Operative Neurosurgery最新文献

{"title":"Commentary: Bilateral High-Riding Persistent First Cervical Intersegmental Arteries in a Case of Klippel-Feil Syndrome: The Technique of Vertebral Artery Mobilization for C1-C2 Reduction and Fusion for Atlantoaxial Dislocation and Basilar Invagination: 2-Dimensional Operative Video.","authors":"Harsh Jain, Ranbir Ahluwalia, Scott L Zuckerman","doi":"10.1227/ons.0000000000001363","DOIUrl":"10.1227/ons.0000000000001363","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"726-727"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300808","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":"Planned Surgical Trajectory Affects Clinical Motor Outcome in Deep Brain Stimulation Targeted at Subthalamic Nucleus for Parkinson's Disease.","authors":"Laura S Wang, John R Younce, Mikhail Milchenko, Mwiza Ushe, Isabel Alfradique-Dunham, Samer D Tabbal, Joshua L Dowling, Joel S Perlmutter, Scott A Norris","doi":"10.1227/ons.0000000000001355","DOIUrl":"10.1227/ons.0000000000001355","url":null,"abstract":"<p><strong>Background and objectives: </strong>Surgical planning is critical to achieve optimal outcome in deep brain stimulation (DBS). The relationship between clinical outcomes and DBS electrode position relative to subthalamic nucleus (STN) is well investigated, but the role of surgical trajectory remains unclear. We sought to determine whether preoperatively planned DBS lead trajectory relates to adequate motor outcome in STN-DBS for Parkinson's disease (PD).</p><p><strong>Methods: </strong>In 49 participants who underwent bilateral STN-DBS for PD using a Leksell® frame, we coregistered the frame and participant MRI images to obtain participant-specific anatomical planes. We evaluated relationships between clinical data and planned trajectories relative to their midsagittal and axial planes. We computed percent change in Unified PD Rating Scale subsection 3 (Unified Parkinson's Disease Rating Scale, part III) scores before and after DBS, and performed binary logistic regression to determine whether planned trajectories affect adequate (>30% Unified Parkinson's Disease Rating Scale, part III improvement) motor outcome.</p><p><strong>Results: </strong>Preoperatively planned left lead trajectory relative to midsagittal plane predicted likelihood of adequate right body motor outcomes (odds ratio = 0.69, P = .024), even when controlling for ventricular width through Evans index. This effect reflects that increasingly lateral angle of approach reduced odds of adequate motor outcome. Right lead trajectory lacked a similar trend.</p><p><strong>Conclusion: </strong>Left DBS lead trajectory predicts adequate right-body motor outcome after bilateral STN-DBS. Greater planned trajectory angle relative to midsagittal plane reduces motor outcomes, independent of patients' ventricular width. These data may guide patient selection, inform risk/benefit discussions, optimize surgical planning, or support evidence-based evaluation of the methodologies used to select the approach trajectory, with careful consideration of the angle of approach relative to target.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"651-656"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985650","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":"Extreme Lateral Supracerebellar Approach for Resection of a Middle Cerebellar Peduncle-Quadrangular Lobule Cavernoma: 2-Dimensional Operative Video.","authors":"Ali Tayebi Meybodi, Purvee Panchmatia, Andrea L Castillo, James K Liu","doi":"10.1227/ons.0000000000001340","DOIUrl":"10.1227/ons.0000000000001340","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"730"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156608","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":"A Standardized Approach to MRI-Guided Stereotactic Laser Corpus Callosotomy: Technical Description and Pediatric Case Series.","authors":"Timothy J Kaufmann, Vance T Lehman, Jamie J Van Gompel, Lily C Wong-Kisiel, Kai J Miller","doi":"10.1227/ons.0000000000001361","DOIUrl":"10.1227/ons.0000000000001361","url":null,"abstract":"<p><strong>Background and objectives: </strong>Corpus callosotomy is an effective procedure approach for treating medication-resistant drop seizures, which pose a significant challenge in patients with epilepsy. Laser interstitial thermal therapy offers an alternative to open surgery for performing corpus callosotomy that may limit approach-related comorbidities. Practices vary regarding the number of laser filaments used and staging; outcome data for pediatric patients remain relatively limited.</p><p><strong>Methods: </strong>We illustrate a set of 4 standardized trajectories for performing MRI-guided stereotactic laser corpus callosotomy (SLCC). For this retrospective cohort study in a pediatric neurosurgery practice, the medical records and imaging were reviewed for 10 consecutive patients who had medication-refractory drop seizures and underwent SLCC. Data collected and analyzed included patient and epilepsy characteristics, procedural details, surgical approaches, and clinical follow-up results.</p><p><strong>Results: </strong>Over 2 years, complete, single-stage SLCC was performed in 8 patients, and posterior completion SLCC was performed in 2 patients who had previously had open anterior corpus callosotomy. Four laser fibers were used in four-eighth complete SLCC, and 3 fibers were used in four-eighth complete SLCC. Seven of 10 patients were discharged from the hospital on postoperative day 1, with only 1 requiring a maximum stay of 6 days. Five of 9 evaluable patients reported no drop seizures at the last clinical follow-up. In the other 4 patients, 1 experienced them only rarely, another experienced less than 25% preoperative frequency, and the remaining 2 had less than a 50% improvement. In addition, improvement in other seizure types exceeded 50% in 8 of 9 patients. Notably, no perioperative or postoperative complications were observed, nor were there any sustained neurological deficits reported.</p><p><strong>Conclusion: </strong>Complete SLCC can be safely and effectively performed in pediatric patients. It is comparable in effectiveness with open surgery but has lower complication rates and shorter hospitalization.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"595-607"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332307","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":"Letter: Minipterional Approach for Cavernous Sinus Hemangioma: 2-Dimensional Operative Video.","authors":"Atul Goel","doi":"10.1227/ons.0000000000001548","DOIUrl":"10.1227/ons.0000000000001548","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"746"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659630","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: Left Cranio-orbital Approach for Trapping of Fusiform Internal Carotid Artery Aneurysm With Common Carotid Artery to Frontal M2 Bypass With Saphenous Vein Interposition Graft and Coiling of Fusiform Anterior Cerebral Artery Aneurysm: A 2-Dimensional Operative Video.","authors":"Nasser M F El-Ghandour","doi":"10.1227/ons.0000000000001398","DOIUrl":"10.1227/ons.0000000000001398","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"735-736"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512924","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":"Quantitative Analysis of the Working Windows for Sitting and Park Bench Positions Through the Retrosigmoid Approach Evaluated in a Cadaver Model.","authors":"Luca Campagnaro, Andrea Boschi, Luca Petrella, Antonio Pisano, Federico Capelli, Alice Esposito, Franco Trabalzini, Walter C Jean, Alessandro Della Puppa","doi":"10.1227/ons.0000000000001605","DOIUrl":"https://doi.org/10.1227/ons.0000000000001605","url":null,"abstract":"<p><strong>Background and objectives: </strong>The choice of the optimal surgical position in the treatment of posterior fossa lesions still remains a controversial and debated issue. Morphometric data on the different perspective of vision offered by different surgical position are scarce. This article investigated the differences due to the vision perspectives provided by the sitting and park bench positions.</p><p><strong>Methods: </strong>The study was conducted using 4 fixed cadaver heads. A standardized retrosigmoid approach was performed on each side of each head. Three operators collected anatomic observation and 2 separate measurements each, for all the sides and diagonals of the projections of 2 areas delimited by the cranial nerves in the cerebellopontine angle (defined as working windows ABCD and ABEF). The collection of the measurements was repeated for each side of each head, both in the sitting and in the park bench positions. The average areas of the working windows were calculated for each position and then compared by statistical analysis.</p><p><strong>Results: </strong>The park bench position is associated to larger areas for both working windows (P = .0013 for ABCD; P < .001 for ABEF) compared with the sitting position. These measures allow to quantify the differences of the working windows that are an indirect expression of the different angle of vision of each position.</p><p><strong>Conclusion: </strong>Our cadaveric study shows that there is a better vision perspective offered by the park bench position for lesions that do not modify the course of the cranial nerves in the cerebellopontine angle. However, different positioning of patients presents different advantages and limitations for surgeon based on size of the tumor and lesion location. In our opinion, choice of patient positioning could be tailored to lesion's peculiarities more than on surgical habits.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060602","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: Minipretemporal Approach for Cavernous Sinus Hemangioma: 2-Dimensional Operative Video.","authors":"Rafael Martinez-Perez, Jorge Mura","doi":"10.1227/ons.0000000000001547","DOIUrl":"10.1227/ons.0000000000001547","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"747"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659629","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":"Anatomic Localization and Compression Points of Occipital Nerves: Therapeutic Insights Using K-Means and Cadaveric Atlas.","authors":"Thania de Oca Mora, Jonathan Samuel Zúñiga-Cordova, Carlos Castillo-Rangel, Gerardo Marín, Cristofer Zarate-Calderon, Pedro G L B Borges, Ariana Tejeda Santiz, Julio César Pérez Cruz, Valeria Forlizzi, Daniel Oswaldo Davila-Rodriguez, Matías Baldoncini","doi":"10.1227/ons.0000000000001598","DOIUrl":"https://doi.org/10.1227/ons.0000000000001598","url":null,"abstract":"<p><strong>Background and objectives: </strong>The greater occipital nerve (GON) and lesser occipital nerve (LON) have gained importance because of conditions such as occipital neuralgia and cervicogenic headaches. To a great depth, their anatomy is essential for performing viable diagnostic and therapeutic procedures such as nerve blocks and decompression procedures. This research involves identifying key anatomic landmarks and the potential compression points of the GON and LON using cadaveric dissections for possible surgical approaches.</p><p><strong>Methods: </strong>Five fresh, untreated cadavers, 3 male and 2 female, were dissected bilaterally to trace the pathways of the GON and LON. Anatomic measurements were made using ImageJ software, and coordinates were analyzed with K-means clustering for optimal intervention points. These dissections focused on determining in detail the relation of these nerves to surrounding muscular and fascial structures.</p><p><strong>Results: </strong>The study shows that for GON, there were many points possible for compression, such as where it pierced through the semispinalis and trapezius muscles along the course of the occipital artery. For the LON, however, the potential compression sites were contact points along the course of the occipital artery. After applying K-means clustering, 4 centroids (M1, M2, M3, and M4) were identified. M1 and M3 correspond to the LON, while M2 and M4 correspond to the GON. These centroid locations lie near the nerves' most common compression sites, suggesting they could serve as strategic landmarks for surgical approaches. Cluster quality measures (inertia and silhouette coefficients) showed well-defined clusters.</p><p><strong>Conclusion: </strong>This study yields anatomic information about the GON and LON anatomy and illustrates key compression points and optimal sites for therapeutic interventions. Within the constraints of sample size, these findings provide preliminary anatomic insights that can guide more precise nerve block and decompression techniques for occipital neuralgia and related headaches.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053003","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 Cerebellopontine Angle Ependymoma Using a Far Lateral Approach: 2-Dimensional Operative Video.","authors":"Ryan M Naylor, Kobie Mensah-Brown, Alessandro De Bonis, Stephen P Graepel, Maria Peris Celda","doi":"10.1227/ons.0000000000001593","DOIUrl":"https://doi.org/10.1227/ons.0000000000001593","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026296","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}