World Neurosurg
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Mixed reality (MR) technology has opened new avenues for planning, visualization, and education in surgery. Neurosurgical pathologies require a very clear understanding of the relationships between pathology and critical neurovascular structures. The decline in cadaveric dissections and resource constraints has pushed the educators to find newer ways of rendering the same knowledge. The aim of this study was to determine the feasibility of employing a MR device in a high-volume center for neurosurgical teaching. The study also evaluated the results of the trainee experience in using the MR platform. ⋯ This study demonstrates the feasibility of using MR platform in neurosurgery training without significant preparation requirements. These data are required to justify the future investment in this technology for training institutions.
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Tuberculum sellae meningiomas (TSMs) have traditionally been removed using a transcranial approach. In recent years, endoscopic surgery for TSMs has been reported with an expansion of indications. ⋯ The endoscopic supraorbital eyebrow approach for TSMs allowed resection of the lesion, including tumor extending to the optic canal, with a good surgical view. This technique is minimally invasive for patients and may represent a good surgical option for medium-sized TSMs.
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Lumbar spinal canal stenosis (LSS) with diffuse idiopathic skeletal hyperostosis (DISH) can require revision surgery because of the intervertebral instability after decompression. However, there is a lack of mechanical analyses for decompression procedures for LSS with DISH. ⋯ The concentration of stress because of DISH may influence adjacent segment disease on the nonunited segment of PLIF. A shorter-level lumbar interbody fixation is recommended to preserve ROM; however, it should be used with caution because it could provoke adjacent segment disease.
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Mutations in isocitrate dehydrogenase 1 (IDH1) induce extensive transcriptional alterations to promote glioma development. However, IDH1 mutation contributes the better clinical outcomes of glioma. Further understanding the transcriptional and DNA methylation changes mediated by IDH1 mutation will provide new therapeutic targets for glioma. ⋯ RARRES2 was downregulated by IDH1 mutation and served as an unfavorable prognostic factor in glioma.
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To investigate trends in the characteristics of postoperative C5 palsy following anterior decompression and fusion associated with advancements in this surgical procedure to treat cervical degenerative disorders. ⋯ With advancements in surgical techniques which allowed necessary and sufficient spinal cord decompression and avoided unnecessary corpectomy, the incidence of C5 palsy in patients without OPLL was decreased significantly. By contrast, for patients with OPLL, the incidence of C5 palsy was similar to the incidence found previously, perhaps because a broad and contiguous multilevel corpectomy was usually needed to decompress the spinal cord sufficiently.