World Neurosurg
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has been rapid technological advancement in navigation-guided minimally invasive surgery over the past two decades, making these advancements an invaluable aid for surgeons by essentially providing real-time virtual reconstruction of patient anatomy. The objectives of these navigation- and robot-guided procedures are to reduce the likelihood of neural and vascular injury, minimize hospitalization time, decrease bleeding and postoperative pain, shorten healing time, and lower infection rates. ⋯ Comparing minimally invasive spine interventions with free-hand instrumentation and robotic instrumentation, a statistically significant difference was identified in radiation exposure per screw and surgical time. The literature on Cirq Robotic is limited; however, minimally invasive spine surgery with robotic assistance appears advantageous in terms of radiation exposure and surgical time.
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This bibliometric analysis aimed to map the knowledge network of laminoplasty research. ⋯ This study drew a knowledge map of the top countries, institutions, authors, publications, and journals on laminoplasty over the past 4 decades. The current and future hotspots of laminoplasty focus on sagittal balance, comparison between other surgery in outcomes and complication, and axial symptoms in laminoplasty.
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Comparative Study
Minimizing Invasiveness in Neurosurgical Osteotomies: A Comparative Histomorphometric Study of Piezoelectric Craniotomy versus High-Speed Drill.
Piezoelectric bone cutting has gained popularity in neurosurgical osteotomies due to perceived lower trauma compared to rotary instruments. However, histological confirmation of its decreased aggressiveness is lacking, hindering conclusive proof. This study compares the bony and neuro-meningeal invasiveness of piezoelectric craniotomy with high-speed drill techniques. ⋯ Piezoelectric craniotomy preserves residual osteoblast viability and leptomeningeal integrity while demonstrating lower rates of thermally induced gliosis and histiocytic infiltration compared to high-speed drills. This suggests the piezoelectric osteotome's minimal invasiveness in bone, meningeal, and brain tissue.
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The primary treatment for peripheral nerve tumors involves maximal surgical resection while preserving nerve function. Sodium fluorescein shows potential for enhancing the safety and efficacy of nerve tumor surgery. This review evaluates the advantages and limitations of sodium fluorescein in this context. ⋯ Sodium fluorescein shows promise as assisting tool in nerve tumor surgery by facilitating differentiation among the tumor, parent nerve, and surrounding soft tissue. However, multicenter randomized controlled trials are necessary to determine its effect on extent of resection rates, clinical outcomes, postoperative complication rates, and surgical duration in comparison to current standard of care.
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The shortcomings of business-like management systems in health care were exposed during the coronavirus disease 2019 pandemic when the need for flexibility and a rapid response to patients' needs became pressing. Almost all administrative decisions concerning the management of health care services have an ethical dimension. This research aims to investigate current debates on this subject and fill in the knowledge gaps. ⋯ Purely financial cost containment strategies in health care can be ineffective or even harmful. Therefore, nonfinancial control mechanisms must ensure adherence to personal and professional ethics, together with professionalism based on sound medical knowledge.