Operative Neurosurgery最新文献

{"title":"Ventral Thoracic Cerebrospinal Fluid Leak Repair in Spontaneous Intracranial Hypotension Complicated by Superficial Siderosis: 2-Dimensional Operative Video.","authors":"Ryan M Naylor, Eugene S Bah, Giorgos Michalopoulos, Jeremy K Cutsforth-Gregory, Ajay A Madhavan, Jeremy L Fogelson","doi":"10.1227/ons.0000000000001372","DOIUrl":"10.1227/ons.0000000000001372","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"893-894"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332319","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":"Spinal Anesthesia for Multilevel Awake Minimally Invasive Transforaminal Lumbar Interbody Fusion: Single-Center Experience.","authors":"Juan P Navarro-Garcia de Llano, Macarena Fuentes-Fernandez Cueto, Andrew P Roberts, Jesus E Sanchez-Garavito, Siddharth Shah, Gaetano De Biase, Harshvandan Iyer, Ogechuku Ariwodo, Loizos Michaelides, Jennifer S Patterson, Kate E White, Elird Bojaxhi, Rodrigo Navarro-Ramirez, Ian A Buchanan, Alfredo Quinones-Hinojosa, Kingsley O Abode-Iyamah","doi":"10.1227/ons.0000000000001380","DOIUrl":"10.1227/ons.0000000000001380","url":null,"abstract":"<p><strong>Background and objectives: </strong>Awake minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) generates minimal surrounding tissue damage and has been shown to be a safe, time-effective, and cost-reductive technique in single-level procedures. The purpose of this study was to advocate for the utilization of multilevel MIS-TLIF even in challenging cases as it has demonstrated positive outcomes.</p><p><strong>Methods: </strong>Chart review was conducted for consecutive patients undergoing awake multilevel MIS-TLIF from 2020 to 2023. Various demographic, preoperative, and postoperative variables were collected and descriptively analyzed.</p><p><strong>Results: </strong>Sixteen patients underwent multilevel awake MIS-TLIF at our institution during the specified period. Among them, 87.5% underwent a two-level procedure and 12.5% a three-level procedure. The median age ± IQR was 69.5 ± 11 years, with a slight male predominance (56.25%). Common comorbidities included hypertension (56.25%), obesity (37.5%), sleep apnea (25%), and type 2 diabetes (18.75%). The American Society of Anesthesiologists risk was 2 in 43.75% of patients and 3 in 56.25%. All patients presented pain, and 12.5% showed motor deficit. Intraoperative data showed a median of 196 minutes in the operating room where 156 ± 27.75 minutes corresponded to actual procedure time. The median estimated blood loss was 50 ± 70 cc. In the immediate postoperative period, 1 patient had nausea and emesis, and 1 reported fatigue. The median pain score during this period was 4.6 ± 2.03. Pain control medications were required for various patients, with methocarbamol (50%), hydromorphone (37.5%), and oxycodone (25%) being the most commonly prescribed in the postanesthesia care unit. No patient had new neurological deficits after the surgical intervention. The median length of stay was 2 days ±1.25. All patients were discharged with no complications.</p><p><strong>Conclusion: </strong>Multilevel awake MIS-TLIF emerges as a safe and effective technique for complex cases, enhancing patient quality of life with minimal blood loss and postoperative pain.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"855-861"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332316","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 a Dorsal Arachnoid Web of the Cervical Spine: 2-Dimensional Operative Video.","authors":"Arjun R Adapa, Anthony J Tang, Andrew K Chan","doi":"10.1227/ons.0000000000001374","DOIUrl":"10.1227/ons.0000000000001374","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"904-905"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332315","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":"Maximizing the Carotid-Oculomotor Triangle and Oculomotor-Trochlear Corridor for Microsurgical Clipping of a Large Wide-Neck Low-Lying Basilar Apex Aneurysm: 2-Dimensional Operative Video.","authors":"Diego Mendez-Rosito, Cristian Alberto Pérez-Carrillo, Jaime Jecsan Serrano-Verduzco, Iván Alejandro Méndez-Guerrero, Gustavo Melo-Guzmán, James K Liu, Jesús Abraham Ibarra-Ramos, Nadin J Abdala-Vargas","doi":"10.1227/ons.0000000000001336","DOIUrl":"10.1227/ons.0000000000001336","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"891-892"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332311","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":"Extended Retrosigmoid Craniotomy for Resection of a Ruptured Cerebellar Petrosal Arteriovenous Malformation: 2-Dimensional Operative Video.","authors":"Matthew Webb, Michael Gaub, Justin Mascitelli","doi":"10.1227/ons.0000000000001376","DOIUrl":"10.1227/ons.0000000000001376","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"899"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300814","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":"Accuracy of Boltless Frame-Based Stereo-Electroencephalography Electrode Implantation.","authors":"Yuya Fujita, Hui Ming Khoo, Yuki Kimoto, Takuto Emura, Takamitsu Iwata, Takahiro Matsuhashi, Shimpei Miura, Takufumi Yanagisawa, Koichi Hosomi, Naoki Tani, Satoru Oshino, Masayuki Hirata, Haruhiko Kishima","doi":"10.1227/ons.0000000000001209","DOIUrl":"10.1227/ons.0000000000001209","url":null,"abstract":"<p><strong>Background and objectives: </strong>Boltless implantation of stereo-electroencephalography electrode is a useful alternative especially when anchor bolt is not available such as in country with limited resources or is less appropriate such as placement in patients with thin skull or at the occiput area, despite some drawbacks including potential dislodgement. While the accuracy of implantation using anchor bolt is well-studied, data on boltless implantation remain scarce. This study aimed to reveal the accuracy, permissible error for actual placement of electrodes within the grey matter, and delayed electrode dislodgement in boltless implantation.</p><p><strong>Methods: </strong>A total of 120 electrodes were implanted in 15 patients using a Leksell Stereotactic G Frame with each electrode fixed on the scalp using sutures. Target point error was defined as the Euclidean distance between the planned target and the electrode tip on immediate postimplantation computed tomography. Similarly, delayed dislodgement was defined as the Euclidean distance between the electrode tips on immediate postimplantation computed tomography and delayed MRI. The factors affecting accuracy were evaluated using multiple linear regression. The permissible error was defined as the largest target point error that allows the maximum number of planned gray matter electrode contacts to be actually placed within the gray matter as intended.</p><p><strong>Results: </strong>The median (IQR) target point error was 2.6 (1.7-3.5) mm, and the permissible error was 3.2 mm. The delayed dislodgement, with a median (IQR) of 2.2 (1.4-3.3) mm, was dependent on temporal muscle penetration ( P = 5.0 × 10 -4 ), scalp thickness ( P < 5.1 × 10 -3 ), and insertion angle ( P = 3.4 × 10 -3 ).</p><p><strong>Conclusion: </strong>Boltless implantation of stereo-electroencephalography electrode offers an accuracy comparable to those using anchor bolt. During the planning of boltless implantation, target points should be placed within 3.2 mm from the gray-white matter junction and a possible delayed dislodgement of 2.2 mm should be considered.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"788-795"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421808","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":"Middle Meningeal Artery Embolization for Chronic Subdural Hematoma Using N-Butyl Cyanoacrylate With a D5W Push Technique: A Multicentric North American Study of 269 Patients.","authors":"Ahmed Abdelsalam, Ian A Ramsay, Evan M Luther, Joshua D Burks, Eva M Wu, Michael A Silva, John W Thompson, Miguel Bandes, Hayes B Fountain, Tiffany Eatz, Sai Sanikommu, Adib A Abla, Mohamed M Salem, Jan-Karl Burkhardt, Visish M Srinivasan, Denise Brunozzi, Ali Alaraj, Gursant Atwal, Fawaz Al-Mufti, Christopher P Kellner, Ansaar T Rai, Robert M Starke","doi":"10.1227/ons.0000000000001369","DOIUrl":"10.1227/ons.0000000000001369","url":null,"abstract":"<p><strong>Background and objectives: </strong>As the aging population increases, the incidence of chronic subdural hematomas (cSDHs) is expected to rise. Surgical evacuation, though effective, sees up to 30% recurrence. Middle meningeal artery (MMA) embolization, particularly with n-butyl cyanoacrylate (n-BCA) glue diluted in D5W for distal penetration, has shown promise in reducing recurrences. Limited reports have investigated the safety and technical feasibility of n-BCA as a primary liquid embolic agent using the D5W push technique in cSDH. This series is the largest in the literature investigating the outcomes of this technique in cSDH.</p><p><strong>Methods: </strong>A multicenter retrospective database analysis was conducted on consecutive patients who underwent MMA embolization using n-BCA embolisate. Data collected included patient demographics, procedural information, angiographic data, and periprocedural complications.</p><p><strong>Results: </strong>The study included 269 patients with a median age of 76 years. Nearly half of the patients had previous surgeries, and 93 underwent contralateral embolization for bilateral cSDH. Successful MMA embolization with effective distal penetration was achieved in all cases. The complication rate was 2.2%. Significant improvements were noted at a 60-day follow-up, with a median reduction in cSDH diameter of 40.6% ( P < .001) and 53% of patients showing neurological improvement. No recurrent cSDH or need for retreatment was observed in patients who underwent follow-up.</p><p><strong>Conclusion: </strong>MMA embolization using n-BCA with the D5W push technique is safe and technically feasible. It can be used adjunctively or as an alternative to surgery in patients with cSDH, resulting in decreased recurrence, high technical success, improved distal penetration, and low complication rates.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"817-823"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300827","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":"Microsurgical Anatomy of the Common Tendinous Ring and Its Surgical Implications.","authors":"Ying Huang, Xu Wang, Zhi-Feng Tian, Li Cai, Xu-Ming Wang, Dan Tang, Jian Ren, Xiao-Hai Liu, Ge Chen, Peng Hu, Ming-Chu Li","doi":"10.1227/ons.0000000000001377","DOIUrl":"10.1227/ons.0000000000001377","url":null,"abstract":"<p><strong>Background and objectives: </strong>The common tendinous ring (CTR), also known as the common annular tendon or annulus of Zinn, is a critical anatomic structure located at the convergence of the orbital apex, superior orbital fissure (SOF), optic canal, and the anterior aspect of the lateral sellar compartment. It plays a vital role in both neurosurgical and neuro-ophthalmological interventions. The aim of this study was to delineate the complex 3-dimensional (3D) topography of the CTR and explore its implications for surgical procedures.</p><p><strong>Methods: </strong>Ten formalin-fixed skull base specimens from adult Chinese cadavers were meticulously dissected to investigate the morphology of the CTR, focusing particularly on its relationship with the 4 extraocular rectus tendons, the optic strut, the SOF, and the optic canal. Additional skull base specimens were subjected to 3D surface scanning, computed tomography, and histopathological examinations to deepen our understanding of the CTR's structural complexities.</p><p><strong>Results: </strong>The CTR establishes a spatial, 3D tendinous assembly, encompassing 4 rectus tendons, 2 tendinous connections, and a singular common tendinous root. These components interlink to form a distinctive dual-ring configuration, featuring the optic foramen and the oculomotor foramen. The posterior part of the superior rectus tendon demarcates the common boundary between these 2 foramina. The oculomotor foramen itself serves as the central sector of the SOF. Precise incisions of the medial and lateral tendinous connections and fusions are essential for safely opening the CTR.</p><p><strong>Conclusion: </strong>The structural composition, interconnections, and dual-ring configuration of the CTR are crucial for precise and safe surgery of orbital apex and adjacent regions.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"862-871"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300824","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":"In Reply: Interpretation and Strategy to Resolve Neuromonitoring Changes Associated With Brain Sag.","authors":"Wenya Linda Bi, Matthew Toczylowski, Xiaopeng Guo, Mitali Bose","doi":"10.1227/ons.0000000000001566","DOIUrl":"10.1227/ons.0000000000001566","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"911"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765862","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":"Transoral Approach for Ruptured Anterior Spinal Artery Aneurysm at the Cervicomedullary Junction: 2-Dimensional Operative Video.","authors":"Tatiana Abou-Mrad, Morteza Sadeh, Laura Stone McGuire, Ashleigh Weyh, Nicholas Callahan, Gursant Singh Atwal","doi":"10.1227/ons.0000000000001353","DOIUrl":"10.1227/ons.0000000000001353","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"900"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114767","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}