Operative neurosurgery (Hagerstown, Md.)最新文献

{"title":"Comparative Efficacy of Embolic Agents for Single-Session Meningeal Artery Embolization and Surgical Evacuation: Evaluating Liquids, Particles, and Adjunct Coils.","authors":"Immaculate Christie, Diego Pichardo-Rojas, Santiago Gomez-Paz, Kent R Richter, Margaret McGrath, Jeffrey M Breton, Samuel H Wakelin, Nicholas Kendall, Alana M McNulty, Alexandra R Paul, Ahmed Aljuboori, Philipp Hendrix, Gregory M Weiner, Edward A M Duckworth, Jan-Karl Burkhardt, Visish M Srinivasan, Brian T Jankowitz, Thomas Snyder, Michael R Levitt, Rocco Armonda, Daniel R Felbaum, Mohamed M Salem, Ramesh Grandhi","doi":"10.1227/ons.0000000000002201","DOIUrl":"https://doi.org/10.1227/ons.0000000000002201","url":null,"abstract":"<p><strong>Background and objectives: </strong>Single-session middle meningeal artery embolization (MMAE) combined with surgical evacuation is an emerging strategy for management of patients with chronic subdural hematoma (cSDH). However, comparative outcome data based on embolic material selection in this setting remain limited. We compared clinical, radiographic, and functional outcomes of patients treated with cSDH using liquid or particle embolic agents and evaluated the effect of adjunctive coil use.</p><p><strong>Methods: </strong>We conducted a retrospective multicenter cohort study of consecutive adults undergoing single-session MMAE with surgical evacuation for cSDH. Outcomes were compared by embolic material (liquid vs particle) using 1:1 propensity score matching. The impact of adjunctive coiling was assessed in the overall cohort. Associations were evaluated using multivariable logistic regression and reported as odds ratios with 95% CIs.</p><p><strong>Results: </strong>Among 268 identified patients, 100 (50 liquid and 50 particle) were propensity-score matched for analysis. Rates of improved or stable functional status at last follow-up were similar between liquid (79.2%) and particle embolization (72.5%) groups (P = .701), as were ≥50% hematoma reduction (66.0% vs 72.0%, P = .464), postoperative complications (6.0% vs 8.0%, P = .672), and all-cause mortality (14.0% vs 14.0%, P = .951). Particle embolization was associated with a higher rate of needing any re-evacuation (20.0% vs 6.0%; adjusted odds ratio 5.13, 95% CI = 1.12-23.42, P = .035). Adjunct coiling lengthened procedure duration (203 [187-269] vs 198 [163-232] minutes, P = .019) without significant differences in clinical, radiographic, or adverse outcomes.</p><p><strong>Conclusion: </strong>In patients undergoing single-session MMAE with surgical evacuation for cSDH, liquid and particle embolic agents demonstrated comparable safety and functional and radiographic efficacy. However, liquid embolization was associated with significantly fewer reinterventions. Adjunctive coiling lengthened procedural time without differences in clinical or radiographic outcomes. Prospective comparative studies are needed to further define the role of embolic material and technical factors in patients undergoing evacuation and MMAE.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042664","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":"Lateral Mass Fusion Using 3D-Printed Anatomic Cages for Atlantoaxial Dislocation: A Multicenter Comparison With Iliac Crest Autograft.","authors":"Zhimin Pan, Jun Liu, Yongfei Zhao, Xin Yin, Jeffrey C Wang, Marc A Abdou, Yoon Ha, Kai Song, Yanlong Zhong, Nanjian Xu, Jianwen Mo, Wenhua Xu, Honglin Lv, Qian Guo, Bo Huang, Shan Li, Yuanguo Zhou, Zheng Wang, Haoqun Yao","doi":"10.1227/ons.0000000000002205","DOIUrl":"10.1227/ons.0000000000002205","url":null,"abstract":"<p><strong>Background and objectives: </strong>Atlantoaxial dislocation (AAD) is a high-risk condition that can lead to significant mortality. Lateral mass fusion offers structural stability and reduction, yet no standardized fusion device currently exists for consistent atlantoaxial fixation. This study compares the clinical outcomes of a novel anatomic cage vs iliac crest autograft in treating AAD.</p><p><strong>Methods: </strong>Radiographic, laboratory, and clinical outcomes were retrospectively compared between 2 surgical groups: one treated with an iliac crest autograft by a traditional posterior approach, the other treated with an anatomic cage using an intermuscular approach. Health-related quality-of-life factors were also analyzed.</p><p><strong>Results: </strong>One hundred nineteen patients underwent fusion with iliac crest autograft and 105 with anatomic cages were finally included. The iliac crest group had a shorter operative time ( P = .043), but the anatomic cage group had significantly less intraoperative blood loss, shorter hospitalization, and fewer C2 neurological symptoms (all P < .05). Bony fusion was similar between 2 groups (3.3 [0.6] months vs 3.1 [0.4] months, P = .163). Compared with the iliac crest group, the anatomic cage group showed greater improvements in lateral mass interspace height (LMIH, P < .001). Inflammatory markers were significantly lower at postoperative day 3 in the anatomic cage group. Improvement in pain (Visual Analog Scale) differed significantly between groups (Δ P <.001). Regression analysis showed that age <55 years was independently associated with greater Neck Disability Index improvement ( P = .025), while C1-C2 Cobb angle and cervicomedullary angle correlated with postoperative Japanese Orthopaedic Association and Neck Disability Index scores. LMIH was significantly associated with C2 neurological symptoms ( P = .015).</p><p><strong>Conclusion: </strong>Lateral mass fusion using the 3-dimensional-printed anatomic cages by an intermuscular approach is a safe and effective treatment of AAD. It offers improved radiological outcomes, preserves C2 nerve root integrity, and reduces early postoperative inflammation. In addition, intraoperative restoration of LMIH may reduce neurological symptoms in patients with AAD.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042871","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":"Study on Effects of Bipolar Coagulation on the Swine Spinal Cord: A Histological, Thermal, and Electrical Current Analysis.","authors":"Ricardo Ferrareto Iglesio, Helbert de Oliveira Manduca Palmiero, Alessandro R Belon, Mônica L A Lima, Vitor R Paes, Antonio M Calvo, Saul A Silva, José P Otoch, Manoel J Teixeira, Eberval G Figueiredo, Almir F Andrade","doi":"10.1227/ons.0000000000002208","DOIUrl":"https://doi.org/10.1227/ons.0000000000002208","url":null,"abstract":"<p><strong>Background and objective: </strong>In spinal surgery, bipolar electrosurgery requires balancing effective hemostasis with the risk of neural injury. No study has systematically correlated electrical current parameters, forceps tip temperature, and histological spinal cord injury under controlled experimental conditions, leaving evidence-based guidelines for safe bipolar use in spinal neurosurgery undefined. The objective was to quantify the relationships among applied energy, cord surface temperature, and histological injury, and to identify a temperature threshold that achieves effective hemostasis with minimal injury.</p><p><strong>Methods: </strong>Eight adult swine underwent thoracolumbar laminectomy and durotomy. Bipolar coagulation of dorsal pial (spinal cord surface) vessels was performed using standardized forceps (3-mm intertip distance) at power settings of 10, 30, and 40 W and durations of 2 to 8 seconds, without saline irrigation. Surface temperature was measured using infrared thermography. A blinded pathologist assessed 45 spinal cord segments (29 coagulated, 16 controls). Linear regression related power, time, applied energy (total energy delivered per site, J = W × s), and temperature to lesion dimensions. Coagulation was rated effective when bleeding ceased and the target vessel was occluded.</p><p><strong>Results: </strong>Applied energy was strongly associated with peak temperature (R2 = 0.670, P < .001), whereas power and time alone were not. Lesion area correlated with temperature (R2 = 0.390, P = .004), energy (R2 = 0.364, P = .006), and power (R2 = 0.280, P = .020), but not with time. Lesion extension correlated with temperature (R2 = 0.546, P < .001) and energy (R2 = 0.345, P = .008), whereas lesion depth showed no significant associations. Effective coagulation occurred at higher temperatures than ineffective coagulation (median 43.5 vs 37.6°C, P = .001).</p><p><strong>Conclusion: </strong>Applied energy is the primary determinant of thermal and histological effects during bipolar coagulation. A surface temperature near 40°C-approximately 40 J at the geometry tested-is a practical threshold for effective hemostasis with limited superficial injury, although deeper effects may depend on current propagation and the neurological consequences of these lesions were not assessed.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043070","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 Transclival Approach to Pontine Cavernous Malformations in the Pediatric Population.","authors":"Christopher H Sollenberger, Alison J Yu, Isha Thapar, Allison C Hyland, Lauren A Beslow, Darby Major, Maria C Espinosa, Jennifer E Douglas, Michael A Kohanski, Nithin D Adappa, James N Palmer, John Y K Lee, Peter J Madsen, Phillip B Storm, Adam J Kundishora","doi":"10.1227/ons.0000000000002209","DOIUrl":"https://doi.org/10.1227/ons.0000000000002209","url":null,"abstract":"<p><strong>Background and objectives: </strong>Brainstem cavernous malformations (CMs) carry high hemorrhage risk and morbidity due to their eloquent location. Although modern microsurgical approaches emphasize safe entry zones, endoscopic endonasal transclival approaches (EETA) have emerged as a less invasive midline corridor for ventral pontine lesions, potentially reducing brainstem manipulation. However, pediatric experience remains limited. We evaluated the safety, feasibility, and early outcomes of EETA for pontine CMs in children and characterized anatomic and technical considerations unique to this population.</p><p><strong>Methods: </strong>We performed a single-institution retrospective case series of 6 pediatric patients (ages 5 months-17 years) treated between 2011 and 2025. All presented with symptomatic hemorrhage and/or focal neurological deficits from ventral pontine CMs. Preoperative evaluation included MRI, computed tomography, and hydrocephalus assessment. Operative planning emphasized pediatric constraints, including limited nasal corridors and developing skull base anatomy, with multilayer reconstruction techniques to minimize cerebrospinal fluid (CSF) leak risk. Routine postoperative CSF diversion (lumbar drain or external ventricular drain) was used. Outcomes included extent of resection, complications, CSF leak, infection, neurological recovery, and swallow function.</p><p><strong>Results: </strong>Gross total resection was achieved in all patients. Five demonstrated neurological improvement, including recovery of cranial neuropathies and hemiparesis; one had persistent abducens palsy. One CSF leak occurred with meningitis and resolved after external ventricular drain placement and flap revision without sequelae. No other leaks were observed. Two patients required temporary gastrostomy tubes, but all regained swallowing function. There were no arterial injuries, new permanent deficits, or mortality. The youngest patient (5 months) demonstrated feasibility in infancy with appropriate planning and specialized instrumentation.</p><p><strong>Conclusion: </strong>EETA is a safe and feasible corridor for selected pediatric ventral pontine CMs, with favorable early outcomes when tailored to pediatric anatomy and careful patient selection.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042681","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":"Tozuleristide Fluorescence-Guided Resection of Gliomas: Results of a Phase II Investigator-Initiated Study.","authors":"Rachel C Fox, Xuemo Fan, Adam N Mamelak, Daniel Gomez, Chirag Patil, Ray M Chu, Jeremy Rudnick, Jethro Hu, Elliott M Sina, Keith L Black, Kristi Harrington, John S Yu","doi":"10.1227/ons.0000000000002203","DOIUrl":"https://doi.org/10.1227/ons.0000000000002203","url":null,"abstract":"<p><strong>Background and objectives: </strong>This Phase II, investigator-initiated, nonrandomized clinical trial evaluated tozuleristide, a tumor-specific near-infrared fluorescence imaging agent, combined with the Canvas® imaging system (Blaze Bioscience) to enhance intraoperative visualization of glial tumors.</p><p><strong>Methods: </strong>Subjects with newly diagnosed, suspected, biopsy-proven, or previously resected high- or low-grade central nervous system tumors received 24 mg (contrast-enhancing glioma) or 36 mg (non-contrast-enhancing glioma) of tozuleristide 1 to 24 hours before surgery. Tumors were visualized intraoperatively using the Canvas imaging system. Biopsies were collected to assess tozuleristide sensitivity and specificity by comparing with histopathology assessment. Extent of resection (EOR), calculated from preoperative and postoperative MRI, was compared with historical controls. Fluorescence did not guide resection, and subjects were not selected for maximal EOR.</p><p><strong>Results: </strong>Thirty-nine subjects (33 contrast-enhancing, 6 nonenhancing tumors) underwent all study procedures. Fluorescence was observed in 30/33 contrast-enhancing tumors. Across 191 biopsies, fluorescence showed sensitivity = 0.735, specificity = 0.500, positive predictive value (PPV) = 0.847, negative predictive value = 0.333, and accuracy = 0.685. Residual fluorescence occurred only when total resection was unsafe and showed a nonsignificant negative correlation with EOR (r = -0.318). The mean EOR was 90.09% (24 mg tozuleristide) with 12 subjects achieving gross-total resection; 0/6 nonenhancing tumors fluoresced. Among patients with glioblastoma undergoing repeat resection, exploratory comparison with historical controls showed higher gross-total resection rates in tozuleristide-treated subjects (6/11 vs 2/11, P = .076); however, fluorescence was not incorporated into surgical decision-making, and these results thus cannot be interpreted toward efficacy.</p><p><strong>Conclusion: </strong>Tozuleristide demonstrated tumor-specific fluorescence with high sensitivity and PPV at 24 mg. The high PPV suggests that fluorescence may be useful for confirming tumor presence in enhancing gliomas, but the low negative predictive value seen cannot exclude tumor in the absence of fluorescence, particularly in infiltrative margins. A well-controlled Phase III trial is necessary to determine the efficacy of image-guided resection in improving EOR.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043155","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":"Mechanical Thrombectomy for Cerebral Venous Sinus Thrombosis: 2-Dimensional Operative Video.","authors":"Ahmad G Khatib, Rafael T Tatit, Jorge Rios-Zermeno, Jeyan S Kumar, Charles A Ritchie, Rabih G Tawk","doi":"10.1227/ons.0000000000002207","DOIUrl":"https://doi.org/10.1227/ons.0000000000002207","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042903","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 Anatomic Comparison of Microsurgical Transcranial, Endoscopic Endonasal, and Transorbital Approaches to the Orbit and Surrounding Skull-Base Regions.","authors":"Edoardo Agosti, Marco Valentini, Karen Mapelli, Ludovico Agostini, Barbara Buffoli, Vittorio Rampinelli, A Yohan Alexander, Maria Peris-Celda, Marco Ravanelli, Amedeo Piazza, Pier Paolo Panciani, Lena Hirtler, Rita Rezzani, Mario Turri-Zanoni, Marco Maria Fontanella, Francesco Doglietto","doi":"10.1227/ons.0000000000002166","DOIUrl":"https://doi.org/10.1227/ons.0000000000002166","url":null,"abstract":"<p><strong>Background and objective: </strong>Microsurgical transcranial approaches (MTAs) to the orbit and surrounding skull-base region lesions have been progressively complemented by endoscopic endonasal approaches (EEAs) and endoscopic transorbital approaches (ETOAs). This study provides the first quantitative, navigation-based comparison of working volumes and exposure areas of major approaches to the orbit and surrounding skull-base regions.</p><p><strong>Methods: </strong>Five alcohol-fixed specimens were dissected. Twenty-six subregions grouped into the orbit, midline, spheno-orbital, and cavernous regions were segmented. Nineteen approaches, including anterior MTAs, anterolateral MTAs, EEAs, and ETOAs, were performed. Exposure areas and working volumes were quantified.</p><p><strong>Results: </strong>Endoscopic endonasal transpterygoid approach (EETPA) provided the greatest exposure of the optic foramen (67.98%, P = .03 vs EEA to the medial orbit). The superior eyelid approach with lateral orbitotomy achieved the widest access to the lateral orbital wall, reaching 98.56% in the middle and 99.42% in the temporal portions (P < .05 vs the orbitozygomatic approach [OZA]). The transcaruncular approach better exposed medial wall (99.41%, P = .04 vs EETPA), and the inferolateral approach gained largest orbital floor exposure (99.18%, P < .001). The extended transbasal approach maximally exposed the planum sphenoidale (99.28%, P = .03 vs orbitozygomatic approach with anterior clinoidectomy [OZA + AC]), while the EETPA the chiasmatic sulcus and the tuberculum sellae (98.76% and 96.47%, P < .001). The OZA + AC dominated most subregions, including greater wing, optic canal roof, and superior orbital fissure (98.49%, 98.18%, and 98.68%, P < .05). The superior eyelid approach with lateral orbitotomy better exposed foramen ovale at 88.89% (P < .01), foramen rotundum at 88.78% (P < .001), intracranial V3 at 92.92% (P = .04), and petrous apex at 93.85% (P < .01), while OZA + AC maximized intracranial V1 and V2 (87.94% and 90.74%, P < .05). The MTAs had largest working volumes (extended transbasal approach 59.35 cm3; OZA + AC 53.69 cm3).</p><p><strong>Conclusion: </strong>ETOAs provide unmatched access to the lateral orbit and cavernous regions, while EEAs excel medially and MTAs, especially OZA + AC, remain indispensable for broad spheno-orbital exposure and maximal working volumes.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043062","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":"Fenestration of a Spinal Intradural Arachnoid Cyst by MIS Approach: 2-Dimensional Operative Video.","authors":"Benjamin S Kahozi, Tristan Brunette-Clément, Antoine Gennari, Sung-Joo Yuh, Michel W Bojanowski, Daniel Shedid","doi":"10.1227/ons.0000000000002210","DOIUrl":"https://doi.org/10.1227/ons.0000000000002210","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042755","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":"Burr Hole Microsurgical Transsylvian Approach for Insular Gliomas.","authors":"David Pitskhelauri, Ronald Goyes, Santiago Fernandez, Elena Pitskhelauri, Andrey Bykanov","doi":"10.1227/ons.0000000000002202","DOIUrl":"https://doi.org/10.1227/ons.0000000000002202","url":null,"abstract":"<p><strong>Background and objectives: </strong>Resection of insular gliomas remains challenging because of their deep-seated location and proximity to eloquent neurovascular structures. Although the transsylvian approach through a standard pterional craniotomy is widely used, we present a minimally invasive alternative using a single burr hole technique.</p><p><strong>Methods: </strong>A prospective analysis was performed on 6 patients who underwent burr hole surgery for insular gliomas using a technique termed burr hole microsurgery.</p><p><strong>Results: </strong>In 6 patients, resection of insular tumors was performed using a 14-mm burr hole approach. A transsylvian corridor with preservation of the superficial middle cerebral veins was used in all cases. The most common clinical presentation was epileptic seizures, observed in 2 patients (33%). Tumors were predominantly located in the right hemisphere (83%, n = 5). Histopathological analysis revealed 3 isocitrate dehydrogenase (IDH)-wildtype glioblastomas (50%), one IDH-mutant World Health Organization grade III astrocytoma (17%), one ganglioglioma (17%), and one IDH-mutant diffuse World Health Organization grade II glioma (17%). Gross total resection (extension of resection >90%) was achieved in all patients (100%). One patient (17%) developed hemiplegia in the early postoperative period (24 hours). The mean preoperative tumor volume was 16.7 cm3 (range, 7.47-27.6 cm3), and the mean operative time was 101 minutes (range, 75-135 minutes).</p><p><strong>Conclusion: </strong>The Burr hole transsylvian approach achieves >90% extension of resection in insula gliomas and represents a viable surgical strategy, with preliminary results indicating an acceptable safety profile.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043266","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":"Biportal Endoscopic Posterior Cervical Foraminotomy and Discectomy: A 2-Dimensional Operative Video: Corrigendum.","authors":"Richelle J Kim, Asim Handy, Gnanesh Gutta, Ryan W Turlip, Richard J Chung, Julia Kincaid, Daksh Chauhan, Mert Marcel Dagli, Hasan S Ahmad, Yohannes Ghenbot, Jang W Yoon","doi":"10.1227/ons.0000000000002196","DOIUrl":"https://doi.org/10.1227/ons.0000000000002196","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993679","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}