World Neurosurg
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Robotic-assisted laser interstitial thermal therapy (LITT) is a minimally invasive method for ablating seizure foci and has gained prominence in epilepsy treatment. The use of robotic guidance in these procedures can minimize errors in probe placement, potentially leading to better clinical outcomes. In this meta-analysis, we assessed the accuracy, safety, and effectiveness of robot-assisted LITT for drug-resistant epilepsy. ⋯ Robot-assisted LITT offers high precision, positive seizure outcomes, and minimal complications, comparable to nonrobotic methods, and is suitable for treating drug-resistant epilepsy with multiple lesions.
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The key-hole technique is highly effective in treating cervical spondylotic radiculopathy (CSR). Recently, various spinal endoscopic techniques have been developed, and we have introduced an innovative catheterization technique known as Cannula Rotary Cutting method combined with Long and Short Tongue Cannulas (CRC-LSTC). The purpose of this article is to evaluate the safety and efficacy of this improved technique in the treatment of CSR. ⋯ The CRC-LSTC combined with the keyhole technique is safe and effective, demonstrating promising short-term outcomes. Further studies with larger cohorts and extended follow-up are needed to confirm its long-term benefits.
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Sphenoid dural arterio-venous fistulas (DAVFs) located on the greater sphenoid wing (GSW) carry a notable risk of intracranial hemorrhage due to the frequent presence of cortical venous reflux. Because of the challenging embolization procedure, microsurgery still remains a valuable option in these cases. While in most cases, the fistula is located in the anterolateral endocranial surface of the middle cranial fossa (MCF) just below the sphenoid ridge, in a small subset of cases, the fistula is positioned posteriorly and medially in the region between the foramen ovale and rotundum. ⋯ With proper brain relaxation a small temporobasal craniotomy opens a direct corridor to the middle cranial fossa. Exoscopic-assisted surgery could improve dissection of middle cranial base, dynamic temporal lobe retraction and expand the range of antero-medial subtemporal trajectories providing angles that may be challenging to achieve using the operative microscope, as well as improve the surgeon's ergonomy. Thus, exoscopic-assisted subtemporal approach is a feasible, safe and a minimally invasive approach to treat unruptured greater sphenoid wing DAVFs and could be considered an alternative to the endovascular treatment.
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Retrospective study. ⋯ Following PEEK rod dynamic fixation surgery, a certain proportion of screw loosening may occur in the short term. With prolonged follow-up, screws gradually restabilize at the bone interface, with most loosened screws returning to a stable state.