Brain & spine最新文献

{"title":"Inadvertent intrathecal application of vindesine and its neurological outcome: case report and systematic review of the literature.","authors":"A Babaee, H Yasin, B Berger, M Simon","doi":"10.1016/j.bas.2025.104292","DOIUrl":"10.1016/j.bas.2025.104292","url":null,"abstract":"<p><strong>Introduction: </strong>Vinca alkaloids are used to treat a diversity of malignancies. Inadvertent intrathecal application is followed by severe neurological consequences, with fatal outcomes in the majority of the reported cases. Therapy of choice has been experimental.</p><p><strong>Research question: </strong>What are the outcomes of inadvertent intrathecal application of vinca alkaloids and how should it be treated? What is the role of irrigation of the cerebrospinal fluid (CSF) in order to remove the vinca alkaloid and potentially toxic metabolites?</p><p><strong>Material and methods: </strong>In this paper we report the case of a 53-year-old man who was, in the course of his treatment for acute lymphoblastic leukemia (ALL), inadvertently injected with vindesine intrathecally. The patient survived following aggressive and invasive treatment, which included irrigation of the CSF via external ventricular and lumbar drains. We also conducted a systematic review of similar published cases.</p><p><strong>Result: </strong>A total of 31 cases with intrathecal inadvertent vinca alkaloid injection were identified. Including the case described in this report only two patients were injected with vindesine (n = 2, 6.5 %), all other received vincristine. Only 6/31 (19.4 %) patients survived the acute phase of the vinca alkaloid intoxication. 6/15 (40.0 %) patients receiving some sort of CSF irrigation survived (cf. 0/12 without irrigation therapy). All survivors were left with very significant neurological deficits.</p><p><strong>Discussion and conclusion: </strong>The combined evidence suggests that intrathecal administration of vincristine is universally fatal without treatment, while CSF irrigation carries a chance of survival. Patients are, however, left with severe neurological deficits such as paraplegia.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104292"},"PeriodicalIF":1.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When can lumbar fusion be considered appropriate in the treatment of recurrent lumbar disc herniation? A systematic review and meta-analysis.","authors":"Gianpaolo Jannelli, Francesco Polinelli, Antonella Giardina, Marco Cuzzolin, Francesco Calvanese, Ivan Cabrilo, Luca Paun, Enrico Tessitore","doi":"10.1016/j.bas.2025.104285","DOIUrl":"10.1016/j.bas.2025.104285","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent lumbar disc herniation (RLDH) is defined as the reappearance, following initial discectomy, of disc material and pain after a period of at least six symptom-free months. Redo surgery is usually considered following unsuccessful conservative management or in the presence of neurological deficits.</p><p><strong>Research question: </strong>Given the lack of consensus on the ideal surgical strategy for RLDH, we conducted this study to evaluate when lumbar fusion (LF) should be considered in the treatment of RLDH.</p><p><strong>Material and methods: </strong>A literature search was conducted on PubMed, Google Scholar and clinicaltrials.gov focusing on the treatment of recurrent disc herniation using microdiscectomy alone or through fusion. The quality of the studies was evaluated using the Newcastle-Ottawa Quality Assessment Scale and Cochrane Risk of Bias Tool 2.0. The weighted mean difference was calculated for both binary and continuous outcomes.</p><p><strong>Results: </strong>This resulted in a list of 900 references, from which 11 studies were identified as meeting the inclusion criteria for the study. There were four prospective studies and seven retrospective studies. A comparison of LF and redo discectomy (RD) revealed no significant differences in clinical outcome scores. LF resulted in significantly higher intraoperative blood loss, longer hospitalizations and longer surgeries. No further differences were identified.</p><p><strong>Discussion and conclusions: </strong>Both LF and RD represent safe and effective treatment options in first RLDH. The choice of surgical strategy should integrate the eventual co-existence of clinical and radiological features of segmental instability, as well subjective aspects, such as surgeons' training and patient preference.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104285"},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic central cord Syndrome: An integrated neurosurgical and neurocritical care perspective.","authors":"Karol Martínez-Palacios, Andrés M Rubiano, Andreas K Demetriades, Sebastián Vásquez-García","doi":"10.1016/j.bas.2025.104281","DOIUrl":"10.1016/j.bas.2025.104281","url":null,"abstract":"<p><p>Traumatic Central Cord Syndrome (TCCS) presents complex challenges in the management of spinal cord injury. Characterized by disproportionate upper limb weakness, TCCS is the most common clinical spinal cord syndrome, typically affecting males in a bimodal age distribution. Mechanisms include hyperextension injuries in older adults with degenerative cervical spine disease and high-energy trauma in younger individuals. Diagnosis is based on neurological assessment, with the American Spinal Injury Association (ASIA) Impairment Scale used for severity classification. Management strategies, including surgical and medical approaches, may influence functional outcomes, although high-quality comparative evidence is limited. Surgical decompression and stabilization are often pursued to relieve mechanical compression, while nonoperative strategies may be considered in selected cases with less severe neurological deficits. The timing of surgical intervention remains a subject of ongoing debate and must be individualized. Neurocritical care considerations are increasingly recognized as potentially important in the early phase of TCCS. Experimental and clinical investigations into intraspinal pressure (ISP), mean arterial pressure (MAP), and spinal perfusion pressure (SPP) monitoring suggest these parameters may aid in minimizing secondary injury, though their routine clinical use is not yet established. Complications such as venous thromboembolism, infection, pressure injuries, and autonomic dysfunction are common and require comprehensive management. The role of corticosteroids remains controversial. This narrative review synthesizes current knowledge on TCCS, with emphasis on diagnostic, surgical, and neurocritical care considerations. As the field advances, further evidence is needed to clarify optimal management pathways and improve outcomes in this challenging clinical entity.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104281"},"PeriodicalIF":1.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations on neurological deficits in patients with glioblastoma: impact of perilesional resection on neuro-oncological outcome. A monocentric real-life experience.","authors":"Andrea Di Cristofori, Chiara Benedetta Rui, Francesca Graziano, Davide Ferlito, Paola Rebora, Andrea Trezza, Gaia Chiarello, Giovanni Stefanoni, Fulvio Da Re, Chiara Julita, Gianpaolo Basso, Giovanni Palumbo, Maria Grazia Valsecchi, Giorgio Carrabba, Carlo Giussani","doi":"10.1016/j.bas.2025.104276","DOIUrl":"10.1016/j.bas.2025.104276","url":null,"abstract":"<p><strong>Introduction: </strong>Maximal resection has a pivotal role in the treatment of glioblastoma (GB), prolonging both progression free survival (PFS) and overall survival (OS). Only few studies analyze the delicate equilibrium between maximal resection, clinical outcome and prognosis.</p><p><strong>Research question: </strong>the aim of this work is to determine the impact of neurological impairment on PFS, OS and access to adjuvant therapies on patients with GB operated with perilesional resection technique.Material and Methods: this retrospective study encompassed patients operated for GB at Fondazione IRCCS San Gerardo dei Tintori Monza (IT), from 2015 to 2023. Histological diagnosis was performed according to the WHO 2021 classification. Patients were more than 18 years old, with pre- and postoperative MRI, who underwent surgery and adjuvant treatments at our Institution.</p><p><strong>Results: </strong>A total of 209 patients fulfilled the criteria. Patients with improvement or complete regression of preoperative deficit had a higher rate of access to adjuvant therapies (p = 0.015). Patients with hemiparesis at discharge had the worst PFS (median 4.60 months) followed by patients with aphasia (6.60 months), and patients with normal neurological examination (9.67 months; p < 0.0001). The median OS was 17.93 months for patients with hemianopia<i>,</i> 6.40 for patients with hemiparesis and 15.7 months for those with aphasia (p < 0.0001).</p><p><strong>Discussion and conclusion: </strong>Hemianopia has no impact on the patient's prognosis, while hemiparesis and aphasia at discharge worsen both PFS and OS prolonging time-to-treatment. When resecting GB, it is mandatory to avoid major neurological deficits that concur which reduce OS and PFS.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104276"},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closing the diagnostic gap: A narrative review of recent advances in functional MRI diagnostics in spinal cord injury.","authors":"Christian J Entenmann, Katharina Kersting, Peter Vajkoczy, Anna Zdunczyk","doi":"10.1016/j.bas.2025.104283","DOIUrl":"10.1016/j.bas.2025.104283","url":null,"abstract":"<p><strong>Introduction: </strong>Conventional MRI (T1 and T2-weighted sequences) is the standard for diagnosing spinal cord injuries but often lacks specificity, showing limited correlation with microstructural changes and function. This creates a diagnostic gap, especially in patients with mild or ambiguous symptoms, delaying early intervention.</p><p><strong>Research question: </strong>Can advanced MRI techniques-such as quantitative MRI (qMRI), functional MRI (fMRI), Magnetic Resonance Spectroscopy (MRS), and Transmagnetic Stimulation (TMS)-address the limitations of conventional MRI by providing enhanced diagnostic metrics and biomarkers of spinal cord integrity?</p><p><strong>Material and methods: </strong>This study reviews advanced MRI modalities and their potential to provide quantifiable insights into spinal cord microstructure and function. It also explores the role of artificial intelligence (AI) in analyzing complex datasets to support more comprehensive diagnostics.</p><p><strong>Results: </strong>Advanced MRI techniques show promise in improving diagnostic accuracy and enabling individualized prognostic assessments. Parameters specific to each modality could serve as biomarkers for injury extent and neurological recovery, supporting their potential as clinical endpoints in therapy trials.</p><p><strong>Discussion and conclusion: </strong>These advanced imaging techniques, combined with AI for data integration, offer a transformative potential for personalized diagnostics in spinal cord injury. Yet, significant technical and validation challenges remain, requiring large, multicenter studies to confirm their effectiveness and enable clinical application. Successfully addressing these challenges could close the diagnostic gap, optimize patient outcomes, and redefine spinal cord injury management.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104283"},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of spinal versus general anesthesia in decompressive surgeries of the lumbar spine.","authors":"Clara F Weber, Anton Früh, Claudius Jelgersma, Ahmad Almahozi, Kiarash Ferdowssian, Nils Hecht, Peter Vajkoczy, Lars Wessels","doi":"10.1016/j.bas.2025.104280","DOIUrl":"10.1016/j.bas.2025.104280","url":null,"abstract":"<p><strong>Introduction: </strong>Decompressive lumbar spine surgery is a common procedure for disc herniation and spinal stenosis. Besides intervention under general anesthesia (GA), awake surgery (AS) in local or spinal anesthesia offers potential benefits regarding GA-related side effects and simplified periprocedural management.</p><p><strong>Research question: </strong>Within this systematic analysis, we sought to compare postsurgical outcomes of spinal decompression surgeries in GA and AS.</p><p><strong>Methods: </strong>Following the PRISMA guidelines, we extracted all relevant studies from three databases and collected all data concerning surgery duration, blood loss, postoperative duration of hospitalization, postoperative pain (VAS), and disability indices (ODI).</p><p><strong>Results: </strong>In total, we identified 11 studies covering 1350 patients. AS was associated with shorter surgery duration [Mean difference (MD) -8.52 (95 % confidence interval (CI) -14.56, -2.49) min] as well as lower relative risk for postoperative complications [risk ratio (RR) 0.86 (0.75, 0.99)] and nausea and vomiting [RR 0.58 (0.51, 0.66)]. There were no significant differences in estimated blood loss [MD -27.59 (-61.85, -9.97) ml], hospital stay duration [MD -1.6 (-3.95, 0.75) d], pain [MD -0.22 (-1.35, 0.92) VAS] and disability scales [MD -0.8 (-3.54, 1.94) ODI]. Selected studies were considerably heterogeneic (<i>I</i> ^<i>2</i>  = 0-99.89 %).</p><p><strong>Discussion and conclusion: </strong>Awake surgery is a safe and promising alternative to GA in decompressive spine surgery, however, high heterogeneity of the present literature warrant confirmation in future prospective, randomized trials.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104280"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double fluorescence-guided surgery with 5-ALA and fluorescein sodium in grade 2 and grade 3 adult-type diffuse gliomas: retrospective analysis of 112 cases.","authors":"Andrea Bianconi, Marta Bonada, Pietro Zeppa, Francesco Bruno, Pietro La Cava, Flavio Panico, Roberta Rudà, Antonio Melcarne, Diego Garbossa, Fabio Cofano","doi":"10.1016/j.bas.2025.104277","DOIUrl":"10.1016/j.bas.2025.104277","url":null,"abstract":"<p><strong>Objective: </strong>Fluorescence-guided surgery (FGS) has been increasingly used to support glioma surgery to obtain a maximal extent of resection (EOR). Current evidence in lower-grade gliomas does not support the routine use of FGS obtained with the most common fluorescence agents (e.g. 5-ALA and fluorescein sodium). However, the combination of these two dyes has not been extensively explored yet. Main objective of this study is to evaluate the role of 5-ALA and FS in LGGs surgery for tumor detection, margin definition, and prognostic relevance.</p><p><strong>Methods: </strong>112 patients affected by a histologically confirmed adult-type diffuse glioma grade 2-3 molecularly defined underwent craniotomy in \"Città della Salute e della Scienza\" hospital (Turin, Italy). Surgery has been performed under general anesthesia with the previous administration of both 5-ALA (20 mg/kg) and fluorescein sodium (3 mg/kg). We retrospectively investigated clinical, radiological, histological and molecular data. Fluorescence positive rate and pattern have been reported both for 5-ALA and for fluoresceine.</p><p><strong>Results: </strong>We included 69 patients with astrocytoma <i>IDH-</i>mutant and 43 with oligodendroglioma <i>IDH-</i>mutant 1p19q-codeleted. Seventeen cases were positive for both 5-ALA and FS (15.1 %), 24 for 5-ALA (21.4 %) only, 1 for FS (1.0 %) only, 70 were negative (62.5 %). The relationship between intraoperative fluorescence and the presence of foci with contrast enhancement uptake on the preoperative MRI was statistically significant (p < 0.001) for both the dyes. 5-ALA intraoperative detection had a statistically significant impact on the overall survival (OS) (HR: 2.51, 95 % CI: 1.25-5.01, p = 0.009) and progression-free survival (PFS) (HR: 2.46, 95 % CI: 1.34-4.52, p = 0.004). Additionally, both FS and 5-ALA fluorescence slightly prevailed in grade 3 gliomas, especially 5-ALA.</p><p><strong>Conclusion: </strong>The results achieved in this study do not support the role of 5-ALA and FS to intraoperatively define the extent of resection, because of low fluorescence rates. Nevertheless, 5-ALA expression could be used to intraoperatively identify more aggressive foci and add useful prognostic information before the histological analysis. Indeed, FS is mostly related to blood-brain barrier damage and, thus, with contrast enhancement in MRI.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104277"},"PeriodicalIF":1.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the role of non-surgical clinicians in the assessment and management of degenerative cervical myelopathy? - Insights from the RECODE-DCM peri-operative rehabilitation incubator.","authors":"Rohil V Chauhan, Andreas K Demetriades, Timothy F Boerger, Justin M Lantz, Caroline Treanor, Sukhvinder Kalsi-Ryan, Vishal Kumar, Lianne Wood, Joshua Plener, Nicky Wilson, Maryse Fortin, Carlo Ammendolia, Annalena Paus, Rana S Dhillon, Benjamin Davies, Michael G Fehlings, David B Anderson","doi":"10.1016/j.bas.2025.104275","DOIUrl":"10.1016/j.bas.2025.104275","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence on degenerative cervical myelopathy (DCM) has frequently focussed on surgical management, overlooking the role of non-surgical clinicians. Their contributions in the patient journey remain largely underexplored in the literature.</p><p><strong>Research question: </strong>What is the role of non-surgical clinicians in the assessment and management of people with DCM?</p><p><strong>Material and methods: </strong>This narrative review synthesizes knowledge from a comprehensive MEDLINE search and the collective expertise of the RECODE-DCM Peri-Operative Rehabilitation Incubator, an expert working group hosted by Myelopathy.org. Key domains of non-surgical clinician involvement include: 1) early recognition and referral, 2) patient education, 3) pain management, 4) preoperative management, and 5) postoperative rehabilitation.</p><p><strong>Results: </strong>Timely DCM diagnosis depends on first-contact clinicians recognizing hallmark symptoms. In the absence of standardized screening criteria, tools like the modified Japanese Orthopaedic Association score can support early identification. Non-surgical clinicians educate patients with mild or non-myelopathic spinal cord compression to recognize signs of DCM progression, ensuring timely surgical consultation. These clinicians also play a multidisciplinary role in the biopsychosocial management of pain, incorporating pharmacological and non-pharmacological strategies to address nociceptive and neuropathic pain. While predictors of postoperative outcomes, such as disease severity, gait dysfunction and smoking, are known, evidence on preoperative optimization and prehabilitation remains limited. Emerging research highlights the benefits of early postoperative rehabilitation, including cervical range of motion and stabilization exercises, in improving 12-month postoperative outcomes.</p><p><strong>Discussion and conclusion: </strong>Non-surgical clinicians play an integral role in DCM management across the care continuum. A multidisciplinary, patient-centred approach is essential. Postoperative rehabilitation holds promise, but prospective trials are necessary to establish standardization and optimal strategies for clinical delivery.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104275"},"PeriodicalIF":1.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-printed guide template for cervical stabilization surgery: A case report.","authors":"Koray Ur, Hatun Mine Şahin, Timurhan Aksoy, Ceren Kızmazoğlu, Reşat Serhat Erbayraktar","doi":"10.1016/j.bas.2025.104267","DOIUrl":"10.1016/j.bas.2025.104267","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical spine injuries are a growing global public health concern. Management depends on injury severity, with severe cases requiring surgical decompression and stabilization. Emerging technologies such as 3D-printed patient-specific templates offer enhanced accuracy and safety in pedicle screw placement compared to traditional freehand techniques.</p><p><strong>Research question: </strong>Can 3D-printed patient-specific guide templates improve the safety, efficiency, and outcomes of cervical spine fusion procedures compared to conventional techniques?</p><p><strong>Case report: </strong>A 62-year-old male with a cervical spinal injury underwent emergency decompression at an external facility. Subsequent imaging revealed iatrogenic instability due to multi-level laminectomies (C3-C6). Preoperative CT data were processed using software (Mimics v14, MeshMixer) to design patient-specific templates, printed with a 3D Ultimaker 2 printer. These sterilized templates were used intraoperatively for navigation, aiding in transpedicular screw placement at C2, C7, and T1 levels, with lateral mass screws placed for C3-C6 using a freehand technique.</p><p><strong>Results: </strong>Intraoperative fluoroscopy confirmed accurate screw placement with no vertebral artery injury or malposition. Postoperative CT validated precise alignment, and no hematoma or complications were observed. The use of 3D templates reduced operative time and radiation exposure compared to traditional methods.</p><p><strong>Discussion: </strong>3D-printed templates offer a cost-effective and accessible alternative to robotic systems, enhancing precision and minimizing complications. Literature supports their safety, accuracy, and potential to reduce operative time, blood loss, and radiation exposure.</p><p><strong>Conclusion: </strong>3D-printed templates represent an effective and innovative tool for improving cervical spine surgery outcomes. Future advancements in 3D-printing technologies could further optimize spinal stabilization and fusion procedures.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104267"},"PeriodicalIF":1.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stem cell therapies for spinal cord injury in humans: A review of recent clinical research","authors":"Keiko Sugai ,&nbsp;Masaya Nakamura ,&nbsp;Hideyuki Okano ,&nbsp;Narihito Nagoshi","doi":"10.1016/j.bas.2025.104207","DOIUrl":"10.1016/j.bas.2025.104207","url":null,"abstract":"<div><div>Recently, cell transplantation has emerged as a promising treatment for spinal cord injury (SCI). Over the past decade, numerous clinical studies of SCI have been conducted using various types of cells, including fetal neural stem/progenitor cells (NS/PCs), pluripotent stem cell-derived NS/PCs, mesenchymal stem/stromal cells (MSCs), olfactory ensheathing cells, and Schwann cells. Promising results have been reported for patients with subacute SCI, especially in studies involving MSCs, such as those conducted with Stemirac, although no universally recognized breakthroughs have been achieved. Allogenic NS/PCs may offer advantages over autologous MSCs because they have the potential for cell engraftment within the spinal cord and can be prepared in advance, facilitating their administration during the hyperacute phase. Recent advances achieved with induced pluripotent stem cells indicate their promise potential to be used in future therapies. This review provides an overview of recent clinical studies and discusses potential advancements anticipated in the future.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104207"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}