An Extended Follow-up of Spinal Instrumentation Rescue with Cement Augmentation.

Background And Purpose: Percutaneous cement augmentation has been reported as an effective salvage procedure for frail patients with spinal instrumentation failure, such as screw loosening, hardware breakage, cage subsidence, and fractures within or adjacent to stabilized segments. Favorable results were reported during a median follow-up period of 16 months in a retrospective analysis of 31 consecutive procedures performed in 29 patients. In the present study, the long-term effectiveness of this treatment in avoiding or postponing revision surgery is reported.

Role of Enhanced Recovery after Surgery (ERAS) Protocol in the Management of Elderly Patients with Glioblastoma.

Objective: Among the already difficult management of neuro-oncological patients, the elderly population remains vulnerable. Because of the pathology and the comorbidities, they present a significantly higher rate of medical issues related to surgical management. Despite this, the surgical option, if feasible, remains the gold standard in these patients, and an Enhanced Recovery After Surgery (ERAS) protocol could improve the postoperative safety of the patients.

Novelties for increased safety in cranio-vertebral surgery: a review.

The cranio-vertebral junction (CVJ) was formerly considered a surgical "no man's land" due to its complex anatomical and biomechanical features. Surgical approaches and hardware instrumentation have had to be tailored in order to achieve successful outcomes. Nowadays, thanks to the ongoing development of new technologies and surgical techniques, CVJ surgery has come to be widely performed in many spine centers.

A patient-reported outcome measure for patients with pituitary adenoma undergoing transsphenoidal surgery.

Purpose: Pituitary adenomas affect patients' quality-of-life (QoL) across several domains, with long-term implications even following gross-total resection or disease remission. While clinical outcomes can assess treatment efficacy, they do not capture variations in QoL. We present the development and validation of a patient reported outcome measure (PROM) for patients with pituitary adenomas undergoing transsphenoidal surgery.

Midline sacral meningeal cyst decompression and repair.

Background: Symptomatic midline sacral meningeal cysts (MSMC) are rare, and, as a consequence, so are reports on the surgical techniques to address these lesions. Here we provide a description of the senior author's (ATC) technique.

Method: A sacral laminectomy is performed.

Intraoperative monitoring of visual evoked potentials in patients undergoing transsphenoidal surgery for pituitary adenoma: a systematic review.

Background: Transsphenoidal surgery is the gold standard for pituitary adenoma resection. Although rare, a serious complication of surgery is worsened vision post-operatively.

Objective: To determine whether, in patients undergoing transsphenoidal surgery for pituitary adenoma, intraoperative monitoring of visual evoked potentials (VEP) is a safe, reproducible, and effective technological adjunct in predicting postoperative visual function.

A Novel Intraoperative Ultrasound Probe for Transsphenoidal Surgery: First-in-human study.

. Ultrasound has been explored as an alternative, less bulky, less time-consuming and less expensive means of intraoperative imaging in pituitary surgery. However, its use has been limited by the size of its probes relative to the transsphenoidal corridor.

Accuracy of bolt external ventricular drain insertion by neurosurgeons of different experience.

Objective: The accuracy of tunneled external ventricular drain (EVD) placement has been shown to be similar among practitioners of varying experience, but this has not yet been investigated for bolt EVDs. Tunneled and bolt EVDs are distinct techniques, and it is unclear if conclusions regarding accuracy can be inferred from one method to the other. The goal of this study was to determine whether neurosurgical experience influences the accuracy of bolt EVD placement.

The cruciform drain: a technical note on the surgical management of cystic lesions of the sella.

Background: The postoperative recurrence of cystic lesions of the sella is frequent and may require further surgery for re-drainage.

Objective: To tackle this problem, we propose to insert a small cross-shaped drain coursing from the cyst lumen to the suprasellar cistern. At this early stage of innovation, the technique is primarily intended for patients who present with a recurrence.

Neuronavigation-assisted bedside placement of bolt external ventricular drains in the intensive care setting: a technical note.

Background: The insertion of bolt external ventricular drains (EVD) on the intensive care unit (ICU) has enabled rapid cranial cerebrospinal fluid (CSF) diversion. However, bolt EVDs tend to be perceived as a more challenging technique, particularly when dealing with small ventricles or when there is midline shift distorting the ventricular morphology. Furthermore, if neuronavigation guidance is felt to be necessary, this usually assumes a transfer to an operating theatre.

Endoscopic endonasal intracanalicular optic nerve decompression: how I do it.

Background: The endoscopic endonasal approach for optic nerve decompression is suited for the management of non-traumatic optic neuropathy but remains underreported, presumably due to transcranial approaches still being favoured at individual centres.

Method: The optic canal is approached endoscopically and transsphenoidally through the contralateral nostril. Its inferomedial wall is opened using an irrigated diamond drill, and neuronavigation is used to confirm anatomical bearings.

Intraoperative monitoring with visual evoked potentials for brain surgeries.

Objective: The goal of this study was to determine the performance of intraoperative visual evoked potentials (VEPs) in detecting visual field changes.

Methods: Assessments of VEPs were performed with simultaneous retinal responses by using white light-emitting diodes protected from scialytic microscope lights. The alarm criterion was a reproducible decrease in amplitude of the VEP P100 wave of 20% or more.

Anterior temporal lobectomy.

Background: Anterior temporal lobectomy is the most established neurosurgical procedure for temporal lobe epilepsy. Here we describe this technique.

Method: A temporal craniotomy is performed flush with the middle fossa and exposing the Sylvian fissure.

Corpus callosotomy.

Background: Corpus callosotomy is an effective, relatively low-risk, palliative procedure for a selected population of patients with medically intractable epilepsy. Here we describe this technique.

Method: An interhemispheric microsurgical approach is performed.

Improving workflows of neuro-interventional procedures with autostereoscopic 3D visualization of multi-modality imaging in hybrid interventional suites.

Purpose: Recent developments in interventional neuroradiology techniques, medical imaging modalities, endovascular stenting and embolization materials lead to an increasing number of patients with cerebral aneurysms and arteriovenous malformations that are eligible for endovascular treatment and have opened new perspectives for novel ways for patient treatment in general. In this paper, we describe a software tool for 3D image fusion of multi-modal acquisitions to assist endovascular treatment of cerebral malformations. The software and an autostereoscopic 3D display were implemented and tested in clinical applications in a hybrid interventional suite that is used for radio-interventional as well as neurosurgical procedures.

Right insular damage decreases heartbeat awareness and alters cardio-visual effects on bodily self-consciousness.

Recent evidence suggests that multisensory integration of bodily signals involving exteroceptive and interoceptive information modulates bodily aspects of self-consciousness such as self-identification and self-location. In the so-called Full Body Illusion subjects watch a virtual body being stroked while they perceive tactile stimulation on their own body inducing illusory self-identification with the virtual body and a change in self-location towards the virtual body. In a related illusion, it has recently been shown that similar changes in self-identification and self-location can be observed when an interoceptive signal is used in association with visual stimulation of the virtual body (i.

Augmented reality-assisted bypass surgery: embracing minimal invasiveness.

Objective: The overlay of virtual images on the surgical field, defined as augmented reality, has been used for image guidance during various neurosurgical procedures. Although this technology could conceivably address certain inherent problems of extracranial-to-intracranial bypass procedures, this potential has not been explored to date. We evaluate the usefulness of an augmented reality-based setup, which could help in harvesting donor vessels through their precise localization in real-time, in performing tailored craniotomies, and in identifying preoperatively selected recipient vessels for the purpose of anastomosis.

Augmented reality-assisted skull base surgery.

Neuronavigation is widely considered as a valuable tool during skull base surgery. Advances in neuronavigation technology, with the integration of augmented reality, present advantages over traditional point-based neuronavigation. However, this development has not yet made its way into routine surgical practice, possibly due to a lack of acquaintance with these systems.