World Neurosurg
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Surgical treatment is an effective strategy for cervical pyogenic spondylodiscitis (CPS). However, the optimal surgical approach is uncertain. This study was conducted to evaluate the clinical efficacy of debridement, reconstruction, and instrumentation via the anterior-only approach for CPS. ⋯ One-stage debridement, reconstruction, and instrumentation via the anterior approach is an effective surgical strategy for CPS. In addition to surgery, targeted and prolonged antibiotic therapy is of crucial importance.
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The transorbital approach (TOA) has a unique advantage to the more common lateral approaches as it provides direct access to the anterior middle fossa and medial sylvian fissure (SF) without significant dissection or retraction. However, when to use the TOA for surgical treatment of middle cerebral artery (MCA) aneurysms remains unclear. This study details the feasibility of clipping unruptured MCA aneurysms via the TOA by highlighting the anatomic features that either facilitate or hinder the approach. ⋯ Given the minimally invasive, technically challenging approach, the feasibility and safety of TOA for MCA aneurysms must be evaluated before wide clinical adoption. This study identified AOF, aneurysm width, and SF accessibility as three features that may significantly impact the possibility of clipping MCA aneurysms via TOA.
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Review Case Reports
Microvascular decompression for oculomotor nerve palsy due to non-aneurysmal neurovaslur conflict: 5 cases report and literature review.
Oculomotor nerve palsy (ONP) is frequently caused by aneurysm compression and diabetes mellitus. However, nonaneurysmal compression (nAVC) of the oculomotor nerve is a condition rarely reported in the literature. Cases treated with microvascular decompression (MVD) for nAVC-induced ONP (nAVC-ONP) are exceptionally rare. ⋯ Neurovascular conflict has been proposed as another possible cause of ONP in a limited number of cases. Based on our findings, MVD is a potentially effective solution for patients experiencing oculomotor nerve palsy resulting from nonaneurysmal neurovascular conflicts. It holds great promise for significantly alleviating symptoms and improving overall quality of life.
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Artificial intelligence (AI) is increasingly significant in neurosurgery, enhancing differential diagnosis, preoperative evaluation, and surgical precision. A recent study in World Neurosurgery evaluated AI's role in aneurysm detection, comparing conventional computed tomography angiography images with AI analysis. AI identified 33 potential aneurysms, with 16 confirmed by radiologists, demonstrating a sensitivity of 36%, specificity of 97.6%, and a negative predictive value of 96.2%. ⋯ However, sensitivity for smaller aneurysms remained lower, indicating the need for further research. In conclusion, AI integration in aneurysm detection and management enhances diagnostic accuracy and precision. While current AI technologies show significant strengths, ongoing research is essential to address limitations and fully realize AI's potential in neurosurgery.
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Review
Stem Cells in the Treatment of Spinal Cord Injury: A Review of Currently Registered Clinical Trials.
Spinal cord injury (SCI) affects around 18,000 individuals annually, representing nearly one-third of all paralysis cases. Stem cell therapy, a focal point in contemporary neuroregeneration research for SCI treatment, holds potential in leveraging undifferentiated stem cells to regenerate damaged tissues. This study seeks to comprehensively analyze current clinical trials exploring the potential use of stem cells in treating spinal cord injuries. ⋯ The promising potential of stem cells in neuroregenerative SCI treatment necessitates further exploration through large-scale, multicenter clinical trials to enhance understanding and guide wider adoption of this emerging treatment paradigm.