Operative Neurosurgery最新文献_第3页

The Transtemporal Isthmus Approach for Insular Glioma Surgery. 岛状胶质瘤手术的跨颞峡部入路

IF 1.7 4区医学

Operative Neurosurgery Pub Date : 2025-04-01 Epub Date: 2024-08-20 DOI: 10.1227/ons.0000000000001308

Guochen Sun, Xujun Shu, Dongdong Wu, Kai Zhao, Zhe Xue, Gang Cheng, Ling Chen, Jianning Zhang

{"title":"The Transtemporal Isthmus Approach for Insular Glioma Surgery.","authors":"Guochen Sun, Xujun Shu, Dongdong Wu, Kai Zhao, Zhe Xue, Gang Cheng, Ling Chen, Jianning Zhang","doi":"10.1227/ons.0000000000001308","DOIUrl":"10.1227/ons.0000000000001308","url":null,"abstract":"Background and objectives: Maximal and safe removal of insular gliomas by a transinsular cortex approach is challenging. In this article, a new transtemporal isthmus approach to resect insular gliomas is presented.Methods: We retrospectively examined 53 patients with insular glioma who underwent resection through the temporal isthmus approach using magnetic resonance imaging and functional neuronavigation guidance and intraoperative electrophysiological monitoring. Extent of resection was determined using intraoperative magnetic resonance imaging.Results: Fifty-three patients were included for analysis, 30 men and 23 women. The median (range) age was 45 (26-70) years. Tumor laterality was left in 22 patients and right in 31. All tumors involved at least zone III or IV (Berger-Sanai classification system), including zones I-IV were involved in 29 (54.7%) and zones III and IV in 17 (32.0%). Among the 37 low-grade gliomas, preoperative median (IQR) volume was 45.7 (31.8, 60.3) cm 3 , and gross total resection was achieved in 24 (64.9%). Among the 16 high-grade gliomas, preoperative median (IQR) volume was 45.3 (40.1, 54.0) cm 3 , and gross total resection was achieved in 14 (87.5%). The median (IQR) extent of resection of the whole group was 100% (89%-100%). The median (IQR) postoperative Karnofsky performance score 3 months after surgery was 90 (80-90). Mean temporal isthmus width was significantly higher in the affected side (involving tumor) than the contralateral one (21.6 vs 11.3 mm; 95% CI: 9.3 to 11.3, P < .01). Muscle strength was grade 4 or higher, and speech was nearly normal in all patients 3 months after surgery.Conclusion: Insular glioma surgery using the transtemporal isthmus approach can achieve safe and maximum resection. A widened temporal isthmus provides a surgical pathway for transisthmic resection of insular tumor.","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"478-486"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005833","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}

引用次数: 0

Amniotic Membrane Interposition Graft for Open Fetal Myelomeningocele Repair.

IF 1.7 4区医学

Operative Neurosurgery Pub Date : 2025-04-01 DOI: 10.1227/ons.0000000000001552

John P Andrews, Alex Yang Lu, Rachel Perry, Hanmin Lee, Michael Harrison, Nalin Gupta

{"title":"Amniotic Membrane Interposition Graft for Open Fetal Myelomeningocele Repair.","authors":"John P Andrews, Alex Yang Lu, Rachel Perry, Hanmin Lee, Michael Harrison, Nalin Gupta","doi":"10.1227/ons.0000000000001552","DOIUrl":"https://doi.org/10.1227/ons.0000000000001552","url":null,"abstract":"Background and objectives: Myelomeningocele (MMC) is a congenital anomaly frequently leading to motor deficits, urological dysfunction, and hydrocephalus. Fetal surgical repair improves motor function and reduces the need for cerebrospinal fluid diversion for hydrocephalus. One complication of MMC repair is spinal cord tethering at the site of surgical repair. Surgical techniques to reduce symptomatic tethering and achieve optimal motor function are an area of ongoing research. This study's objective is to evaluate a technique for interposing an amniotic membrane graft between the pia of the closed placode and the overlying dural closure in a prospectively treated cohort of patients with open fetal MMC closure. The theoretical advantage of this technique is that an amniotic membrane barrier may reduce the likelihood of tethering between surgically closed layers.Methods: Under an approved, prospective protocol, open fetal MMC repair with an amniotic membrane interposition graft was performed by a single surgeon at 1 institution over a 1-year period. At the time of surgery, amniotic membrane was harvested from the edges of hysterotomy. This membrane was cleaned, trimmed, and secured over the closed pial surface of the repaired placode. The dura and overlying layers were closed in a standard fashion. Outcomes were obtained by interviews with patients' families.Results: Open fetal MMC repairs were performed with amniotic membrane graft interposition. One of 8 patients with a 5-year follow-up subsequently underwent spinal cord detethering surgery.Conclusion: Amniotic patch interposition for fetal MMC repair can be performed safely alongside standard MMC repair techniques. Evidence for effectiveness on rates of subsequent detethering surgeries requires larger studies with longer follow-up.","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765858","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}

引用次数: 0

Absence of Foramen Spinosum on Computed Tomography Scan Determines Feasibility of Middle Meningeal Artery Embolization. 计算机断层扫描上无棘突孔决定中脑膜动脉栓塞术的可行性

IF 1.7 4区医学

Operative Neurosurgery Pub Date : 2025-04-01 Epub Date: 2024-08-20 DOI: 10.1227/ons.0000000000001316

Zachary S Hubbard, Conor M Cunningham, Guilherme Porto, Mohammad-Mahdi Sowlat, Sameh Samir Elawady, Sami Al Kasab, Kimberly Kicielinski, Jonathan Lena, Alejandro M Spiotta

{"title":"Absence of Foramen Spinosum on Computed Tomography Scan Determines Feasibility of Middle Meningeal Artery Embolization.","authors":"Zachary S Hubbard, Conor M Cunningham, Guilherme Porto, Mohammad-Mahdi Sowlat, Sameh Samir Elawady, Sami Al Kasab, Kimberly Kicielinski, Jonathan Lena, Alejandro M Spiotta","doi":"10.1227/ons.0000000000001316","DOIUrl":"10.1227/ons.0000000000001316","url":null,"abstract":"Background and objectives: Middle meningeal artery embolization (MMAE) has emerged as a novel treatment of chronic subdural hematoma. In 0.5% of patients, however, there exists an ophthalmic origin of the middle meningeal artery (MMA) known as the recurrent meningeal artery. It is known that the recurrent MMA is associated with failure of its skeletal aperture, the foramen spinosum, to form during development. The aim of this study was to investigate MMAE feasibility as a function of the presence/absence of the foramen spinosum on preprocedure computed tomography (CT) scan.Methods: We performed a retrospective review of 100 consecutive patients undergoing MMAE from January 2022 to December 2023 at the Medical University of South Carolina. Preprocedure CT scan of the head was reviewed, and the presence or absence of the foramen spinosum, along with laterality, was recorded. Subsequently, angiographic studies were reviewed.Results: All patients (n = 100) had preprocedural CT scan available for review. The incidence of an absent foramen spinosum was 3% (n = 3). All absent foramen spinosum were left sided (2F, 1M). All embolization attempts in these patients were aborted due to recurrent meningeal artery. 97% of patients had patent bilateral foramen spinosum (n = 97). Two of these patients possessed partial ophthalmic contribution to the MMA (2%), and embolization was not performed. In patients with patent foramen spinosum, successful embolization was achieved in 92/97 patients (94.8%).Conclusion: The review of preprocedure CT scan may serve as an opportunity to identify patients with ophthalmic arterial origin of the MMA, subverting unnecessary risks associated with catheter angiography.","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"564-570"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005866","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}

引用次数: 0

Frameless Stereotactic Biopsy of Brainstem Tumors Using the Stealth Autoguide: A Technical Note. 使用 Stealth Autoguide 对脑干肿瘤进行无框架立体定向活检：技术说明。

IF 1.7 4区医学

Operative Neurosurgery Pub Date : 2025-04-01 Epub Date: 2024-08-20 DOI: 10.1227/ons.0000000000001314

Ajay Patel, Nicholas Hux, Piiamaria S Virtanen, Hailey Budnick, Fezaan Kazi, Jignesh K Tailor

{"title":"Frameless Stereotactic Biopsy of Brainstem Tumors Using the Stealth Autoguide: A Technical Note.","authors":"Ajay Patel, Nicholas Hux, Piiamaria S Virtanen, Hailey Budnick, Fezaan Kazi, Jignesh K Tailor","doi":"10.1227/ons.0000000000001314","DOIUrl":"10.1227/ons.0000000000001314","url":null,"abstract":"Background and objectives: In the molecular era of neuro-oncology, it is increasingly necessary to obtain tissue for next-generation sequencing and methylome profile for prognosis and targeted oncological management. Brainstem tumors can be technically challenging to biopsy in the pediatric population. Frame-based and frameless techniques have previously been described and proven to be safe and efficacious in children. Recent cranial robotic guidance platforms have augmented the fluency of frameless stereotactic approaches, but the technical nuances of these procedures in children are not often discussed. We present a technical workflow for frameless stereotactic biopsy of brainstem tumors in children using the Medtronic Stealth Autoguide cranial robotic guidance platform and examine safety and efficacy of this surgical approach.Methods: A minimally invasive, frameless, transcerebellar approach is described, including operative steps and workflow. We assessed operative times, diagnostic accuracy and yield, and complication rates.Results: Five patients underwent biopsy with the technique described. The youngest patient in our series was of 2 years. The intended target was achieved on postoperative imaging in all cases, and diagnostic tissue was obtained in all 5 patients. One patient had a clinically insignificant hemorrhage.Conclusion: Frameless stereotactic biopsy of the brainstem can be performed safely, efficiently, and accurately using the Medtronic Stealth Autoguide robotic platform in children as young as 2 years.","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"558-563"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005872","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}

引用次数: 0

Combined Endovascular-Microsurgical Treatment for a Parietal Brain Arteriovenous Malformation and Neuropsychological Implications: An Operative 2-Dimensional Video Case: 2-Dimensional Operative Video.

IF 1.7 4区医学

Operative Neurosurgery Pub Date : 2025-04-01 Epub Date: 2024-07-05 DOI: 10.1227/ons.0000000000001289

René Alejandro Apaza-Tintaya, Luis Gustavo Biondi-Soares, Luis Ángel Canache Jiménez, Talita Helena Martins Sarti, Edgar David Tenelema Aguaisa, Felipe Pereira Salvagni, Daniela de Souza Coelho, José Maria de Campos Filho, Feres Chaddad-Neto

引用次数: 0

Minimally Invasive Lateral Transorbital Approach for Clipping of Right Middle Cerebral Artery Aneurysm: 2-Dimensional Operative Video. 经眶外侧微创入路夹闭右侧大脑中动脉动脉瘤：二维手术视频。

IF 1.7 4区医学

Operative Neurosurgery Pub Date : 2025-04-01 Epub Date: 2024-07-22 DOI: 10.1227/ons.0000000000001291

Walter C Jean, Hayes H Patrick, Edinson Najera

引用次数: 0

Interhemispheric Contralateral Transcallosal Approach to a Giant Thalamic Cavernous Malformation: 2-Dimensional Operative Video. 大脑半球间对侧经胼胝体入路治疗巨大丘脑海绵状畸形：二维手术视频。

IF 1.7 4区医学

Operative Neurosurgery Pub Date : 2025-04-01 Epub Date: 2024-07-22 DOI: 10.1227/ons.0000000000001295

A Yohan Alexander, Lorenzo Rinaldo, Luis E Savastano, Giuseppe Lanzino

引用次数: 0

Commentary: Cranio-Orbital Approach and Decompression of the Optic Nerves: A 2-Stage, 4-by-4 Step Approach to Improve Vision in Sellar and Parasellar Lesions. 评论：颅眶入路和视神经减压术：改善ellar和副ellar病变视力的两阶段、4乘4步骤方法。

IF 1.7 4区医学

Operative Neurosurgery Pub Date : 2025-04-01 Epub Date: 2024-09-19 DOI: 10.1227/ons.0000000000001382

Nasser M F El-Ghandour

引用次数: 0

Commentary: Endoscopic Extended Transsphenoidal Surgery for Transbasal Tuberculum Sellae Meningioma: 2-Dimensional Operative Video.

IF 1.7 4区医学

Operative Neurosurgery Pub Date : 2025-04-01 Epub Date: 2024-11-13 DOI: 10.1227/ons.0000000000001364

Zachary A Abecassis, Spencer Raub, Jacob Ruzevick

引用次数: 0

The Comparison of Partial Hemivertebrae Resection Versus Total Hemivertebrae Resection in Children With Congenital Scoliosis. 先天性脊柱侧凸患儿半椎骨部分切除术与全半椎骨切除术的比较。

IF 1.7 4区医学

Operative Neurosurgery Pub Date : 2025-04-01 Epub Date: 2024-08-20 DOI: 10.1227/ons.0000000000001329

Emmanuel Alonge, Gengming Zhang, HongQi Zhang, Chaofeng Guo, Deng Ang

{"title":"The Comparison of Partial Hemivertebrae Resection Versus Total Hemivertebrae Resection in Children With Congenital Scoliosis.","authors":"Emmanuel Alonge, Gengming Zhang, HongQi Zhang, Chaofeng Guo, Deng Ang","doi":"10.1227/ons.0000000000001329","DOIUrl":"10.1227/ons.0000000000001329","url":null,"abstract":"Background and objectives: The surgical intervention for hemivertebra removal is complex, leading to a lack of a definitive solution. We aim to compare the clinical efficacy of less invasive, partial hemivertebra resection vs total hemivertebra resection in children.Methods: Between 2011 and 2016, a retrospective study was conducted on a cohort of 43 patients diagnosed with congenital scoliosis coexisting with hemivertebrae. This study evaluated the outcomes of a posterior-only surgical approach, dividing the cohort into 2 groups based on the surgical technique applied: 23 patients underwent total hemivertebrae resection (TR), whereas 20 patients received partial hemivertebrae resection (PR), accompanied by short-segment fusion.Results: There were 43 patients with congenital scoliosis associated with hemivertebrae in both the PR and TR groups. The average age at the time of surgery was 6.3 ± 2.0 years for the PR group and 6.0 ± 1.9 years for the TR group. The PR group exhibited a comparable correction rate of the Cobb angle at postoperation (4.3 ± 4.9 and 2.2 ± 3.2, P = .174) and the last follow-up (7.8 ± 1.3 and 5.5 ± 2.3, P = .113) compared with the TR group.Conclusion: Partial hemivertebra resection is efficient and secure. A less invasive technique obtained an equivalent, well-maintained correction rate to the total hemivertebra resection. However, this is the initial result, and the patients continue to be followed; we will await the results of the outcome at full-growth sprouts.","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"528-535"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005832","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}

引用次数: 0