World Neurosurg
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Ventriculoscopic neuronavigation has been described in several articles. However, there are different ventriculoscopes and navigation systems. Due to these different combinations, it is difficult to find detailed neuronavigation protocols. We describe, step-by-step, a simple method to navigate both the trajectory until reaching the ventricular system, as well as the intraventricular work. ⋯ This protocol is easy-to-set-up, avoids head rigid-fixation and bulky optical-based attachments to the ventriculoscope, and allows continuous navigation of both parts of the surgery. Since we have implemented this protocol, we have noticed a significant enhancement in both simple and complex ventriculoscopic procedures because the surgery is dramatically simplified.
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Interruption of the fistulous point is the goal of treatment of spinal dural arteriovenous fistulas (dAVFs). Microsurgery remains a highly efficient treatment in terms of complete occlusion with the lowest risk of recurrence rate. It is reported that the hardest step involves finding the fistulous site itself, potentially extending surgical access and time and increasing potential postoperative surgical-related complications. The accurate preoperative detection of the shunt and spinal level together is crucial for guiding optimal, fast, and safe microsurgical treatment. ⋯ Nowadays, neurosurgeons advocate for minimally invasive procedures and procedures with low morbidity risk for treatment of spinal dural arteriovenous fistulas. Our preoperative approach for accurate angiographic localization of the fistulous point through nonsubtracted and three-dimensional reconstructed angiography allowed us to achieve safe and definitive occlusion of the shunt.
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Measuring spinal alignment with radiological parameters is essential in patients with spinal conditions likely to be treated surgically. These evaluations are not usually included in the radiological report. As a result, spinal surgeons commonly perform the measurement, which is time-consuming and subject to errors. We aim to develop a fully automated artificial intelligence (AI) tool to assist in measuring alignment parameters in whole-spine lateral radiograph (WSL X-rays). ⋯ Vertebrai's measurements can accurately detect alignment parameters, making it a promising tool for measuring GSP automatically.
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Pedicle screw and rod systems are widely employed in spine surgeries and loosening due to insufficient mechanical stimulation on the bone is frequently encountered in pedicle screws. This mechanical stimulation problem also arises due to the high rigidity of the implant material. This study aimed to develop new pedicle screws with composite material to solve the pedicle screw loosening problem. ⋯ In conclusion, FGM pedicle screw decreased the strain on the bone which is an important parameter for the loosening failure according to the study. The other important conclusion is that FGM pedicle screw can be the solution to the loosening of the screw but not in all vertebrae.
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The Low-Profile Visualized Intraluminal Support (LVIS) device has been frequently used as an intracranial stent for treating intracranial aneurysms. However, the feasibility and efficacy of LVIS devices in Y-stent-assisted coiling (Y-SAC) have remained contentious. This study aimed to evaluate long-term angiographic and clinical outcomes of Y-SAC using LVIS devices. ⋯ Y-SAC using the LVIS device for intracranial bifurcation aneurysms is a feasible and relatively safe procedure with favorable long-term angiographic and clinical outcomes.