World Neurosurgery

OBJECTIVE: This experimental study aimed to demonstrate the effect of medical ozone therapy on the development of epidural fibrosis. METHODS: A total of 25 Sprague-Dawley male rats were randomly divided into three groups: control group (L3-L4 laminectomy only), systemic ozone therapy (SOT) group (L3-L4 laminectomy only + intraperitoneal 15 mL [30 mcg/mL] ozone), and local ozone therapy (LOT) group (L3-L4 laminectomy only + subcutaneous 15 mL (30 mcg/mL) ozone). Ozone therapy was administered four times on a 3-day interval during the wound healing process, with the first dose immediately administered after surgery...

BACKGROUND AND IMPORTANCE: Nontraumatic pedicle fracture is uncommon, with sparsely described cases of conservative management versus surgical treatment by open fusion or percutaneous fixation. CLINICAL PRESENTATION: We report the case of a 60 year old woman with nontraumatic L4 and L5 pedicle fracture who developed additional pedicle fractures at L3 while undergoing conservative management in a brace. The patient underwent percutaneous pediculosynthesis with screw fixation without fusion at L3-5 bilaterally...

OBJECTIVE: We present the Jenkins classification for Bertolotti's Syndrome, or symptomatic lumbosacral transitional vertebrae (LSTV) and compare this with the existing Castellvi classification in patients presenting for treatment. METHODS: A retrospective cohort study of 150 new patients presenting for treatment of back, hip, groin, and/or leg pain from July 2012 through February 2022. Using MRI, CT, and X-Ray imaging, patients with radiographic finding of LSTV, appropriate clinical presentation, and identification of LSTV as the primary pain generator via diagnostic injections were diagnosed with Bertolotti's syndrome...

OBJECTIVE: Open corpus callosotomy (CC) poses a higher risk of perioperative morbidity than MR-guided laser interstitial thermal therapy (MRgLITT) for treatment of drop and generalized seizures without documented superiority. We present a single-institution comparison between open and MRgLITT corpus callosotomy. METHODS: A two-year retrospective review was performed on patients who underwent Open and MRgLITT CC (January 2019-January 2021). Demographics, surgical outcome data, hospital costs and interhemispheric connectivity with diffusion tensor imaging (DTI) were compared...

OBJECTIVE: The clinical features and surgical techniques related to patients undergoing resection of extracranial large primary intraosseous meningiomas are studied. METHODS: The clinical characteristics, treatment, and prognosis of 6 patients with primary intraosseous meningiomas larger than 5 cm in diameter were retrospectively reviewed in the 10th Neurosurgical Department of Beijing Tiantan Hospital, Capital Medical University. RESULTS: Five males and one female (18-57 years old) suffered from large primary intraosseous meningiomas...

OBJECTIVE: To examine current neurosurgical oncology leadership trends and provide a guide for those interested in obtaining fellowship directorship, we investigated fellowship director (FD) demographic, educational and leadership characteristics. METHODS: The American Association of Neurological Surgeons (AANS) Academic Fellowship Directory and Committee on Advanced Subspecialty Training (CAST) websites were reviewed for current U.S. program FDs for which data was collected using online resources and surveys...

BACKGROUND: Long standing overt ventriculomegaly in adults (LOVA) is a heterogenous term describing forms of adult hydrocephalus. LOVA incidence is increasing, yet the optimal treatment strategy for symptomatic cases remains unclear. We compared the success and complication rates between Endoscopic Third Ventriculostomy (ETV) and Ventriculoperitoneal Shunt (VPS) as a first line treatment for LOVA. METHODS: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines (PROSPEROID CRD42021277542)...

OBJECTIVE: This study aimed to compare the prognostic value of Marshall, Rotterdam, and Neuroimaging Radiological Interpretation Systems (NIRIS) in predicting the in-hospital outcomes of patients with traumatic brain injury (TBI). METHODS: We identified 250 TBI patients in a retrospective single-center cohort from 2019-2020. Computed tomography (CT) scans were reviewed by two radiologists and scored according to three CT scoring systems. One-month outcomes were evaluated, including hospitalization, intensive care unit (ICU) admission, neurosurgical procedure, and mortality...

OBJECTIVES: To investigate the predictive value of noncontrast computed tomography (NCCT) models based on radiomics features and machine learning (ML) for early perihematomal edema (PHE) expansion in patients with spontaneous intracerebral hemorrhage (ICH). METHODS: We retrospectively reviewed NCCT data from 214 patients with spontaneous intracerebral hemorrhage. All radiomics features were extracted from volume of interest (VOI) of hematomas on admission scans...

BACKGROUND: Spontaneous intraventricular hemorrhage (IVH) is a cause of significant morbidity and mortality. Treatment for the resulting obstructive hydrocephalus has traditionally been via an external ventricular drain (EVD). We aimed to compare patient outcomes after neuroendoscopic surgery (NES) evacuation of IVH versus EVD management. METHODS: MEDLINE, EMBASE, and the Cochrane Library were searched on October 8, 2022, with adherence to PRISMA guidelines. Of the 252 records remaining after removal of duplicates, 12 met the study's inclusion criteria...

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No abstract text is available yet for this article.

BACKGROUND: Chiari malformation type 1 (CM-1) diagnosis is based on measurement of the cerebellar tonsils on cranial or cervical spine MRI. However. imaging parameters of cranial and cervical spine MRIs could differ because spine MRIs have greater resolution. METHODS: We conducted a retrospective chart review of 161 patients of a single neurosurgeon for Adult CM-I consultation between February 2006 and March 2019. Patients were selected based on receiving both cranial and cervical spine MRIs within a month of each other to determine tonsillar ectopia length for CM-1...

BACKGROUND: Tuberculum sellae meningiomas (TSMs) have traditionally been removed using a transcranial approach. In recent years, endoscopic surgeries for TSMs have been reported with an expansion of indications. OBJECTIVE: We have performed a fully endoscopic supraorbital keyhole approach for small to medium size TSMs, and performed radical tumor removal similar to conventional transcranial procedure. We report the details of this surgical procedure including cadaveric stepwise dissection and initial surgical results for small to medium size TSMs...

BACKGROUND: Intramedullary spinal AVM (ISAVM, glomus type) is a type of spinal cord arteriovenous malformation, which is a rare disease known often to have a complex vascular supply interfering with that of the spinal cord, and is in complex anatomical relations with cord structures and nerve roots. Though microsurgical and endovascular treatment has mainly been the standard options, in high-risk cases with these treatments, stereotactic radiotherapy (SRT) might be the option of choice...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVE: A cerebrospinal fluid (CSF) venous fistula (CVF) is an aberrant connection between the subarachnoid space and a vein resulting in CSF loss. The presentation and management of CVF with cognitive decline is incompletely understood. METHODS: A systematic review was completed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles that included at least one case of imaging-confirmed CVF with details on patient treatment were included...

OBJECTIVE: Spinopelvic parameters are vital components that must be considered when treating patients with spinal pathologies. Several finite element studies have explored spinopelvic parameters such as sacral slope (SS) and the impact on the lumbar spine, though no study has examined the effect on the hip and sacroiliac joint (SIJ) on varying SS angles. Therefore, it is necessary to have a biomechanical understanding of the impact on the spinopelvic complex. METHODS: A finite element (FE) lumbar, pelvis, and femoral model was created from CT scans of a 55-year-old female patient with no abnormalities...

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