Neurocirugia (English Edition)最新文献

{"title":"Fully percutaneous posterior transarticular C1-C2 stand-alone screw instrumentation: A case series and technical note","authors":"Ivan Lvov,&nbsp;Andrey Grin,&nbsp;Anton Kordonskiy,&nbsp;Zaali Barbakadze,&nbsp;Aleksandr Talypov,&nbsp;Aleksandr Tupikin","doi":"10.1016/j.neucie.2025.500665","DOIUrl":"10.1016/j.neucie.2025.500665","url":null,"abstract":"<div><div>Magerl’s technique remains a widely accepted method for achieving C1-C2 fusion. Although two approaches using intermuscular corridors and biplanar X-ray guidance have been reported, there are no published studies dedicated to fully percutaneous techniques employing cannulated screws.</div></div><div><h3>Objective</h3><div>To demonstrate the feasibility of a fully percutaneous C1-C2 fixation technique using cannulated screws and to analyze the short- and long-term outcomes of the initial case series.</div></div><div><h3>Material and methods</h3><div>This case series included patients over 15 years of age who were presented with acute or subacute atlantoaxial instability at C1-C2 due to fractures of the odontoid process<span>, C1 vertebra<span>, or C2 vertebral body. Surgical details and fusion criteria were described. Due to the absence of comparison groups, only descriptive statistical methods were employed.</span></span></div></div><div><h3>Results</h3><div><span>A total of 11 patients (8 men, 3 women; mean age 41.5 ± 18.2 years) underwent fully percutaneous transarticular C1-C2 fixation. The mean operative time was 115.0 ± 30.8 min for patients stabilized using a Halo device and 80.6 ± 33.2 min for those immobilized with a Mayfield clamp. The mean blood loss across all cases was 38.8 ± 8.7 mL. One patient died from concurrent cardiac pathology. Two patients were lost to follow-up due to relocation, leaving 8 patients for final assessment. At final follow-up, the mean VAS score was 2 ± 1.5 and the mean </span>NDI<span> score was 5.3 ± 5.2. All patients with preoperative neurological deficits improved by one level on the ASIA scale. Fusion was achieved in 7 of 8 cases (87.5%), and 1 patient (12.5%) developed a stable C1-C2 pseudoarthrosis.</span></div></div><div><h3>Conclusion</h3><div>Our initial clinical experience demonstrated that fully percutaneous posterior transarticular C1-C2 stand-alone screw fixation using cannulated instruments could be a feasible and safe procedure. Critical requirements for this technique include complete reduction of atlantoaxial dislocation, compression in the lateral joint region, adequate intraoperative visualization, and strict adherence to specific screw trajectories.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500665"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588465","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":"ALIF in a Spanish female cohort: No urinary and sexual complications or a gender bias?","authors":"Cristina Romero-López ,&nbsp;Santiago Rocha-Romero ,&nbsp;María de los Ángeles Cañizares-Méndez ,&nbsp;Julio Valencia-Anguita","doi":"10.1016/j.neucie.2025.500662","DOIUrl":"10.1016/j.neucie.2025.500662","url":null,"abstract":"<div><h3>Background</h3><div>The objective of the present study is to analyze urinary and sexual functions in females treated with ALIF and to describe possible complications not previously reported in the literature.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of urinary and sexual functions in females treated with this technique in our hospital between 2019 and 2022. Inclusion criteria were: females treated with ALIF who provided informed consent.</div></div><div><h3>Results</h3><div><span><span>22 patients consented to participate. The median age was 51.5 years, the median follow-up was 11.5 months, and there was an improvement in low back pain of 4 points on the postoperative (postop) visual analogue scale (VAS). Overall, 36.3% of patients reported postoperative urinary deterioration, including 27.3% with new-onset </span>urinary incontinence. The international consultation on incontinence questionnaire-short form score worsened by 3.5 points. 77.2% maintained an active sexual life; within this group, there was a worsening of 2.4 points in the postop female sexual function index and 35.2% described worsening in sexual function. We hypothesized that age, underlying lumbar pathology and changes in postoperative VAS scores could be confounding factors; however, only the relationship between age and postoperative urinary deterioration reached statistical significance (</span><em>p</em> = 0.034).</div></div><div><h3>Conclusions</h3><div>The present study describes deterioration in urinary function in 36.3% and in sexual function in 35.2% after the procedure, findings also supported by specific scales. In view of the above, we cannot discount a possible gender bias in the literature. Despite that, we believe that ALIF is still an adequate technique, but studies of higher level of evidence should be conducted to improve the information process of our patients.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500662"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588458","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":"Continuous sitting position during the postoperative period as an intervention to reduce risk of cerebrospinal fluid leak after endoscopic endonasal surgery","authors":"José de Jesús Martínez-Manrique ,&nbsp;Ricardo A. Palacios-Rodríguez ,&nbsp;Luis A. Rodríguez-Hernández ,&nbsp;Jorge F. Aragón-Arreola ,&nbsp;Marcos V. Sangrador-Deitos ,&nbsp;Juan Luis Gómez-Amador","doi":"10.1016/j.neucie.2025.500658","DOIUrl":"10.1016/j.neucie.2025.500658","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div><span>In recent decades, endoscopic endonasal surgery<span> for skull base tumours<span> has modified the way in which this region is approached. One of the most feared complications is the cerebrospinal fluid leak. It has been shown in different publications about </span></span></span>CSF<span> physiology that changes in the position modify the pressure of the CSF (pCSF). With this background, it is proposed as a viable, noninvasive, and very low-risk option, the continuous sitting position in patients during their hospital stay after endoscopic endonasal surgery as an adjuvant intervention to reduce the risk of CSF leak in patients considered to be at high risk. The objective is to demonstrate that the continuous sitting position in the postoperative period is a useful adjuvant intervention for the prevention of CSF leak in endoscopic endonasal surgery.</span></div></div><div><h3>Methods</h3><div>This is a retrospective, observational, cross-sectional, comparative study. It included patients over 18 years of either sex, intervened by endoscopic endonasal surgery with intraoperative CSF leak observed and with advanced reconstruction technique realized. A continuous sitting position (between 70 ° and 90 °) was considered when the patient remained in this position from the immediate postoperative period until the hospital discharge.</div></div><div><h3>Results</h3><div>A total of 60 patients were included. No statistically significant difference was found on all the variables studied, except when patients were stratified into sitting and non-sitting patients (p = 0.045). OR of 0.12 (95% CI 0.002–1.03) was observed. In the sitting group, only 1 patient (6.67%) had CSF leak, which was resolved with non-surgical treatment. The average length of hospital stay was 18 days (7–38) for sitting patients and 14 days (5–80) for non-sitting patients, with statistical significance stablished by the dispersion of the data (p = 0.023).</div></div><div><h3>Conclusions</h3><div>The continuous sitting position during the immediate postoperative period is an intervention that shows a decrease in the risk of CSF leak in patients intervened by endoscopic endonasal approach, included extended routes.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500658"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574985","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":"Ossification of posterior longitudinal ligament of the cervical spine: A review article","authors":"Shengyu Cui ,&nbsp;Jinze Li ,&nbsp;Xiaoxu Yu ,&nbsp;Hongyu Zhao ,&nbsp;Fengzeng Jian","doi":"10.1016/j.neucie.2025.500668","DOIUrl":"10.1016/j.neucie.2025.500668","url":null,"abstract":"<div><div><span>This article reviews the literature on the status of cervical OPLL in recent years, and reviews the etiology, clinical manifestations, imaging features, treatment and prognosis. Evidence was collected through PubMed and Google Scholar databases. After screening, weight removal and irrelevant articles, 57 articles were finally included in the review. Imaging is the only way to confirm the diagnosis, and </span>CT<span> and MRI are used to assess the patient's ossified material and spinal cord compression. Because there are hundreds of surgical approaches to cervical OPLL, each with advantages and disadvantages, clinicians must develop a personalized surgical plan based on the patient’s preoperative relevant factors to maximize prognosis. Clinicians should also actively follow up on discharged patients, carefully analyze cases with a poor prognosis, and summarize their experiences.</span></div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500668"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733467","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 genesis of Academic Neurosurgery. Part II: The contribution of Johns Hopkins School of Medicine leaders","authors":"Ramiro D. Lobato ,&nbsp;Alfonso Lagares ,&nbsp;Igor Paredes ,&nbsp;Ana M. Castaño-Leon ,&nbsp;Pablo M. Munarriz ,&nbsp;Irene Panero","doi":"10.1016/j.neucie.2025.500672","DOIUrl":"10.1016/j.neucie.2025.500672","url":null,"abstract":"<div><div>This paper describes the influence of the Jonhs Hopkins School of Medicine on the origin of academic neurosurgery in America. The impact, arising from two of the founders, W Osler and W Halsted, was vehiculated by their direct pupils Harvey Cushing and Walter Dandy. The relationships between all these pioneers (sometimes stormy) are analized along with the development of the primitive residency program and the efforts to create the first neurosurgical society (the Society of Neurological Surgeons).</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500672"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562219","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":"Topical and systemic effects of medical ozone therapy on epidural fibrosis: Experimental research","authors":"Nur Balcin ,&nbsp;Mine Ozsen ,&nbsp;Pinar Eser ,&nbsp;Tamer Kala ,&nbsp;Gokhan Ocakoglu ,&nbsp;Seref Dogan","doi":"10.1016/j.neucie.2025.500663","DOIUrl":"10.1016/j.neucie.2025.500663","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Epidural fibrosis<span> (EF) causes adhesions in the epidural distance, resulting in chronic low back and leg pain symptoms during the </span></span>postoperative period<span>. Currently, ozone is used for treating lumbar disk herniation and low back pain. However, its effect on epidural fibrosis is largely unknown.</span></div></div><div><h3>Material and methods</h3><div><span>This rodent study examined the histopathological and biochemical effects of ozone therapy on epidural fibrosis. Forty-seven male Sprague–Dawley rats were divided into four groups, as follows: Control Group (CG) (</span><em>n</em><span> = 12): Laminectomy was performed, and no substance was applied. Saline Group (SG) (</span><em>n</em> = 11): Rats underwent intraoperative washing with 50 mL saline after laminectomy. Local Ozone Group (LOG) (<em>n</em> = 12): Rats underwent intraoperative washing with 50 mL ozonated distilled water after laminectomy. Systemic Ozone Group (SOG) (<em>n</em> = 12): Ozone was administered intraperitoneally (0.7 mg/kg) for 7 consecutive days postoperatively. At the end of 4 weeks, all subjects were sacrificed. Histopathological and biochemical data obtained from the tissues were analyzed in terms of EF.</div></div><div><h3>Results</h3><div>No statistically significant differences regarding EF, spinal cord retraction, inflammation, and fibroblast density were observed between the groups (<em>p</em> = 0.728; <em>p</em> = 0.813; <em>p</em> = 0.152; and <em>p</em><span> = 0.226, respectively). Hydroxyproline levels were higher in LOG than in SOG (</span><em>p</em> = 0.007); however, no statistically significant differences were observed among other groups (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>In our study, we could not record the positive effect of ozone therapy in terms of histopathology<span> and biochemistry with the current doses and application methods. We think that caution should be exercised in the ozone dose and method of application in the clinical approach. In addition, we are of the opinion that statistically significant results can be obtained by creating a treatment protocol that includes different dose applications.</span></div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500663"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588472","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":"Symptomatic thrombosed venous aneurysm after stereotactic radiosurgery for brain arteriovenous malformation: Case report of a late complication mimicking radiation necrosis","authors":"Gino A. Mendoza-Vega ,&nbsp;Jason Riveros-Ruiz ,&nbsp;Juan E. Basilio-Flores","doi":"10.1016/j.neucie.2025.500669","DOIUrl":"10.1016/j.neucie.2025.500669","url":null,"abstract":"<div><div><span><span>Late complications of radiosurgery for brain </span>arteriovenous malformation include cystic formation, chronic encapsulated </span>hematoma and radiation-induced tumors. Other complications are rarely reported.</div><div><span>We present a case of an adult patient who received radiosurgery for treatment of an unruptured parietal arteriovenous malformation. He was followed-up for 10 years and angiographic cure was documented. Fifteen-years after radiosurgery, he complained of new-onset progressive </span>focal seizures<span><span> associated with a thrombosed venous aneurysm with persistent </span>arteriovenous shunt angiographically occult but evidenced intraoperatively. After resection of the lesion, symptoms disappeared.</span></div><div><span>This case depicts a symptomatic thrombosed venous aneurysm presenting as a rare delayed complication of radiosurgery for the treatment of </span>brain arteriovenous malformation, which can be associated with angiographically-occult persistent arteriovenous shunt.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500669"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733501","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":"Removal of a giant musculocutaneous nerve schwannoma under intraoperative neurophysiological monitoring: Case report video and review of the literature","authors":"Edward Emerson Susanibar Mesías ,&nbsp;Alba León Jorba ,&nbsp;Antoni Raventós Estellé ,&nbsp;Christian Abel Schinder ,&nbsp;David Rodriguez Rubio","doi":"10.1016/j.neucie.2025.500667","DOIUrl":"10.1016/j.neucie.2025.500667","url":null,"abstract":"<div><div><span>Schwannomas of the </span>musculocutaneous nerve<span> (MCN) are rare benign tumors<span><span> of the peripheral nerve sheath. Due to their slow growth, they are often diagnosed late. In the upper limbs, schwannomas typically affect longer peripheral nerves at a distal level, making MCN cases uncommon. Ultrasound (US) and magnetic resonance imaging (MRI) are essential tools for early detection. While most schwannomas can be surgically removed without damaging the nerve, </span>intraoperative neurophysiological monitoring (IONM) is critical if fascicular involvement exists.</span></span></div><div><span>We present a 73-year-old right-handed Jehovah's Witness with a history of mild polio affecting the right arm. MRI showed a slow-growing, cystic mass in the right biceps, originating from the MCN and suggestive of schwannoma. Surgery achieved gross total resection without nerve damage. </span>Histopathology confirmed a cystic schwannoma.</div><div>In atypical proximal upper limb tumors, MCN schwannoma should be considered, with US/MRI crucial for diagnosis. IONM-assisted removal can minimize postoperative complications.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500667"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733470","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":"Intradural anastomoses between the cervical spinal nerves: Anatomical study","authors":"Matilde Lissarrague ,&nbsp;Franklin Miranda Solís ,&nbsp;Fernando Martínez Benia","doi":"10.1016/j.neucie.2025.500666","DOIUrl":"10.1016/j.neucie.2025.500666","url":null,"abstract":"<div><h3>Introduction</h3><div>Peripheral nerves can present anastomoses at different levels, with intraspinal anastomoses being relatively common, but little studied.</div></div><div><h3>Objective</h3><div>To study the presence and number of intradural anastomoses of the cervical spinal nerves in the Latin population.</div></div><div><h3>Materials and methods</h3><div>14 adult corpses of both sexes were dissected, fixed in formaldehyde solution. Sex of the corpse, existence of anastomosis, side, height of the anastomoses and sensory/motor origin were recorded.</div></div><div><h3>Results</h3><div>of the 14 corpses, 8 were male and 6 were female. Eleven cases presented anastomoses (79%), 8 of them bilaterally. In the total number of corpses, 52 anastomoses were found, 43 were between sensory roots (83%) and 9 between motor roots (17%). The levels where anastomoses were found most frequently were C1-C2 and C2-C3 (63% of the total).</div></div><div><h3>Discussion and conclusions</h3><div>intraspinal anastomoses between motor or sensory nerves can vary the clinical presentation of spinal cord injuries, radicular or medullar compressions, brachial plexus lesions or nerve root tumors, because the sensory or motor information of a given spinal cord level may be exiting the neuraxis with the adjacent spinal nerve.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500666"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103302","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":"Craniopharyngioma and abscess: When tumor and infection co-exist","authors":"Luis Miguel Moreno-Gómez ,&nbsp;Pablo M. Munarriz ,&nbsp;Aurelio Hernández-Laín ,&nbsp;Alfonso Lagares","doi":"10.1016/j.neucie.2025.500657","DOIUrl":"10.1016/j.neucie.2025.500657","url":null,"abstract":"<div><div>Pituitary abscesses are rare entities that may occur in a previously healthy gland or in the setting of a pituitary tumor<span>. Only eleven cases of abscesses associated with craniopharyngioma have been reported in the literature. The etiology is unknown and the diagnosis is difficult because there are no specific clinical or radiologic features that allow us to suspect the synchrony of both entities before surgery. Intraoperative findings and culture are the only definitive signs to confirm this association.</span></div><div>Here we present the first surgical video showing this unique association and highlighting the technical pearls of the procedure. In a 9-year-old boy, we performed a transphenoidal approach to resect the tumor and saw pus during surgery. Pathology revealed a papillary craniopharyngioma, with microbiology showing <span><em>Staphylococcus aureus</em></span><span>. The tumor resection resulted in ophthalmologic improvement but pituitary insufficiency. A brief review of the literature is presented.</span></div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500657"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569048","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}