World Neurosurg
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Review Historical Article
Cranial surgery in antiquity: the size of trepanations during the Neolithic period in France.
The trepanation, a surgical procedure performed on the skull, finds its roots in prehistoric times. This investigation delves into the analysis of the trepanned skulls housed at the Musée de l'Homme in Paris, focusing on those found in France, a region abundant in archaeological evidence of early neurosurgical techniques. With the opportunity to scrutinize these human remains, our study aimed to analyze the dimensions of Neolithic trepanations across 41 skulls. ⋯ Additionally, we successfully applied a straightforward protocol to determine the perforation area in ten Neolithic trepanations. These findings shed light on the medical practices of ancient civilizations, particularly in France during the Neolithic era. Moreover, this study underscores the significance of museum collections as valuable resources for scientific inquiry and the historical understanding of medicine.
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As advances are made in quantitative magnetic resonance imaging, specifically diffusion tensor imaging, researchers have investigated its potential to serve as a biomarker of disease or prognosticator for postoperative recovery in the management of cervical spondylotic myelopathy. Here, we narratively review the current state of the emerging literature, describing areas of consensus and disagreement. ⋯ Preoperative fractional anisotropy most frequently and best correlates with functional outcomes following surgery for cervical spondylotic myelopathy, according to a review of the current literature. The findings were not universal and at times contradictory, highlighting the need for high-quality future investigations to better define the utility of diffusion tensor imaging in spinal disease.
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Review Meta Analysis Comparative Study
Percutaneous Vertebroplasty vs. Non-operative Treatment of Osteoporotic Vertebral Fractures: A meta-analysis of Randomized Controlled Trials.
Osteoporotic vertebral fractures frequently result in pain and decreased quality of life (QoL). The management of these fractures remains a topic of debate. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we analyzed randomized controlled trials comparing percutaneous vertebroplasty (PV) with non-operative treatment (non-OT). ⋯ PV emerges as a promising intervention for specific time intervals regarding pain relief, especially in the extended-term analysis, and QoL, especially in the short-term analysis, compared to non-OT. However, clinicians must consider cement leakage risks. Heterogeneity among studies underscores careful patient selection.
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Within neurosurgery, it has always been important to individualize patient care. In recent years, however, technological advances have brought a new dimension to personalized care as developing methods, including next-generation sequencing, have enabled us to molecularly profile pathologies with increasing scale and resolution. In this review, the authors discuss the history and advances in precision medicine and neurosurgery, focusing both on neuro-oncology, as well as its extension to other neurosurgical subspecialties. They highlight the important roles of neurosurgeons in past work and future work, with the extension of tissue collection and precision medicine principles to additional sample types and disease indications.
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Recent developments in technology have led to rapid advances in precision medicine, especially due to the rise of next-generation sequencing and molecular profiling. These technological advances have led to rapid advances in research, including increased tumor subtype resolution, new therapeutic agents, and mechanistic insights. ⋯ They also highlight a few key efforts to address these challenges, including new frontiers in drug delivery, a rapidly expanding treatment repertoire, and improvements in active response monitoring. With continued improvements and developments, the authors anticipate that precision medicine will increasingly become the gold standard for clinical care.