Brain & spine最新文献

{"title":"From knife to needle - the trend of vascular neurosurgery in Belgium.","authors":"Jorn Van Der Veken, Vera Van Velthoven, Gilles Reuter, Steven De Vleeschouwer, Tomas Menovsky, Johnny Duerinck, Michaël Bruneau","doi":"10.1016/j.bas.2024.104158","DOIUrl":"10.1016/j.bas.2024.104158","url":null,"abstract":"<p><strong>Introduction: </strong>The management of neurovascular pathologies has changed globally over the last few decades. Endovascular treatments are increasing, and fewer surgical procedures are performed.</p><p><strong>Research question: </strong>Evaluate the evolution of vascular neurosurgery in Belgium over the last 30 years and compare with other countries.</p><p><strong>Material and methods: </strong>Belgian nationwide data was obtained from 1991 to 2021 via the National Institute for Health and Disability Insurance (INAMI-RIZIV). Cost of surgical and endovascular implants used in 2022 was obtained.</p><p><strong>Results: </strong>Over a 30-year period a total of 37,504 procedures were performed in Belgium, consisting of 13,767 (36.7%) surgeries and 23,737 (63.3%) endovascular treatments (EVT).Adjusted to population per 100000, surgical management peaked at 6.02 in 1996 and gradually dropped below 3.0 in 2019. EVT increased from 1.06 in 1991 to 10.5 in 2021.Important regional differences are seen in terms of total number of procedures as well as ratio of surgery to endovascular surgery.The total cost of surgical implants in 2022 was the equivalent of 1% of the total cost of endovascular implants.</p><p><strong>Discussion and conclusions: </strong>This data confirms a similar trend to other regions in the world: a reduction in surgical management and increase in endovascular management for CNS vascular pathologies.Important regional differences are noted in terms of volume and ratio of endovascular to surgery.A nationwide registry based on patient data and outcomes can help decide whether there should be centralization to manage vascular pathologies.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104158"},"PeriodicalIF":1.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973670","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":"Bio-ethical considerations in the application of artificial intelligence in spinal surgery.","authors":"B Bhavani Sowndharya, C M Mathan Muthu, A S Vickram, A Saravanan","doi":"10.1016/j.bas.2024.104161","DOIUrl":"10.1016/j.bas.2024.104161","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104161"},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985655","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":"Kinematic limitations during stair ascent and descent in patients with adult spinal deformity.","authors":"Marc Fakhoury, Rami Rachkidi, Karl Semaan, Krystel Abi Karam, Maria Saadé, Elma Ayoub, Celine Chaaya, Ali Rteil, Elena Jaber, Elio Mekhael, Nabil Nassim, Mohamad Karam, Julien Abinahed, Ismat Ghanem, Abir Massaad, Ayman Assi","doi":"10.1016/j.bas.2024.104153","DOIUrl":"https://doi.org/10.1016/j.bas.2024.104153","url":null,"abstract":"<p><strong>Background: </strong>Adults with spinal deformity (ASD) are known to have spinal malalignment, which can impact their quality of life and their autonomy in daily life activities. Among these tasks, ascending and descending stairs is a common activity of daily life that might be affected.</p><p><strong>Research question: </strong>What are the main kinematic alterations in ASD during stair ascent and descent?</p><p><strong>Methods: </strong>112 primary ASD patients and 34 controls filled HRQoL questionnaires and underwent biplanar X-from which spino-pelvic radiographic parameters were calculated. Patients were divided into 3 groups: 44 with sagittal malalignment (ASD-Sag: PT > 25°, SVA>5 cm or PI-LL>10°), 42 with isolated thoracic hyperkyphosis (ASD-HyperTK: TK > 60°), 26 with isolated frontal spine deformity (ASD-Front: Cobb>20°). All participants underwent 3D motion analysis of the whole body while ascending and descending a stair step from which kinematic waveforms were extracted.</p><p><strong>Results: </strong>During stair ascent, ASD-Sag exhibited an increased thorax flexion (20 vs 5°), a decreased lumbar lordosis L1L3-L3L5 (7 vs 14°), and an increased ROM of lumbo-pelvic joint (15 vs 10°, all p < 0.05), compared to controls. Similar compensations were shown while descending the stairstep. ASD-HyperTK had similar kinematic limitations as ASD-Sag but to a lesser extent. ASD-Front had normal kinematic patterns. PCS-SF36 correlated to thorax flexion (r = -0.45) and ODI was correlated to pelvic tilt ROM (r = 0.46).</p><p><strong>Discussion and conclusion: </strong>ASD subjects with sagittal malalignment tend to ascend and descend stairs with increased thorax flexion, making them more prone to falls. Compensation mechanisms occur at the head and lumbo-pelvic levels to maintain balance and avoid falling forward.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104153"},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933954","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":"Lumbar disc space height in relation to neural foraminal dimensions and patient characteristics: A morphometric analysis from L1-S1 using computed tomography.","authors":"David Shin, Ethan Vyhmeister, Daniel Im, Andrew Fay, Owen Faehner, Andrew Cabrera, Alexander Bouterse, Lauren Seo, Derran Bedward, Mei Carter, Davis Carter, Jacob Razzouk, Omar Ramos, Nathaniel Wycliffe, Wayne Cheng, Olumide Danisa","doi":"10.1016/j.bas.2024.104162","DOIUrl":"https://doi.org/10.1016/j.bas.2024.104162","url":null,"abstract":"<p><strong>Introduction: </strong>The normative relationship between lumbar intervertebral disc space height (DSH) and neuroforaminal dimensions (NFD) has yet to be defined.</p><p><strong>Research question: </strong>The purpose of this study was to investigate the relationship between lumbar DSH and NFD using computed tomography (CT), accounting for influences of patient demographic and anthropometric characteristics.</p><p><strong>Materials and methods: </strong>We analyzed CT imaging of 350 female and 350 male patients. Anterior, middle, and posterior DSH were measured. NFD were defined as sagittal anterior-to-posterior (AP) width, axial AP width, foraminal height, and area. Statistical analyses were performed to assess associations among DSH, NFD, and patient height, weight, body mass index, sex, and ethnicity.</p><p><strong>Results: </strong>Irrespective of disc level, mean anterior, middle, and posterior DSH were 7.98 mm (n = 3500), 8.16 mm (n = 3500), and 4.09 mm (n = 3500). DSH measurements demonstrated increasing, linear trends moving caudally from L1-L2 to L5-S1, while NFD demonstrated a unimodal distribution pattern with largest NFD at L3-L4 and smallest NFD at L1-2 and L5-S1. Male patients demonstrated larger DSH compared to female patients from L1-S1. Asian patients demonstrated taller DSH across all levels L1-S1.</p><p><strong>Discussion and conclusion: </strong>This study describes 38,500 CT-based L1-S1 DSH and NFD in young patients without spinal pathology. DSH follows an increasing trend moving caudally from L1-S1, while NFD demonstrate a unimodal distribution clustered at L3-L4. NFD are not moderately or strongly associated with DSH. DSH is influenced by sex and ethnicity but is not moderately or strongly influenced by patient height, weight, and BMI.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104162"},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933971","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":"Answer to the letter to the editor concerning \"Current state of preoperative embolization for spinal metastasis - A survey by the EANS spine section\".","authors":"S Motov, F Stengel, F Ringel, O Bozinov, M N Stienen","doi":"10.1016/j.bas.2024.104160","DOIUrl":"10.1016/j.bas.2024.104160","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104160"},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985652","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 influence of government-issued lockdowns during the COVID-19 pandemic on traumatic brain injuries in Tyrol, Austria.","authors":"Victoria Schön, Alina Farbmacher, Lukas Grassner, Barbara Klein, Claudius Thomé, Daniel Pinggera","doi":"10.1016/j.bas.2024.104159","DOIUrl":"10.1016/j.bas.2024.104159","url":null,"abstract":"<p><strong>Introduction: </strong>In February 2020, COVID-19 infections started to spread in Austria. This was followed by governmental actions and constraints such as lockdowns, quarantine protocols, and a ban on outdoor sports. The goal of this study was to investigate the influence of these measures on the number of traumatic brain injuries (TBI) in the state of Tyrol.</p><p><strong>Methods: </strong>The incidence of TBI during lockdowns and restrictions of outdoor activities in 2020 and 2021 were compared with corresponding periods in previous years. The data was retrospectively collected and analyzed.</p><p><strong>Results: </strong>During the first lockdown in the winter of 2020/2021, there was a notably lower incidence of moderate and severe TBIs compared to the corresponding period in 2019/2020 (p = 0.016). Similarly, there was a reduction in TBIs from sports accidents during this period (p = 0.010). However, when comparing other lockdown periods to the previous years, no differences were observed.</p><p><strong>Conclusion: </strong>The various governmental measures restricting mobility aimed to contain the COVID-19 pandemic but showed little influence on the number of TBI cases. Only a lockdown in the accident-prone winter months has influenced the incidence of TBIs.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104159"},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973694","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":"Recommendations on the management of meningioma and sex hormone therapy: The results of a collaborative effort between neurosurgical, endocrine and gynecological societies.","authors":"Gilles Reuter, Iulia Potorac, Carlien de Herdt, Linda Ameryckx, Géraldine Brichant, Sébastien Froelich, Bertrand Baussart, Steven De Vleeschouwer, Tomas Menovsky, Tony Van Havenberghe, Patrice Finet, Michael Bruneau, Axelle Pintiaux","doi":"10.1016/j.bas.2024.104154","DOIUrl":"10.1016/j.bas.2024.104154","url":null,"abstract":"<p><strong>Introduction: </strong>Exogenous and endogenous sex hormones, especially Progesterone agonists, may be causally linked to meningioma progression. Cessation of treatment leads to stabilization or regression of Progestin-induced meningioma. In many cases, avoiding sex hormone therapy may be possible in the context of meningioma treatment. However, hormonal treatment is not always easily replaceable and concise real-world recommendations regarding sex hormones and meningioma are lacking.</p><p><strong>Material and methods: </strong>A combined effort was initiated between Neurosurgical, Gynaecological and Endocrinological societies of Belgium to gather relevant information regarding sex hormone therapies and meningioma. After complete literature review, consensual recommendations were established.</p><p><strong>Results: </strong>Collegial recommendations regarding sex hormones therapies and meningioma in the context of oral contraceptives, menopause hormonal treatment, fertility treatment, pregnancy and gender-affirming therapies are emitted and nuanced.</p><p><strong>Discussion and conclusion: </strong>Withdrawal and monitoring of sex hormone therapies are discussed in detail.A decision tree regarding Meningioma and Combined contraception, Progestin Contraception, Menopause Hormonal treatment, Progestin and Gender-affirming therapy is suggested.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104154"},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973691","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":"Knowledge, interest and perspectives on Artificial Intelligence in Neurosurgery. A global survey.","authors":"A Boaro, E Mezzalira, F Siddi, C Bagattini, N Gabrovsky, N Marchesini, M Broekman, F Sala","doi":"10.1016/j.bas.2024.104156","DOIUrl":"10.1016/j.bas.2024.104156","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial Intelligence (AI) applications in healthcare are growing exponentially. The field of neurosurgery is particularly suited to implement AI solutions given its technology-driven nature. It is of paramount importance to understand the basics of AI to make informed decision on how to shape current and future applications.</p><p><strong>Research question: </strong>What is the level of confidence, knowledge and the attitude of the global neurosurgical community towards AI basic concepts and applications?</p><p><strong>Material and methods: </strong>A 24-item survey was designed and distributed. The survey results reported on level of knowledge, confidence and interest in AI, perspectives and attitude towards the application of AI technologies in neurosurgery. The potential influence of demographics and work-related environment features on AI knowledge was investigated.</p><p><strong>Results: </strong>We received a total of 250 responses from 61 countries. The correct definition of 'Machine Learning', 'Deep Learning' and main Big Data features were identified by respectively 42%, 23% and 23% of the respondents. The survey unveiled a strong interest and a positive attitude towards the introduction of AI in the neurosurgical practice. The main concerns included trustworthiness and liability, the main barriers to implementation were considered lack of funding, infrastructure, knowledge and multidisciplinary collaboration.</p><p><strong>Discussion and conclusion: </strong>There is a low familiarity with basic AI concepts in the neurosurgical community. Nevertheless, there is a strong interest and a positive attitude towards AI implementation. The systematization of training and the production of educational resources will be key in guaranteeing a successful implementation of AI in the evolving history of neurosurgery.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104156"},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973672","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 the editor \"Treatment-limiting decisions in patients with severe traumatic brain injury in the Netherlands\".","authors":"Sadia Farhana","doi":"10.1016/j.bas.2024.104157","DOIUrl":"https://doi.org/10.1016/j.bas.2024.104157","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104157"},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933955","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 identification of low-pathogenic bacteria on removed spinal implants and implications for antimicrobial prophylaxis.","authors":"Ann-Kathrin Joerger, Vicki M Butenschoen, Susanne Feihl, Sebastian Rühling, Jan S Kirschke, Bernhard Meyer, Sandro M Krieg","doi":"10.1016/j.bas.2024.104152","DOIUrl":"10.1016/j.bas.2024.104152","url":null,"abstract":"<p><strong>Introduction: </strong>The role of low-pathogenic bacteria cultured from removed spinal implants is unclear and the efficacy of perioperative single-dose antibiotics against such bacteria remains underexplored.</p><p><strong>Research question: </strong>This study aims to investigate whether pedicle screw loosening is associated with pathogens and if the choice of perioperative antibiotics can prevent these bacteria.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 93 patients with implants removed between 01/01/2018 and 03/31/2020. Patients with both loosened and non-loosened implants were included. The latter group was subdivided into cases where implants were exchanged due to adjacent segment degeneration (ASD) and those with elective implant removal after fracture healing. Bacterial cultures from removed implants were analyzed for resistance profiles against the prophylactic single-shot antibiotics administered during implantation. Patients with acute infection, spondylodiscitis, deep wound infection, empyema, and carbon/polyetheretherketone spinal implants were excluded.</p><p><strong>Results: </strong>Bacterial isolates were detected in both loosened (41%) and non-loosened (27%) implants (p = 0.23). The most frequently cultivated bacteria were <i>Cutibacterium acnes</i> and <i>Staphylococcus epidermidis</i>. Sensitivity to the administered antibiotics was 75%. While <i>Cutibacterium acnes</i> was entirely sensitive, <i>Staphylococcus epidermidis</i> was completely resistant. Patients with loosened implants without bacteria had a significantly lower bone mineral density (BMD) than patients with implants removed due to ASD. However, patients with loosened implants and positive bacterial cultures had comparable BMD to ASD patients.</p><p><strong>Conclusions: </strong>The high rate of sensitive <i>Cutibacterium acnes</i> and resistant <i>Staphylococcus epidermidis</i> on removed spinal implants suggests a need to revisit current antimicrobial prophylaxis. Further research is required to determine the clinical significance of low-virulence bacteria, especially on non-loosened implants.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"104152"},"PeriodicalIF":1.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916418","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}