Use of 3- Dimensional Modeling and Virtual Reality in the Education of Posterior Spinal Instrumentation.

Aim: To assess the effectiveness and safety of Virtual Reality (VR) simulations for education of posterior spinal instrumentation.

Material And Methods: Participants were instructed to apply Cervical-Thoracic-Lumbar and Sacral posterior instrumentation techniques using the VR. Each participant underwent a qualitative assessment of the use of the VR.

Exosomes encapsulated in hydrogels for effective central nervous system drug delivery.

The targeted delivery of pharmacologically active molecules, metabolites, and growth factors to the brain parenchyma has become one of the major challenges following the onset of neurodegeneration and pathological conditions. The therapeutic effect of active biomolecules is significantly impaired after systemic administration in the central nervous system (CNS) because of the blood-brain barrier (BBB). Therefore, the development of novel therapeutic approaches capable of overcoming these limitations is under discussion.

The association between calreticulin and glucagon-like peptide-1 expressions with prognostic factors in high-grade gliomas.

Objective: The aim of this study is to present the expressions of Calreticulin (CALR) and Glucagon-like peptide-1 (GLP-1) in high-grade gliomas and to further show the relation between the levels of these molecules and Ki-67 index, presence of Isocitrate dehydrogenase (IDH)-1 mutation, and tumor grade.

Patients And Methods: A total of 43 patients who underwent surgical resection due to high-grade gliomas (HGG) (grades III and IV) were included. The control group comprised 27 people who showed no gross pathology in the brain during the autopsy procedures.

Does long segment subarachnoido-subarachnoid shunt prevent posttraumatic and postinfectious spinal arachnoid cyst recurrence?: technical note and case series.

Syringomyelia associated with extensive spinal adhesive arachnoiditis (SAA) can be defined as a rare but progressive disease with potentially devastating clinical consequences. Diagnosis can be challenging due to the absence of specific clinical findings, confusion with other pathologies, and late imaging modalities. The treatment strategy for syringomyelia associated with extensive SAA should include direct drainage of the syringomyelia, and dissection of the adhesive arachnoid with expansive duraplasty.

Use of 3-Dimensional Modeling and Augmented/Virtual Reality Applications in Microsurgical Neuroanatomy Training.

Background: Understanding the microsurgical neuroanatomy of the brain is challenging yet crucial for safe and effective surgery. Training on human cadavers provides an opportunity to practice approaches and learn about the brain's complex organization from a surgical view. Innovations in visual technology, such as virtual reality (VR) and augmented reality (AR), have immensely added a new dimension to neuroanatomy education.

Frame-Based Stereotactic Biopsy - A Single Neurosurgeon Experience of 604 Diagnostic Procedures and Literature Review.

Aim: Frame-based stereotactic biopsy (SB) is essential in managing patients with suspected intracranial lesions. This study aimed to evaluate the surgical experience of the senior neurosurgeon to define the lesion, radiology, and technique-related factors that affect the diagnostic yield and complications, along with the literature review.

Material And Methods: Documents were examined for consecutively performed frame-based SBs from 1999 to 2021.

Preoperative Magnetic Resonance Imaging Abnormalities Predictive of Lumbar Herniation Recurrence After Surgical Repair.

Objective: There are currently no standard criteria for evaluating the risk of recurrent disk herniation after surgical repair. This study investigated the predictive values of 5 presurgical imaging parameters: paraspinal muscle quality, annular tear size, Modic changes, modified Phirrmann disk degeneration grade, and presence of sacralization or fusion.

Methods: Between 2015 and 2018, 188 patients (89 female, 99 male, median age 50) receiving first corrective surgery for lumbar disk herniation were enrolled.

Lumbar Foraminal Stenosis Classification That Guides Surgical Treatment.

Background: There are numerous radiological and anatomical studies on lumbar foramina in the literature, but there are no distinctive studies about the relationship between treatment and the type of foraminal stenosis. This study was conducted to better evaluate foraminal stenosis and to plan treatment accordingly.

Methods: Foraminal stenosis was divided into 2 groups: stable and unstable stenosis.

Contralateral vs. Ipsilateral Approach to Superior Hypophyseal Artery Aneurysms: An Anatomical Study and Morphometric Analysis.

Introduction: Surgical clipping of superior hypophyseal artery (SHA) aneurysms is a challenging task for neurosurgeons due to their close anatomical relationships. The development of endovascular techniques and the difficulty in surgery have led to a decrease in the number of surgical procedures and thus the experience of neurosurgeons in this region. In this study, we aimed to reveal the microsurgical anatomy of the ipsilateral and contralateral approaches to SHA aneurysms and define their limitations via morphometric analyses of radiological anatomy, three-dimensional (3D) modeling, and surgical illustrations.

Gamma Knife radiosurgery for the treatment of central neurocytoma: a single-institution experience of 25 patients.

Central neurocytomas (CNs) are extremely rare tumors that account for 0.1-0.5% of all intracranial neoplasms.

Long-term results of gamma knife radiosurgery for foramen magnum meningiomas.

Outcomes of 37 patients of foramen magnum meningioma (FMM) were evaluated, and the related literature was reviewed to determine the efficacy of Gamma Knife radiosurgery (GKRS) for treating patients with FMM. We present the largest series reported from a single institution with the longest follow-up to date. The database of patients who underwent GKRS for FMM between 2007 and 2019 was evaluated retrospectively.

Long-term results of Gamma Knife radiosurgery for facial nerve schwannomas.

Objective: Long-term outcomes of eleven cases of facial nerve schwannoma were evaluated and the related literature was reviewed to determine the efficacy of Gamma Knife radiosurgery for treating patients with facial nerve schwannoma.

Methods: Eleven patients with facial nerve schwannoma (7 women and 4 men; mean age, 44.2 years; range, 19-73 years) underwent Gamma Knife radiosurgery.

Dynamic Stabilization of the Lumbar Spine using the Dynesys® System.

Aim: To present the clinical results in patients with minor instability with Dynesys® a soft spinal stabilization system.

Material And Methods: A total of 83 patients were operated upon and the Dynesys® system was applied. Indications for surgery included painful degenerative disc disease, degenerative spondylolisthesis and lumbar canal stenosis.

Gamma knife radiosurgery for pituitary spindle cell oncocytomas.

Objectives: Spindle cell oncocytomas (SCOs) are benign lesions of the posterior portion of the pituitary gland that typically come to neurosurgical attention due to compression of the sellar or parasellar structures, and headaches. Initial treatment options for SCOs include surgical resection, particularly via the transsphenoidal approach. However, given that initial resection tends to be insufficient and subsequent revision surgery carries high complication risk, adjuvant treatment modalities may appear to offer promising solutions for controlling tumor progression.

Gamma Knife Radiosurgery for Anterior Clinoid Process Meningiomas: A Series of 61 Consecutive Patients.

Objective: Gamma Knife radiosurgery (GKRS) outcomes for anterior clinoid process (ACP) meningiomas have not been specifically reported within any meningioma series. We present the initial and largest series in the literature that describes the presenting features, radiosurgery parameters, and radiologic and long-term clinical outcomes for 61 patients with ACP meningiomas treated with GKRS.

Methods: Medical records were reviewed for 61 consecutive patients at a single center who underwent GKRS for ACP meningioma between 2008 and 2016.

Can Right-Handed Surgeons Insert Upper Thoracic Pedicle Screws in much Comfortable Position? Right-Handedness Problem on the Left Side.

Objective: Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons.

High Infection Rates in Patients with Long-Segment Dynesys System.

Background: Infection follow-up in patients stabilized with the Dynesys system. Infection rates were determined in patients who had ≥5 segments stabilized with the Dynesys system.

Methods: Eighty-three patients with various etiologies were stabilized with the Dynesys system.

Minimally Invasive Translaminar Endoscopic Approach to Percutaneous Vertebroplasty Cement Leakage: Technical Note.

Background: Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty are 2 common procedures that could be applied simply in treatment of vertebral compression fractures. Despite simplicity and safe application of these procedures, there are some drawbacks as well. Cement leakage into the spinal canal is the most common complication of PVP and PKV procedures.

How to Reduce Stress on the Pedicle Screws in Thoracic Spine? Importance of Screw Trajectory: A Finite Element Analysis.

Aim: To investigate the biomechanical comparison of thoracic transpedicular screw trajectories on the sagittal plane.

Material And Methods: A three-dimensional, non-linear finite element analysis (FEA) model of T8 through T9 was used. Anatomic trajectory (AT) and Straightforward trajectory (ST) models of the transpedicular screws were used in the intact FEA model.

A New Technique for the Surgical Treatment of Atlantoaxial Instability: C1 Lateral Mass and C2-3 Transfacet Screwing.

Aim: Atlantoaxial instability is a special entity that may be caused by many disorders such as trauma, tumor, arthritis, congenital malformation and infection. Atlantoaxial fixation is needed to provide stability, prevent neurological deficits and correct deformity. The objective of this study is to introduce an alternative technique for the treatment of atlantoaxial instability in patients who have vertebral artery anomaly, anomalous C2 or osteoporosis.

Lumbar Epidural Varix Mimicking Disc Herniation.

Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively.

Early and long-term changes in adjacent vertebral body bone mineral density determined by quantitative computed tomography after posterolateral fusion with transpedicular screw fixation.

Objective: The aim of this study is to investigate vertebral body bone mineral density (BMD) changes following posterolateral fusion with transpedicular screw fixation using quantitative computerized tomography (QCT) in short and relatively long-term periods.

Patients And Methods: A retrospective study was performed to investigate vertebral body BMD changes in the patients who underwent posterolateral fusion with transpedicular screw fixation at thoracic and lumbar spine. A total of 160 patients were enrolled into the study.