British Journal of Neurosurgery最新文献

{"title":"Evaluating the impact of polypharmacy in elderly patients undergoing neurosurgery: a retrospective study.","authors":"Sarvesh Kutty, Jonathan P Funnell, John G Hanrahan, Simon C Williams, Isabel Allison, Ahmed K Toma","doi":"10.1080/02688697.2025.2498569","DOIUrl":"https://doi.org/10.1080/02688697.2025.2498569","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the impact of polypharmacy on length of hospital stay (LOS) and occurrence of postoperative complications in elderly patients undergoing neurosurgery.</p><p><strong>Methods: </strong>This study represents a single-centre retrospective review of consecutive patients above 65 years old undergoing elective or emergency neurosurgery between June 2021 and January 2022. Patients were categorised into two groups based on the presence (five or more medications) or absence of polypharmacy. Chi-Square and/or Fisher exact test were used to compare baseline characteristics between groups and Mann-Whitney U test for continuous non-normally distributed variables. Multiple logistic regression models were constructed using significant variables affecting LOS and postoperative complications with adjusted Odds Ratios and 95% CIs reported.</p><p><strong>Results: </strong>In total 499 patients over the age of 65 underwent emergency or elective neurosurgery, and 218 (43%) met the criteria for polypharmacy. The polypharmacy group had a higher median LOS than the non-polypharmacy cohort (6 days vs. 5 days, p = 0.005). Polypharmacy was also associated with increased likelihood of postoperative complications (OR 1.62, CI 1.05-2.50, p = 0.02).</p><p><strong>Conclusion: </strong>Our findings highlight the need for considered medication review in the perioperative period to support elderly patients undergoing neurosurgery for better postsurgical outcomes.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-10"},"PeriodicalIF":1.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of C2 tuberculosis using C1-3 inter-lateral mass structural bone graft and short segment fixation: a case report.","authors":"Guanghai Zhao, Haihong Zhang, Jing Wang","doi":"10.1080/02688697.2025.2494864","DOIUrl":"https://doi.org/10.1080/02688697.2025.2494864","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) infections involving the C2 vertebra (C2 TB) are uncommon and surgery is their primary treatment. Although occipitocervical fusion is presently the main surgical intervention for the disease-helping in restoring spinal stability, it inevitably compromises cervical mobility, significantly impacting patients' postoperative quality of life.</p><p><strong>Case report: </strong>A 39-year-old female with C2 TB underwent a single posterior route lesion removal, structural bone graft between the C1-3 lateral masses, and short segment fixation from C1-3. A one-year follow-up showed significant recovery with minimal clinical complications. Neck rotation was slightly restricted, whereas neck flexion and extension remained unaffected.</p><p><strong>Conclusions: </strong>This case demonstrates the technical viability of a C1-3 inter-lateral mass structural bone graft with short segment fixation for C2 TB.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-4"},"PeriodicalIF":1.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First insights into the utilisation of the M.BLUE^® device for post-haemorrhagic hydrocephalus treatment.","authors":"Quentin Berton, Marta Arrighi, Paul Roblot, Jean-Rodolphe Vignes, Emmanuel Chabert, Alice Belmas, Guillaume Coll","doi":"10.1080/02688697.2025.2494555","DOIUrl":"https://doi.org/10.1080/02688697.2025.2494555","url":null,"abstract":"<p><strong>Background/objectives: </strong>Gravitational shunt systems reduce the risk of over-drainage in aneurysmal subarachnoid hemorrhage-associated hydrocephalus (aSAH-aH). The Miethke M.BLUE® valve, initially designed for pediatric use, has been scarcely studied in adults. This study assesses its safety and effectiveness in managing aSAH-aH.</p><p><strong>Methods: </strong>A retrospective study was conducted on 17 adult patients treated with the M.BLUE® valve for aSAH-aH. Outcomes included radiological assessment (Evans' Index, callosal-marginal angle), clinical improvement (gait, urinary, cognitive functions), and post-operative valve adjustments.</p><p><strong>Results: </strong>The Evans' Index decreased by 14.9 ± 12.2% (P < .001), and the callosal-marginal angle increased by 27.3 ± 21% (P < .001). One case of over-drainage and three of under-drainage required post-operative adjustment. Three non-device-related mechanical complications were recorded (ventricular catheter malposition, peritoneal catheter migration, infection). No valve dysfunctions were reported. Clinical improvements were observed in gait (15/15), cognition (14/15, P < .001), and urinary function (12/13, P < .001).</p><p><strong>Conclusions: </strong>.The M.BLUE® device appears to be a safe and effective option for treating aSAH-aH in adults. It achieved positive radiological changes with limited post-operative adjustments and demonstrated significant clinical improvements.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-8"},"PeriodicalIF":1.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A modified vertebroplasty technique for intraoperative thoracic spine localisation: a technical report.","authors":"Renée R Cruickshank, Vittorio M Russo, Antonino Russo","doi":"10.1080/02688697.2023.2165637","DOIUrl":"10.1080/02688697.2023.2165637","url":null,"abstract":"<p><p>The aim is to illustrate the modified vertebroplasty technique as a fixed marker for intraoperative thoracic spine localisation. Open and minimally invasive surgery in the thoracic spine has been correlated with a disproportionately high rate of wrong-level spinal surgery in pathologies where a focal deformity or fracture is absent. Spinal markers have evolved with time, and vertebroplasty as a spinal marker was initially described in 2008. A significant disadvantage is that the cement in the vertebral body and pedicle may preclude a more extensive osteotomy or subsequent instrumentation at the level of interest. We demonstrate the modified vertebroplasty technique, which introduces percutaneous polymethylmethacrylate cement two levels below the thoracic disc herniation on the contralateral side to the surgical approach using standard vertebroplasty methods. The vertebroplasty was performed as an outpatient procedure, and the radiopaque cement was instantaneously located on intraoperative fluoroscopy, identifying the correct level above. The modified vertebroplasty technique is a quick, safe and accurate method of thoracic spine localisation, facilitating the room required for the bony exposure and instrumentation if needed.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"281-285"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10511688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising trajectory planning for stereotactic brain tumour biopsy using artificial intelligence: a systematic review of the literature.","authors":"Joachim Starup-Hansen, Simon C Williams, Jonathan P Funnell, John G Hanrahan, Shah Islam, Alaa Al-Mohammad, Ciaran S Hill","doi":"10.1080/02688697.2023.2210225","DOIUrl":"10.1080/02688697.2023.2210225","url":null,"abstract":"<p><strong>Purpose: </strong>Despite advances in technology, stereotactic brain tumour biopsy remains challenging due to the risk of injury to critical structures. Indeed, choosing the correct trajectory remains essential to patient safety. Artificial intelligence can be used to perform automated trajectory planning. We present a systematic review of automated trajectory planning algorithms for stereotactic brain tumour biopsies.</p><p><strong>Methods: </strong>A PRISMA adherent systematic review was conducted. Databases were searched using keyword combinations of 'artificial intelligence', 'trajectory planning' and 'brain tumours'. Studies reporting applications of artificial intelligence (AI) to trajectory planning for brain tumour biopsy were included.</p><p><strong>Results: </strong>All eight studies were in the earliest stage of the IDEAL-D development framework. Trajectory plans were compared through a variety of surrogate markers of safety, of which the minimum distance to blood vessels was the most common. Five studies compared manual to automated planning strategies and favoured automation in all cases. However, this comes with a significant risk of bias.</p><p><strong>Conclusions: </strong>This systematic review reveals the need for IDEAL-D Stage 1 research into automated trajectory planning for brain tumour biopsy. Future studies should establish the congruence between expected risk of algorithms and the ground truth through comparisons to real world outcomes.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"163-172"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9459116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of intraparenchymal rhabdomyosarcoma.","authors":"Melissa Lannon, Dhuha Al-Sajee, Jacqueline Bourgeois, John Sehl, Kesava Reddy, Jian-Qiang Lu","doi":"10.1080/02688697.2022.2163980","DOIUrl":"10.1080/02688697.2022.2163980","url":null,"abstract":"<p><strong>Background: </strong>Intracranial rhabdomyosarcomas represent a rare condition, posing a diagnostic challenge to physicians. Brain intraparenchymal rhabdomyosarcomas are exceptionally rare with poorly understood pathogenesis.</p><p><strong>Methods: </strong>Here we report the first adult case of intraparenchymal rhabdomyosarcoma (RMS) with brainstem and cranial nerve involvement. We conducted a literature search using Embase, MEDLINE, and PubMed for published cases of patients with rhabdomyosarcoma of the brain. The keywords used were 'rhabdomyosarcoma' combined with 'intraparenchymal', 'parenchymal', 'cerebral' or 'brain' for title/abstract. Included cases were adult patients (>18 years of age).</p><p><strong>Results: </strong>A 59-year-old man presents with multiple cranial nerve palsies. MRI revealed a solitary pontine lesion that was not responsive to steroids. No systemic lesions were identified with an extensive imaging workup. A wide range of serum and cerebrospinal fluid tests were non-diagnostic during a ten-month workup until, ultimately, the patient died as a result of aspiration pneumonia. At autopsy, pathological examination on whole-brain autopsy revealed RMS, centred in the left side of pons with extension to the left side of the midbrain and the right side of pons with multiple cranial nerve involvement. There are only 20 adult cases of primary intraparenchymal RMS reported in the literature. Our present case is the first reported adult RMS in this location, with novel molecular information, providing some insight into the pathogenesis of this rare diagnosis.</p><p><strong>Conclusions: </strong>Intraparenchymal rhabdomyosarcoma without evidence of systemic primary disease is extremely rare, resulting in delayed diagnosis in some cases, particularly those not amenable to biopsy. The diagnostic challenge posed by this complementary case highlights the importance of maintaining a differential of neoplasm in the face of non-diagnostic investigations to the contrary.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"232-239"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10476298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and descriptive characteristics associated with high-grade meningioma in a large clinical series.","authors":"Sepideh Mokhtari, Noah C Peeri, Andre Beer-Furlan, Mark D Anderson, Sajeel Chowdhary, Renato V LaRocca, Aaron G Mammoser, L Burt Nabors, Jeffrey J Olson, Reid C Thompson, Zachary J Thompson, Yessica C Martinez, Kathleen M Egan","doi":"10.1080/02688697.2023.2219759","DOIUrl":"10.1080/02688697.2023.2219759","url":null,"abstract":"<p><strong>Purpose: </strong>We studied 571 patients with intracranial meningioma for clinical characteristics and tumor location associated with high grade meningioma (WHO II/III).</p><p><strong>Materials and methods: </strong>Patients were participants in a multicentre epidemiologic study of risk factors for primary brain tumors including meningioma recruited from September 2005 to November 2019. We included patients 18 or older with a recent diagnosis of a primary intracranial meningioma of any subtype (ICD9/10: 9530-0, 9531-0, 9532-0, 9537-0, 9533-0, 9534-0, 9530-0, 9538-1, 9538-3) who were enrolled at neuro-oncology and neuro-surgery clinics in the southeastern U.S.</p><p><strong>Results: </strong>The median patient age was 58 years (IQR: 48-68) and the majority of patients were female (<i>n</i> = 415; 72.7%) and Caucasian (<i>n</i> = 516; 90.4%). Most patients were symptomatic (<i>n</i> = 460; 80.6%) and their tumours more commonly occurred in a non-skull base location (<i>n</i> = 298; 52.2%). A total of 86 patients (15.0%) had a WHO grade II/III meningioma. Compared to patients with WHO grade I tumours, patients with WHO II/III meningiomas were over 3-times more likely to be male (odds ratio (OR): 3.25; 95% confidence interval (CI): 1.98, 5.35) adjusting for age, race, symptomatic presentation, and skull-based location. Moreover, a WHO grade II/III meningioma was substantially less likely to be observed in asymptomatic patients (OR: 0.15, 95% CI: 0.04, 0.42), and in patients with a skull-based tumour (OR: 0.40, 95% CI: 0.24, 0.66), adjusting for other factors. Male gender, symptomatic tumour, and a non-skull base location were independently associated with WHO grade II/III meningioma.</p><p><strong>Conclusion: </strong>These findings may shed additional light on the underlying pathogenesis of meningioma.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"224-227"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9645651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aneurysm management in patients over 80 years old with good grade subarachnoid haemorrhage.","authors":"Frederick Ewbank, Samuel Hall, Benjamin Gaastra, Benjamin Fisher, Laura Coe, James Booker, Antony Kaldas, Ian Anderson, Giles Critchley, Mario Teo, Ahmed Toma, Rikin Trivedi, Chris Uff, Raghu Vindlacheruvu, Louise Dulhanty, Mohsen Javadpour, Daniel Walsh, James Galea, Hiren Patel, Diederik Bulters","doi":"10.1080/02688697.2023.2205939","DOIUrl":"10.1080/02688697.2023.2205939","url":null,"abstract":"<p><strong>Background: </strong>An increasing proportion of aneurysmal subarachnoid haemorrhage (aSAH) occurs in older patients, in whom there is widespread variability in treatment rates due to a different balance of risks. Our aim was to compare outcomes of patients over 80 years old with good grade aSAH who underwent treatment of their aneurysm with those who did not.</p><p><strong>Methods: </strong>Adult patients with good grade aSAH admitted to tertiary regional neurosciences centres contributing to the UK and Ireland Subarachnoid Haemorrhage Database (UKISAH) and a cohort of consecutive patients admitted from three regional cohorts were included for analysis. Outcomes were functional outcome at discharge, three months and survival at discharge.</p><p><strong>Results: </strong>In the UKISAH, patients whose aneurysm was treated were more likely to have a favourable outcome at discharge (OR 2.34, CI 1.12-4.91, <i>p</i> = .02), at three months (OR 2.29, CI 1.11-4.76, <i>p</i> = .04), and lower mortality (10% vs. 29%, OR 0.83, CI 0.72-0.94, <i>p</i> < .01). In the regional cohort, a similar pattern was seen, but after correction for frailty and comorbidity there was no difference in survival (HR 0.45, CI 0.12-1.68, <i>p</i> = .24) or favourable outcome at discharge (OR 0.83, CI 0.23-2.94, <i>p</i> = .77) and at three months (OR 1.03, CI 0.25-4.29, <i>p</i> = .99).</p><p><strong>Conclusions: </strong>Better early functional outcomes in those undergoing aneurysm treatment appear to be explained by differences in frailty and comorbidity. Therefore, treatment decisions in this patient group are finely balanced with no clear evidence overall of either benefit or harm in this cohort.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"184-190"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9765751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volume maximised glycerol rhizolysis for trigeminal neuralgia: a single centre analysis of outcomes.","authors":"Aimee Goel, Girish Kulkarni, Alexandru Cotici, Alessandro Paluzzi, Tom Hayton, Ramesh Chelvarajah","doi":"10.1080/02688697.2023.2207657","DOIUrl":"10.1080/02688697.2023.2207657","url":null,"abstract":"<p><strong>Objectives: </strong>Glycerol rhizotomy is an established treatment for medically refractory trigeminal neuralgia in select cases where microvascular decompression is contraindicated or not preferred. The standard approach is to inject a fixed volume of glycerol using Hartel's technique into Meckel's cave. We discuss a 'volume-maximised' technique of measuring the volume of Meckel's cave using intra-operative fluoroscopy and injecting an equivalent volume of glycerol such that every patient receives a tailored quantity of glycerol dependent on the volume of Meckel's cave. The safety and efficacy of this approach is analysed.</p><p><strong>Methods: </strong>A retrospective analysis of 53 procedures where volume-maximised glycerol rhizolysis was utilised over a 7-year period (2012 -2018) at a single centre by the senior author was carried out. The incidence and duration of pain freedom and complications incurred over a median follow-up period of 8 years were analysed.</p><p><strong>Results: </strong>37 procedures were carried out for typical trigeminal neuralgia, 13 for secondary trigeminal neuralgia, and 3 for atypical trigeminal neuralgia. Overall, pain freedom was achieved in 85% cases, and 92% in patients with typical trigeminal neuralgia. Median duration of pain freedom in patients with typical trigeminal neuralgia was 63 months, versus 6 months in those with secondary trigeminal neuralgia (<i>p</i> < 0.00001). 14 procedures (26.4%) resulted in mild and temporary complications. 54.7% of cases experienced hypoaesthesia in a distribution similar to or less extensive than the distribution of trigeminal neuralgia. The presence of hypoaesthesia post-procedure was highly predictive of longer pain freedom (95 months versus 8 months median pain freedom (<i>p</i> = 0.00003)).</p><p><strong>Conclusions: </strong>Volume-maximised glycerol injection is safe and effective when compared to literature-reported outcomes post-standard volume glycerol injections. The duration of pain freedom achieved exceeds most literature-reported studies, with hypoaesthesia outcomes being comparable with previous studies. Pain freedom outcomes are more favourable in those with post-procedure hypoaesthesia.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"191-196"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9410928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A transfacet approach to the lumbar nerve root canal: technical note.","authors":"Asen H Cekov, Martin H M Sailer, Marin Guentchev","doi":"10.1080/02688697.2022.2159929","DOIUrl":"10.1080/02688697.2022.2159929","url":null,"abstract":"<p><strong>Background: </strong>Intraforaminal and extraforaminal nerve root compressions caused by disk herniation or stenosis are relatively common causes of lumbar radiculopathy. Currently, the two available surgical treatment methods are decompression from the spinal canal or lateral decompression via the Wiltse approach.</p><p><strong>Objective: </strong>To describe a novel transosseous approach to the lumbar nerve root canal.</p><p><strong>Methods: </strong>Transfacet foraminotomy was performed in 11 patients with intraforaminal or extraforaminal disk herniation. The outcome was measured using the Patient Satisfaction Index (PSI), need for reoperation, radiographic criteria, and finite element analysis.</p><p><strong>Results: </strong>We noted that at the time of dismissal, PSI scores of 1 and 3 were reported by 10 and one patients, respectively. At the last follow-up, 10 patients reported a PSI score of 1 or 2. Two patients required reoperation because of recurrent disk herniation. Two patients underwent computed tomography (CT) postoperatively, which showed the transfacet approach. Intriguingly, a second postoperative CT after one month showed that the hole through the facet joint had shrunk significantly.</p><p><strong>Conclusion: </strong>A posterior-anterior transfacet approach for intraforaminal or extraforaminal disk herniations using an ellipsoid facetectomy is safe and allows for fast and comfortable decompression of the nerve root without compromising the long-term strength of the facet joint.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"270-275"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10474814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}