Operative neurosurgery (Hagerstown, Md.)最新文献

{"title":"Lead-Shift Error and Pneumocephalus in Awake, Robotic Deep Brain Stimulation Patients.","authors":"Sibi Rajendran, Lokeshwar S Bhenderu, Jesus G Cruz-Garza, John D Patterson, Shourya Kumar, Paras Gupta, Taimur Hassan, Khaled M Taghlabi, Amir H Faraji","doi":"10.1227/ons.0000000000001642","DOIUrl":"https://doi.org/10.1227/ons.0000000000001642","url":null,"abstract":"<p><strong>Background and objectives: </strong>The mechanisms of lead placement error and brain shift in deep brain stimulation (DBS) remain poorly understood. Further understanding is critical as lead displacement >2 mm can lead to poor treatment efficacy. Differences between anesthesia and surgical techniques often vary significantly, making the cause of error challenging to ascertain. The objective of this study was to demonstrate the relationship between pneumocephalus and lead shift error in patients undergoing awake, robotic-assisted surgery.</p><p><strong>Methods: </strong>Seventy-six patients undergoing DBS with target ventral intermediate nucleus of the thalamus (VIM) or subthalamic nucleus (STN) were included. All patients underwent bilateral lead placement under robotic guidance in an awake procedure, with left-sided leads placed first, followed by right-sided leads. Preoperative plan target points were compared with the final lead placement based on stereotactic computed tomography performed immediately postoperatively. The radial error between the postoperative computed tomography observation of the lead placement and the planned target was compared with the volume of pneumocephalus in the left vs right leads.</p><p><strong>Results: </strong>All patients had some degree of pneumocephalus, with an average amount of 18.9 ± 15.8 cm3 for both STN and VIM targets combined. The right-sided leads were placed medially to the planned target for both STN and VIM. There was a significant increase in the error magnitude for right-sided leads compared with left-sided leads for both STN and VIM targets (P < .01). Pneumocephalus was similar when comparing STN and VIM placement. No significant correlation existed between the total volume of pneumocephalus measured and lead misplacement.</p><p><strong>Conclusion: </strong>This study contributes valuable insights into lead placement errors and pneumocephalus variability in bilateral DBS procedures in awake patients. Addressing these issues, correcting for possible systematic errors during preoperative planning, and further exploring the relationship between pneumocephalus and lead placement accuracy can optimize the therapeutic benefits of DBS.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210755","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":"Flow Diversion in Patients With Concurrent Anticoagulation: Multicenter Experience and Systematic Review of Literature.","authors":"Joanna M Roy, Basel Musmar, Sravanthi Koduri, Alessandra Baldari, Zachary Sokol, Cheritesh Amaravadi, Spyridon Karadimas, Osman Kozak, Larami Mackenzie, Richard F Schmidt, Ritam Ghosh, Stavropoula I Tjoumakaris, M Reid Gooch, Hekmat Zarzour, Robert H Rosenwasser, Pascal M Jabbour","doi":"10.1227/ons.0000000000001660","DOIUrl":"https://doi.org/10.1227/ons.0000000000001660","url":null,"abstract":"<p><strong>Background and objectives: </strong>Dual antiplatelet therapy is used to minimize thromboembolic complications after flow diversion (FD). Oral anticoagulation (AC) has been associated with increased risk of hemorrhagic complications. Our multicenter study and systematic review of literature describes the safety and efficacy of FD in patients on concurrent AC.</p><p><strong>Methods: </strong>This was a retrospective study of patients on concurrent AC before FD for an intracranial aneurysm at 3 participating institutions between January 2018 and January 2024. Outcomes of interest were angiographic occlusion (assessed using the O'Kelly-Marotta (OKM) Grade), postoperative complications, in-stent stenosis, and functional outcome (measured using the modified Rankin Scale). PubMed was searched to identify articles that reported outcomes of interest in patients undergoing FD on AC.</p><p><strong>Results: </strong>Nineteen patients with 20 aneurysms underwent FD while on AC. The median age of the cohort was 71%, and 89.4% were female (n = 17). Forty percentage (n = 8) of aneurysms were completely occluded (OKM grade D) and 20% (n = 4) developed clinically asymptomatic in-stent stenosis at their last follow-up. Overall, 84.2% of patients (n = 16) were functionally independent, 1 patient was lost to follow-up and 2 patients experienced mortality. Our systematic review of literature identified 2 articles describing rates of occlusion ranging from 25% to 71.4%, with increased rates of delayed rupture and retreatment among patients on AC.</p><p><strong>Conclusion: </strong>We report low rates of complete aneurysm obliteration after FD in patients on concurrent AC. Future research could help identify the appropriate antithrombotic regimen in this cohort.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210754","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 Role of Intraoperative Imaging Modalities in Surgical Resection of Supratentorial Gliomas: A Review of 300 Cases.","authors":"Hajrullah Ahmeti, Mareike Ziegler, Ulrich Stefenelli, Christoph Röcken, Olav Jansen, Hubertus Maximilian Mehdorn, Michael Synowitz","doi":"10.1227/ons.0000000000001628","DOIUrl":"https://doi.org/10.1227/ons.0000000000001628","url":null,"abstract":"<p><strong>Background and objectives: </strong>Intraoperative tumor visualization is an essential factor for successful glioma surgery. The aim of this study was to examine the extent of glioma resection and the patients' postoperative clinical conditions after resection with intraoperative imaging guidance (iMRI and \"modern\" ultrasound combined with neuronavigation [iUS]) and without intraoperative imaging guidance.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of 300 glioma patients who underwent surgery for supratentorial low-grade gliomas and high-grade gliomas at our department between 2015 and 2022.</p><p><strong>Results: </strong>Among all the patients, 65 (21.7%) underwent tumor resection under iMRI guidance, and 35 (11.7%) underwent tumor resection under iUS guidance. Two hundred patients (66.7%) underwent tumor resection without intraoperative imaging control. Gross total resection (GTR) was achieved in 125 patients (41.7%) in the entire cohort. GTR was significantly more common under iMRI (56.9%) and iUS (57.1%), than without intraoperative imaging guidance (34%) (P = .001). The mean extent of tumor resection of contrast enhancement was the highest in the iMRI subgroup (96.6%), followed by the iUS subgroup (93.2%) and the subgroup without intraoperative imaging (92%) (P = .002). The 2 most common postoperative new neurological deficits were cognitive deficits (8%) and speech disorders (7.3%). Patients without intraoperative imaging guidance had weakness significantly more often (odds ratio = 0.520, CI = 0.272-0.994, P = .048) than patients with iMRT or iUS. The Karnofsky Performance Status score at 1 year after surgery was the lowest in patients without intraoperative imaging guidance. Multiple regression analyses for progression-free survival did not reveal any significant differences between the subgroups. Overall survival was significantly worse in patients without intraoperative imaging guidance (odds ratio = 1.534, CI = 1.058-2.225, P = .024) than in patients with iMRI and iUS.</p><p><strong>Conclusion: </strong>For glioma patients, GTR is more commonly performed under iMRI and iUS, than without intraoperative imaging guidance. Patients without intraoperative imaging control have significantly higher incidences of postoperative weakness and significantly worse overall survival than patients with iMRI and iUS.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210757","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":"Assessment of the Risk of Cerebral Parenchymal Hemorrhage After Thrombectomy in Acute Ischemic Stroke With Dynamic Cerebral Autoregulation.","authors":"Ran Liu, Songwei Chen, Liuping Cui, Hongxiu Chen, Xijuan Pan, Fubo Zhou, Wenbo Zhao, Yingqi Xing","doi":"10.1227/ons.0000000000001643","DOIUrl":"https://doi.org/10.1227/ons.0000000000001643","url":null,"abstract":"<p><strong>Background and objectives: </strong>Parenchymal hematoma (PH) worsens the prognosis in acute ischemic stroke patients who undergo endovascular thrombectomy (EVT). Dynamic cerebral autoregulation (dCA), the brain's ability to maintain stable cerebral blood flow despite fluctuating blood pressure, may be impaired in these patients. However, the relationship between PH and dCA remains unclear. The aim of this study was to investigate the correlation between PH after EVT and impaired dCA.</p><p><strong>Methods: </strong>We recruited patients who suffered from anterior large-vessel occlusion and underwent EVT. The dCA parameters, including gain, phase, and coherence, were measured 24 hours and 2-3 days post-EVT. The change in phase between these time points was calculated (Δphase = phase2-3 d - phase24 h). The European Cooperative Acute Stroke Study II guidelines were used to evaluate PH. Clinical outcomes were measured by the modified Rankin scale at 3 months post-EVT, with a modified Rankin scale score below 3 indicating a favorable outcome.</p><p><strong>Results: </strong>There was an independent correlation between PH and unfavorable outcomes (odds ratio [OR]: 6.66, 95% CI: 1.46-31.08, P = .016). Phase at 2-3 days post-EVT was significantly associated with PH (P = .045). Δphase (OR: 0.91, 95% CI: 0.94-0.99, P = .014) was an independent factor of PH. The optimal Δphase cutoff was -10°, with an area under the curve of 0.715 (sensitivity 82.6%, specificity 70.0%, P = .043).</p><p><strong>Conclusion: </strong>Poor results in acute ischemic stroke patients after EVT are independently predicted by PH. Modifications to dCA from 24 hours to 2-3 days post-EVT may be a novel marker for PH.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164565","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":"Intraoperative Evaluation of Dural Arteriovenous Fistula Obliteration Using FLOW 800 Hemodynamic Analysis.","authors":"Karl L Sangwon, Eric A Grin, Bruck Negash, Daniel D Wiggan, Cathryn Lapierre, Eytan Raz, Maksim Shapiro, Ilya Laufer, Vera Sharashidze, Caleb Rutledge, Howard A Riina, Eric K Oermann, Erez Nossek","doi":"10.1227/ons.0000000000001646","DOIUrl":"https://doi.org/10.1227/ons.0000000000001646","url":null,"abstract":"<p><strong>Background and objectives: </strong>Dural arteriovenous fistula (dAVF) surgery is a microsurgical procedure that requires confirmation of obliteration using formal cerebral angiography, but the lack of intraoperative angiogram or need for postoperative angiogram in some settings necessitates a search for alternative, less invasive methods to verify surgical success. This study evaluates the use of indocyanine green videoangiography FLOW 800 hemodynamic intraoperatively during cranial and spinal dAVF obliteration to confirm obliteration and predict surgical success.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using indocyanine green videoangiography FLOW 800 to intraoperatively measure 4 hemodynamic parameters-Delay Time, Speed, Time to Peak, and Rise Time-across venous drainage regions of interest pre/post-dAVF obliteration. Univariate and multivariate statistical analyses to evaluate and visualize presurgical vs postsurgical state hemodynamic changes included nonparametric statistical tests, logistic regression, and Bayesian analysis.</p><p><strong>Results: </strong>A total of 14 venous drainage regions of interest from 8 patients who had successful spinal or cranial dAVF obliteration confirmed with intraoperative digital subtraction angiography were extracted. Significant hemodynamic changes were observed after dAVF obliteration, with median Speed decreasing from 13.5 to 5.5 s-1 (P = .029) and Delay Time increasing from 2.07 to 7.86 s (P = .020). Bayesian logistic regression identified Delay Time as the strongest predictor of postsurgical state, with a 50% increase associated with 2.16 times higher odds of achieving obliteration (odds ratio = 4.59, 95% highest density interval: 1.07-19.95). Speed exhibited a trend toward a negative association with postsurgical state (odds ratio = 0.62, 95% highest density interval: 0.26-1.42). Receiver operating characteristic-area under the curve analysis using logistic regression demonstrated a score of 0.760, highlighting Delay Time and Speed as key features distinguishing preobliteration and postobliteration states.</p><p><strong>Conclusion: </strong>Our findings demonstrate that intraoperative FLOW 800 analysis reliably quantifies and visualizes immediate hemodynamic changes consistent with dAVF obliteration. Speed and Delay Time emerged as key indicators of surgical success, highlighting the potential of FLOW 800 as a noninvasive adjunct to traditional imaging techniques for confirming dAVF obliteration intraoperatively.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164573","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":"Segmental Lordosis After Open Transforaminal Lumbar Interbody Fusion Using Expandable Oblique Versus Static Anterior Banana Cages.","authors":"David Ben-Israel, Brian J Park, Connor Berlin, Faraz Farzad, Hong Joo Moon, Mark E Shaffrey, Juan P Sardi, Chun-Po Yen, Justin S Smith","doi":"10.1227/ons.0000000000001639","DOIUrl":"https://doi.org/10.1227/ons.0000000000001639","url":null,"abstract":"<p><strong>Background and objectives: </strong>Expandable oblique interbody cages have gained popularity because of their suitability in minimally invasive surgical approaches and their ease of operative insertion. We aimed to determine whether static anteriorly placed banana cages or expandable obliquely placed cages provide greater lordosis when performing open transforaminal lumbar interbody fusion with concomitant posterior column osteotomy (PCO).</p><p><strong>Methods: </strong>We performed a single-surgeon retrospective consecutive cohort study which compared patients who underwent transforaminal lumbar interbody fusion using a static anteriorly placed banana cage vs an expandable obliquely placed cage. All TLIFs were performed open with PCO and included patients with focal degenerative pathology as well as global spinal deformity. Patient data were collected preoperatively, at 6-month follow-up, and at the last available follow-up. The primary outcome was defined as the change in segmental lordosis (ΔSL) measured using 6-month postoperative upright lumbar spine x-rays.</p><p><strong>Results: </strong>In total, 210 patients met inclusion criteria, including a total of 227 static cages and 100 expandable cages. The median ΔSL for the expandable cohort was significantly higher than the static cohort (6.1° [2.4, 8.4] vs 4.1° [1.3, 6.9], P = .016). This difference persisted after multivariate regression analyses and propensity score matching. Preoperative SL was found to have the greatest impact on ΔSL with a 3.23° increase for segments with preoperative SL < 15° compared with segments with preoperative SL ≥ 25° (P < .001). The overall median (T12-S1) delta lumbar lordosis (ΔLL) for all patients was 3.5° [-0.5, 10.2]. Although ΔLL was larger for static cages (median difference of 2.2°, P = .031), after propensity score matching, the expandable cage cohort experienced 3.24° greater ΔLL compared with the static cohort (P = .004).</p><p><strong>Conclusion: </strong>Open TLIFs performed in conjunction with a PCO yielded 2.0° greater median ΔSL when using expandable obliquely placed cages compared with using static anteriorly placed banana cages. This represents a 50% increase between static and expandable cages. Cage type did not provide a clear advantage for overall ΔLL.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164616","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":"Microsurgical Endoscope-Assisted Removal of a Pulvinar Glioma Through a Supracerebellar Transtentorial Approach to the Cisternal Surface of the Thalamus: 2-Dimensional Operative Video.","authors":"Luca Zanuttini, Victor E Staartjes, Stefanos Voglis, Elisa Colombo, Philipp Bardelli, Carlo Serra","doi":"10.1227/ons.0000000000001661","DOIUrl":"https://doi.org/10.1227/ons.0000000000001661","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164596","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":"Safety and Effectiveness of Flow-Diversion for Flow-Related Aneurysms in Patients With Brain Arteriovenous Malformations: A Case Series and Review of Literature.","authors":"Wuyang Yang, Alice L Hung, James Feghali, Risheng Xu, Christopher C Jackson, Justin M Caplan, Rafael J Tamargo, Judy Huang, L Fernando Gonzalez","doi":"10.1227/ons.0000000000001645","DOIUrl":"https://doi.org/10.1227/ons.0000000000001645","url":null,"abstract":"<p><strong>Background and objectives: </strong>Flow-diversion for aneurysm is widely adopted. However, reports on flow-diversion for flow-related aneurysms (FA) in brain arteriovenous malformations (bAVM) are scarce. We aim to introduce our institutional experience in this case series.</p><p><strong>Methods: </strong>We compiled all patients with bAVMs and FA from an institutional database, among which those treated with flow-diverters were extracted. Patient demographics, clinical presentation, aneurysm, and AVM characteristics were summarized. Management of both FA and bAVM were listed. Associated bleeding with dual antiplatelet therapy, aneurysm and bAVM obliteration, and follow-up hemorrhage of bAVM were reported as outcomes of interest.</p><p><strong>Results: </strong>From a database of 1066 patients with bAVMs, a total of 5 patients with 7 FAs treated with pipeline embolization device (PED) were included. All aneurysm treatment preceded bAVM management. Spetzler-Martin grades were the following: II (n = 2.40%), III (n = 2.40%), and V (n = 1.20%), among which 1 presented with hemorrhage. Only 2 bAVMs (40%) were treated with radiosurgery, and none were obliterated at last follow-up. A total of 9 aneurysms were identified, with just 7 (77.8%) being flow-related and treated with flow-diversion. Three FA treatments (42.9%) received preprocedural Brilinta + Aspirin, with the rest being Plavix + Aspirin, and none of the bAVMs had ruptured while on dual-antiplatelet therapy. With average follow-up duration of 4.8 years, 85.7% (n = 6) of the treated aneurysms were obliterated at follow-up.</p><p><strong>Conclusion: </strong>PED use to treat for FAs in bAVMs demonstrated favorable risk profile. The effectiveness of FA obliteration with flow-diversion is also favorable and on par with regular non-bAVM aneurysms. The current data suggest PED as an option to manage FAs in bAVMs.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164603","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":"Transarticular Drainage Catheter Technique for Spondylodiscitis: 2-Dimensional Operative Video.","authors":"Sezer Onur Gunara, Mehmet Ali Tepebasili, Mehmet Yigit Akgun, Ozkan Ates, Bekir Tunc Oktenoglu, Ali Fahir Ozer","doi":"10.1227/ons.0000000000001632","DOIUrl":"https://doi.org/10.1227/ons.0000000000001632","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164633","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 Revision Diskectomy for Recurrent Lumbar Disk Herniation Using O-Arm Navigation: 2-Dimensional Operative Video.","authors":"Sang Hyub Lee, Dong-Geun Lee, Choon Keun Park","doi":"10.1227/ons.0000000000001648","DOIUrl":"https://doi.org/10.1227/ons.0000000000001648","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164567","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}