Operative Neurosurgery最新文献

{"title":"Neurosurgical Residency Training at Veterans Affairs Medical Centers, the Resident Perspective.","authors":"Alexander G Yearley, Marcelle Altshuler, Ruchit V Patel, Jacob R Rachlin, Michael A Mooney","doi":"10.1227/ons.0000000000001390","DOIUrl":"10.1227/ons.0000000000001390","url":null,"abstract":"<p><strong>Background and objective: </strong>Department of Veteran's Affairs (VA) Medical Centers play a crucial role in training neurosurgery residents. Although previous studies have examined the impact of VA rotations from the attending perspective, the resident experience remains unexplored. We present a national survey of neurosurgery residents to assess their perceptions of VA rotations, focusing on operative experience, call burden, longitudinal patient care experiences, and overall strengths and limitations.</p><p><strong>Methods: </strong>A 33-question survey was distributed by email to all neurosurgery residents who had previously completed a VA rotation within the past 7 years.</p><p><strong>Results: </strong>Responses were received from 77 residents, representing 36 out of 40 neurosurgical residency programs with an active VA rotation. Most residents (79.2%) found their VA rotations adequate in length, having spent a median of 5 months at the VA. Residents completed an average of 11.7 (SD 7.2) cases per month while at the VA, including 8.9 (SD 5.5) spine, 1.7 (SD 2.0) cranial, and 1.4 (SD 1.6) peripheral nerve cases. Many residents reported completing a greater proportion of spine and peripheral nerve cases at the VA compared with their primary clinical sites. Across all postgraduate years, residents felt that the VA offered increased operative autonomy (79.0% agreement) at the expense of total operative volume (98.7% agreement) and complexity (81.9% agreement). Importantly, 94.8% of residents participated in longitudinal patient care experiences, and 59.7% followed all patients longitudinally.</p><p><strong>Conclusion: </strong>The resident experience at the VA varies, presenting both strengths and limitations. Addressing these factors could enhance the overall effectiveness of VA rotations in neurosurgical training programs in the future.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"876-882"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332314","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":"In Reply: A Staged Approach for Surgical Management of Basilar Invagination.","authors":"Steven Knafo","doi":"10.1227/ons.0000000000001544","DOIUrl":"10.1227/ons.0000000000001544","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"907-908"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574681","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":"Combined Microscopic-Endoscopic Retrosigmoid Approach for a Cerebellopontine Angle Epidermoid Cyst With Supratentorial Extension: Nuances for Maximizing Resection With Cranial Nerve Preservation: 2-Dimensional Operative Video.","authors":"Mehdi Khaleghi, Adnan Hussain Shahid, Asa Record Barnett, Danner Butler, Garrett Dyess, Ursula Hummel, Danielle N Chason, Jai Deep Thakur","doi":"10.1227/ons.0000000000001624","DOIUrl":"https://doi.org/10.1227/ons.0000000000001624","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081951","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":"Is Reoperation Within 6 Months of Adult Spinal Deformity Surgery Associated With Worse Outcomes?","authors":"Iyan Younus, Omar Zakieh, Hani Chanbour, Harsh Jain, Ranbir Ahluwalia, Campbell Liles, Amir M Abtahi, Byron F Stephens, Scott L Zuckerman","doi":"10.1227/ons.0000000000001578","DOIUrl":"https://doi.org/10.1227/ons.0000000000001578","url":null,"abstract":"<p><strong>Background and objectives: </strong>In a cohort of patients undergoing Adult Spinal Deformity (ASD) surgery, we sought to (1) report the rate of and reason for reoperation within 6 months of the index surgery and (2) determine the association between early reoperation and 2-year patient-reported outcome measures (PROMs).</p><p><strong>Methods: </strong>A single-institution, retrospective cohort study was performed for patients undergoing ASD surgery from 2009 to 2021. The primary outcomes included early reoperations within 6 months and reason for reoperation, including proximal junctional kyphosis/failure (PJK/F), distal junctional kyphosis, pseudarthrosis/rod fracture, and implant failure. Secondary outcomes included all mechanical complications requiring reoperation beyond 6 months and PROMs. Descriptive statistics and multivariable logistic regression were performed.</p><p><strong>Results: </strong>Of 238 patients undergoing ASD surgery, 19 (8%) underwent early reoperation within 6 months primarily for PJK/F (42%), distal junctional kyphosis (11%), implant failure (11%), and pseudarthrosis (11%). Early reoperation was significantly more likely in patients with 2+ comorbidities (63.2% vs 38.6%, P = .038) but did not predict future reoperation beyond 6 months (47.4% vs 58.0%; P = .159). At 2 years, patients with early reoperation had worse PROMs: higher Oswestry Disability Index (ODI) (53.9 vs 33.8, P = .001), Numeric Rating Scales for back pain (NRS-BP) (6.8 vs 4.7, P = .019), Numeric Rating Scales for leg pain (NRS-LP) (5.7 vs 2.8, P = .004) and lower EuroQoL Group questionnaire (EQ-5D) (0.50 vs 0.70, P = .003). There was less improvement in ODI (-16.6 vs -2.0, P = .025) and EQ-5D (0.0 vs 0.2, P = .038), with no significant change in NRS-BP (P = .051) and NRS-LP (P = .115). Early reoperation was linked to decreased odds of ODI improvement (OR 14.41, P = .028).</p><p><strong>Conclusion: </strong>Reoperation within 6 months after ASD surgery occurred in 8% of patients at mean 85.5 days, primarily because of PJK/F (42%). Early reoperations did not significantly increase the rate of subsequent reoperations beyond 6 months. Patients with early reoperation within 6 months had worse ODI, NRS-BP, and NRS-LP and less improvement in ODI and EQ-5D, but no difference in change for NRS-BP and NRS-LP. Early reoperation significantly decreased odds of ODI improvement.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081980","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":"Endoscopic Fenestration of Midbrain Cyst: 2-Dimensional Operative Video.","authors":"Colin P Sperring, Evan F Joiner, Brett E Youngerman","doi":"10.1227/ons.0000000000001631","DOIUrl":"https://doi.org/10.1227/ons.0000000000001631","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026291","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":"Effective Use of a Minimally Invasive Lighted Tubular Retractor System for Resection of a Ruptured Aneurysm in a Patient with Moyamoya Disease: 2-Dimensional Operative Video.","authors":"David R Hallan, Francis Jareczek, Ephraim W Church","doi":"10.1227/ons.0000000000001627","DOIUrl":"https://doi.org/10.1227/ons.0000000000001627","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039467","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":"Endovascular Treatment of a Ruptured Complex Sigmoid Sinus Dural Arteriovenous Fistula Via Direct Puncture Technique: 2-Dimensional Operative Video.","authors":"Ehsan Dowlati, Jeffrey M Breton, Kyriakos Papadimitriou, Jeffrey C Mai, Daniel R Felbaum, Rocco A Armonda, Ai-Hsi Liu, Samir Sur","doi":"10.1227/ons.0000000000001626","DOIUrl":"https://doi.org/10.1227/ons.0000000000001626","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058077","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":"Trends in Thalamic Stereoelectroencephalography Utilization During Phase II Monitoring in North America: A Survey.","authors":"Ahmad Alhourani, Philip B Ostrov, Jason M Schwalb, Andrew I Yang, Adriana E Palade, Edward F Chang, Joseph S Neimat","doi":"10.1227/ons.0000000000001614","DOIUrl":"https://doi.org/10.1227/ons.0000000000001614","url":null,"abstract":"<p><strong>Background and objectives: </strong>Thalamic neuromodulation is widely used in epilepsy surgery. However, thalamic sampling in invasive monitoring is not consistently used. We aimed to quantify current trends in thalamic stereoelectroencephalography (SEEG) utilization.</p><p><strong>Methods: </strong>We performed a survey of epilepsy neurosurgeons and neurologists to gauge their attitudes and experience with thalamic SEEG. We contacted all members of the American Society for Stereotactic and Functional Neurosurgery and American Epilepsy Society organizations using a mailing list.</p><p><strong>Results: </strong>We received 40 responses from centers using SEEG, including 31 neurosurgeons and 9 epileptologists. Among these respondents, 65% (26/40) included thalamic targets in their SEEG plans. The most common clinical rationales were to define the seizure network (22/26, 84.6%) or the high probability of targeted structure being a neuromodulation target (22/26, 84.6%). Over half of the respondents who used thalamic SEEG (15/26, 57.6%) endorsed that the findings informed target selection and feasibility of thalamic neuromodulation. The most commonly implanted thalamic targets included centromedian (23/26) and anterior nucleus of the thalamus (ANT) (22/26), followed by pulvinar (19/26).</p><p><strong>Conclusion: </strong>Thalamic SEEG is a diagnostic tool that is being increasingly used across epilepsy centers. This may be an important tool to support the paradigm shifts occurring in the surgical management of epilepsy.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039775","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":"Microsurgical Resection of a Recurrent Neurenteric Cyst Through an Anterior Cervical Approach: 2-Dimensional Operative Video.","authors":"Wanru Duan, Yue-Qi Du, Zan Chen","doi":"10.1227/ons.0000000000001615","DOIUrl":"https://doi.org/10.1227/ons.0000000000001615","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040523","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":"Skull Base Anatomy Presented in 360° Photogrammetry 3-Dimensional Models.","authors":"Francesco Carbone, Daniele Armocida, Toma Spiriev, Michael Wolf-Vollenbröker, Martin Trandzhiev, Matteo de Notaris, Jan F Cornelius","doi":"10.1227/ons.0000000000001601","DOIUrl":"https://doi.org/10.1227/ons.0000000000001601","url":null,"abstract":"<p><strong>Background and objectives: </strong>Realistic 3-dimensional (3D) anatomical models may enhance three-dimensional comprehension of the complex anatomy of the skull base. Such models may be generated by photogrammetry, a technical algorithm for photorealistic surface scanning. This study presents a 360° visualization of key neuroanatomical landmarks of the central skull base.</p><p><strong>Methods: </strong>One formaldehyde-fixed head specimen with polymer-injected vessels underwent extensive exocranial and endocranial dissections on the right side after a sagittal cut. Initially, the dissection of the orbital region, cavernous sinus, and paranasal sinuses identified cranial nerves II, III, IV, and VI; their branches; extraocular muscles; and major vessels. Subsequently, the 5 terminal branches of the VII were exposed, along with cranial nerves IX, X, XI, and XII. A retrolabyrinthine approach and neck dissection revealed the entire course of cranial nerve VII, sigmoid sinus, the jugular bulb, and the intracranial and extracranial segments of nerves IX, X, XI, and XII. In addition, the infratemporal fossa, pterygopalatine fossa, and middle ear structures were presented. Finally, the vertebral artery segments (v2-v4) and the internal carotid artery, including the petrosal and cavernous segments, were dissected and documented. The specimen was 3D scanned by photogrammetry 3D, refined with 3D modeling software, and uploaded to virtual reality and web visualization.</p><p><strong>Results: </strong>Seven photorealistic models were created and virtual reality videos demonstrating the relevant anatomy in an immersive environment. The courses of intracranial nerves and the associated vascular and soft tissue anatomy were systematically captured from both intracranial and exocranial viewpoints, creating an accurate 360° virtual depiction of the pertinent anatomy.</p><p><strong>Conclusion: </strong>The 3D 360° photogrammetric models developed in this study may allow a better understanding of essential intracranial and extracranial structures of the skull base. These models facilitate customizable views and represent a valuable, freely accessible resource that complements traditional dissections, photographic atlases, and conventional 3D models.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018872","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}