Integrating Augmented Reality in Spine Surgery: Redefining Precision with New Technologies.

Introduction: The integration of augmented reality (AR) in spine surgery marks a significant advancement, enhancing surgical precision and patient outcomes. AR provides immersive, three-dimensional visualizations of anatomical structures, facilitating meticulous planning and execution of spine surgeries. This technology not only improves spatial understanding and real-time navigation during procedures but also aims to reduce surgical invasiveness and operative times.

The Use of Technology-Based Simulation among Medical Students as a Global Innovative Solution for Training.

Background: Technological advancements have been rapidly integrated within the neurosurgical education track since it is a high-risk specialty with little margin for error. Indeed, simulation and virtual reality during training can improve surgical performance and technical skills. Our study aims to investigate the impact of neurosurgical technology-based simulation activities on medical students.

A guide to interpreting systematic reviews and meta-analyses in neurosurgery and surgery.

Introduction: Systematic reviews (SRs) and meta-analyses (MAs) are methods of data analysis used to synthesize information presented in multiple publications on the same topic. A thorough understanding of the steps involved in conducting this type of research and approaches to data analysis is critical for appropriate understanding, interpretation, and application of the findings of these reviews.

Methods: We reviewed reference texts in clinical neuroepidemiology, neurostatistics and research methods and other previously related articles on meta-analyses (MAs) in surgery.

Boosting teamwork between scrub nurses and neurosurgeons: exploring the value of a role-played hands-on, cadaver-free simulation and systematic review of the literature.

Background: Recently, non-technical skills (NTS) and teamwork in particular have been demonstrated to be essential in many jobs, in business as well as in medical specialties, including plastic, orthopedic, and general surgery. However, NTS and teamwork in neurosurgery have not yet been fully studied. We reviewed the relevant literature and designed a mock surgery to be used as a team-building activity specifically designed for scrub nurses and neurosurgeons.

Reducing the Gap in Neurosurgical Education in LMICs: A Report of a Non-Profit Educational Program.

Introduction: Central to neurosurgical care, neurosurgical education is particularly needed in low- and middle-income countries (LMICs), where opportunities for neurosurgical training are limited due to social and economic constraints and an inadequate workforce. The present paper aims (1) to evaluate the validity and usability of a cadaver-free hybrid system in the context of LMICs and (2) to report their learning needs and whether the courses meet those needs via a comprehensive survey.

Methods: From April to November 2021, a non-profit initiative consisting of a series of innovative cadaver-free courses based on virtual and practical training was organized.

Needs, Roles, and Challenges of Young Asian Neurosurgeons.

Background: Asia has a marked shortage of neurosurgical care, with approximately 2.5 million critical cases left untreated. The Young Neurosurgeons Forum of the World Federation of Neurosurgical Societies surveyed Asian neurosurgeons to identify research, education, and practice.

Exoscope and operative microscope for training in microneurosurgery: A laboratory investigation on a model of cranial approach.

Objective: To evaluate the viability of exoscopes in the context of neurosurgical education and compare the use of a 4k3D exoscope to a traditional operative microscope in the execution of a task of anatomic structure identification on a model of cranial approach.

Material And Methods: A cohort of volunteer residents performed a task of anatomical structure identification with both devices three times across an experimental period of 2 months. We timed the residents' performances, and the times achieved were analyzed.

Applying objective metrics to neurosurgical skill development with simulation and spaced repetition learning.

Objective: Surgical skills laboratories augment educational training by deepening one's understanding of anatomy and allowing the safe practice of technical skills. Novel, high-fidelity, cadaver-free simulators provide an opportunity to increase access to skills laboratory training. The neurosurgical field has historically evaluated skill by subjective assessment or outcome measures, as opposed to process measures with objective, quantitative indicators of technical skill and progression.

Does the Timing of the Surgery Have a Major Role in Influencing the Outcome in Elders with Acute Subdural Hematomas?

Background: The incidence of traumatic acute subdural hematomas (ASDH) in the elderly is increasing. Despite surgical evacuation, these patients have poor survival and low rate of functional outcome, and surgical timing plays no clear role as a predictor. We investigated whether the timing of surgery had a major role in influencing the outcome in these patients.

Virtual-Augmented Reality and Life-Like Neurosurgical Simulator for Training: First Evaluation of a Hands-On Experience for Residents.

Background: In the recent years, growing interest in simulation-based surgical education has led to various practical alternatives for medical training. More recently, courses based on virtual reality (VR) and three-dimensional (3D)-printed models are available. In this paper, a hybrid (virtual and physical) neurosurgical simulator has been validated, equipped with augmented reality (AR) capabilities that can be used repeatedly to increase familiarity and improve the technical skills in human brain anatomy and neurosurgical approaches.

Pre-clinical Comparison of a High-Definition 3-Dimensional Exoscope and an Operating Microscope: A Prospective Randomized Crossover Study.

Objective: The high-definition 3D operating exoscope is a new tool for surgical visualization and magnification that was designed to replace the operating microscope. However, the paucity of studies that have prospectively compared the two systems has made it difficult to draw clear recommendations. The purpose of this study was to compare the operating exoscope and the operating microscope in first-time users in a pre-clinical setting.

Tentorial Notch Meningiomas: Innovative Preoperative Management and Literature Review.

Background: Tentorial meningiomas account for only 3-6% of all intracranial meningiomas. Among them, tentorial incisura (notch) location must be considered as a subgroup with specific surgical anatomy and indications, morbidity, and mortality. In this study, we propose an update on preoperative management in order to reduce postoperative deficits.

New neuroanatomy learning paradigms for the next generation of trainees: A novel literature-based 3D methodology.

Background: An appreciation for complex three-dimensional relationships in neuroanatomy forms a fundamental tenet of neurosurgical education. The value of experience in the cadaver lab is indisputable; however, it is expensive and often inaccessible. The wide availability of 3D technologies has opened new possibilities, although scientific inaccuracy has hitherto limited their use.

Minimally Invasive Subfrontal Approach: How to Make it Safe and Effective from the Olfactory Groove to the Mesial Temporal Lobe.

Background:  Different surgical approaches have been developed to manage lesions of the anterior and middle skull base areas. Frontal, pterional, bifrontal, and fronto-orbito-zygomatic approaches are traditionally used to reach these regions. With advancements in the neurosurgical field, skull opening should be simple and as minimally invasive as possible, tailored on the surgical corridor to the target.

The World Federation of Neurosurgical Societies Young Neurosurgeons Survey (Part II): Barriers to Professional Development and Service Delivery in Neurosurgery.

Background: Strengthening health systems requires attention to workforce, training needs, and barriers to service delivery. The World Federation of Neurosurgical Societies Young Neurosurgeons Committee survey sought to identify challenges for residents, fellows, and consultants within 10 years of training.

Methods: An online survey was distributed to various neurosurgical societies, personal contacts, and social media platforms (April-November 2018).

The World Federation of Neurosurgical Societies Young Neurosurgeons Survey (Part I): Demographics, Resources, and Education.

Background: Providing a comprehensive and effective neurosurgical service requires adequate numbers of well-trained, resourced, and motivated neurosurgeons. The survey aims to better understand 1) the demographics of young neurosurgeons worldwide; 2) the challenges in training and resources that they face; 3) perceived barriers; and 4) needs for development.

Methods: This was a cross-sectional study in which a widely disseminated online survey (April 2018-November 2019) was used to procure a nonprobabilistic sample from current neurosurgical trainees and those within 10 years of training.

Surgical Management of Brain Cavernous Malformations.

Surgical removal of accessible lesions is the only direct therapeutic approach for cerebral cavernous malformations (CCMs). The approach should be carefully evaluated according to clinical, anatomical, and neuroradiological assessment in order to both select the patient and avoid complications. In selected cases, a quantitative anatomical study with a preoperative simulation of surgery could be used to plan the operation.

Custom-Made Porous Hydroxyapatite Cranioplasty in Patients with Tumor Versus Traumatic Brain Injury: A Single-Center Case Series.

Background: Cranioplasty is a common neurosurgical procedure with the goal of restoring skull integrity. Custom-made porous hydroxyapatite prostheses have long been used for cranial reconstruction in patients with traumatic brain injury. We present a large consecutive series of 2 groups of patients undergoing cranioplasty with hydroxyapatite custom bone and compare the adverse events (AEs) between the 2 groups.

Three-Dimensional Virtual Intraoperative Reconstruction: A Novel Method to Explore a Virtual Neurosurgical Field.

Background: Acquisition of neurosurgical anatomy knowledge requires the progressive construction of a 3-dimensional (3D) mental image from the study of 2-dimensional pictures. Tridimensional neuroimaging modeling and 3D pictures and videos have facilitated a better understanding of intricate brain anatomy. One of the main limitations of these methods however is that the user is unable to freely change his or her own point of view of the observed structures.