World Neurosurg
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Tumor necrosis factor receptor-related factor 3 (TRAF3) interacting protein 3 (TRAF3IP3) is involved in the development of immune tissues and the immune response of the body. Downregulated expression of TRAF3IP3 in malignant melanoma can inhibit tumor growth. The role of TRAF3IP3 in glioma is unknown. ⋯ TRAF3IP3 play an important role in the occurrence and development of glioma and may be a potential biomarker for the prognosis of glioma.
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The parahippocampal gyrus is understood to have a role in high cognitive functions including memory encoding and retrieval and visuospatial processing. A detailed understanding of the exact location and nature of associated white tracts could significantly improve postoperative morbidity related to declining capacity. Through diffusion tensor imaging-based fiber tracking validated by gross anatomic dissection as ground truth, we have characterized these connections based on relationships to other well-known structures. ⋯ The parahippocampal gyrus is an important center for memory processing. Subtle differences in executive functioning following surgery for limbic tumors may be better understood in the context of the fiber-bundle anatomy highlighted by this study.
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This video describes an awake robotic minimally invasive transforaminal lumbar interbody fusion (TLIF). Minimally invasive spine surgery leads to reduced perioperative morbidity while accelerating recovery by limiting soft tissue damage, blood loss, and postoperative pain. Robotic guidance systems have recently emerged to increase accuracy of instrumentation placement, reduce radiation burden, and enhance surgical ergonomics. ⋯ Given that the patient failed conservative measures, and considering that she had severe nausea and delirium after general anesthesia, she was offered an awake L4-5 robotic TLIF using the Mazor X robotic guidance system (Medtronic, Minneapolis, Minnesota, USA) (Video 1). We document the first awake robotic TLIF in the literature. This video describes how to efficiently insert robotic techniques into the awake spine workflow.1,2.
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The acute-stage intraoperative findings of the spinal dural laceration in patients with traumatic cerebrospinal fluid (CSF) leakage have not been clearly revealed so far. Herein, we report an interesting case of traumatic CSF leakage in a patient who underwent acute-stage direct closure for a dural laceration similar to a stab at the C1/2 level. Because a 41-year-old man strongly twisted his neck, he had a typical orthostatic headache. ⋯ Direct surgical closure was performed 13 days after the onset of symptoms, and dural laceration with sharp edges was detected on the right side at the C1/2 level. The laceration was sutured and coated with dural sealant. Finally, the patient's orthostatic headache was relieved completely after the operation.
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In microneurosurgery, the operating microscope plays a vital role. The classical neurosurgical operation is bimanual, that is, the microsurgical instruments are operated with both hands. Often, operations have to be carried out in narrow corridors at the depth of several centimeters. With current technology, the operator must manually adjust the field of view during surgery-which poses a disruption in the operating flow. Until now, technical adjuncts existed in the form of a mouthpiece to move the stereo camera unit or voice commands and foot pedals to control other interaction tasks like optical configuration. However, these have not been widely adopted due to usability issues. This study tests 2 novel hands-free interaction concepts based on head positioning and gaze tracking as an attempt to reduce the disruption during microneurosurgery and increase the efficiency of the user. ⋯ The hands-free interaction concepts presented in this study demonstrated a more efficient execution of the microneurosurgical tasks than the classical manual microscope and were assessed to be more preferable by both residents and consultant neurosurgeons.