Acta Neurochirurgica最新文献

{"title":"Comparative analysis of endovascular treatment methods for anterior choroidal aneurysms: single center study with 80 aneurysms","authors":"Yigit Can Senol,&nbsp;Halis Emre Ciftci,&nbsp;Zeynep Gence Oz,&nbsp;Dilara Duman,&nbsp;Bige Sayin,&nbsp;Ilkay Akmangit,&nbsp;Musa Onur Ozbakir,&nbsp;Denizhan Divanlioglu,&nbsp;Ahmet Deniz Belen,&nbsp;Ergun Daglioglu","doi":"10.1007/s00701-025-06647-9","DOIUrl":"10.1007/s00701-025-06647-9","url":null,"abstract":"<div><h3>Purpose</h3><p>Anterior choroidal artery (AChoA) aneurysms are rare and pose a significant treatment challenge due to the artery’s small caliber and critical vascular territory. Endovascular treatment (EVT) has become a preferred approach, but optimal management strategies remain debated. This study compares the efficacy and safety of different EVT techniques, including primary coiling, stent-assisted coiling (SAC), and flow diversion (FD), in treating AChoA aneurysms.</p><h3>Methods</h3><p>Patients were categorized by endovascular technique, aneurysm morphology, and rupture status. Angiographic occlusion rates were assessed using the Raymond-Roy Occlusion Scale (RROS), and clinical outcomes were measured via the Modified Rankin Scale (mRS) at discharge and follow-ups. Statistical analyses compared occlusion rates, procedural complications, and functional outcomes among treatment groups.</p><h3>Results</h3><p>In this study, 60 patients with 80 anterior choroidal artery aneurysms were treated. Among these, 44 aneurysms (55%) were classified as dependent, meaning the choroidal branch arose from the aneurysm dome or neck, while 36 aneurysms (45%) were independent, originating from the carotid artery near the choroidal branch. Primary coiling was used in 29 cases, stent-assisted coiling (SAC) in 21, and flow diversion (FD), with or without additional coiling, in 30 cases. Complete occlusion rates were significantly higher with SAC (83.3%) and FD (76.1%) compared to primary coiling (31.8%) (p &lt; 0.05). Flow diversion was associated with more technical complications (25%), and ischemic events were more common in dependent aneurysms (p &lt; 0.05). Importantly, no cases of symptomatic AChoA occlusion occurred after FD treatment. The overall mortality rate was 5%, with all deaths occurring in the primary coiling group among patients with ruptured aneurysms.</p><h3>Conclusion</h3><p>EVT of AChoA aneurysms is effective, with SAC and FD demonstrating superior occlusion rates compared to primary coiling. FD carries a higher risk of technical complications but maintains AChoA patency. To optimize outcomes, treatment choice should be guided by aneurysm morphology and patient risk factors.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06647-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial pressure changes during early postoperative mobilization in patients with chronic subdural hematoma","authors":"Anders Schack MD,&nbsp;Markus Harboe Olsen MD, PhD,&nbsp;Jonathan Truels Hansen BSc,&nbsp;Anna Søgaard Magnussen MD,&nbsp;Ida Møller Larsen RN-ICU, BSc,&nbsp;Helene Ravnholt Jensen RN-ICU, CSci-Health,&nbsp;Marianne Juhler MD, DMSc,&nbsp;Alexander Lilja-Cyron MD, PhD,&nbsp;Kåre Fugleholm MD, PhD, DMSc,&nbsp;Thorbjørn Søren Rønn Jensen MD, PhD","doi":"10.1007/s00701-025-06655-9","DOIUrl":"10.1007/s00701-025-06655-9","url":null,"abstract":"<div><h3>Background</h3><p>Passive subdural drainage is used to reduce the risk of chronic subdural hematoma (cSDH) recurrence and mortality. However, the effects of patient positioning on intracranial pressure (ICP) during passive drainage remain unclear.</p><h3>Objective</h3><p>To examine how subdural drainage and patient positions influence postoperative ICP in cSDH patients with a subdural passive drainage system.</p><h3>Methods</h3><p>This was a prospective, single-center observational cohort study. Eleven patients (mean age 78 years) underwent burr hole evacuation for cSDH with placement of a subdural drain connected to a bile bag system. An ICP probe was placed in the subdural space posteriorly via the same burr hole. During the first 48 h, ICP was measured in supine, 30° head elevation, and sitting positions before and after removal of the subdural drain. Given the small sample size, the study was a priori considered hypothesis‑generating; the width of confidence intervals and potential type II error are therefore emphasised throughout. Also, the associations between ICP and radiographic parameters (midline shift, hematoma size, pneumocephalus) were assessed.</p><h3>Results</h3><p>When all positions were combined, mean ICP with the drain in situ was − 2.5 (− 4.8 to − 0.2) mmHg versus − 0.5 (− 2.9 to 1.9) mmHg after removal (<i>p</i> = 0.233). Position-specific differences after vs before removal were likewise small and non-significant: supine -1.9 (-7.8 to 4.1, <i>p</i> = 0.537), 30° -2.6 mmHg (-8.5 to 3.3, <i>p</i> = 0.378), sitting -3.6 (-9.8 to 2.6, <i>p</i> = 0.244) mmHg; mixed-effects modelling confirmed these findings.</p><p>Greater midline shift and hematoma volume were associated with higher ICP, whereas larger pneumocephalus volumes correlated with lower ICP.</p><h3>Conclusions</h3><p>After burr-hole evacuation of cSDH, ICP remained within normal physiological limits across all head positions, both with the subdural drain in situ and after its routine removal at 24 h. Providing that the drainage height is adjusted to the pivot point for CSF pressure at shoulder level, mobilization—even to the upright position—did not provoke dangerously low ICP. These data, together with emerging randomised evidence, support early mobilisation after cSDH surgery; nonetheless, confirmation in adequately powered multicentre trials is required before firm practice recommendations can be issued.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06655-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of growing skull fractures: How I do it","authors":"Manina M. Etter,&nbsp;Tamara Vernik,&nbsp;Maria Licci,&nbsp;Raphael Guzman,&nbsp;Jehuda Soleman,&nbsp;Ladina Greuter","doi":"10.1007/s00701-025-06646-w","DOIUrl":"10.1007/s00701-025-06646-w","url":null,"abstract":"<div><h3>Background</h3><p>Growing skull fractures (GSF) represent a rare complication following linear traumatic skull fractures with an underlying dural tear, mainly occurring during infancy and early childhood. GSF can cause encephalocele, hydrocephalus, or encephalomalacia, potentially leading to long-term neurological sequelae. Therefore, prompt diagnosis and early treatment is paramount.</p><h3>Methods</h3><p>We outline our surgical reconstruction technique for managing GSF.</p><h3>Conclusion</h3><p>GSF is effectively treated with a dural and bony reconstruction, using a fast-resorbable polymer mesh.\u0000</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06646-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing matters: evaluating lateral spreads response disappearance as a prognostic marker in microvascular decompression for hemifacial spasm: a phenomenological study","authors":"Ahmed Al Menabbawy,&nbsp;Marie Eisold,&nbsp;Ehab El Refaee,&nbsp;Ina Lange,&nbsp;Ines Peters,&nbsp;Marc Matthes,&nbsp;W. S. Schroeder","doi":"10.1007/s00701-025-06642-0","DOIUrl":"10.1007/s00701-025-06642-0","url":null,"abstract":"<div><h3>Purpose</h3><p>Prognostic significance of lateral spreads response (LSR) disappearance in microvascular decompression (MVD) for hemifacial spasm (HFS) remains controversial. Still the timing of LSR disappearance and its association with overall outcomes has not been sufficiently investigated. We evaluate the prognostic significance of the timing of LSR disappearance during MVD in HFS.</p><h3>Methods</h3><p>Prospective documentation of the LSR-Status during the procedural steps was performed alongside routinely collected data. Surgical steps were categorized into three phases: Opening phase (skin incision till cisternal opening), arachnoid dissection, and actual Decompression phase. Outcome assessment was conducted after a follow-up period of at least 12 months, with favorable outcome defined as at least 90% resolution of the spasms.</p><h3>Results</h3><p>214 patients were included with a mean age (SD) of 54.9 ± 11.6 years and a follow-up duration (SD) of 25.8 ± 15.7 months. The male-to-female ratio was 1:1.6. LSR was \"not detected\" in 32 patients (15.0%), with a 93.8% favorable outcome. LSR \"persisted\" in 22 patients (10.3%), showing only 77.3% favorable outcome. In 16 patients (7.4%), LSR disappeared during the opening phase, yielding a 100% favorable outcome. LSR disappearance occurred during arachnoid dissection in 40 patients (18.7%), with a 91.1% favorable outcome. Finally, LSR disappearance following nerve decompression was observed in 104 patients (48.6%), showing a 78.9% favorable outcome. Earlier disappearance of the LSR was associated with long-term cure (P-value &lt; 0.05).</p><h3>Conclusion</h3><p>LSR may serve as a valuable intraoperative indicator during MVD for HFS. Early intraoperative disappearance of the LSR may predict favorable long-term outcomes. However, the disappearance of the LSR in general does not consistently correlate with surgical success.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06642-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of acute alcohol intoxication and alcohol dependence on outcomes after subarachnoid hemorrhage","authors":"Isaac B. Thorman,&nbsp;Ankita Jain,&nbsp;Elad Mashiach,&nbsp;Ariel Sacknovitz,&nbsp;Eris Spirollari,&nbsp;Rachid Kaddoura,&nbsp;Ruaa Alsaeed,&nbsp;Michael C. Schubert,&nbsp;Uchenna N. Okafo,&nbsp;Jon B. Rosenberg,&nbsp;Pankajavalli Ramakrishnan,&nbsp;Stephan A. Mayer,&nbsp;Chirag D. Gandhi,&nbsp;Fawaz Al-Mufti","doi":"10.1007/s00701-025-06639-9","DOIUrl":"10.1007/s00701-025-06639-9","url":null,"abstract":"<div><h3>Background</h3><p>Non-traumatic subarachnoid hemorrhage (SAH) is most commonly caused by a ruptured aneurysm. Risk factors for rupture include hypertension, smoking, and substance use, but the relationship between alcohol use and clinical outcomes after SAH is poorly understood. The objective of this population-based, longitudinal, study is to characterize the relationships between alcohol use, alcohol dependence, and adverse clinical outcomes following SAH.</p><h3>Methods</h3><p>Patients with alcohol use disorder (International Classification of Disease 10th Revision Diagnostic Code F10) in the TriNetX Research Network were compared to patients with no substance use disorders (None of F10-F19). Short-term (30-day) outcomes were assessed among patients with blood alcohol concentrations tested on the day of SAH. Outcome frequencies and Cox proportional hazard models used propensity score matching on demographics, comorbidities, blood counts, substance use, and SAH severity.</p><h3>Results</h3><p>We identified 216,894 patients with non-traumatic SAH. Of these, 11,648 were tested for alcohol and 27,079 patients had alcohol use disorder. Blood alcohol levels of 1–100 mg/dL and above at the time of SAH were associated with decreased 30-day mortality in acute alcohol use compared to 0 mg/dL, and alcohol concentrations of 201–300 mg/dL and higher were further protective relative to 1–100 mg/dL. Patients with alcohol use disorder exhibited an increased hazard of mortality (HR = 1.175 [95% CI: 1.129, 1.223]; p &lt; 0.0001) compared to patients with no substance use disorders (n = 151,377). Patients with severe alcohol dependence had an even higher hazard of mortality compared to patients with mild/moderate use disorder (HR = 1.139 [1.128, 1.150] p &lt; 0.0001).</p><h3>Conclusions</h3><p>In patients with non-traumatic SAH, alcohol in the blood at the time of SAH is protective against 30-day mortality, and increased alcohol concentration adds increased protection. Paradoxically, alcohol use disorder leads to a worsening of clinical outcomes, including mortality. There appears to be a significant dose-dependent effect of severity of alcohol dependence on mortality.\u0000</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06639-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144905064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a radiofrequency thermocoagulation strategy targeting the propagation network in MRI-negative post-encephalitic insular epilepsy: a case report","authors":"Tomotaka Ishizaki,&nbsp;Satoshi Maesawa,&nbsp;Shun Yamamoto,&nbsp;Takahiro Suzuki,&nbsp;Hajime Hamasaki,&nbsp;Takafumi Tanei,&nbsp;Ryuta Saito","doi":"10.1007/s00701-025-06652-y","DOIUrl":"10.1007/s00701-025-06652-y","url":null,"abstract":"<div><p>Insular epilepsy after encephalitis is often drug-resistant and MRI-negative, limiting resection due to eloquent cortex involvement. We describe a case in which radiofrequency thermocoagulation (RFTC) was applied to disconnect the propagation network (PN) identified by stereoelectroencephalography. In a woman with focal to bilateral tonic–clonic seizures, the epileptogenic network (EN) was in the left insula and temporal operculum, and the PN spread to the perirolandic area. PN-targeted RFTC, guided by tractography, preserved the EN. At 18 months, seizures decreased by 95.6% with preserved function. Selective PN disconnection may be an option when EN resection is limited.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06652-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144905075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymmetric efficacy of VNS within a single patient with bilateral focal frontal lobe epilepsy: A case report","authors":"Masanobu Kumon,&nbsp;Shunsuke Nakae,&nbsp;Daijiro Kojima,&nbsp;Noeru Kawase,&nbsp;Yuichi Hirose","doi":"10.1007/s00701-025-06653-x","DOIUrl":"10.1007/s00701-025-06653-x","url":null,"abstract":"<div><p>The lateralized efficacy of vagus nerve stimulation (VNS) remains insufficiently explored. We report a case of drug-resistant epilepsy with bilateral frontal lobe seizure onset, treated with left cervical VNS. Preoperative video- electroencephalogram revealed predominant interictal discharges in the right hemisphere and frequent seizures from both hemispheres. Following VNS, overall seizure frequency decreased. Notably, stereo-electroencephalography performed 15 months postoperatively showed a marked reduction in right-sided seizures, while left-sided seizures remained frequent. This case highlights the potential lateralized effect of VNS in a single patient with bilateral frontal lobe epilepsy, suggesting that VNS may preferentially suppress seizures originating from the right hemisphere.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06653-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nerve transfer to musculocutaneous for elbow flexion restoration in brachial plexus injury (Ulnar and/or Median vs. Intercostal): A systematic review and meta-analysis of comparative studies","authors":"Mohamed K. A. Genedy,&nbsp;Esraa Y. Salama,&nbsp;Mohamed Ashraf Elsaadany,&nbsp;Mohamed A. F. AbdelWahab,&nbsp;Ahmed Fathy Amin,&nbsp;Ahmed A. Lashin,&nbsp;Ahmed O. Sabry","doi":"10.1007/s00701-025-06650-0","DOIUrl":"10.1007/s00701-025-06650-0","url":null,"abstract":"<div><h3>Background</h3><p>Nerve transfers are a cornerstone in the surgical management of traumatic brachial plexus injuries (BPIs) to restore elbow flexion. Common donor nerves include intraplexal sources like the ulnar and median nerves (fascicular transfers) and extraplexal sources like the intercostal nerves (ICNs). Despite the widespread use of both techniques, the optimal donor nerve remains a subject of debate. This systematic review and meta-analysis aims to compare these techniques for restoring elbow flexion in BPIs.</p><h3>Methods</h3><p>A systematic search was conducted across PubMed, Embase, Cochrane Library, Scopus, and Web of Science to identify comparative studies. The quality of the studies included was assessed using the Newcastle–Ottawa Scale (NOS). Meta-analyses were performed to compare motor recovery (≥ M3), time to M3 recovery, and complication rates between the two surgical approaches.</p><h3>Results</h3><p>The analysis included 13 studies with a total of 537 patients. In the overall cohort, which included mixed injury patterns, fascicular transfers showed a statistically significant advantage for achieving ≥ M3 recovery (RR = 0.84, 95% CI [0.75, 0.94]). However, when the analysis was restricted to patients with only upper-BPIs, there was no significant difference in achieving ≥ M3 strength between fascicular and ICN transfers (RR = 0.92, 95% CI [0.82, 1.04]). Fascicular transfers resulted in a significantly faster time to ≥ M3 recovery by approximately five months (MD = 5.25, 95% CI [2.87, 7.62]). Donor-site morbidity (18 sensory, 10 motor deficits) and wrist co-flexion were reported in fascicular transfer groups, whereas pneumothorax (4 cases) was the primary complication for ICN transfers.</p><h3>Conclusion</h3><p>In patients with upper-BPIs, fascicular and ICN transfers yield comparable elbow flexion strength. The choice of procedure is a trade-off between the faster recovery offered by fascicular transfers and the better rehabilitation course of ICN transfers.\u0000</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06650-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a keypoint region-based convolutional neural network to automate thoracic Cobb angle measurements using whole-spine standing radiographs","authors":"Mert Marcel Dagli,&nbsp;Jonathan H. Sussman,&nbsp;Jaskeerat Gujral,&nbsp;Bhargavi R. Budihal,&nbsp;Marie Kerr,&nbsp;Jang W. Yoon,&nbsp;Ali K. Ozturk,&nbsp;Patrick J. Cahill,&nbsp;Jason Anari,&nbsp;Beth A. Winkelstein,&nbsp;William C. Welch","doi":"10.1007/s00701-025-06645-x","DOIUrl":"10.1007/s00701-025-06645-x","url":null,"abstract":"<div><h3>Purpose</h3><p>Adolescent idiopathic scoliosis (AIS) affects a significant portion of the adolescent population, leading to severe spinal deformities if untreated. Diagnosis, surgical planning, and assessment of outcomes are determined primarily by the Cobb angle on anteroposterior spinal radiographs. Screening for scoliosis enables early interventions and improved outcomes. However, screenings are often conducted through school entities where a trained radiologist may not be available to accurately interpret the imaging results.</p><h3>Methods</h3><p>In this study, we developed an artificial intelligence tool utilizing a keypoint region-based convolutional neural network (KR-CNN) for automated thoracic Cobb angle (TCA) measurement. The KR-CNN was trained on 609 whole-spine radiographs of AIS patients and validated using our institutional AIS registry, which included 83 patients who underwent posterior spinal fusion with both preoperative and postoperative anteroposterior X-ray images.</p><h3>Results</h3><p>The KR-CNN model demonstrated superior performance metrics, including a mean absolute error (MAE) of 2.22, mean squared error (MSE) of 9.1, symmetric mean absolute percentage error (SMAPE) of 4.29, and intraclass correlation coefficient (ICC) of 0.98, outperforming existing methods.</p><h3>Conclusion</h3><p>This method will enable fast and accurate screening for AIS and assessment of postoperative outcomes and provides a development framework for further automation and validation of spinopelvic measurements.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06645-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How I do it—tubular trans-spinous process muscle-sparing approach for bilateral lumbar microdiscectomy: surgical technique with illustrative video","authors":"Anthony M. T. Chau,&nbsp;Aaron Lerch","doi":"10.1007/s00701-025-06648-8","DOIUrl":"10.1007/s00701-025-06648-8","url":null,"abstract":"<div><p>This video demonstrates our surgical approach for an entirely tubular trans-spinous process bilateral lumbar discectomy. A 47-year-old man presented with 12 months of severe predominantly right L5 radiculopathy. Magnetic resonance imaging revealed a large diffuse disc bulge at L4/5 resulting in bilateral lateral recess and central stenosis. He underwent bilateral discectomies via a trans-spinous process tubular approach. Postoperatively, his pain resolved and was discharged home the following day. Clinical resolution was sustained at 6 weeks. An entirely tubular trans-spinous process technique for lumbar decompression provides excellent bilateral lateral recess exposure through a minimally invasive muscle-sparing approach.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06648-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}