Operative Neurosurgery (Hagerstown, Md.)

BACKGROUND AND OBJECTIVES: Neurosurgeons need a profound knowledge of the surgical anatomy of the cerebral arteries to safely treat patients. This is a challenge because of numerous branches, segments, and tortuosity of the main blood vessels that supply the brain. The objective of this study was to create high-quality three-dimensional (3D) anatomic photorealistic models based on dissections of the brain arterial anatomy and to incorporate this data into a virtual reality (VR) environment...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND AND OBJECTIVES: Distal nerve transfers for muscle reinnervation and restoration of function after upper and lower motor neuron lesions are a well-established surgical approach. The brachialis to anterior interosseous nerve (BrAIN) transfer is performed for prehension reanimation in lower brachial plexus and traumatic cervical spinal cord injuries. The aim of the study is to shed light on the inconsistent results observed in patients who undergo the BrAIN transfer. METHODS: An anatomic dissection was conducted on 30 fresh upper limb specimens to examine the intraneural topography of the median nerve (MN) in the upper arm at the level of the BrAIN transfer and the presence of intraneural fascicular interconnections distally...

BACKGROUND AND OBJECTIVES: The jugular fossa (JF) is a challenging area for surgical approaches because of its complex anatomy and proximity to neurovascular structures. The study evaluates the feasibility of the neuronavigated microsurgical transmastoid extended infralabyrinthine extradural retrofacial approach (mTEIER-A) in human head specimens for accessing the entire intraosseous JF in relation to the position of the sigmoid sinus (SS), horizontal angle of attack, and size of the SS...

BACKGROUND AND OBJECTIVES: Although diffuse gliomas in the primary somatosensory cortex (S1) are often considered resectable, gliomas in the primary motor cortex require motor mapping to preserve motor function. Recent evidence indicates that some somatosensory cortex neurons may trigger motor responses, necessitating refined somatosensory mapping techniques. METHODS: Using piezoelectric tactile stimulators on patients' faces and hands, we delivered 25 Hz vibrations and prompted patients to discriminate between dermatomes...

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BACKGROUND AND OBJECTIVES: The transorbital approach (TOA) facilitates access to pathologies lateral to the optic nerve, a region that is difficult to access with an endonasal approach. In this study, we sought to investigate the feasibility of robotic-assisted surgery in lateral TOA. METHODS: Six colored-silicon-injected human postmortem heads were prepared for dissection. The DaVinci Xi model was used with a 0-degree camera, 8 mm in diameter. A black diamond microforceps with an 8-mm diameter and 10-mm jaw length was used...

BACKGROUND AND OBJECTIVES: We present a novel technique of selective apical convex rod derotation as an effective and safe maneuver for the correction of adolescent idiopathic scoliosis and give the clinical results of our patients. Adolescent idiopathic scoliosis is the three-dimensional deformity of the spine of more than 10° affecting children from 10 to 18 years. The gold standard for the correction of larger curves is posterior fusion. With the help of osteotomies, the spine becomes mobile and the ideal alignment can be achieved with correction maneuvers...

BACKGROUND AND OBJECTIVES: For irreducible atlantoaxial rotary fixation (AARF), anterior or posterior release was often needed before posterior reduction and fusion. Anterior atlantoaxial joint release has potential complications such as retropharyngeal abscess, persistent hoarseness, and infection. This study aims to assess the efficacy of posterior release, reduction, and intra-articular fusion without resecting the C2 nerve root on irreducible type III AARF. METHODS: The data of 9 pediatric patients diagnosed with AARF who underwent posterior atlantoaxial release, reduction, and intra-articular fusion without resecting the C2 nerve root were retrospectively reviewed...

BACKGROUND AND OBJECTIVES: Transection of the free edge of tentorium (FET) might be necessary when approaching cavernous sinus lesions, clip placement in certain posterior communicating artery aneurysms, or during transpetrosal and retrosigmoid transtentorial approaches. No anatomic study has investigated the relationship of the trochlear and oculomotor nerve and FET in an attempt to identify a safe zone for such maneuver. METHODS: Ten embalmed specimens (20 sides) were studied and the following morphometric measurements were taken using digital microcalipers: trochlear (TP) to oculomotor porus (OP), length of the intratentorial segment of cranial nerve (CN) IV, nerve free FET, and distance along the oculomotor (CN III) from its OP to CN III/trochlear (CN IV) crossing and angle between the long-axis petrous ridge and TP (petrotrochlear angle)...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND AND OBJECTIVES: As advancements in cancer treatments have allowed patients with a high burden of disease to live longer, the number of patients who present with debilitating refractory pain has increased. Anterolateral cordotomy has long been used for the treatment of intractable unilateral cancer pain using either an imaging-guided percutaneous approach or an open surgical approach. In this report, we describe a novel minimally invasive modification to the open surgical approach...

BACKGROUND AND OBJECTIVES: Open thoracic diskectomy often requires significant bone resection and fusion, whereas an endoscopic thoracic diskectomy offers a less invasive alternative. Therefore, we sought to compare one-level open vs endoscopic thoracic diskectomy regarding (1) perioperative outcomes, (2) neurological recovery, and (3) total cost. METHODS: A single-center, retrospective, cohort study using prospectively collected data of patients undergoing one-level thoracic diskectomy was undertaken from 2018 to 2023...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND AND OBJECTIVES: The abducens nerve (CN VI) is vulnerable to injury during endoscopic endonasal transcavernous surgery. In this study, the authors aimed to develop the surgical anatomic landmark and explore the relationship between the sympathetic nerves (SNs) around the internal carotid artery (ICA) and CN VI within the cavernous sinus (CS). METHODS: The relationship and patterns between the SNs and CN VI were investigated in 15 cadaveric specimens. The intraoperative examples of anatomic landmark were presented...