Brain & spine最新文献

{"title":"Advancing spine surgery: Evaluating the potential for full robotic automation","authors":"Nicolás Samprón ,&nbsp;Jesus Lafuente ,&nbsp;Jorge Presa-Alonso ,&nbsp;Marcel Ivanov ,&nbsp;Roger Hartl ,&nbsp;Florian Ringel","doi":"10.1016/j.bas.2025.104232","DOIUrl":"10.1016/j.bas.2025.104232","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of robotic systems in spine surgery is expanding, with growing interest in the potential for full automation. This review explores current robotic technologies, their limitations, and future automation possibilities, focusing on technical and practical aspects.</div></div><div><h3>Research question</h3><div>What are the current capabilities and limitations of robotic systems in spine surgery, and how might advancements in tracking technologies facilitate a transition toward greater automation?</div></div><div><h3>Material and methods</h3><div>A narrative review of literature on robotic spine surgery systems was conducted, analyzing benefits, accuracy, limitations, and innovations necessary for full automation. Focus was placed on trajectory-guiding technologies, such as optical tracking and alternative tracking methods.</div></div><div><h3>Results</h3><div>Current robotic systems (e.g., Cirq®, Mazor X™, ExcelsiusGPS™) assist in trajectory guidance but lack autonomy. Optical tracking systems present challenges, such as obstruction vulnerability and inaccuracies in complex constructs. Conversely, encoder-based tracking demonstrated superior accuracy, offering a promising pathway toward increased automation. The potential advantages of robotics over conventional navigation, including their nature and clinical relevance, remain a topic of active discussion. However, the inherent complexity of spine surgery and the critical role of human decision-making remain substantial barriers.</div></div><div><h3>Discussion and conclusion</h3><div>While full automation in robotic spine surgery is not yet attainable, advancements in tracking technologies point to a future of enhanced robot-surgeon collaboration, which could optimize clinical outcomes and improve procedural safety.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104232"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680258","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":"Posterior transpetrosal approach to a suprasellar retroinfundibular pituicytoma: A case report and comprehensive literature review","authors":"Tancredo Alcântara ,&nbsp;Jerold Justo ,&nbsp;Tingting Jiang ,&nbsp;Rosaria Abbritti ,&nbsp;Stefan Lieber ,&nbsp;Thibault Passeri ,&nbsp;Marc-Antoine Labeyrie ,&nbsp;Sébastien Froelich","doi":"10.1016/j.bas.2025.104239","DOIUrl":"10.1016/j.bas.2025.104239","url":null,"abstract":"<div><h3>Introduction</h3><div>Pituicytomas are rare benign glial neoplasms (WHO grade I) located in the sellar or suprasellar regions, arising from the neurohypophysis and infundibular area. They typically present with symptoms due to the slow growth of the tumor, including hormonal changes, visual impairment, and headaches.</div></div><div><h3>Research question</h3><div>This case report evaluates the effectiveness of the posterior transpetrosal approach for the resection of a retroinfundibular suprasellar pituicytoma, focusing on preserving pituitary function and minimizing surgical risks.</div></div><div><h3>Material and methods</h3><div>We present a 59-year-old female with a pituicytoma diagnosed by MRI and digital subtraction angiography (DSA). Preoperative embolization was performed to reduce the tumor’s vascularity. The patient underwent a left posterior transpetrosal approach for tumor resection, with key surgical steps focusing on preserving the pituitary stalk, optic chiasm, and perforating vessels.</div></div><div><h3>Results</h3><div>The posterior transpetrosal approach provided excellent exposure, enabling near-total resection of the tumor. The patient had no new neurological deficits postoperatively, and follow-up MRI at 6 months showed no tumor recurrence.</div></div><div><h3>Discussion and conclusion</h3><div>This case demonstrates the safety and efficacy of the posterior transpetrosal approach for pituicytoma resection. The approach allowed for optimal visualization and preservation of critical structures, particularly the pituitary stalk, leading to a favorable clinical outcome. Our findings, supported by a literature review, suggest that this technique is a valuable option for tumors in retroinfundibular and suprasellar locations.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104239"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680313","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":"Partial sacrectomy with en bloc tumor resection without instrumentation. What level is safe?","authors":"Jan Štulík ,&nbsp;Michaela Rybárová ,&nbsp;Pavel Hladík ,&nbsp;Robert Lischke ,&nbsp;Zdeněk Klézl ,&nbsp;Radek Kaiser ,&nbsp;Ondřej Naňka","doi":"10.1016/j.bas.2025.104246","DOIUrl":"10.1016/j.bas.2025.104246","url":null,"abstract":"<div><h3>Introduction</h3><div><em>En bloc</em> sacrectomy is an extensive surgical procedure which is often the only option which provides cure. Our experience shows that, in selected cases, instrumentation is not necessary even in case of a high <em>en bloc</em> sacrectomy retaining the cranial part of the sacrum <em>in situ</em>. This creates suitable conditions for subsequent proton therapy.</div></div><div><h3>Research question</h3><div>What level of resection is safe without reconstruction?</div></div><div><h3>Material and methods</h3><div>Between 2014 and 2023 we performed a total of 29 sacral resections for various etiologies. Patients following reconstruction of the lumbosacral region by internal fixator (3) and patient after hemicorporectomy (1) were excluded from the study. The study group comprised 25 patients, 15 men and 10 women with a mean age of 45.1 years (range, 1.7–72.2 years). The most frequent indication for surgery was chordoma (8), followed by MPNST (4), yolk sac tumor (2) and undifferentiated sarcoma (2).</div></div><div><h3>Results</h3><div>Stress fractures of the sacral stump occur in elderly patients with lower bone mineral density, or in younger patients with a higher bone mineral density who are more active when resuming their daily routine after the operation.</div></div><div><h3>Discussion and conclusion</h3><div>Instrumentation is, in our view, primarily indicated in younger and more active patients, whereas in most cases, even with lower bone mineral density, non-instrumented procedure results in sufficient stability in all levels of partial resection.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104246"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769254","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":"Guidelines and good clinical practices in Italian IOM: The Bianco-Gelli Law","authors":"Giuseppe Stipa,&nbsp;Chiara Rabbito,&nbsp;Antonio Vittorino Gaddi","doi":"10.1016/j.bas.2025.104248","DOIUrl":"10.1016/j.bas.2025.104248","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104248"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786279","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":"The acute phase management of traumatic spinal cord injury (tSCI) with polytrauma: A narrative review.","authors":"Edoardo Picetti, Nicolò Marchesini, Walter L Biffl, Susan E Biffl, Fausto Catena, Raul Coimbra, Michael G Fehlings, Wilco C Peul, Chiara Robba, Michele Salvagno, Fabio S Taccone, Andreas K Demetriades","doi":"10.1016/j.bas.2024.104146","DOIUrl":"10.1016/j.bas.2024.104146","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic spinal cord injury (tSCI) is frequently observed in polytrauma patients.</p><p><strong>Research question: </strong>What is the optimal strategy to manage tSCI in the setting of polytrauma?</p><p><strong>Material and methods: </strong>This narrative review focuses on: 1) extraspinal damage control surgery and resuscitation, 2) the perioperative protection of the injured spine during emergency surgery, 3) imaging and timing of spinal surgery in polytrauma, 4) early interventions for skin, bowel and bladder, and 5) the multidisciplinary approach to tSCI polytrauma patients.</p><p><strong>Results: </strong>Damage control resuscitation (DCR) and damage control surgery (DCS), aim to prevent/correct post-traumatic physiological derangements to minimize bleeding until definitive hemostasis is achieved. Spinal protection during emergency surgery is of paramount importance to reduce secondary insults to the injured spine. Imaging, especially magnetic resonance imaging (MRI), is useful for decision-making regarding surgical management of the injured spine. Early decompressive surgery (within 24 h from trauma) is associated with better neurological outcomes. Early consultation with a physical medicine and rehabilitation physician is beneficial to optimize recovery. A close collaboration between different medical specialties involved in the early management of tSCI patients with polytrauma is advisable to improve outcome.</p><p><strong>Discussion and conclusion: </strong>This narrative review aims to collate basic knowledge regarding acute phase management of tSCI patients in the context of polytrauma. More evidence and data form well-powered studies are necessary in this setting.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"104146"},"PeriodicalIF":1.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866652","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":"Letter to Editor: Fluorescence-guided surgery for high-grade gliomas.","authors":"Diogo Roque, Nida Kalyal, Yasir A Chowdhury, Ali Elhag, Matthew Elliot, Keyoumars Ashkan, Francesco Vergani, Ranjeev Bhangoo, José Pedro Lavrador","doi":"10.1016/j.bas.2024.104147","DOIUrl":"10.1016/j.bas.2024.104147","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"104147"},"PeriodicalIF":1.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866706","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":"<i>Stria Terminalis</i>: An intraoperative image.","authors":"Énia Sousa, Francesco Marchi, Yagmur Esemen, Ali Elhag, Francesco Vergani, José Pedro Lavrador","doi":"10.1016/j.bas.2024.104144","DOIUrl":"10.1016/j.bas.2024.104144","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"104144"},"PeriodicalIF":1.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820142","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":"Spine deformity board and the need for a multidisciplinary discussion of complex spine surgery cases: A proposal from the EANS young neurosurgeons committee.","authors":"Luca Ricciardi, Stefan Motov, Gabriele Capo, Lorenzo Bertulli, Felix C Stengel, Belo Diogo, Thomas Schoefl, Torstein R Meling, Florian Ringel, Andreas K Demetriades, Giovanni Raffa","doi":"10.1016/j.bas.2024.104145","DOIUrl":"10.1016/j.bas.2024.104145","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"104145"},"PeriodicalIF":1.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803688","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":"Patients' experience of care index: A new, reliable, and useful questionnaire in lumbar spine surgery.","authors":"Arkan Sam Sayed Noor, Björn Knutsson","doi":"10.1016/j.bas.2024.104140","DOIUrl":"10.1016/j.bas.2024.104140","url":null,"abstract":"<p><strong>Introduction: </strong>Patient's experience of care (PEC) is crucial in enhancing and sustaining healthcare quality.</p><p><strong>Research question: </strong>the primary aim of this study is to establish and assess a new questionnaire index designed to measure PEC following elective spinal surgery. This index serves as a tool to document, enhance, and maintain the quality of healthcare provided in this context.</p><p><strong>Material and methods: </strong>The studied PEC index comprises 7 questions, each addressing different aspects of perioperative care. Our study involved 300 post-spinal surgery patients, sourced from the Swedish national register for spine surgery. Collected data included age, gender, education level, self-rated health, and primary language. The patients were contacted via telephone by trained interviewers, approximately 35 days after their surgery (with 60 patients re-interviewed after a few weeks). We employed linear regression, <i>t</i>-test, and ANOVA models to examine the associations between the PEC index and the documented variables.</p><p><strong>Results: </strong>The PEC index demonstrated good internal consistency and reliability (Cronbach alpha = 0.76, interclass correlation coefficient = 0.87). Additionally, the utility measures indicated associations between the PEC index and factors such as higher age (p = 0.014), male gender (p = 0.012), and better self-rated health (p = 0.011).</p><p><strong>Discussion and conclusion: </strong>The PEC index seems to be a promising tool with a clinically useful composite questionnaire for assessing PEC in patients undergoing elective spine surgery. In clinical settings, the index can accompany other outcome scores to evaluate and compare different diagnoses and management methods.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"104140"},"PeriodicalIF":1.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781832","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":"The impact of paraspinal muscle morphology on functional outcome in patients with degenerative lumbar spine disease undergoing surgery - A prospective observational study.","authors":"Niraj Ghimire, Prashant Lakhe, Anil Kumar, Nisha Ghimire, Chayanika Kutum, Deepak Choudhary, Bhanu Pratap Singh Chauhan, Poonam Narang, Hukum Singh, Daljit Singh","doi":"10.1016/j.bas.2024.104141","DOIUrl":"10.1016/j.bas.2024.104141","url":null,"abstract":"<p><strong>Introduction: </strong>Paraspinal muscle atrophy has been implicated in low back pain (LBP) as well as degenerative disc disease, lumbar spinal stenosis, and disc herniation. The objective of the study was to determine the association of paraspinal muscle morphology with functional outcomes in patients undergoing spine surgery in degenerative spine diseases.</p><p><strong>Research question: </strong>Can the degree of paraspinal muscle atrophy be a reliable prognostic indicator of post-operative functional outcome in patients undergoing surgery for degenerative lumbar spine disease?</p><p><strong>Materials and methods: </strong>Forty-one patients with degenerative lumbar spine disease planned for surgery were included. Pre-operative and postoperative MRI-based muscle morphology including total cross-sectional area (TCSA) and muscle atrophy were recorded. Association between muscle parameters and functional status as indicated from the visual analogue scale (VAS), and Oswestry Disability Index (ODI) were assessed, and compared between prior and after surgery.</p><p><strong>Results: </strong>The MF and ES cross-sectional area on MRI was in proportion to the functional status. (higher ODI and VAS). Preoperative MF TCSA was positively correlated with preoperative ODI ((r = -0.441, p = = 0.032), preoperative VAS (r = -0.338, p = 0.048) and was negatively correlated with change in ODI (r = -0.268, p = 0.016) while preoperative ES TCSA was negatively correlated with preoperative ODI (r = -0.420, p = 0.003). Preoperative ODI, change in ODI and preoperative VAS had significant correlation with muscle atrophy (<i>p</i> < 0.05). There was a positive correlation between preoperative ODI with Grade 2 (<i>r</i> = 0.332, <i>p</i> = 0.016) and Grade 3 (<i>r</i> = 0.299, <i>p</i> = 0.048) MF muscle; and Grade 2 (<i>r</i> = 0.308, <i>p</i> = 0.067) and Grade 3 (<i>r</i> = 0.202, <i>p</i> = 0.018) ES muscles atrophy. The change in ODI, negatively correlated with Grade 3 MF and ES atrophy (r = -0.332, p = 0.018 and r = -0.286, P = 0.011 respectively). Linear regression analysis showed duration of symptom (p = 0.005) was positively associated with preoperative ODI. Age and BMI were negatively associated with improvement in ODI. (p = 0.073, 0.098 respectively).</p><p><strong>Discussion and conclusion: </strong>Preoperative paraspinal muscle area is an independent variable that affects preoperative functional status. The grade of paraspinal muscle atrophy is a good predictor of preoperative, postoperative and improvement in functional status.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"104141"},"PeriodicalIF":1.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803615","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}