Neurosurgery
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Multicenter Study Observational Study
Safety and Efficacy of Management for Intraprocedural Rupture During Endovascular Treatment for Intracranial Aneurysms.
Although intraprocedural rupture (IPR) is rare, it is a devastating complication of endovascular treatment (EVT) for intracranial aneurysms. Very few studies have been conducted on IPR, and the safety and efficacy of management techniques of IPR have not been investigated. ⋯ Although the setting of IPR may be miscellaneous, and optimal management varies depending on individual cases, heparin reversal might be associated with ischemic complications, and its role in the successful hemostasis in IPR during EVT for ruptured aneurysms remains unclear.
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Review
Beyond Pedicle Screw Placement: Future Minimally Invasive Applications of Robotics in Spine Surgery.
Advancements in spine surgery have dramatically enhanced minimally invasive techniques, prominently through integrating robotic systems. Although pedicle screw placement remains the most widespread application of this technology, new developments are emerging to create innovative future avenues for these tools. ⋯ We also discuss the potential for integrating artificial intelligence and augmented reality with robotic systems. If the current trajectory of research and innovation continues, there is promise in creating fully autonomous robotic systems that can revolutionize spine surgery by processing, planning, and performing procedures without heavy reliance on the surgeon.
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Single-position prone transpsoas (PTP) lateral interbody fusion has been proposed as an alternative to lateral lumbar interbody fusion performed in the lateral decubitus position. The advantages to this single-position technique include facilitating segmental lordosis, obviating the need for repositioning for posterior instrumentation, and providing access for posterior decompression. ⋯ This review provides a detailed technical description of the PTP technique at L4-L5. In addition, we provide technical pearls aimed at improving surgical ergonomics, workflow, and safety.
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Minimally invasive surgery (MIS) has significantly revolutionized spine surgery by reducing morbidity, minimizing tissue damage, and improving postoperative outcomes compared with traditional open surgeries. Although MIS is well-documented for degenerative spine diseases, its full scope and limitations in spine trauma remains underexplored. Thus, this review aims to address this gap by examining relevant literature on the evolution, current practices, and future directions of MIS applications in spinal trauma care. ⋯ Based on a literature review of 85 studies, the following manuscript focuses on the indications, complications, current literature, clinical outcomes, future directions, and limitations of MIS in managing thoracolumbar and cervical spine injuries with particular emphasis on percutaneous pedicle screw fixation, lateral thoracic and lumbar corpectomies, anterior thoracoscopic/endoscopic approaches, and treatment algorithms. Although MIS for spinal trauma offers numerous advantages, continuous research and data collection are crucial to developing clear treatment algorithms and improving clinical outcomes. However, the future of MIS in spine trauma care remains promising, with advancements in technology and surgical techniques anticipated to enhance safety, efficacy, and patient satisfaction.
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Lateral lumbar interbody fusion (LLIF) is traditionally performed with the patient in the lateral decubitus position for interbody implant insertion and indirect decompression. In cases requiring 360-degree fusion or direct decompression, the patient is repositioned to the prone position during surgery, a technique referred to as dual-position LLIF (DP-L). To improve efficiency and eliminate the need for repositioning, surgeons have adopted single-position approaches, completing the entire procedure either in the lateral decubitus or prone position. ⋯ The development of LLIF represents a notable advancement in spine surgery. SPS builds on this foundation, offering potential improvements over the original technique. While SPS has demonstrated certain advantages, there remains room for further refinement and optimization in its application.