Publications by authors named "Cardia A"

Purpose: The OF5 type of vertebral osteoporotic fracture (AO Spine-DGOU classification) represents a three-column lesion and as such is considered as highly unstable. These lesions, however, tend to affect elderly, frail patients, in whom invasive management options are limited. The stent-screw-assisted internal fixation (SAIF) technique has previously been reported as a minimally invasive treatment for osteoporotic and neoplastic vertebral fractures.

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Introduction: Intensive research is dedicated to the development of novel biomaterials and medical devices to be used as grafts in reconstructive surgery, with the purpose of enhancing their therapeutic effectiveness, safety, and durability. A variety of biomaterials, from autologous bone to polymethylmetacrylate, polyether ether ketone, titanium, and calcium-based ceramics are used in cranioplasty. Porous hydroxyapatite (PHA) is reported as a possible material for bone reconstruction, with good signs of biocompatibility, osteoconductive and osteointegrative properties.

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The urgent etiological diagnosis represents the main management objective of cervical spondylodiscitis (CSD) to start as soon as possible antibiotic treatment to prevent neurological deterioration. The present study aimed to evaluate a multicenter experience implementing a minimally invasive surgical approach (MISA) to manage CSD such pathology vs the most complex and aggressive surgical strategies currently used.This retrospective multicenter study used a database of 70 patients from five European neurosurgical centers.

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Article Synopsis
  • Spontaneous supratentorial intracerebral hemorrhage is a severe type of stroke with high mortality rates, and there are currently no effective treatments to improve patient outcomes.
  • This trial will assess the effects of early minimally invasive endoscopic surgery compared to the best medical treatment, focusing on functional outcomes after 6 months.
  • Conducted in Switzerland, this multicenter study aims to fill the gap in large randomized trials, potentially establishing new treatment options for this life-threatening condition.
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Spinal cord injury (SCI) is a devastating condition that can cause significant motor and sensory impairment. Microglia, the central nervous system's immune sentinels, are known to be promising therapeutic targets in both SCI and neurodegenerative diseases. The most effective way to deliver medications and control microglial inflammation is through nanovectors; however, because of the variability in microglial morphology and the lack of standardized techniques, it is still difficult to precisely measure their activation in preclinical models.

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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.

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Purpose: Glioblastoma is the most common type of primary brain malignancy and has a poor prognosis. The standard treatment strategy is based on maximal safe surgical resection followed by radiotherapy and chemotherapy. Surgical resection can be optimized by using 5-delta-aminolevulinic acid (5-ALA)-induced fluorescence, which is the current mainstay.

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Article Synopsis
  • No existing algorithms guide surgical strategies in complex cases of degenerative cervical myelopathy (DCM), prompting the creation of the Cervical Surgical Score (CSS) to identify and suggest treatment options for complex cases.
  • The CSS was developed through multidisciplinary discussions and considers eight parameters related to cervical pathology and clinical myelopathy, with a study involving 100 patients undergoing surgery and comparing surgical recommendations from the CSS and a standard outpatient approach.
  • Results indicated that CSS effectively identified cases in a "grey zone" for surgical approach options, leading to changes in planned surgeries for nearly 43% of those cases, with 62% of patients showing improved clinical outcomes.
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Glioblastoma multiforme (GBM) is usually treated with surgery followed by adjuvant partial radiotherapy combined with temozolomide (TMZ) chemotherapy. Recent studies demonstrated a better survival and good response to TMZ in methylguanine-DNA methyltransferase ()-methylated GBM cases. However, approximately 20% of patients with -unmethylated GBM display an unexpectedly favorable outcome.

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is a Gram-positive pathogenic bacterium which can be found in soil or water. Infection with the microorganism can occur after ingestion of contaminated food products. Small and large outbreaks of listeriosis have been described in the past.

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Anterior Visual Pathway (aVP) damage may be linked to diverse inflammatory, degenerative and/or vascular conditions. Currently however, a standardized methodological framework for extracting MRI biomarkers of the aVP is not available. We used high-resolution, 3-D MRI data to generate a probabilistic anatomical atlas of the normal aVP and its intraorbital (iOrb), intracanalicular (iCan), intracranial (iCran), optic chiasm (OC), and tract (OT) subdivisions.

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Introduction: In recent years, introduction of the exoscope system has been responsible for a new era of optics in surgery. Such a system has started to be widely used in neurosurgery. More recently, the exoscope has also been increasingly used for spinal procedures.

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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.

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Introduction: Intracranial aneurysms occur in 3%-5% of the general population. While the precise biological mechanisms underlying the formation, growth, and sudden rupture of intracranial aneurysms remain partially unknown, recent research has shed light on the potential role of inflammation in aneurysm development and rupture. In addition, there are ongoing investigations exploring the feasibility of employing new drug therapies for controlling the risk factors associated with aneurysms.

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Subarachnoid hemorrhage (SAH) represents a severe acute event with high morbidity and mortality due to the development of early brain injury (EBI), secondary delayed cerebral ischemia (DCI), and shunt-related hydrocephalus. Secondary events (SSE) such as neuroinflammation, vasospasm, excitotoxicity, blood-brain barrier disruption, oxidative cascade, and neuronal apoptosis are related to DCI. Despite improvement in management strategies and therapeutic protocols, surviving patients frequently present neurological deficits with neurocognitive impairment.

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Background: The aim of this study was to achieve a consensus on the minimum set of outcome measures and predictors to be used in the neurosurgical practice and on the timing of outcome assessment.

Methods: A consensus building approach was employed. All neurosurgical departments in Lombardy (Italy) were invited to participate by the Carlo Besta Neurologic Institute IRCCS Foundation.

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Glioblastoma multiforme (GBM) remains one of the tumors with the worst prognosis. In recent years, a better overall survival (OS) has been described in cases subjected to Gross Total Resection (GTR) that were presenting hypermethylation of Methylguanine-DNA methyltransferase (MGMT) promoter. Recently, also the expression of specific miRNAs involved in MGMT silencing has been related to survival.

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Introduction: Neurosurgery is one of the fields in which intraoperative imaging is paramount. One of these main imaging tools that have been acquiring the interest of the neurosurgical community is Ultrasound elastography (USE), which is an imaging technology sensitive to tissue stiffness. Here we present a systematic review of the use of USE in neurosurgery.

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Background: In the last years, laser interstitial thermal therapy (LITT) has started to be used also in neurosurgical setting. Its efficacy for intracranial pathologies, namely, tumors and epilepsy, has been widely demonstrated. However, the literature evidences about the use of LITT for spinal lesions are recent, and it is still a topic of discussion regarding its efficacy.

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Article Synopsis
  • - The study investigates the treatment outcomes of high-grade arteriovenous malformations (AVMs) in a multicenter setting across two Italian hospitals from 2015 to 2019, focusing on those graded IV and V using surgical risk assessment scales.
  • - A total of 20 patients were analyzed, with results showing that 65% had favorable outcomes after surgery, indicating that pre-operative factors like mRS score, age, and bleeding history influenced recovery.
  • - The findings suggest that surgical intervention should be reserved for select patients with severe symptoms or repeated bleeding, and that classification systems can help in making informed decisions about suitable candidates for surgery.
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