World Neurosurg
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When medical devices and equipment in an operating room are connected to a network, vast amounts of data concerning the progress of the operation and the patient's condition can be comprehensively processed to improve the precision and safety of the surgical procedure. To make this possible, a next-generation networked operating room, "Smart Cyber Operating Theater" (SCOT), has been developed with medical-engineer cooperation. SCOT integrates stand-alone medical devices using the "OPeLiNK" communication interface. Using OPeLiNK, medical devices are connected and various data, such as intraoperative magnetic resonance imaging, neuromonitoring, biochemical monitoring, and navigation system, are integrated and displayed in the same timeline. ⋯ This is the first case report of endoscopic endonasal approach performed successfully in the SCOT. Further developments in this technology may lead to innovations in not only microscopic neurosurgery but also endoscopic neurosurgery.
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A 39-year-old man presented with a large left paramedian frontal lobe intracerebral hemorrhage. Computed tomography angiography and magnetic resonance imaging revealed a tangle of vessels arising from the anterior cerebral arteries (ACAs) and dilated draining veins entering the superior sagittal sinus. Angiography confirmed a Spetzler-Martin grade 3, supplemented 2 arteriovenous malformation (AVM) with predominant supply from branches of the left ACA with superficial and deep drainage (Video 1). ⋯ Once the AVM was disconnected and skeletonized from the A2s, the draining vein was clipped and the nidus was removed. Indocyanine green angiography confirmed patency of the A2s and pericallosal arteries. Postoperative angiography demonstrated no residual shunting, and the patient was discharged in good condition.
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Thus study was a retrospective cohort analysis. Anterior cervical discectomy and fusion (ACDF) has been the gold-standard procedure for single-level degenerative disc disease (DDD). Recently, cervical disc arthroplasty (CDA) has become increasingly prevalent as an alternative intervention. ⋯ We found no difference in health care utilization between ACDF and CDA procedures for DDD 5 years after surgery. Also, there was no difference in reoperation rates during the study period. ACDF resulted in significant reduction in overall opioid use after versus before procedure.
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Mastery of the microsurgical anastomosis is an indispensable component of neurosurgical training. However, in many resource-limited countries, the training, materials, and equipment to obtain these surgical and decision making skills are severely lacking. This study aimed to compare different suturing techniques for microvascular anastomosis and to complete a comparative assessment of the performance of a young neurosurgeon when using the various techniques. ⋯ Suturing time was the only statistically significant difference among the 3 anastomotic techniques, with the lid technique apparently the quickest to perform. Such techniques can be designed to assess microsurgical abilities and help neurosurgery residents in developing countries improve their surgical skills and techniques.
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The long-term outcomes of patients with intraprocedural aneurysm rupture (IPR) during endovascular coiling of unruptured intracranial aneurysms (UIAs) remain unclear. We investigated the long-term outcomes and predictors of neurological outcomes in patients who sustained IPR during coil embolization of UIAs. ⋯ The proportion of functionally independent patients did not differ between patients with and without IPR. Patients with BA aneurysms who developed an IPR tended to exhibit more unfavorable clinical courses than patients with AcomA aneurysms.