Operative neurosurgery (Hagerstown, Md.)最新文献

{"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}

{"title":"Commentary: The Modified Sparing Binostril Endoscopic Endonasal Approach Combined With an Algorithm-Based Reconstruction Strategy: Surgical and Functional Outcomes in Sellar and Suprasellar Lesions.","authors":"Andrii Sirko","doi":"10.1227/ons.0000000000002220","DOIUrl":"https://doi.org/10.1227/ons.0000000000002220","url":null,"abstract":"","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":"149140386","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":"The Modified Sparing Binostril Endoscopic Endonasal Approach Combined With an Algorithm-Based Reconstruction Strategy: Surgical and Functional Outcomes in Sellar and Suprasellar Lesions.","authors":"Carmine Antonio Donofrio, Giacomo Bertazzoni, Lucia Riccio, Marika Cominetti, Claudia Lodovica Modesti, Marco Faustini Fustini, Luca Pianta, Daniel Prevedello, Richard Shane Tubbs, Antonio Fioravanti","doi":"10.1227/ons.0000000000002214","DOIUrl":"https://doi.org/10.1227/ons.0000000000002214","url":null,"abstract":"<p><strong>Background and objectives: </strong>Conventional binostril endoscopic endonasal approaches (EEAs) provide optimal surgical ergonomics but are often associated with sinonasal morbidity. Conversely, mononostril approaches preserve mucosal integrity at the expense of surgical maneuverability. We hypothesized that the modified sparing binostril approach (moSBA) may provide a favorable balance between surgical exposure, ergonomics, and sinonasal preservation while maintaining flexibility for risk-adapted reconstruction. This study evaluates the feasibility and functional outcomes of this technique combined with a risk-adapted skull base reconstruction strategy.</p><p><strong>Methods: </strong>We retrospectively reviewed 81 patients who underwent EEA or extended EEA for sellar and suprasellar lesions between 2021 and 2025. All procedures were performed combining a paraseptal and a contralateral endonasal corridor (moSBA). The risk-adapted reconstructive algorithm included type 1 (hemostatic material with free mucosal graft), type 2 (inlay fat graft with onlay nasoseptal flap), and type 3 (modified gasket-seal). Outcomes included extent of resection, complications, and 22-item Sinonasal Outcome Test (SNOT-22) assessment.</p><p><strong>Results: </strong>EEAs were performed in 56 (69.1%) and extended EEAs in 25 (30.9%) patients. Intraoperative cerebrospinal fluid (CSF) leakage occurred in 48 cases (59.3%) and was graded as 1 in 12.3%, 2 in 34.6%, and 3 in 12.3%. Reconstruction types 1, 2, and 3 were used in 40.7%, 46.9%, and 12.4% of cases, respectively. Gross total resection was achieved in 72.9%. Postoperative CSF leakage occurred in 2.5%. On exploratory multivariate analysis, reconstruction complexity was independently associated with higher postoperative SNOT-22 score (B = 3.379, 95% CI: 0.827-5.930, P = .010).</p><p><strong>Conclusion: </strong>The moSBA appears to be a feasible and safe option for selected sellar and suprasellar lesions, providing favorable surgical and functional outcomes in this single-center experience. Although higher reconstruction complexity was independently associated with higher postoperative SNOT-22 scores, residual confounding related to surgical invasiveness, skull base defect magnitude, and intraoperative CSF leakage severity cannot be excluded.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122883","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":"Surgical Implications of Anatomic Relationships Among Foramen Ovale, Foramen Spinosum, and VI Cranial Nerve in the Anterior Transpetrosal Approach.","authors":"Luigi Mauro, Alessandro Pesaresi, Paula Nathalie Espinoza Apolo, Nicola Gorgoglione, Giandomenico Petrella, Andrea Cardia, Arianna Fava, Vincenzo Esposito, Paolo di Russo","doi":"10.1227/ons.0000000000002216","DOIUrl":"https://doi.org/10.1227/ons.0000000000002216","url":null,"abstract":"<p><strong>Background and objective: </strong>The anterior transpetrosal approach (ATA) is a valuable option for accessing the petroclival region, although it can be associated with considerable morbidity. The objective of the study was to provide a detailed description of the anatomic relationship between key neurovascular structures encountered in the ATA, to facilitate crucial steps of the approach.</p><p><strong>Methods: </strong>ATA has been performed on 34 sides in cadaveric heads. The extent of drilling was divided into standard ATA and extended ATA with removal of the petrous apex below the mandibular nerve (V3) and Gasserian ganglion. The relationship between middle meningeal artery and foramen spinosum (FS), greater superficial petrosal nerve (GSPN), foramen ovale, and arcuate eminence was evaluated. Finally, the abducens nerve (CN VI) was analyzed in its cisternal and interdural segment (CN VI-IS).</p><p><strong>Results: </strong>The FS was located posterolateral to the foramen ovale at a mean distance of 3.5 mm. The mean FS distances from the craniotomy edge and the arcuate eminence measured 24 and 29 mm, respectively. The mean distance between the FS and the GSPN-V3 intersection was 6.2 mm. At the root exit zone of CN VI, the mean distance from the inferior petrosal sinus was 7.8 mm. At the petrous apex, CN VI lay 9.7 mm deep to the Gasserian ganglion before passing beneath Gruber's ligament. The mean length of the CN VI-IS was 6.6 mm, and according to its exposure obtained with standard or extended ATA, it was divided into 3 patterns.</p><p><strong>Conclusion: </strong>An understanding of the relationship among the middle meningeal artery, V3, GSPN and CN VI is essential to reduce operative time and neurological morbidity. The CN VI with a longer CN VI-IS could represent a potential risk factor for indirect injury during aggressive bone removal in the ATA.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122875","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":"SurgiCorr: A Physics-Based Computational Framework for Patient-Specific Surgical Corridor Planning in Brain Tumor Surgery.","authors":"Amin Tavallaii, Antonio Di Ieva","doi":"10.1227/ons.0000000000002215","DOIUrl":"https://doi.org/10.1227/ons.0000000000002215","url":null,"abstract":"<p><strong>Background and objectives: </strong>Transcortical corridor selection is guided by anatomic intuition and neuronavigation, with no quantitative tool to estimate retraction injury to brain tissue. Such injury depends on corridor-specific tissue properties, opening width, and hold duration, variables existing systems do not model. We present SurgiCorr, a preoperative framework that generates patient-specific corridor candidates, simulates each biomechanically, and ranks them by a composite risk score (CRS) integrating strain, viscoelastic dose, imaging burden, and ventricular proximity.</p><p><strong>Methods: </strong>MRI volumes were resampled to isotropic resolution, segmented into 5 tissue classes, and meshed with per-element material properties. A surgeon-defined cortical entry patch was sampled to generate candidate corridors, each evaluated by parallel finite element analysis at 4 opening widths (4, 6, 8, and 12 mm). Four risk metrics were computed per corridor: volumetric cumulative strain injury (mm3), strain damage index, damage escalation metric (mm-1), and viscoelastic damage dose. These were combined with fluid-attenuated inversion recovery burden and ventricular proximity into a normalized CRS.</p><p><strong>Results: </strong>In a pediatric supratentorial tumor and an adult with multiple deep-seated metastases, the pipeline generated 176 and 68 candidate corridors, and completed 704 and 272 finite element modeling solves in 68/9 and 28/3 minutes (central processing unit/graphics processing unit), respectively. CRS spanned 0.025 to 0.819 and 0.134 to 0.694 across the 2 cases (case means 0.395 and 0.379), respectively, with the highest-quartile corridors flagged AVOID in each. Viscoelastic damage dose separated the lowest- from the highest-risk corridor by 2.2- and 1.4-fold, respectively. Cortical heatmap produced spatially coherent risk zones. All risk labels are relative to the candidate distribution for the individual patient and do not imply an absolute threshold of mechanical safety.</p><p><strong>Conclusion: </strong>SurgiCorr demonstrates the feasibility of physics-based preoperative corridor planning that quantifies retraction injury as a patient-specific, time-integrated biomechanical dose. Prospective clinical validation against surgical outcomes is required before deployment.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122868","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":"Rod-Suspended \"Hammock\" Expanded Polytetrafluoroethylene Reconstruction for Posterolateral Chest Wall Defects After Multilevel En Bloc Spondylectomy.","authors":"Takayoshi Shimizu, Satona Tanaka, Takashi Sono, Shuichi Matsuda, Bungo Otsuki","doi":"10.1227/ons.0000000000002213","DOIUrl":"https://doi.org/10.1227/ons.0000000000002213","url":null,"abstract":"<p><strong>Background and objectives: </strong>Multilevel en bloc spondylectomy (MES) for thoracic spinal tumors occasionally requires combined resection of ribs and parietal pleura, resulting in a large posterolateral chest wall defect adjacent to posterior instrumentation and a vertebral body cage. If unreconstructed, lung may herniate through the defect, and intrathoracic contents may migrate toward implants and neural elements. Our objective was to describe a simple, reproducible rod-suspended \"hammock\" reconstruction using expanded polytetrafluoroethylene (ePTFE) for extensive posterolateral chest wall defects after MES.</p><p><strong>Methods: </strong>We report 3 cases undergoing thoracic MES (2022-2025) at a single institution. Reconstruction used one or two 2-mm ePTFE (Gore-Tex) sheets sutured to rib stumps and anchored to adjacent intercostal muscles with 2-0 Ethibond. When 2 sheets were required, they were overlapped and sutured together. The barrier was routed anterior to the cage, delivered contralaterally, and suspended from the contralateral posterior rod under controlled tension, with approximately 1 cm of overlap onto the residual vertebral body.</p><p><strong>Results: </strong>Three cases are presented (aneurysmal bone cyst, chondroblastoma, and osteosarcoma), including a combined anterior-posterior approach and a case requiring diaphragmatic resection. The technique was feasible under two-lung ventilation with gentle lung retraction. Rod suspension provided a readily available rigid anchor within the posterior field, enabling controlled tensioning to form a stable sling that separated lung and pleura from the paraspinal corridor, confirmed on postoperative computed tomography.</p><p><strong>Conclusion: </strong>Rod-suspended \"hammock\" ePTFE reconstruction is a simple, adaptable technique for extensive posterolateral chest wall defects after multi-level MES with rib and pleural resection. By maintaining durable separation between intrathoracic contents and the reconstructed spine, it may help prevent postoperative lung herniation.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122865","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":"Clinical Importance and Usefulness of Direct Targeting of the Ventral Intermediate Nucleus of the Thalamus Using Fluid and White Matter Suppression Imaging at 3T MRI.","authors":"Junhyung Kim, Sungyang Jo, Sun Ju Chung, Yangsean Choi, Seok Ho Hong, Sang Ryong Jeon","doi":"10.1227/ons.0000000000002212","DOIUrl":"https://doi.org/10.1227/ons.0000000000002212","url":null,"abstract":"<p><strong>Background and objectives: </strong>Stereotactic targeting of the ventral intermediate nucleus of the thalamus (Vim) in tremor surgery traditionally relies on indirect, atlas-based coordinates, whereas direct visualization of the Vim using advanced MRI sequences has the potential to improve targeting precision and clinical outcomes. We evaluated the feasibility and clinical utility of fluid and white matter suppression (FLAWS) imaging for direct Vim targeting in the MRI-guided focused ultrasound (MRgFUS) procedure.</p><p><strong>Methods: </strong>We retrospectively reviewed 30 MRgFUS procedures in 29 patients. Cases were divided into conventional indirect targeting (non-FLAWS group, n = 15) and direct targeting (FLAWS group, n = 15). We compared initial targeting accuracy (positive clinical response at the first target location), procedural metrics, and clinical outcomes.</p><p><strong>Results: </strong>The Vim was reliably delineated on FLAWS imaging as a hypointense region at 14.7 ± 1.2 mm lateral (10.7 ± 1.4 mm from the medial border of the thalamus), 7.3 ± 0.7 mm anterior, and 0.4 ± 0.5 mm inferior relative to the posterior commissure, representing a more anterior location (29.2% ± 2.9% of the intercommissural line from the posterior commissure) compared with conventional indirect Vim coordinates. In comparing the 2 targeting strategies, the FLAWS group demonstrated significantly higher initial targeting accuracy (86.7% vs 40.0%; P = .021) and a lower number of target realignments (3.0 vs 6.0; P = .003) than the non-FLAWS group. Regarding clinical outcomes, the FLAWS group exhibited a trend toward a lower incidence of sensory adverse effects (20.0% vs 46.7%) and tremor recurrence (0.0% vs 13.3%) compared with the non-FLAWS group, although this did not reach statistical significance.</p><p><strong>Conclusion: </strong>Direct image-based targeting of the Vim using FLAWS imaging at 3T MRI is feasible and offers practical advantages by improving initial targeting accuracy and reducing the need for target realignments in the MRgFUS procedure.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122566","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: Fenestration of a Spinal Intradural Arachnoid Cyst by Minimally Invasive Tubular Approach: 2-Dimensional Operative Video.","authors":"Olivia E Gilbert, Michael Galgano","doi":"10.1227/ons.0000000000002217","DOIUrl":"https://doi.org/10.1227/ons.0000000000002217","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122582","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}