World Neurosurg
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Immune checkpoint inhibitors (ICIs) have shown growing promise in the treatment of brain metastases, especially combined with stereotactic radiosurgery (SRS). The combination of ICIs with SRS has been studied for efficacy as well as increasing radiation necrosis risks. In this review, we compare clinical outcomes of radiation necrosis, intracranial control, and overall survival between patients with brain metastases treated with either SRS alone or SRS-ICI combination therapy. ⋯ Combination SRS-ICI therapy is associated with significant overall survival benefit for patients with brain metastases without significantly increasing radiation necrosis risks compared to SRS alone. Although intracranial control rates appear to be similar between the 2 groups, timing of treatment delivery may improve control rates and demands further study attention.
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Sporadic spinal hamartomas in adults are extremely rare tumor-like lesions, without defined guidelines of treatment. The aim of this study is to investigate the peculiar features of this pathologic entity to support a more accurate diagnosis and management. ⋯ Spinal hamartomas in adults may sometimes account for progressive worsening of neurologic symptoms and lead to potentially irreversible neurologic deficit; therefore, prompt and adequate diagnosis and treatment are mandatory. Surgical resection represents the only curative treatment and is indicated for symptomatic lesions to achieve neurologic symptoms restoration or arrest/prevent their progressive deterioration.
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Surgeons sustain deviated postures during procedures even with the use of loupes or an operative microscope. The surgical exoscope is a new intraoperative visualization technology designed to improve surgical ergonomics; however, no objective data exist to say that surgeon posture is significantly improved. This study aimed to quantify the difference in posture during standard anterior cervical spine procedures performed with the aid of an operative microscope versus an exoscope. ⋯ Utilizing the exoscope for anterior cervical spine procedures allows surgeons to spend less time in a deviated posture.
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There is scant data on the role that robotics and navigation play in spine surgery training and practice of early attendings. This study aimed to assess the impact of navigation and robotics on spine surgery training and practice. ⋯ Navigation and robotics have a perceivably positive impact on training and are increasingly being incorporated into practice. However, associated concerns demand spine surgeons to be thoughtful about how they integrate these technologies moving forward.
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Randomized Controlled Trial
The Application of Ultrasound-CT Fusion Navigation Technology in Complex Bone Tumor Biopsy:*A Randomized Double-Blind Controlled Trial.
This study aims to investigate the clinical application value of ultrasonography-computed tomography (CT) fusion navigation technology in bone tumor biopsy surgery. ⋯ The real-time localization of the biopsy needle in bone tumor biopsy surgery using ultrasonography-CT fusion navigation technology can significantly reduce intraoperative radiation exposure for both patients and surgeons during the procedure. Consequently, this technique holds certain clinical applicability.