Brain & spine最新文献

{"title":"Multiple isolated spinal aneurysms – A rare condition with uncertain treatment strategies: A case report and literature review","authors":"F.M.C. Lioi ,&nbsp;D. Dahlberg ,&nbsp;J. Sundseth ,&nbsp;K.B. Olsen ,&nbsp;H.L. Lilleby ,&nbsp;B. Nedregaard ,&nbsp;M.K.H. Wiedmann","doi":"10.1016/j.bas.2025.104192","DOIUrl":"10.1016/j.bas.2025.104192","url":null,"abstract":"<div><h3>Purpose</h3><div>Isolated spinal aneurysms (iSAs) are rare, with an uncertain natural history and no established treatment guidelines. Multiple iSAs are even more uncommon, complicating treatment decisions.</div></div><div><h3>Methods</h3><div>This study reports a case of a ruptured radiculo-pial artery aneurysm in a patient with multiple iSAs, treated with surgical excision, assisted by intraoperative neurophysiological monitoring (IONM). Further, we review and analyze all previously reported cases of multiple iSAs.</div></div><div><h3>Results</h3><div>A 67-year-old woman with spinal subarachnoid hemorrhage and spinal cord compression due to a ruptured radiculo-pial artery aneurysm was treated surgically. Digital subtraction angiography (DSA) showed three spinal aneurysms. Intraoperative indocyanine green video-angiography (ICG-VA) revealed an aneurysm contributing to the left posterior spinal artery. The aneurysm was excised after proximal inflow occlusion under IONM. The other aneurysms spontaneously regressed, and the patient had a good functional outcome. Through a systematic literature review, we analyzed 13 multiple iSAs including our case, involving 34 aneurysms in total.</div></div><div><h3>Conclusions</h3><div>There is no standardized treatment approach for multiple iSAs. These aneurysms are often fusiform and clustered in contiguous metameric regions. They can be classified into flow-related and wall-weakening aneurysms. Surgery offers definitive treatment for ruptured iSAs and relieves spinal cord compression. Due to the common fusiform shape, parent vessel sacrifice may be necessary, and should include IONM and ICG-VA to minimize complications. Conservative treatment is viable as spontaneous regression often occurs.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104192"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101926","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":"Current and emergent therapies targeting spinal cord injury","authors":"Giovanni Grasso,&nbsp;Luigi Cusimano,&nbsp;Manfredi Noto,&nbsp;Rosario Maugeri,&nbsp;Domenico Gerardo Iacopino","doi":"10.1016/j.bas.2025.104243","DOIUrl":"10.1016/j.bas.2025.104243","url":null,"abstract":"<div><div>Spinal cord injury (SCI) is a serious condition characterized by high rates of disability. The complexities of SCI repair arise from intricate pathological mechanisms and the challenges of neural regeneration within the central nervous system. In recent decades, researchers have sought to fully understand these mechanisms and develop effective strategies for promoting axon regeneration and reconstructing neural circuits, though outcomes have often fallen short. Surgical techniques have evolved considerably, with options such as early surgical decompression, effective bony decompression, and expansile duroplasty providing favorable results in enhancing neurological recovery for patients. Accordingly, surgical intervention should be undertaken within 24 h when medically feasible. In addition, there has been a concerted effort to improve non-surgical management, particularly in critical care.</div><div>In pre-clinical settings, a range of innovative therapies is currently being explored, with some showing enough promise to advance to clinical trials. In this regard, the use of riluzole and anti NOGO antibodies has shown promising results from secondary analyses of high quality RCTs. Moreover, technological innovations in biomechanics and bioengineering are playing an essential role in managing SCI with growing emphasis on creating intermediate neural networks to facilitate regeneration and circuit rebuilding.</div><div>This review presents an overview of SCI, current treatments, and illustrates future avenues for SCI repair and clinical application.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104243"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838538","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":"Challenges in studying neuroanatomy in sub-Saharan Africa: The case of Cameroon","authors":"Kelvine Nkenfou ,&nbsp;Nathan Kengo ,&nbsp;Berjo Takoutsing ,&nbsp;Ernestine Renée Bikono Atangana ,&nbsp;Josiane Ngouanfo ,&nbsp;Joy Noumedem ,&nbsp;Nformi Caleb ,&nbsp;Aka Elvira Nkenganyi ,&nbsp;Steve Kamdem ,&nbsp;Karen Yossa ,&nbsp;Roland Nchufor ,&nbsp;Eleonore Ngounou ,&nbsp;Joseph Eloundou Ngah ,&nbsp;Mathieu Motah ,&nbsp;Victor-Claude Eyenga ,&nbsp;Nathalie Ghomsi ,&nbsp;Ignatius Esene","doi":"10.1016/j.bas.2025.104259","DOIUrl":"10.1016/j.bas.2025.104259","url":null,"abstract":"<div><h3>Introduction</h3><div>Quality education is key in addressing the skilled neurological workforce gap in Africa. However, many medics are scared of the neurological sciences because of the challenges faced in medical schools in studying the neurosciences. Understanding its state and educational challenges is crucial for fostering interest in neurosurgery and related specialities on the continent.</div></div><div><h3>Research question</h3><div>What are the current state, challenges, and solutions to improve neuroanatomy education in Cameroon, Africa in miniature?</div></div><div><h3>Materials and methods</h3><div>A cross-sectional study using an 11-item electronic survey was conducted among medical students from all nine medical schools in Cameroon. Data were analysed using descriptive statistics and independent t-tests, with significance set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Among 220 respondents, 40.1 % and 35.0 % respectively, reported cranial nerves/brainstem and neurovascular anatomy to be the most challenging, with a mean comprehension score of 5.83/10. Faculty predominantly relied on PowerPoint lectures (83.2 %), while most students supplemented learning with YouTube videos (77.7 %). 63.9 % of the respondents perceived classroom teaching alone to limit their understanding of neuroanatomy, and 85.8 % of students reported the time allocated for neuroanatomy teaching to be inadequate. The usage of cadaver dissection (69.5 %), and neurosimulation practicals (66.4 %) were the most recommended tools by students to improve neuroanatomy teaching.</div></div><div><h3>Discussion and conclusion</h3><div>Challenges in neuroanatomy education in Cameroon are perceived to arise from insufficient hands-on learning, time constraints, and limited access to specialised faculty. These suggest interactive teaching, increased curriculum time, and diverse resources as potential improvements, though further research is needed to assess their effectiveness and ultimately improve understanding, fostering a stronger neurological workforce.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104259"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859447","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":"Increase in (semi-) acute non-instrumented lumbar spine surgeries during the COVID-19 pandemic","authors":"C.L.C. Gallé ,&nbsp;A.Y.J.M. Smeets ,&nbsp;E.A. Krekels-Huijbregts ,&nbsp;H. van Santbrink ,&nbsp;R.H.L. Haeren","doi":"10.1016/j.bas.2025.104270","DOIUrl":"10.1016/j.bas.2025.104270","url":null,"abstract":"<div><h3>Introduction</h3><div>Due to the COVID-19 pandemic healthcare resources were reallocated, thereby reducing elective surgery capacity. An increase in acute surgeries due to postponed elective surgeries was expected. Since elective lumbar spine surgery for degenerative indications was among the cancelled or postponed surgical interventions, we hypothesized that the number of acute and semi-acute surgeries would increase during the pandemic.</div></div><div><h3>Research question</h3><div>What was the effect of the COVID-19 pandemic on the number of (semi-)acute lumbar spinal surgeries?</div></div><div><h3>Material and methods</h3><div>This prospective cohort study included patients who underwent non-instrumented degenerative lumbar spine surgery, i.e. interlaminar decompression, laminectomy or lumbar microdiscectomy. We distinguished a pre-COVID cohort (between 01.03.2019 and 29.02.2020) and a COVID-cohort (between 01.03.2020 and 28.02.2021).</div></div><div><h3>Results</h3><div>We included 313 patients in the pre-COVID cohort and 194 in the COVID-cohort, reflecting a decline of 38.7 %. The number of (semi-)acute indications increased with 300 % in the COVID-cohort, which was mainly the result of more surgeries for severe and intractable radiculopathy. We also noted an increase in good clinical outcome and a decline in complications in the COVID-cohort.</div></div><div><h3>Discussion and conclusion</h3><div>The number of elective degenerative lumbar spine surgeries declined due to the COVID-19 pandemic, while the rate of (semi)-acute lumbar spinal surgeries increased strongly. The latter may be due to altered patients’ clinical presentations and surgical decision making in times of severe health care scarcity of elective surgical care.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104270"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906275","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":"Cementation strategies in the osteoporotic, metastatic, or ankylosing thoracolumbar spine in older adults: Cement-associated complications and implant failure","authors":"Ulrich J.A. Spiegl ,&nbsp;Philipp Gomon ,&nbsp;Georg Osterhoff,&nbsp;Christoph-E. Heyde,&nbsp;Philipp Pieroh","doi":"10.1016/j.bas.2025.104227","DOIUrl":"10.1016/j.bas.2025.104227","url":null,"abstract":"<div><h3>Background</h3><div>Although cement augmentation of pedicle screws increases stability, complications, such as pulmonary embolism, must be considered. One possible approach to minimize complication risk is not augmenting all pedicle screws. It remains unclear whether full augmentation is necessary or if restricted cement augmentation is sufficient regarding cement-associated complications, implant failure, or adjacent fractures.</div></div><div><h3>Research question</h3><div>Is there a difference in cement-associated complications, implant failure rate, and revision rates in non-cemented, fully augmented, and restricted cement-augmented long-segment posterior stabilization of the thoracolumbar spine?</div></div><div><h3>Methods</h3><div>In a single-center retrospective observational study, patients aged ≥60 years who underwent pedicle screw fixation of ≥3 segments in the thoracic/lumbar spine treating an osteoporotic fracture, metastatic lesion, or ankylosing spondylitis fracture were enrolled and categorized into no, full, and restricted cementation groups. Demographics, cement-associated complications, revision surgeries, implant failures, adjacent fractures, and other complications were also recorded.</div></div><div><h3>Results</h3><div>Cement leakage rate was significantly higher in the full than in the restricted cementation group (p &lt; 0.05), with no sign of pulmonary embolism in either group. Patients with osteoporotic fractures experienced implant failure and adjacent fractures significantly more frequently than those with other pathologies (p &lt; 0.05). In the full cementation group, the rate of screw cut-out with fractures of the last instrumented vertebra and adjacent fractures was the highest (p &lt; 0.05).</div></div><div><h3>Discussion and conclusion</h3><div>Restricted cementation does not result in a higher rate of complications, particularly cement-associated complications, screw cut-out, or implant failure, and appears more favorable than full cementation.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104227"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890684","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":"Treatment decisions for intermediate-sized brain metastases in or near the motor cortex among the neuro-oncology community","authors":"C.A.C. Jessurun ,&nbsp;D. Brandsma ,&nbsp;A. Compter ,&nbsp;P.C. de Witt Hamer ,&nbsp;R.J.A. Nabuurs ,&nbsp;A. Kloet ,&nbsp;M.L.D. Broekman ,&nbsp;P.V. ter Wengel","doi":"10.1016/j.bas.2025.104278","DOIUrl":"10.1016/j.bas.2025.104278","url":null,"abstract":"<div><h3>Purpose</h3><div>Currently, there is lack of consensus regarding the optimal treatment strategy (surgery versus radiotherapy) for intermediate-sized (2–4 cm) brain metastases (BM), especially those located in or near the motor cortex. This survey aims to gain insight into treatment decisions for these BM among the Dutch multidisciplinary neuro-oncology community.</div></div><div><h3>Methods</h3><div>An electronic survey was distributed among neurosurgeons, radiation oncologists, neurologists, and medical oncologists in The Netherlands. The survey comprised 13 questions regarding physician's practices and questions about treatment decisions for BM in or near the motor cortex using statements and three theoretical patient cases.</div></div><div><h3>Results</h3><div>Tumor size (n = 34, 89 %), degree of neurological deficit (n = 31, 82 %), and the need for (temporarily) discontinuation of immunotherapy because of dexamethasone dependence (n = 30, 79 %) were highlighted as the most important factors to steer the treatment decision to radiotherapy or surgery. When divided by specialty, 15 neurologists (33 %), 14 radiation oncologists (30 %), 12 neurosurgeons (26 %), and 5 medical oncologists (11 %), some variability about the importance of factors exists. The respondents suggested a median cutoff size of 3,5 cm for conducting surgery on BM.</div></div><div><h3>Conclusion</h3><div>Surgical resection is preferred in patients with larger tumors, with neurologic symptoms that are unresponsive to dexamethasone, and in patients receiving immunotherapy. Future investigations should compare the effectiveness of surgical resection and stereotactic radiosurgery, and the effects on survival and quality of life in patients with BM in or near the motor cortex in a prospective and preferable randomized manner.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104278"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072740","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":"Fusion of 3D photorealistic lateral-to-medial brain white matter dissection and diffusion tensor imaging for dynamic visualization of key fiber tracts","authors":"Daniele Armocida ,&nbsp;Toma Spiriev ,&nbsp;Milko Milev ,&nbsp;Francesco Carbone ,&nbsp;Michael Wolf-Vollenbröker ,&nbsp;Michael Sabel ,&nbsp;Marion Rapp ,&nbsp;Jan Frederick Cornelius","doi":"10.1016/j.bas.2025.104261","DOIUrl":"10.1016/j.bas.2025.104261","url":null,"abstract":"<div><h3>Introduction</h3><div>Knowledge of fiber tract organization is vital for understanding brain connectivity and function. Integrating traditional anatomical dissection with advanced imaging methods like diffusion tensor imaging (DTI) and 3D-photographic surface scanning (photogrammetry) provides detailed visualization of white matter (WM) pathways. However, both modalities are typically presented as separate 3D-models. This study presents photorealistic 3D photogrammetric models of lateral-to-medial dissections of clinically relevant fiber tracts combined with 3D DTI fiber tract data.</div></div><div><h3>Research question</h3><div>Can the integration of photorealistic 3D photogrammetric models and DTI data enhance the understanding of WM fiber tract anatomy and improve its educational and neurosurgical applications?</div></div><div><h3>Material and methods</h3><div>One brain fixed using Klingler's method was dissected. Stepwise identification of the arcuate, superior longitudinal, inferior fronto-occipital fasciculi, uncinate fascicle, anterior commissure, Mayer's loop, and the internal capsule was documented with detailed 3D-photogrammetric models generated at each dissection step. Relevant fiber tracts were also generated from population-averaged DTI data using open-access databases and software.</div></div><div><h3>Results</h3><div>Seven photorealistic models and five integrated DTI-photogrammetry fusion 3D models were produced. Data fusion in 3D software enabled integrated models showing spatial relationships and boundaries between fiber tracts, adjustable by viewing angle and opacity changes. Combining photogrammetry with DTI-segmentation added educational value for understanding 3D-localization and fiber tract trajectories.</div></div><div><h3>Discussion and conclusion</h3><div>The photogrammetric models and DTI data presented enhance the comprehension of critical WM fiber tracts, benefiting education and surgical planning. Customizable views allow straightforward comparisons between Klingler dissection models and fully explorable DTI models, providing a comprehensive understanding of WM anatomy.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104261"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923457","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":"Complications and risk factors of endoscopic third ventriculostomy: A 10-year single-centre study and systematic literature review","authors":"Einar Naveen Møen ,&nbsp;Christian André Helland ,&nbsp;Rupavathana Mahesparan","doi":"10.1016/j.bas.2025.104291","DOIUrl":"10.1016/j.bas.2025.104291","url":null,"abstract":"<div><h3>Introduction</h3><div>Endoscopic third ventriculostomy is considered a safe and low-risk treatment of obstructive hydrocephalus. No systematic review has been conducted recently to establish benchmarks for success and complication rates. This knowledge gap makes it difficult to evaluate local institutional performance against international results.</div></div><div><h3>Research question</h3><div>What are the results of endoscopic third ventriculostomy for obstructive hydrocephalus in the literature, and how does it compare to the results of our medium-sized neurosurgical center?</div></div><div><h3>Material and methods</h3><div>We performed a retrospective case series of patients treated at the Department of Neurosurgery, Haukeland University Hospital, from January 1, 2013, to December 31, 2023. A systematic review was performed in accordance with the PRISMA guidelines.</div></div><div><h3>Results</h3><div>Our case series consisted of 127 patients in a mixed-age cohort (mean: 37.3, range: 0–86) treated with endoscopic third ventriculostomy for hydrocephalus the last ten years. Previous shunting and neurosurgery were identified as risk factors for endoscopic third ventriculoscopy failure. In our systematic review, we found 64 reports with a total of 8409 patients eligible for inclusion. A higher success rate (78.7%) and complication rate (21.3%) were found in our patient material compared to the findings in our systematic review (respectively 73.4% and 11.6%). All complications in our material were transient and did not cause any permanent morbidity.</div></div><div><h3>Discussion and conclusions</h3><div>Endoscopic third ventriculostomy has a favorable safety profile with high success rates in the treatment of obstructive hydrocephalus. Results from our systematic review can be used for internal audits at other neurosurgical centers.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104291"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204383","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":"Management of hydrocephalus associated with large vestibular schwannomas","authors":"Leslie Lemnos ,&nbsp;Lucas Troude ,&nbsp;Mohamed Boucekine ,&nbsp;Stéphane Gargula ,&nbsp;Anne Balossier ,&nbsp;Jean Régis ,&nbsp;Pierre-Hugues Roche","doi":"10.1016/j.bas.2025.104318","DOIUrl":"10.1016/j.bas.2025.104318","url":null,"abstract":"<div><h3>Introduction</h3><div>Some patients with vestibular schwannoma (VS) may present with hydrocephalus.</div></div><div><h3>Research question</h3><div>In such cases, some authors suggest cerebrospinal fluid (CSF) shunting, while others prefer tumor removal from the outset.</div></div><div><h3>Material and methods</h3><div>In our study, we retrospectively compared patients for whom we chose to treat the hydrocephalus with CSF shunting and those for whom VS surgery was performed first.</div></div><div><h3>Results</h3><div>Among a group of n consecutive patients harboring a stage 3 and 4 VS and eligible for resection, 34 patients presented with hydrocephalus. Thirteen patients underwent CSF shunting (group 1). Twenty-one patients had their VS removed first (group 2). Among the latter group, 18 patients had resolution of hydrocephalus. There was a significant difference between group 1 and 2 in the presence of signs of intracranial hypertension (p = 0.00), preoperative tumor volume (p = 0.04).</div><div>Previous radiosurgery and a strong adherence of the tumor capsule to the brain were statistically associated with requirement of CSF shunting (p = 0.01).</div></div><div><h3>Discussion and conclusion</h3><div>The results of this study suggest that VS patients presenting with a well-tolerated hydrocephalus should be preferentially treated of their schwannoma with rare need for a shunt.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104318"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579379","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":"The effect of 3D virtual surgical planning in sacroiliac joint fusion","authors":"Nick Kampkuiper ,&nbsp;Asal Abkar ,&nbsp;Jorm Nellensteijn ,&nbsp;Marjolein Brusse‐Keizer ,&nbsp;Gabriëlle Tuijthof ,&nbsp;Maaike Koenrades ,&nbsp;Femke Schröder","doi":"10.1016/j.bas.2025.104334","DOIUrl":"10.1016/j.bas.2025.104334","url":null,"abstract":"<div><h3>Background</h3><div>Sacroiliac (SI) dysfunction causes of up to 30 % of lower back pain. When conservative treatment is insufficient, SI joint fusion (SIJF) can be indicated to reduce pain. Due to high anatomical variability, poor visibility during intraoperative 2D fluoroscopic imaging, and the absence of 3D spatial information, placing the implant in a stable configuration without damaging critical structures is challenging. To improve patient outcomes, a virtual surgical planning (VSP) method using simulated fluoroscopic images has been developed.</div></div><div><h3>Research question</h3><div>What is the effect of VSP on patient outcomes, including complications, pain scores, satisfaction scores, and Oswestry Disability Index (ODI) scores?</div></div><div><h3>Methods</h3><div>This retrospective case-control study compared procedures performed with VSP to those conducted prior to its implementation. Data were collected from the medical records, Numeric Rating Scale (NRS) questions, and patient reported outcome measures (PROMs). All postoperative CT scans were assessed on implant placement (mal)positioning and fractures. Malposition complications were categorized as severe malposition and suboptimal implant placement.</div></div><div><h3>Results</h3><div>Seventy-eight procedures were included, 43 in the VSP group and 35 in the conventional group. Severe malposition complications reduced from 9 % to 0 % after VSP was implemented. Suboptimal implant placement reduced from 46 % to 9 % of the interventions. Sacral fractures reduced from 37 % to 14 %. All other primary outcome measures did not show a significant difference between the groups.</div></div><div><h3>Conclusions</h3><div>VSP in SIJF reduced implant malpositioning and sacral fractures. This can lead to better patient outcomes. A larger multicenter study is needed to explore the broader impact of VSP on SIJF.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104334"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711281","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}