Acta neurochirurgica. Supplement最新文献_第6页

VHL: Trends and Insight into a Multi-Modality, Interdisciplinary Approach for Management of Central Nervous System Hemangioblastoma. VHL：中枢神经系统血管母细胞瘤多模式、跨学科管理方法的趋势和启示。

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-36084-8_14

S A Matloob, D Paraskevopoulos, S M O'Toole, W Drake, N Plowman, N Foroglou

{"title":"VHL: Trends and Insight into a Multi-Modality, Interdisciplinary Approach for Management of Central Nervous System Hemangioblastoma.","authors":"S A Matloob, D Paraskevopoulos, S M O'Toole, W Drake, N Plowman, N Foroglou","doi":"10.1007/978-3-031-36084-8_14","DOIUrl":"10.1007/978-3-031-36084-8_14","url":null,"abstract":"Von Hippel-Lindau (VHL) is a multi-system disease which results in significant morbidity from central nervous system (CNS) involvement as well as ocular, renal and neuro-endocrine effects. Haemangioblastomas of the CNS present a number of challenges. The natural history of these lesions is varied, as is the size and location within the CNS. Whilst surgery is considered the mainstay of treatment and best chance at curing these lesions, this is also often associated with significant risks due to the anatomical location of these lesions, most commonly the posterior fossa and spinal cord.We review the literature and describe our experience across two separate European VHL referral centres. Alternative treatment options and combined modalities are increasingly being used in the context of managing CNS haemangioblastomas. We analyse the increasing use of stereotactic radiosurgery and the evolution of medical treatments as potential future adjuncts to surgery. The availability of multiple modalities in our armamentarium is essential in tailoring a personalised treatment approach to these patients. Owing to the multi-systemic nature of the disease, in our experience, managing the care of patients with VHL is best delivered using an interdisciplinary approach utilising multiple specialties and adopting an individually tailored holistic approach.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"135 ","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Why the Funnel in Neurosurgery? 为什么要在神经外科中使用漏斗？

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-36084-8_1

Massimiliano Visocchi

{"title":"Why the Funnel in Neurosurgery?","authors":"Massimiliano Visocchi","doi":"10.1007/978-3-031-36084-8_1","DOIUrl":"10.1007/978-3-031-36084-8_1","url":null,"abstract":"According to Cambridge Dictionary, Funnel is an object that has a wide round opening at the top, sloping sides, and a narrow tube at the bottom, used for pouring liquids or powders into containers with narrow necks.From an semplified anatomic point of view, the skull base along with its offshoot, the spine, replicate a bone funnel as a vessel sustaining the brain, the cerebellum and the spinal cord along with cranial and radicular nerves. Non doubt at all that the knowledge of the embryology, anatomy, physiology, pathophysiology and the more effective surgical pathways to engage and remove surgical diseases is of paramount importance in the surgical cultural heritage to be strongly encouraged and supported in young neurosurgeons.So to the steps that seem to emerge from this Issue of Acta Neurochirurgica suppl are exploratory, strategic, tactical and finally operational. From the skull base to the sacrum we meet a macrosystem of anatomic and functional complex network with a common embryological hystory as well as contiguity. Different skills are necessary to face with a 360° universe of functions and diseases to deal with. Intelligence and culture as knowledge of both anatomy and pathology help to elaborate the STRATEGY while technical and manual supports are part of the TACTIC armamentarium which is proactive and determinant to the final OPERATIONAL step.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"135 ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Injury of the Internal Carotid Artery During Dissection of a Craniopharyngioma via the Pterional Approach: Case Report. 翼点入路颅咽管瘤解剖过程中内颈动脉损伤1例报告。

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI: 10.1007/978-3-030-12887-6_5

Kazuhiro Hongo, Keiichi Sakai, Tetsuya Goto, Tetsuyoshi Horiuchi

引用次数: 0

Complication Avoidance in Neurosurgery with Use of Intraoperative Ultrasonography. 术中超声检查在神经外科并发症预防中的应用。

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI: 10.1007/978-3-030-12887-6_17

D Gavin Quigley

引用次数: 0

Complications in Neurosurgery: General Ethical Principles for Minimizing Them and Subsequent Legal Action. 神经外科并发症:减少并发症和后续法律行动的一般伦理原则。

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI: 10.1007/978-3-030-12887-6_26

Sunil K Pandya

引用次数: 0

Comparison Between Sagittal Balance Outcomes After Corpectomy, Laminectomy, and Fusion for Cervical Spondylotic Myelopathy: A Matched Cohort Study. 颈椎病椎体后凸切除术、椎板切除术和融合术后矢状体平衡结果的比较：匹配队列研究

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-36084-8_52

R Reinas, D Kitumba, L Pereira, V Pinto, O L Alves

{"title":"Comparison Between Sagittal Balance Outcomes After Corpectomy, Laminectomy, and Fusion for Cervical Spondylotic Myelopathy: A Matched Cohort Study.","authors":"R Reinas, D Kitumba, L Pereira, V Pinto, O L Alves","doi":"10.1007/978-3-031-36084-8_52","DOIUrl":"10.1007/978-3-031-36084-8_52","url":null,"abstract":"Cervical spondylotic myelopathy (CSM) can be successfully decompressed via either anterior cervical corpectomy and fusion (ACCF) or posterior laminectomy with fusion (LMF). However, few studies have compared the isolated effect of both techniques on cervical sagittal balance, a surrogate end point for clinical outcomes.We aimed to compare the sagittal balance radiological outcomes of ACCF against LMF. A case-matched controlled study of radiological cervical alignment parameters (C0-2, C2-3, index angles, T1 slope, and sagittal vertical axis (SVA)) in two groups of patients was performed by using pre- and postoperative neutral cervical X-rays.In total, 34 patients were enrolled (ACCF n = 17; LMF n = 17). The mean preoperative C2-7 angle was similar (11.58 ± 16.00° for ACCF; 13.36 ± 12.21° for LMF) in both cohorts. Both led to a loss of lordosis (-2.68 ± 13.8°, p = 0.43; -2.94 ± 11.5°, p = 0.31, respectively). At the C0-2, the two operations induced opposite variations (-0.9 ± 8.0°, p = 0.709 for ACCF; 3.5 ± 15.4°, p = 0.357 for LMF). ACCF led to a significant increase in SVA (7.1 ± 11.9 mm, p = 0.002). The C2-3 disk angle more pronouncedly increased with LMF.Both techniques show an equivalent kyphotic effect, with a greater disadvantage for ACCF. The negative impact on SVA changes is greater with ACCF. Both affect the C0-2 unit, with a tendency for kyphosis with ACCF and one for lordosis with LMF. When choosing the appropriate decompression and fusion technique, preoperative sagittal balance parameters should be included in the decision-making process.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"135 ","pages":"345-349"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of Adult and Pediatric Chiari Type 1 Malformation Patients: Do Consensus Documents Fit Everyday Practice? 评估成人和小儿 Chiari 1 型畸形患者：共识文件是否适合日常实践？

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-36084-8_24

Laura Grazia Valentini, Tommaso Francesco Galbiati, Veronica Saletti, Mariangela Farinotti, Alessandra Erbetta, Carolina Croci, Ignazio Gaspare Vetrano

{"title":"Evaluation of Adult and Pediatric Chiari Type 1 Malformation Patients: Do Consensus Documents Fit Everyday Practice?","authors":"Laura Grazia Valentini, Tommaso Francesco Galbiati, Veronica Saletti, Mariangela Farinotti, Alessandra Erbetta, Carolina Croci, Ignazio Gaspare Vetrano","doi":"10.1007/978-3-031-36084-8_24","DOIUrl":"10.1007/978-3-031-36084-8_24","url":null,"abstract":"The management of Chiari 1 malformation (CM1) and Syringomyelia (Syr) has shown many changes in surgical indications and techniques over time. The dedicated neurosurgical and neurological community recently planned to analyze the state of the art and find conduct uniformity. This led to international consensus documents on diagnostic criteria and therapeutic strategies. We aimed to evaluate, in a large, monocentric surgical series of adult and children CM1 patients, if the daily clinical practice reflects the consensus documents. Our series comprises 190 pediatric and 220 adult Chiari patients submitted to surgery from 2000 to 2021. The main indications for the treatment were the presence of Syr and symptoms related to CM1. While there is great correspondence with the statements derived from the consensus documents about what to do for Syr and symptomatic CM1, the accordance is less evident in CM1 associated with craniosynostosis or hydrocephalus, especially when considering the early part of the series. However, we think that performing such studies could increase the homogeneity of surgical series, find a common way to evaluate long-term outcomes, and reinforce the comparability of different strategies adopted in different referral centers.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"135 ","pages":"147-155"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lateral Approach to the Cervical Spine to Manage Degenerative Cervical Myelopathy and Radiculopathy. 颈椎外侧入路治疗退行性颈椎髓病和根性颈椎病

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-36084-8_51

S Chibbaro, J F Cornelius, C H Mallereau, M Bruneau, I Zaed, M Visocchi, R Maduri, J Todeschi, C Bruno, B George, S Froelich, M Ganau

{"title":"Lateral Approach to the Cervical Spine to Manage Degenerative Cervical Myelopathy and Radiculopathy.","authors":"S Chibbaro, J F Cornelius, C H Mallereau, M Bruneau, I Zaed, M Visocchi, R Maduri, J Todeschi, C Bruno, B George, S Froelich, M Ganau","doi":"10.1007/978-3-031-36084-8_51","DOIUrl":"10.1007/978-3-031-36084-8_51","url":null,"abstract":"Background: The cervical lateral approach can enlarge the spinal canal and foramen to achieve an effective neural decompression without needing spine stabilization. For this review, the authors' main objective was to illustrate the rationale, advantages, disadvantages, complications, and pitfalls of this technique, highlighting also areas for future development.Materials and methods: A Medline via PubMed database search was carried out by using both keywords, namely \"cervical oblique corpectomy,\" \"multilevel oblique corpectomy and foraminotomy,\" and \"lateral vertebrectomy,\" and Medical Subject Headings (MeSH) terms from 1 January 1991, up to 31 December 2021.Results: The analyzed articles suggested that the use of such a technique has declined over time; only 29 clinical studies met all the inclusion criteria and were retained for data analysis, including 1200 patients undergoing such an approach for the management of degenerative cervical myelopathies (DCMs) or of radiculopathies. The main etiopathogeneses were cervical stenosis, degenerative disk disease, or a mix of them-78% of which had a favorable outcome; the most frequent complications were transient and permanent Horner syndrome in 13.6% and 9.2% of cases, respectively. Long-term stability was reported in 97% of patients.Conclusion: Multilevel cervical oblique vertebrectomy and/or lateral foraminotomy allow wide neural structure decompression and optimal stability given that the physiological spinal motion is preserved.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"135 ","pages":"339-343"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Methods and Principles of the Intraoperative Neurophysiologic Monitoring in Neurosurgery. 神经外科术中神经电生理监测的方法和原理》（Methods and Principles of the Intraoperative Neurophysiologic Monitoring in Neurosurgery）。

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-36084-8_9

Michele Di Domenico, Diana Viola, Alessandro Izzo, Manuela D'Ercole, Francesco Signorelli, Nicola Montano, Massimiliano Visocchi

{"title":"Methods and Principles of the Intraoperative Neurophysiologic Monitoring in Neurosurgery.","authors":"Michele Di Domenico, Diana Viola, Alessandro Izzo, Manuela D'Ercole, Francesco Signorelli, Nicola Montano, Massimiliano Visocchi","doi":"10.1007/978-3-031-36084-8_9","DOIUrl":"10.1007/978-3-031-36084-8_9","url":null,"abstract":"Intraoperative neurophysiologic monitoring (IONM) is an innovation introduced in neurosurgery in the past decades. It aims to support and guide the neurosurgeon to obtain the best surgical result possible, preventing the occurrence of neurological deficits. The somatosensory evoked potentials (SSEP) assess the integrity of the sensory pathways monitoring the dorsal column-medial lemniscus pathway during spine and cerebral surgery. Motor evoked potentials (MEPs) provide information on the integrity of the motor pathway monitoring the efferent motor pathways from the motor cortex to the muscle through corticospinal (or corticobulbar) tracts. Free-running EMG is the standard technique to monitor peripheral nerves, roots, or cranial motor nerves during surgery. Intraoperative EMG signals are activated during cranial motor nerves damaging or after an irritative stimulus. The duration, morphology, and persistence of EMG reflects the severity of neural injury. Nerve mapping consists of recording muscle activations given by direct nerve stimulation. This technique makes use of a stimulation probe available to the neurosurgeon which allows administering current directly to the nervous tissue (nerves, roots, etc.). Intraoperative neurophysiological monitoring (IONM) represents the standard of care during many procedures, including spinal, intracranial, and vascular surgeries, where there is a risk of neurological damage. Close communication and collaboration between the surgical team, neurophysiologist, and anesthesiologist is mandatory to obtain high-quality neuromonitoring, thus preventing neurologic injuries and gaining the best surgical \"safe\" results.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"135 ","pages":"45-49"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spinal Intradural Extramedullary Tumors: A Retrospective Analysis on Ten-Years' Experience of Minimally Invasive Surgery and a Comparison with the Open Approach. 脊柱硬膜外肿瘤：微创手术十年经验回顾分析及与开放式手术的比较。

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-36084-8_54

D Kitumba, R Reinas, L Pereira, V Pinto, O L Alves

{"title":"Spinal Intradural Extramedullary Tumors: A Retrospective Analysis on Ten-Years' Experience of Minimally Invasive Surgery and a Comparison with the Open Approach.","authors":"D Kitumba, R Reinas, L Pereira, V Pinto, O L Alves","doi":"10.1007/978-3-031-36084-8_54","DOIUrl":"10.1007/978-3-031-36084-8_54","url":null,"abstract":"Spinal intradural extramedullary (ID-EM) tumors are pathologies widely treated through a classical open approach. However, minimally invasive surgery is gaining traction as a comparable treatment option because it carries less morbidity and may reduce healthcare costs.This study aimed to compare the clinical and functional outcomes of open versus minimally invasive approaches for patients with ID-EM tumors. We performed a retrospective analysis on prospectively collected data from patients with ID-EM tumors submitted to surgery. Baseline features and operative variables were compared, including surgery duration and estimated blood loss (EBL). Postoperative data covered tumor histology, length of stay (LOS), complication(s), and neurological status (Medical Research Council (MRC) scale) at the last follow-up.In total, 46 patients were included: 30 (65.2%) operated through an open approach and 16 (34.8%) through a minimally invasive surgical (MIS) approach. The predominant histology type was schwannomas (43.5%). Lesions more frequently affected the lumbar spine (34.8%). The tumor dimensions were similar in both cohorts. The minimally invasive approach was on average 76.7 min faster and correlated positively with less EBL (140 mL less than that of the open approach). Patients in the MIS group had shorter LOSs (5.63 days vs. 17.27 days) and had fewer postoperative complications. No significant difference in functional outcome was found.MIS is as effective as the traditional approach in achieving comparable functional outcomes, with advantages such as shorter surgery durations, less blood loss, and shorter hospital LOSs.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"135 ","pages":"357-360"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0