Brain & spine最新文献

{"title":"Management of C2 fractures following multiple classifications, a narrative review.","authors":"Michael McDermott, Guisela Quinteros, Federico Landriel, Chase Stastny, Daniel Raskin, Guillermo Ricciardi, Andrei Fernandes Joaquim, Charles Carazzo, Amna Hussein, Jahangir Asghar, Alfredo Guiroy","doi":"10.1016/j.bas.2024.102928","DOIUrl":"10.1016/j.bas.2024.102928","url":null,"abstract":"<p><strong>Introduction: </strong>Classifications are helpful for surgeons as they can be a resource for decision-making, often providing the individual indicators that may deem a case necessary for surgery. However, when there are multiple classifications, the decision-making might be compromised. That is the case with C2 fractures. For this reason, this study was designed to review the different classifications of axis fractures.</p><p><strong>Research question: </strong>What are the most commonly used classifications for C2 fractures, and how do these classifications compare in terms of clinical utility?</p><p><strong>Methods: </strong>A systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines was performed. Three different Pub-med searches (https://pubmed.ncbi.nlm.nih.gov/) were done to isolate the most common C2 fracture classifications of odontoid process fractures, the posterior element of the axis and axis body fractures.</p><p><strong>Results: </strong>The search isolated 530 papers. Applying the inclusion and exclusion criteria yielded seven papers on axis body fractures, six on odontoid fractures, and ten on \"hangman's fractures.\" Most of the classifications proposed are modified versions of the classic ones: Benzel's for body fractures, Anderson and D'Alonzo's for odontoid fractures, and Effendi's for \"hangman's fractures.\" The proposal by AO Spine of a different classification seems promising and had good early results of interobserver and intraobserver agreement.</p><p><strong>Discussion and conclusion: </strong>Currently, no classification is universally accepted or widely used. The emergence of the AO Spine Upper Cervical Injury Classification system seems promising as it encompasses radiological and clinical elements.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11415952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302348","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":"Neurosurgical intervention in ultra-severe closed traumatic brain injury: Is it worth the effort?","authors":"Nikolaos Gkantsinikoudis, Iftakher Hossain, Niklas Marklund, Parmenion P Tsitsopoulos","doi":"10.1016/j.bas.2024.102907","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102907","url":null,"abstract":"<p><strong>Introduction: </strong>A subgroup of severe Traumatic Brain Injury (TBI) patients, known as ultra-severe (us-TBI), is most commonly defined as a post-resuscitation Glasgow Coma Scale (GCS) of 3-5. There is uncertainty on whether these critically injured patients can benefit from neurosurgical intervention.</p><p><strong>Research question: </strong>The available evidence regarding the decision-making and outcome following management of us-TBI patients is critically reviewed.</p><p><strong>Material and methods: </strong>Selected databases (PubMed, Google Scholar, Scopus and Cochrane Library) were searched from 1979 to May 2024 for publications on us-TBI patients, with a focus on treatment strategy, mortality and functional outcomes. Inclusion criteria were adult patients >18 years old with closed head trauma and admission post-resuscitation GCS 3-5. Studies were independently assessed for inclusion by two reviewers, and potential disagreements were solved by consensus.</p><p><strong>Results: </strong>Where such data could be extracted, mortality rate was 27-100%, and favorable outcome was observed in 4-30% of us-TBI patients. While early aggressive neurosurgical management was associated with decreased mortality, a high proportion of patients survived with unfavorable functional status.</p><p><strong>Discussion and conclusion: </strong>With supportive care only, outcome of patients with us-TBI is almost universally poor. Early and aggressive neurosurgical intervention in addition to best medical management can lead to favorable functional outcome in selected cases particularly in younger patients with an initial GCS>3 and traumatic mass lesions. There is insufficient data regarding the effectiveness of neurosurgical management on the outcome of us-TBI patients. and the decision to initiate treatment should be based on an individual basis.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11388290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302350","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":"Retraction notice to \"Decency in neurosurgery\" [Brain Spine 4 (2024), 102744].","authors":"Minaam Farooq, Hira Saleem, Amr Badary, Bipin Chaurasia","doi":"10.1016/j.bas.2024.102841","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102841","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1016/j.bas.2023.102744.].</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11166705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312396","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":"Impact of implant removal on quality of life and loss of correction in the treatment of traumatic fractures of the thoracolumbar spine.","authors":"André El Saman, Simon Lars Meier, Florian Rüger, Jason Alexander Hörauf, Ingo Marzi","doi":"10.1016/j.bas.2024.102845","DOIUrl":"10.1016/j.bas.2024.102845","url":null,"abstract":"<p><strong>Background: </strong>Benefit of implant removal in spine surgery remains unclear. While there is mostly consensus about necessity of implant removal in posterior-only stabilized patients, the effect of this measure in cases with combined anterior-posterior stabilization is undetermined. With this work we present a retrospective analysis of 87 patients with traumatic thoracolumbar vertebral fractures concerning quality of life (QOL), loss of correction (LOC) and range of motion (ROM). The effect of implant removal on the outcome 18-74 months after surgery was analyzed to determine how implant removal affects radiologic, functional and quality-of life-related parameters.</p><p><strong>Patients and methods: </strong>87 patients suffering from a traumatic vertebral body fracture (T11 - L2) were included. Quality of life was determined using four different scoring systems (SF 36, VAS, Oswestry, LBOS). Clinical examination included range of motion. Radiologic findings were correlated with QOL.</p><p><strong>Results: </strong>Patients with removal of the internal fixator had a trend towards better range of motion than patients with posterior instrumentation left in place. Radiologic findings showed no correlation to QOL. Implant removal led to better values in Oswestry and SF-36. 69% of patients after removal reported a reduction of their symptoms.All patients with persistence of severe pain after implant removal belonged to subgroup II.2 (anterior monosegmental fusion with bone graft).</p><p><strong>Conclusion: </strong>Removal of the internal fixator can lead to a reduction of symptoms. Patient selection is crucial for successful indication. Radiologic findings do not correlate with QOL.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332628","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":"Under pressure - A historical vignette on surgical timing in traumatic spinal cord injury.","authors":"Paula Valerie Ter Wengel, Florence Reith, Charlotte Y Adegeest, Michael G Fehlings, Brian K Kwon, W Peter Vandertop, Cumhur F Öner","doi":"10.1016/j.bas.2024.102825","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102825","url":null,"abstract":"<p><strong>Introduction: </strong>It was not even a century ago when a spinal cord injury (SCI) would inevitably result in a fatal outcome, particularly for those with complete SCI. Throughout history, there have been extensive endeavours to change the prospects for SCI patients by performing surgery, even though many believed that there was no way to alter the catastrophic course of SCI. To this day, the debate regarding the efficacy of surgery in improving the neurological outcome for SCI patients persists, along with discussions about the timing of surgical intervention.</p><p><strong>Research question: </strong>How have the historical surgical results shaped our perspective on the surgical treatment of SCI?</p><p><strong>Material and methods: </strong>Narrative literature review.</p><p><strong>Results: </strong>Throughout history there have been multiple surgical attempts to alter the course of SCI, with conflicting results. While studies suggest a potential link between timing of surgery and neurological recovery, the exact impact of immediate surgery on individual cases remains ambiguous. It is becoming more evident that, alongside surgical intervention, factors specific to both the patient and their surgical treatment will significantly influence neurological recovery.</p><p><strong>Conclusion: </strong>Although a growing number of studies indicates a potential correlation of surgical timing and neurological outcome, the precise influence of urgent surgery on an individual basis remains uncertain. It is increasingly apparent that, despite surgery, patient- and treatment-specific factors will also play a role in determining the neurological outcome. Notably, these very factors have influenced the results in previous studies and our views concerning surgical timing.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11096936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961334","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":"Under pressure - A historical vignette on surgical timing in traumatic spinal cord injury","authors":"P. V. ter Wengel, Florence Reith, Charlotte Y. Adegeest, M. Fehlings, Brian K. Kwon, W. P. Vandertop, Cumhur F. Öner","doi":"10.1016/j.bas.2024.102825","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102825","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141023399","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}

{"title":"Ethical tightrope: Navigating neuro-ethics in brain computer interface (BCI) technology","authors":"Allah Yar Yahya Khan,&nbsp;Ammar Anjum,&nbsp;Haseeb Mehmood Qadri (Dr)","doi":"10.1016/j.bas.2024.102800","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102800","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000560/pdfft?md5=70f55a8c1ad7c44e72aed5cf7dedab5c&pid=1-s2.0-S2772529424000560-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140342511","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":"Revitalizing neurosurgical frontiers: The EANS frontiers in neurosurgery committee's strategic framework","authors":"Aaron Lawson McLean ,&nbsp;Ignazio G. Vetrano ,&nbsp;Anna C. Lawson McLean ,&nbsp;Alfredo Conti ,&nbsp;Patrick Mertens ,&nbsp;Michael Müther ,&nbsp;Jakob Nemir ,&nbsp;Simone Peschillo ,&nbsp;Antonio Santacroce ,&nbsp;Can Sarica ,&nbsp;Constantin Tuleasca ,&nbsp;Cesare Zoia ,&nbsp;Jean Régis ,&nbsp;EANS Frontiers in Neurosurgery Committee","doi":"10.1016/j.bas.2024.102794","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102794","url":null,"abstract":"<div><h3>Introduction</h3><p>The field of neurosurgery faces challenges with the increasing involvement of other medical specialties in areas traditionally led by neurosurgeons. This paper examines the implications of this development for neurosurgical practice and patient care, with a focus on specialized areas like pain management, peripheral nerve surgery, and stereotactic radiosurgery.</p></div><div><h3>Research question</h3><p>To assess the implications of the expanded scope of other specialties for neurosurgical practice and to consider the response of the EANS Frontiers in Neurosurgery Committee to these challenges.</p></div><div><h3>Materials and methods</h3><p>Analysis of recent trends in neurosurgery, including the shift in various procedures to other specialties, demographic challenges, and the emergence of minimally invasive techniques. This analysis draws on relevant literature and the initiatives of the Frontiers in Neurosurgery Committee.</p></div><div><h3>Results</h3><p>We explore a possible decrease in neurosurgical involvement in certain areas, which may have implications for patient care and access to specialized neurosurgical interventions. The Frontiers in Neurosurgery Committee's role in addressing these concerns is highlighted, particularly in terms of training, education, research, and networking for neurosurgeons, especially those early in their careers.</p></div><div><h3>Discussion and conclusion</h3><p>The potential decrease in neurosurgical involvement in certain specialties warrants attention. This paper emphasizes the importance of carefully considered responses by neurosurgical societies, such as the EANS, to ensure neurosurgeons continue to play a vital role in managing neurological diseases. Emphasis on ongoing education, integration of minimally invasive techniques, and multidisciplinary collaboration is essential for maintaining the field's competence and quality in patient care.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277252942400050X/pdfft?md5=493589aab9b4a8d28af20563039cc3da&pid=1-s2.0-S277252942400050X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140344093","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":"Term and definition of a deformity after a spine trauma: Results of an international Delphi study","authors":"E.E.A. De Gendt ,&nbsp;S.P.J. Muijs ,&nbsp;L.M. Benneker ,&nbsp;F.C. Oner","doi":"10.1016/j.bas.2024.102749","DOIUrl":"10.1016/j.bas.2024.102749","url":null,"abstract":"<div><h3>Introduction</h3><p>Deformity of the spinal column after trauma could lead to pain, impaired function, and may sometimes necessitate extensive and high-risk surgery. This ‘condition’ has multiple terms and definitions that are used in research and clinics. A specific term and definition of this condition however is still lacking. A uniform and internationally accepted term and definition are necessary to compare cases and treatments in the future.</p></div><div><h3>Research question</h3><p>Reach consensus on the term and definition of this deformity after spine trauma using a Delphi approach.</p></div><div><h3>Material and methods</h3><p>An ‘all-rounds invitation’ Delphi process was used in this study among a group of international experts. The first round consisted of an online survey using input from preparatory studies, a typical clinical case and ICD-11 codes. The second round showed the results in-person and discussion was encouraged. Participants voted for rejection of certain terms. In the third round the final vote took place. When &gt;80 % of the votes was for or against a term the term was rejected or accepted.</p></div><div><h3>Results</h3><p>Response rate was high (≥84 %). The 3 Delphi rounds were completed. Unanimous voting led to the acceptance of the term and abbreviation as PSD. Deformity in any plane, pain, impaired function, and neurological deficit, were deemed important to include in the definition of PSD.</p></div><div><h3>Discussion and conclusion</h3><p>Unanimous consensus was reached on ‘Posttraumatic spinal deformity: Condition where a trauma to the spine results in a deformity in any plane and results in pain and an impaired function with or without a neurological deficit.’</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000055/pdfft?md5=623adbd091140a9d72e0de6e597c7e53&pid=1-s2.0-S2772529424000055-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139638243","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":"Sport-related concussion in soccer –a scoping review of available guidelines and a call for action to FIFA & soccer governing bodies","authors":"Andreas K. Demetriades ,&nbsp;Imran Shah ,&nbsp;Niklas Marklund ,&nbsp;Hans Clusmann ,&nbsp;Wilco Peul","doi":"10.1016/j.bas.2024.102763","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102763","url":null,"abstract":"<div><h3>Introduction</h3><p>Sport-related concussions (SRC) have been a concern in all sports, including soccer. The long-term effects of soccer-related head injuries are a public health concern. The Concussion in Sport Group (CISG) released a consensus statement in 2017 and several soccer governing associations have published their own SRC guidelines while referring to it but it is unclear whether this has been universally adopted.</p></div><div><h3>Research question</h3><p>We aimed to investigate whether guidelines published by soccer associations have any discrepancies; and the extent to which they follow the CISG recommendations.</p></div><div><h3>Materials and methods</h3><p>A scoping review of available soccer-specific SRC guidelines was performed via databases PubMed, Google Scholar, and official soccer association websites via web browser Google. The inclusion criteria were soccer-specific SRC guidelines. Comparisons between guidelines were made concerning the following index items: initial (on-site) assessment, removal from play, re-evaluation with neuroimaging, return-to-sport protocol, special populations, and education.</p></div><div><h3>Results</h3><p>Nine soccer associations with available guidelines were included in this review. Guidelines obtained were from official associations in the United Kingdom, United States of America, Canada, Australia, and New Zealand. When compared to each other and the CISG recommendations, discrepancies were found within guidelines regarding the index items. Additionally, major soccer associations in some countries famous for soccer were found to have not published any publicly available guidelines.</p></div><div><h3>Discussion and conclusion</h3><p>SRC guidelines from different soccer associations contain discrepancies which may be detrimental to athletes, both short and long-term. We recommend that all major soccer governing associations publish guidelines that are standardised and accessible to all athletes.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000195/pdfft?md5=7444a396ddee30abda9f8259b2a422b1&pid=1-s2.0-S2772529424000195-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139718464","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}