World Neurosurg
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Feasibility and safety of endoscopic endonasal approaches have become well established, and focus has now shifted to minimizing nasal morbidity. To this end, several modifications in the nasal stage have been described that focus primarily on preservation of nasal mucosa on right side of the nasal cavity. However, nasal mucosal preservation on the left side of the nasal cavity has largely been ignored. This technical note describes a modified technique that can eliminate mucosal damage in the left nasal cavity. ⋯ A combination of endonasal and transseptal approaches uses the advantages of both endoscopic and microscopic approaches sans the disadvantage of restricted space seen in microscopic approaches. It makes the binostril approach least disruptive to the left nasal mucosa and thus can reduce overall morbidity of endoscopic endonasal approaches.
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Review Historical Article
Historical roots of modern neurosurgical cadaveric research practices: dissection, preservation, and vascular injection techniques.
Because of the complexity of the brain and its structures, anatomical knowledge is fundamental in neurosurgery. Anatomical dissection, body preservation, and vascular injection remain essential for training, teaching, and refining surgical techniques. This article explores the historical development of these practices and provides the contextual background of modern neurosurgical cadaveric brain models. ⋯ In 1868, August Hofmann synthesized formaldehyde, markedly improving tissue preservation. Later, William Kruse introduced latex in 1939, and Sidney Sobin introduced silicone in 1965 for vascular studies. These advancements laid the foundation for modern neurosurgical cadaveric studies, many remaining relevant today.
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Japanese neurosurgery faces challenges such as a declining number of neurosurgeons and their concentration in urban areas. Particularly in rural areas, access to neurosurgical care for patients with conditions, such as stroke, is limited, raising concerns about the collapse of regional healthcare. Robot-assisted surgical technologies have advanced in recent years, contributing to the improved precision and safety of deep brain surgery. ⋯ However, challenges, such as data bias, ethical issues, costs, and regulations, remain. In Japan, issues such as the uneven distribution and decline of neurosurgeons, collapse of regional healthcare, and increase in the number of patients with spinal disorders due to aging have been highlighted. The "AI and Robot-Assisted Surgery Moonshot Plan" serves as a guide to overcome the challenges of neurosurgery in Japan and establish a sustainable medical system.
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Review
Navigating Challenges and Embracing Opportunities: The Outlook of Functional Neurosurgery in Africa.
This narrative review explores the current landscape of functional neurosurgery in Africa, focusing on the challenges and opportunities facing the field. Drawing upon existing literature and expert insights, the review highlights the scarcity of resources, including trained personnel, infrastructure, and specialized equipment, as major hurdles impeding the widespread adoption of advanced neurosurgical techniques. ⋯ Moreover, the review underscores the significance of addressing cultural beliefs and stigmas surrounding neurological conditions to ensure equitable access to care and promote acceptance of neurosurgical interventions. By navigating these challenges and embracing emerging opportunities, functional neurosurgery in Africa holds the potential to significantly impact neurological health outcomes and enhance overall well-being.
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To observe the short-term to medium-term therapeutic effects and radiological outcomes of adjacent 2-level cervical spondylosis treated with artificial cervical disc replacement (ACDR) using Mobi-C and Bryan discs. To observe changes and discrepancies in the flexion-extension centers of rotation (FE-COR) of different ACDR segments. ⋯ In continuous 2-level cervical ACDR surgery, both Mobi-C and Bryan artificial cervical discs achieved satisfactory clinical outcomes in the short to medium term postoperatively. The FE-COR exhibited different trends of change. In the Mobi-C group, the FE-COR for both upper and lower segments shifted anteriorly and inferiorly, whereas in the Bryan group, whether upper or lower, the FE-COR remained closer to the preoperative state. The changes in FE-COR did not significantly affect the short-term to medium-term clinical outcomes postoperatively.