Operative Neurosurgery最新文献

{"title":"Cervicothoracic Deformity in the Setting of Adhesive Arachnoiditis: An Operative Video Article.","authors":"Christina Feller, Mohamad G Bakhaidar, Hope M Reecher, Saman Shabani","doi":"10.1227/ons.0000000000001488","DOIUrl":"https://doi.org/10.1227/ons.0000000000001488","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Supplemental Rod Constructs in Adult Spinal Deformity Surgery: A Review.","authors":"Juan P Sardi, Connor Berlin, Thomas J Buell, Chun-Po Yen, David O Okonkwo, D Kojo Hamilton, Justin S Smith","doi":"10.1227/ons.0000000000001484","DOIUrl":"https://doi.org/10.1227/ons.0000000000001484","url":null,"abstract":"<p><p>Adult spinal deformity comprises a heterogeneous group of disorders that primarily affects older patients and can have a significant negative affect on health-related quality of life. Operative treatment for adult spinal deformity typically entails posterior instrumented fusions that have demonstrated the potential to significantly improve health-related quality of life outcomes. However, until fusion is achieved, the instrumentation providing structural support is subject to repetitive cyclical loading that disproportionately fatigues high-stress areas and can result in instrumentation failure. Despite considerable advances in surgical fixation techniques and technology, pseudarthrosis with subsequent implant failure still poses a challenge for surgeons and continues to be 1 of the most common complications, leading to revision surgery. The addition of supplemental rods to primary constructs has gained widespread popularity to mitigate implant failure. Theoretically, more rods will add stiffness, stability, and decreased surface strain, which will provide longer instrumentation lifespan to allow for osseous fusion. There is significant heterogeneity in these constructs, and different types of supplemental rods (eg, satellite, accessory, delta rods, \"kickstand rod,\" and \"iliac accessory rod\") can be used independently or in combination to further increase strength. However, the use of supplemental rods may increase the rate of proximal junctional kyphosis/failure and paradoxically diminish anterior column fusion rates. Hence, indications and optimal configurations are still a matter of debate. The aim of this narrative review is to provide an overview of the supplemental rod constructs described in the literature and focus on the current evidence supporting their indications and potential impact.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resection of Secreting Right Carotid Body Paraganglioma: 2-Dimensional Operative Video.","authors":"Guilherme J Agnoletto, Farshad Nassiri, Vance Mortimer, William T Couldwell","doi":"10.1227/ons.0000000000001233","DOIUrl":"10.1227/ons.0000000000001233","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"130-131"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Subdural Versus Subgaleal Drain Placement After Minicraniotomy for Chronic Subdural Hematoma.","authors":"Gregory W J Hawryluk","doi":"10.1227/ons.0000000000001304","DOIUrl":"10.1227/ons.0000000000001304","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"76-78"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Endovascular Deep Brain Stimulation of Anterior Nucleus of the Thalamus for Refractory Epilepsy.","authors":"Varun Kashyap, Mark Ashby, Scott Stanslaski, Kevin Nguyen, Kristin Hageman, Yao-Chuan Chang, Alexander A Khalessi","doi":"10.1227/ons.0000000000001226","DOIUrl":"10.1227/ons.0000000000001226","url":null,"abstract":"<p><strong>Background and objectives: </strong>Deep brain stimulation (DBS) has developed into an effective therapy for several disease states including treatment-resistant Parkinson disease and medically intractable essential tremor, as well as segmental, generalized and cervical dystonia, and obsessive-compulsive disorder (OCD). Dystonia and OCD are approved with Humanitarian Device Exemption. In addition, DBS is also approved for the treatment of epilepsy in the anterior nucleus of the thalamus. Although overall considered an effective treatment for Parkinson disease and epilepsy, a number of specific factors determine the treatment success for DBS including careful patient selection, effective postoperative programming of DBS devices and accurate electrode placement. Furthermore, invasiveness of the procedure is a rate limiter for patient adoption. It is desired to explore a less invasive way to deliver DBS therapy.</p><p><strong>Methods: </strong>Here, we report for the first time the direct comparison of endovascular and parenchymal DBS in a triplicate ovine model using the anterior nucleus of the thalamus as the parenchymal target for refractory epilepsy.</p><p><strong>Results: </strong>Triplicate ovine studies show comparable sensing resolution and stimulation performance of endovascular DBS with parenchymal DBS.</p><p><strong>Conclusion: </strong>The results from this feasibility study opens up a new frontier for minimally invasive DBS therapy.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"79-87"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical Considerations for the Surgical Management of a C2 Spinal Cord Hemangioblastoma and Subjacent Cervical Spondylotic Myelopathy: A 2-Dimensional Operative Video.","authors":"Olivia E Gilbert, Mia Cranmer, Michael Galgano","doi":"10.1227/ons.0000000000001241","DOIUrl":"10.1227/ons.0000000000001241","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"126"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning Curve Associated With Thoracoscopic Anterior Vertebral Body Tether and Double Anterior Vertebral Body Tether for Idiopathic Scoliosis: Analysis of Three Independent Surgeons.","authors":"Darryl Lau, David B Kurland, Sean Neifert, Joshua Pahys, Amer Samdani, Steven Hwang","doi":"10.1227/ons.0000000000001212","DOIUrl":"10.1227/ons.0000000000001212","url":null,"abstract":"<p><strong>Background and objectives: </strong>Anterior vertebral body tether (VBT) is a fusionless approach to treat idiopathic scoliosis, and surgeons are beginning to implement the technique into current practice. This study aims to evaluate the learning curve for single and double VBT.</p><p><strong>Methods: </strong>A retrospective review of 3 surgeons' first 40 single and 20 double VBT was performed. Skeletally immature patients with idiopathic scoliosis who underwent thoracic (single) or thoracolumbar (double) VBT were included. Thoracic VBT was done via video-assisted thoracoscopic surgery and lumbar VBT through a mini-open retroperitoneal approach. Primary outcomes of interest were operative time, radiation exposure, and radiographic correction. Pooled and individual-surgeon analyses were performed.</p><p><strong>Results: </strong>A total of 180 patients were included: 120 single and 60 double. Mean age was 12.7 years, and 87.8% were female. Mean segments tethered was 7.8 in single and 11.0 in double. Mean preoperative thoracic scoliosis was 51.5: single 50.5° and double 53.3°. Mean lumbar scoliosis was 36.4°: single 30.0° and double 49.0°. Average operating time was 276.2 minutes; double VBT was significantly longer (217.3 vs 394.0 minutes, P < .001). Mean blood loss was 198.5 mL, and mean fluoroscopy dose was 73.0 mGy. For single VBT, there was a decrease in operative time (283.3-174.8 minutes, P < .001) and fluoroscopy dose (70.1-53.5 mGy, P = .047) over time. Every 10 cases resulted in a 31.4 minute decrease in operative time ( P < .001). There were no intraoperative complications. Single VBT resulted in 54.9% thoracic curve correction. Double VBT achieved 53.0% thoracic and 56.7% lumbar correction. There were no differences in curve correction across the learning curve.</p><p><strong>Conclusion: </strong>VBT is viable fusionless surgical option for scoliosis. As expected, increased experience resulted in shorter operative time; the threshold for such improvement seems to be 10 cases. Importantly, adequate and consistent curve correction can be achieved at the start of the learning curve while mitigating complications.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"43-51"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microvascular Decompression Using the Gelatin Sponge Insertion Technique for Trigeminal Neuralgia: A Retrospective Cohort Study.","authors":"Zhongding Zhang, Hua Zhao, Yinda Tang, Baimiao Wang, Qing Yuan, Haopeng Wang, Xiaomin Cai, Wanchun Zhu, Shiting Li","doi":"10.1227/ons.0000000000001229","DOIUrl":"10.1227/ons.0000000000001229","url":null,"abstract":"<p><strong>Background and objectives: </strong>Microvascular decompression (MVD) is the primary surgical intervention for trigeminal neuralgia (TN), with Teflon being the most conventional decompressing material. However, Teflon has been associated with adhesion and granulomas after MVD, which closely correlated with the recurrence of TN. Therefore, we developed a new technique to prevent direct contact between Teflon and nerve. The purpose of this study is to compare the efficacy of MVD using the gelatin sponge (GS) insertion technique with that of Teflon inserted alone in treating primary TN.</p><p><strong>Methods: </strong>We retrospectively analyzed the medical records and the follow-up data of 734 patients with unilateral primary TN who underwent MVD at our center from January 2014 to December 2019. After exclusions, we identified 313 cases of GS-inserted MVD and 347 cases of traditional MVD. The follow-up exceeded 3 years.</p><p><strong>Results: </strong>The operating time of the GS-inserted group was longer than that of the Teflon group (109.38 ± 14.77 vs 103.53 ± 16.02 minutes, P < .001). There was no difference between 2 groups in immediate surgical outcomes and postoperative complications. The yearly recurrence rate for GS-inserted MVD was lower at first (1.0%), second (1.2%), and third (1.2%) years after surgery, compared with its counterpart of Teflon group (3.7%, 2.9%, and 1.7% respectively). The first-year recurrence rate ( P = .031) and total recurrence rate in 3 years ( P = .013) was significantly lower in the GS-inserted group than Teflon group. Kaplan-Meier survival analysis demonstrated better outcomes in GS-inserted MVD groups ( P = .020).</p><p><strong>Conclusion: </strong>The application of the GS insertion technique in MVD reduced first-year postoperative recurrence of TN, with similar complications rates compared with traditional MVD.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"52-58"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"V2 Vertebral Artery Transposition for Microvascular Decompression of C5 Nerve Root: A 2-Dimensional Operative Video.","authors":"Michael Ortiz, Inamullah Khan, Abdul Fettah Buyuk, Farhan Siddiq","doi":"10.1227/ons.0000000000001227","DOIUrl":"10.1227/ons.0000000000001227","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"129"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of a Suction-Monopolar Stimulator for Continuous Neurophysiology Monitoring During Endonasal Resection of a Cavernous Sinus Schwannoma: 2-Dimensional Operative Video.","authors":"Daniel Quintana, Ivan H El Sayed, Ezequiel Goldschmidt","doi":"10.1227/ons.0000000000001228","DOIUrl":"10.1227/ons.0000000000001228","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"127-128"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}