Operative neurosurgery (Hagerstown, Md.)最新文献

{"title":"Commentary: Robotic Sacroiliac Fixation Technique for Triangular Titanium Implant in Adult Degenerative Scoliosis Surgery: 2-Dimensional Operative Video.","authors":"Ibrahim Youssef, Yamaan S Saadeh, Michael J Strong, Paul Park","doi":"10.1227/ons.0000000000000205","DOIUrl":"https://doi.org/10.1227/ons.0000000000000205","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e289-e290"},"PeriodicalIF":2.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616872","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: Facilitation of Pediatric Posterior Fossa Vascular Malformation Resection Utilizing Virtual Reality Platform: 2-Dimensional Operative Video.","authors":"Dhiraj J Pangal, David J Cote, Ilaria Bove, Ben A Strickland, Jacob J Ruzevick, Gabriel Zada","doi":"10.1227/ons.0000000000000237","DOIUrl":"https://doi.org/10.1227/ons.0000000000000237","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e270"},"PeriodicalIF":2.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616865","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":"Stereotactic Neurosurgical Robotics With Real-Time Patient Tracking: A Cadaveric Study.","authors":"Faith C Robertson,&nbsp;Kyle C Wu,&nbsp;Raahil M Sha,&nbsp;Jose M Amich,&nbsp;Avinash Lal,&nbsp;Benjamin H Lee,&nbsp;Ramez W Kirollos,&nbsp;Min Wei Chen,&nbsp;William B Gormley","doi":"10.1227/ons.0000000000000155","DOIUrl":"https://doi.org/10.1227/ons.0000000000000155","url":null,"abstract":"<p><strong>Background: </strong>Robotic neurosurgery may improve the accuracy, speed, and availability of stereotactic procedures. We recently developed a computer vision and artificial intelligence-driven frameless stereotaxy for nonimmobilized patients, creating an opportunity to develop accurate and rapidly deployable robots for bedside cranial intervention.</p><p><strong>Objective: </strong>To validate a portable stereotactic surgical robot capable of frameless registration, real-time tracking, and accurate bedside catheter placement.</p><p><strong>Methods: </strong>Four human cadavers were used to evaluate the robot's ability to maintain low surface registration and targeting error for 72 intracranial targets during head motion, ie, without rigid cranial fixation. Twenty-four intracranial catheters were placed robotically at predetermined targets. Placement accuracy was verified by computed tomography imaging.</p><p><strong>Results: </strong>Robotic tracking of the moving cadaver heads occurred with a program runtime of 0.111 ± 0.013 seconds, and the movement command latency was only 0.002 ± 0.003 seconds. For surface error tracking, the robot sustained a 0.588 ± 0.105 mm registration accuracy during dynamic head motions (velocity of 6.647 ± 2.360 cm/s). For the 24 robotic-assisted intracranial catheter placements, the target registration error was 0.848 ± 0.590 mm, providing a user error of 0.339 ± 0.179 mm.</p><p><strong>Conclusion: </strong>Robotic-assisted stereotactic procedures on mobile subjects were feasible with this robot and computer vision image guidance technology. Frameless robotic neurosurgery potentiates surgery on nonimmobilized and awake patients both in the operating room and at the bedside. It can affect the field through improving the safety and ability to perform procedures such as ventriculostomy, stereo electroencephalography, biopsy, and potentially other novel procedures. If we envision catheter misplacement as a \"never event,\" robotics can facilitate that reality.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"425-432"},"PeriodicalIF":2.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616857","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":"Dorsal Root Entry Zone Lesioning for the Treatment of Pain After Brachial Plexus Avulsion Injury: 2-Dimensional Operative Video and Technical Report.","authors":"Jawad M Khalifeh,&nbsp;Daniel Lubelski,&nbsp;Arinze Ochuba,&nbsp;Allan J Belzberg","doi":"10.1227/ons.0000000000000149","DOIUrl":"https://doi.org/10.1227/ons.0000000000000149","url":null,"abstract":"<p><strong>Background: </strong>Neuropathic pain after nerve root or plexus avulsion injury is disabling and often refractory to medical therapy. Dorsal root entry zone (DREZ) lesioning is a neurosurgical procedure that disrupts the pathological generation and transmission of nociceptive signaling through the selective lesioning of culprit neurons within the dorsal horn of the spinal cord.</p><p><strong>Objective: </strong>To present a case report and describe the operative technique for cervical spinal cord DREZ lesioning using radiofrequency thermocoagulation.</p><p><strong>Methods: </strong>We present the case of a 29-year-old man who experienced a traumatic right-sided brachial plexus avulsion injury. The patient experienced severe neuropathic pain in his distal right upper extremity. He underwent cervical spinal DREZ lesioning. Postoperatively, he reported immediate and total pain relief that was sustained on follow-up at 3 months. We describe the operative technique for DREZ lesioning, including preoperative considerations, patient position, incision, approach, exposure, microsurgical dissection, DREZ lesioning, fixation, and closure.</p><p><strong>Results: </strong>The goal of DREZ lesioning is the selective destruction of nociceptive fibers within the lateral bundle of the dorsal rootlet and superficial layers of the dorsal horn gray matter, while preserving the medial inhibitory fibers. DREZ lesioning targets the putative pain generator and ascending pain pathways that mediate the characteristic neuropathic pain after avulsion injury. Neurological complications include worsening pain or motor and sensory deficits of the ipsilateral lower extremity.</p><p><strong>Conclusion: </strong>DREZ lesioning provides an effective and durable treatment for neuropathic pain after nerve root or plexus avulsion injury.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e252-e258"},"PeriodicalIF":2.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616863","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 Feasibility of DTRAX Cervical Cages in the Atlantoaxial Joint for C1/2 Stabilization.","authors":"Fabian Sommer,&nbsp;Sertac Kirnaz,&nbsp;Jacob L Goldberg,&nbsp;Lynn B McGrath,&nbsp;Franziska Schmidt,&nbsp;Pravesh Gadjradj,&nbsp;Branden Medary,&nbsp;Roger Härtl","doi":"10.1227/ons.0000000000000139","DOIUrl":"https://doi.org/10.1227/ons.0000000000000139","url":null,"abstract":"BACKGROUND: Pathological changes in the atlantoaxial joint often lead to instability, pain, and neurological deterioration. One treatment option is the surgical stabilization of the atlantoaxial joint. In other areas of the spine, fusion rates have been improved by the introduction of an interbody cage. Our aim was to use cervical interbody spacers, originally designed to augment fusion across subaxial posterior cervical facets, to optimize the conditions for atlantoaxial fusion. OBJECTIVE: To evaluate the safety and efficacy of implanting cervical cages in the atlantoaxial joint for C1/2 stabilization. METHODS: Our retrospective study evaluated patients who had undergone C1/2 cervical fusions by the Harms/Goel technique. This technique was modified by implanting a titanium cervical interbody spacer into the joint space. Mean overall pain, as measured by a 0 to 10 visual analog scale (VAS) and neurological outcomes were measured preoperatively and postoperatively. In addition, radiological outcomes were collected using follow-up imaging. RESULTS: Nine patients were included in this case series. The mean preoperative VAS for overall pain was 5.0 ± 4.0, which changed to a mean VAS of 2.0 ± 3.0 after an average follow-up period of 41.4 ± 20.4 (P = .043). All patients showed a bony fusion in our case series. None of the radiological imaging during follow-up showed screw loosening, hardware breakage, implant migration, or nonunion. CONCLUSION: The implantation of cervical titanium cages into the atlantoaxial joint in combination with posterior fixation appears to be a safe and effective method for achieving C1/2 fusion.","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"322-327"},"PeriodicalIF":2.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312212","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":"An Unusual Presentation of Retro-Odontoid Intradural Pannus Managed With an Endoscopic Endonasal Transclival Approach.","authors":"Lena Mary Houlihan,&nbsp;Xiaochun Zhao,&nbsp;Mohamed A Labib,&nbsp;John Milligan,&nbsp;Andrew S Little","doi":"10.1227/ons.0000000000000140","DOIUrl":"https://doi.org/10.1227/ons.0000000000000140","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e220"},"PeriodicalIF":2.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312211","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: A Novel Mobile-Device-Based Navigation System for Placement of Posterior Spinal Fixation.","authors":"Travis Hamilton,&nbsp;Victor Chang","doi":"10.1227/ons.0000000000000181","DOIUrl":"https://doi.org/10.1227/ons.0000000000000181","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e231-e232"},"PeriodicalIF":2.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312683","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":"A Novel 5-Aminolevulinic Acid-Enabled Surgical Loupe System-A Consecutive Brain Tumor Series of 11 Cases.","authors":"Xiaoran Zhang,&nbsp;Emade Jaman,&nbsp;Ahmed Habib,&nbsp;Alp Ozpinar,&nbsp;Edward Andrews,&nbsp;Nduka M Amankulor,&nbsp;Pascal O Zinn","doi":"10.1227/ons.0000000000000141","DOIUrl":"https://doi.org/10.1227/ons.0000000000000141","url":null,"abstract":"<p><strong>Background: </strong>The concept of maximally safe resection (MSR) has been shown to improve clinical outcomes in the treatment of high-grade gliomas (HGGs). To achieve MSR, surgical adjuncts such as functional imaging, neuronavigation, intraoperative mapping, ultrasound, and fluorescence-guided surgery are routinely used. 5-Aminolevulinic acid (5-ALA) is an oral agent that has been increasingly adopted in fluorescence-guided resection of HGG. In randomized clinical trials of 5-ALA, it has been shown to increase the extent of resection and progression-free survival in HGG. Current commercially available 5-ALA detection systems are all microscope-based and can sometimes be cumbersome to use.</p><p><strong>Objective: </strong>To present our experience using a novel 5-ALA-enabled surgical loupe system.</p><p><strong>Methods: </strong>5-ALA-enabled loupes were used in 11 consecutive patients with either suspected HGG on magnetic resonance imaging or recurrence of known lesions. Lesion appearance was examined under white light, 5-ALA loupes, and a 5-ALA microscope. Tumor specimens were checked for fluorescence and sent for pathologic examination.</p><p><strong>Results: </strong>In our experience, a 5-ALA-enabled surgical loupe system offers excellent visualization of 5-ALA in patients with HGG. In 10 of 11 patients, fluorescent tissue was confirmed to be high-grade glioma by pathology. In 1 patient, tissue was not fluorescent, and final pathology was World Health Organization grade I meningioma.</p><p><strong>Conclusion: </strong>A 5-ALA-enabled surgical loupe system offers excellent intraoperative visualization of 5-ALA fluorescence in HGG and can be a viable surgical adjunct for achieving MSR of HGG.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"298-304"},"PeriodicalIF":2.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40313250","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 Final Cut: Evolution of Cavernous Sinus Decompression Beyond the Dolenc Cut.","authors":"Kara Parikh,&nbsp;L Madison Michael","doi":"10.1227/ons.0000000000000172","DOIUrl":"https://doi.org/10.1227/ons.0000000000000172","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e204-e205"},"PeriodicalIF":2.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312218","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 Presets of Ruptured Dermoid Cyst Resection: 2-Dimensional Operative Video.","authors":"Antonio Aversa,&nbsp;Walid Ibn Essayed,&nbsp;Ossama Al-Mefty","doi":"10.1227/ons.0000000000000142","DOIUrl":"https://doi.org/10.1227/ons.0000000000000142","url":null,"abstract":"Intracranial dermoid cyst is a benign expansive lesion typically affecting children and young adults. They become symptomatic by progressive enlargement of the cyst and spilling of its content. In such cases, recurrent aseptic meningitis is observed. When located in the suprasellar area, optic pathways are usually displaced and compressed, and visual symptoms are common, as well as seizures. The tumor capsule can be thick and very adherent to the anterior cerebral arteries and the small arterial perforators. Radical surgical resection, including the capsule, is the current mainstay of treatment.1-5 The cranio-orbital approach is considered as an excellent surgical access option. Vascular adhesions are associated with a considerable surgical risk to the circle of Willis and its small branches. Residual cyst or perioperative spilling of its content produces severe aseptic meningitis and vasospasm associated with postoperative complications and long-term recurrences.4 This article demonstrates the details of the surgical management of a ruptured suprasellar dermoid cyst in a 22-year-old man. The patient consented to the procedure and publication of images. Image at 2:23 reprinted with permission from Al-Mefty O, Operative Atlas of Meningiomas, Vol 1, ©LWW, 1998. Illustration at 2:47 reprinted from Surgical Neurology, 50(6), Arnautovic et al, \"A combined microsurgical skull-base and endovascular approach to giant and large paraclinoid aneurysms,\" p 17, ©1998, with permission from Elsevier.","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e217"},"PeriodicalIF":2.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312220","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}