and Sanchez’s Points” Morone et al1 provide an excellent overview of the various methods of obtaining ventricular access based on different cranial starting points and drain trajectories. As the authors expertly illustrate, Kocher’s point is the most common starting cranial location and is used in the vast majority of cases, especially for emergency external ventricular drain (EVD) placement. We agree with the authors that the other cranial points of access are most commonly used intraoperatively when the entry point is limited by the exposed surgical field. The authors should be commended for their","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e347"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33503210","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":"Resection of Giant Craniopharyngioma, Contending With Multiple Compartments and Myriad Perforating Arteries: 2-Dimensional Operative Video.","authors":"Samuel N Emerson,&nbsp;Ossama Al-Mefty","doi":"10.1227/ons.0000000000000402","DOIUrl":"https://doi.org/10.1227/ons.0000000000000402","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e320"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33504826","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":"Middle Fossa Approach for Resection of a Petrous Apex Cholesterol Granuloma: 2-Dimensional Operative Video.","authors":"Peter A Weisskopf,&nbsp;Evelyn L Turcotte,&nbsp;Rudy J Rahme,&nbsp;Bernard R Bendok","doi":"10.1227/ons.0000000000000374","DOIUrl":"https://doi.org/10.1227/ons.0000000000000374","url":null,"abstract":"Cholesterol granulomas (CGs) are the most common cyst of the petrous apex.1 The management options for CG include observation and surgical resection. Surgery is complicated by the proximity of these lesions to critical neurological and vascular structures, as with many skull base lesions; however, if left untreated, their growth may lead to mass effect resulting in conductive hearing loss, cranial nerve dysfunction, tinnitus, and/or chronic headaches.2,3 In this video, we present the case of 52-year-old woman who presented with medically refractory right retro-orbital headaches. MRI revealed a large, right-sided petrous apex cystic structure consistent with a CG. Computed tomography of the head demonstrated bony remodeling. Given the large size of the cyst and the patient's symptoms, surgery was proposed, and the patient agreed. We performed a middle fossa craniotomy and elevated the dura from the floor of the middle fossa, working posteriorly from the petrous ridge and extending anteriorly. The cyst was exposed and decompressed, and its wall was then dissected off. After all cystic components were removed, the cavity was packed with abdominal fat, which is believed to prevent cyst reaccumulation. Postoperative MRI demonstrated good resection, and the patient reported complete resolution of her headaches. The patient consented to the procedure as shown in this operative video and gave informed written consent for use of her images in publication.","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e322-e323"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40358270","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: Clipping Ophthalmic Segment Artery Aneurysms Using a Modified Subdural Dolenc Approach: Classification and Experience Sharing.","authors":"Long Wang,&nbsp;Shujun Tang","doi":"10.1227/ons.0000000000000405","DOIUrl":"https://doi.org/10.1227/ons.0000000000000405","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e346"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33502815","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}