Operative neurosurgery (Hagerstown, Md.)最新文献

{"title":"Advances and Integrations of Computer-Assisted Planning, Artificial Intelligence, and Predictive Modeling Tools for Laser Interstitial Thermal Therapy in Neurosurgical Oncology.","authors":"Anmol Warman, Dharani Moorthy, Ryan Gensler, Melanie Alfonzo Horowtiz, Jeremy Ellis, Luke Tomasovic, Ethan Srinivasan, Karim Ahmed, Tej D Azad, William Stanley Anderson, Jordina Rincon-Torroella, Chetan Bettegowda","doi":"10.1227/ons.0000000000001673","DOIUrl":"https://doi.org/10.1227/ons.0000000000001673","url":null,"abstract":"<p><p>Laser interstitial thermal therapy (LiTT) has emerged as a minimally invasive, MRI-guided treatment of brain tumors that are otherwise considered inoperable because of their location or the patient's poor surgical candidacy. By directing thermal energy at neoplastic lesions while minimizing damage to surrounding healthy tissue, LiTT offers promising therapeutic outcomes for both newly diagnosed and recurrent tumors. However, challenges such as postprocedural edema, unpredictable heat diffusion near blood vessels and ventricles in real time underscore the need for improved planning and monitoring. Incorporating artificial intelligence (AI) presents a viable solution to many of these obstacles. AI has already demonstrated effectiveness in optimizing surgical trajectories, predicting seizure-free outcomes in epilepsy cases, and generating heat distribution maps to guide real-time ablation. This technology could be similarly deployed in neurosurgical oncology to identify patients most likely to benefit from LiTT, refine trajectory planning, and predict tissue-specific heat responses. Despite promising initial studies, further research is needed to establish the robust data sets and clinical trials necessary to develop and validate AI-driven LiTT protocols. Such advancements have the potential to bolster LiTT's efficacy, minimize complications, and ultimately transform the neurosurgical management of primary and metastatic brain tumors.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478550","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":"Sequential Brain Shift Patterns During Staged Bilateral Deep Brain Stimulation Surgery for Parkinson's Disease.","authors":"Junhyung Kim, Sungyang Jo, Sun Ju Chung, Seok Ho Hong, Sang Ryong Jeon","doi":"10.1227/ons.0000000000001664","DOIUrl":"https://doi.org/10.1227/ons.0000000000001664","url":null,"abstract":"<p><strong>Background and objectives: </strong>Brain shift is a major contributor to targeting errors in stereotactic procedures. This study investigates sequential brain shift patterns during deep brain stimulation (DBS) surgery and discusses the clinical implications of using a staged bilateral targeting strategy in Parkinson's disease.</p><p><strong>Methods: </strong>Quantitative image analysis was conducted for 210 DBS procedures in 105 patients with Parkinson's disease undergoing staged bilateral operations. Brain shift was quantified by coordinate displacements of subcortical structures, including the globus pallidus internus (GPi) and subthalamic nucleus (STN), across 4 MRI sessions during the 2 staged DBS procedures. Brain shift was evaluated in 3 configurations: pre-first vs post-first DBS MRIs (ⅰ), pre-first vs post-second DBS MRIs (ⅱ), and pre-second vs post-second DBS MRIs (ⅲ).</p><p><strong>Results: </strong>Brain shift was predominant in posterior, inferior, and medial directions, with greater magnitude in the GPi than in the STN. After the first DBS procedure (ⅰ), clinically relevant brain shift (displacement >3 mm) was observed in 6.8% of the GPi, while none was noted in the STN. After the second DBS procedure (ⅱ), brain shift was observed in up to 20.3% of the GPi and 4.1% of the STN on the second targeted side. However, when evaluated relative to the rescanned MRI (ⅲ), brain shifts within the second DBS procedure were reduced to 4.1% for the GPi and none for the STN, supporting the importance of precise target adjustment via a staged bilateral strategy. The extent of pneumocephalus showed the strongest correlation with the posterior displacement of the GPi, and low intraoperative mean arterial pressure appeared to be significantly associated with an increased risk of brain shift in this cohort.</p><p><strong>Conclusion: </strong>These findings suggest that brain shift should be an important consideration in bilateral DBS surgery, and staged operations may provide particular advantages when targeting the GPi.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478566","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":"Angiographic Occlusion After Flow Diversion of Ruptured and Unruptured Intracranial Aneurysms Using the Flow Redirection Endoluminal Device-X: A Multicenter Analysis.","authors":"Joanna M Roy, Arbaz Momin, Basel Musmar, Saman Sizdahkhani, Sravanthi Koduri, Alexandra R Paul, Nicholas C Field, Yi Zhang, Jan-Karl Burkhardt, Anna Luisa Kühn, Ajit Puri, Elad Levy, M Reid Gooch, Pascal Jabbour, Robert H Rosenwasser, Stavropoula I Tjoumakaris","doi":"10.1227/ons.0000000000001672","DOIUrl":"https://doi.org/10.1227/ons.0000000000001672","url":null,"abstract":"<p><strong>Background and objectives: </strong>Flow diversion induces progressive aneurysm occlusion by reducing blood flow across the aneurysm neck over time. Various factors, including comorbid conditions, aneurysm characteristics, and stent design, have been shown to affect occlusion rates after flow diversion. Our study analyzed predictors of angiographic occlusion after flow diversion of intracranial aneurysms using the Flow Redirection Endoluminal Device with X-technology (FRED-X).</p><p><strong>Methods: </strong>This was a multicenter study of ruptured and unruptured aneurysms treated at 6 participating institutions across the United States. Data were collected on patient-specific factors and aneurysm characteristics. Angiographic occlusion was assessed using the Raymond Roy Occlusion Classification. Multivariate logistic regression was used to analyze predictors of complete angiographic occlusion at either the 6- or 12-month follow-up.</p><p><strong>Results: </strong>One hundred forty-four patients with 152 aneurysms met criteria for inclusion. A total of 69.4% of patients (n = 100) achieved complete occlusion. The average age of the cohort that achieved complete occlusion was 56.2 years, and 84% (n = 84) was female. On univariate analysis, aneurysm laterality, partial thrombosis of the aneurysm sac, proximal and distal diameters of the parent artery, and procedure time were significantly associated with complete angiographic occlusion. On multivariate analysis, parent artery diameter distal to the aneurysm was associated with 0.46-fold decreased odds of complete occlusion (95% CI: 0.26-0.78, P < .002). One patient in the incompletely occluded cohort underwent retreatment using the Pipeline Shield at 7 months after the initial flow diversion procedure using the FRED-X.</p><p><strong>Conclusion: </strong>Our study identified that parent artery diameter distal to the aneurysm was associated with decreased odds of aneurysm occlusion after flow diversion using the FRED-X. This adds to the literature on the importance of device sizing during flow diversion. Further prospective studies could help validate these findings.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478551","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":"Hybrid Therapy for Newly Diagnosed and Recurrent Glioblastoma: Staged Procedure Integrating Open Surgical Resection With Laser Interstitial Thermal Therapy.","authors":"Chandler N Berke, Adham M Khalafallah, Muhammet Enes Gurses, Victor M Lu, Michael E Ivan, Ricardo J Komotar, Ashish H Shah","doi":"10.1227/ons.0000000000001668","DOIUrl":"https://doi.org/10.1227/ons.0000000000001668","url":null,"abstract":"<p><strong>Background and objectives: </strong>Glioblastoma (GBM) is the most common and aggressive primary malignant brain tumor in adults with a median overall survival of 15.6 months. Despite advancements, 5-year survival rates have not significantly improved. Laser interstitial thermal therapy (LITT) has been used to treat both newly diagnosed (nGBM) and recurrent GBM (rGBM) with demonstrable safety and efficacy. Traditionally, LITT has been limited to smaller lesions given physical and thermal constraints. We present 2 case examples of a novel, hybrid treatment approach to GBM, using both surgery and laser ablation as part of a staged procedure.</p><p><strong>Methods: </strong>Two geriatric (older than 65 years) patients with nGBM or rGBM were treated with surgical resection followed by LITT the subsequent day. Both patients underwent preoperative MRI showing multifocal disease with a dominant component, causing mass effect in the second case, and an unresectable component.</p><p><strong>Results: </strong>The first case underwent surgical resection of a large, multicentric rGBM in the parieto-occipital region, followed by LITT of an unresectable lesion in the inferior temporal gyrus. The second patient underwent surgical resection of the dominant temporal lobe component and LITT of the insular component. Neither patient had intraoperative or ablation complications. Both patients had stable postoperative neurological examinations and were discharged on the day after ablation, with no new deficits at follow-up.</p><p><strong>Conclusion: </strong>The prognosis for GBM remains dismal despite attempts at advancements in patient management. Surgical resection is a critical component of the GBM treatment paradigm, although, alone, is not sufficient for maximal therapeutics in many patients. LITT is a minimally invasive means of cytoreduction that has shown promise for improving GBM outcomes. We demonstrate a novel, hybrid approach to GBM using hybrid surgical resection and LITT in a staged procedure to overcome traditional constraints of both open resection or LITT alone.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478563","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":"Double Supinator Branch Transfer to Posterior Interosseous Nerve May Confer Superior Hand Opening Restoration Outcomes in Brachial Plexus and Spinal Cord Injury Compared to Single Branch.","authors":"Pavlos Texakalidis, Nikhil Murthy, Colin K Franz, Kevin Swong","doi":"10.1227/ons.0000000000001670","DOIUrl":"https://doi.org/10.1227/ons.0000000000001670","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cervical spinal cord injury (SCI) and lower trunk brachial plexus injury (BPI) commonly result in hand paralysis. The supinator to posterior interosseous nerve (SPIN) transfer is a well-established surgical approach that can achieve restoration of hand opening with similar outcomes in SCI and BPI. Most often, the radial nerve has 2 branches to the supinator. Studies have reported utilization of either single or double supinator branches as donors for the SPIN transfer. The aim of this study was to study whether using one or both supinator branches can affect recovery of hand opening.</p><p><strong>Methods: </strong>A systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All studies reporting outcomes of the SPIN transfer were included.</p><p><strong>Results: </strong>A total of 16 studies with 108 patients and 152 SPIN transfers were included (132 with double and 20 with single supinator donor branches; 123 for SCI and 29 for BPI). Four of the 16 included studies reported the use of a single motor supinator branch as a donor, while the remaining 12 studies used both branches. The average time interval from injury to surgery was <12 months in each study. Finger extension (Medical Research Council ≥3/5) recovered in 65% (13/20) and 86.3% (114/132) of the single and double donor transfers (P = .016), respectively. Thumb extension restoration was achieved in 60% (12/20) and 83.3% (110/132) of the single and double branch transfers (P = .014), respectively. The median reported follow-up was more than 20 months per study. One patient in the cohort developed supination weakness; however, this patient had preexisting biceps weakness. Four patients developed temporary wrist extension weakness.</p><p><strong>Conclusion: </strong>Utilization of both supinator branches for the SPIN transfer might achieve superior hand opening outcomes in SCI and BPI, compared with the single supinator branch.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478552","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":"Photogrammetry Foundations and Guidelines for Acquisition of High-Definition 3-Dimensional Models Using Photographic Cameras and Smartphones: An Optimized Tool to Improve Neuroanatomy Research and Education.","authors":"Amedeo Piazza, Luciano C P C Leonel, Fabio Torregrossa, Stephen Graepel, Matteo De Notaris, Toma Spiriev, Maria Peris-Celda","doi":"10.1227/ons.0000000000001675","DOIUrl":"https://doi.org/10.1227/ons.0000000000001675","url":null,"abstract":"<p><strong>Background and objectives: </strong>Photogrammetry application is rapidly growing within the anatomical field as a new technique, underlining the need for the development of a comprehensive step-by-step methodology and guide to facilitate the pursuit of high-definition photogrammetry. Therefore, the aim of this study was to describe 2 photogrammetry techniques and their step-by-step from positioning and preparing the specimens for photodocumentation to the final 3-dimensional (3D) model displayed on online platforms.</p><p><strong>Methods: </strong>Two dry skulls, 2 embalmed brains, and 30 embalmed and latex-injected heads were used for the study, rendering a total of 130 3D models. The specimens were placed on a turntable and photodocumented using a digital single-lens reflex camera or smartphone, and the key steps and notes were methodically described.</p><p><strong>Results: </strong>The photogrammetry technique using either a digital single-lens reflex camera or smartphone required images captured in 3 different steps: overview images, close range photographs, and images of depth-located structures. All images were then upload to Agisoft Metashape software, postprocessed and rendered into the final 3D model and displayed using Sketchfab®.</p><p><strong>Conclusion: </strong>This article provided a detailed description of a high-resolution photogrammetry scanning technique, highlighting the advantages and relevance of acquiring 3D models through mobile devices to demystify and clarify the technique to enhance the experience in clinical and neuroanatomical application.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500302","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":"Occipital Artery to a3 Anterior Inferior Cerebellar Artery Bypass With Distal Occlusion of an Intrameatal a2 Fusiform Aneurysm.","authors":"Visish M Srinivasan, Mohamed A Labib, Michael T Lawton","doi":"10.1227/ons.0000000000001680","DOIUrl":"https://doi.org/10.1227/ons.0000000000001680","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478565","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":"Kissing Vertebral Arteries Causing Myelopathy Treated With Microvascular Decompression Using Transposition Technique: 2-Dimensional Operative Video.","authors":"Alexander D Rebchuk, Jeremy Kam, Gary J Redekop","doi":"10.1227/ons.0000000000001674","DOIUrl":"https://doi.org/10.1227/ons.0000000000001674","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478564","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: The Rocker Technique for Atlantoaxial Dislocation With or Without Basilar Invagination: A Prospective Observational Study.","authors":"Jitin Bajaj","doi":"10.1227/ons.0000000000001684","DOIUrl":"10.1227/ons.0000000000001684","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"323-324"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334825","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: The Rocker Technique for Atlantoaxial Dislocation With or Without Basilar Invagination: A Prospective Observational Study.","authors":"Xin Zhou","doi":"10.1227/ons.0000000000001683","DOIUrl":"10.1227/ons.0000000000001683","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"321-322"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334826","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}