World Neurosurg
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Cranioplasty is a common neurosurgical procedure aimed at providing structural protection to cerebral tissues and enhancing neurological function. The choice of implant material, particularly polyetheretherketone (PEEK) and titanium mesh, significantly influences postoperative outcomes, including the incidence of subgaleal fluid collections (SFC). This study investigates the incidence of SFC associated with PEEK and titanium mesh in cranioplasty, identifying risk factors and implications for clinical practice. ⋯ The selection of implant materials in cranioplasty significantly affects postoperative outcomes, with PEEK associated with a higher incidence of SFC. Careful material selection, particularly in patients with comorbidities, and meticulous surgical techniques are essential to improve patient outcomes. Future research should focus on the biological interactions between implant materials and cranial tissues to refine guidelines for clinical practice.
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Lumbar interbody fusion is a well-established surgical technique for treating various lumbar degenerative pathologies. Expandable cages have been introduced to allow for insertion via the confined access and to improve disc height restoration, although concerns about the stability of the screw-based cages in the expanded state remain a concern. This study aims to evaluate the short-term clinical and radiographic outcomes of a novel nonscrew-based expandable transforaminal lumbar interbody fusion cage. ⋯ The novel nonscrew-based expandable cage effectively restored and maintained disc height with a low incidence of complications, suggesting it as a safe and effective alternative for lumbar interbody fusion. Further long-term studies are needed to confirm its efficacy and safety.
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The retrosigmoid approach (RSA) is used in a wide variety of diseases in the cerebellopontine angle, and according to the findings, it can preserve hearing function during the resection of vestibular schwannomas. Complete exposure of the fundus of the internal auditory canal (IAC) could jeopardize the integrity of the otic capsule and subsequently cause profound hearing loss and chronic disabling vertigo. Great variability has been described in labyrinthine structures and to date there are no clear data on the distances of these structures to safely expose the IAC fundus. ⋯ The ELSD is a safe anatomic technique for dissection and exposure of the IAC during RSA in vestibular schwannoma surgery. In our study, the structures evaluated presented little variability, with the exception of the distances between the ELSD and the JF; in some cases, the JF exceeded the lower limit of the ELSD and IAC.
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Three-dimensional (3D) navigation offers real-time guidance in surgery. However, there is limited and inconsistent data regarding the usability, safety, and efficacy. To address gaps in knowledge about 3D navigation in spinal surgery, we conducted a comprehensive review of success rates, complications, revisions, radiation exposure, and operative time associated with Federal and Drug Administration-approved 3D surgical navigation tools. ⋯ The 3D navigation in spinal procedures has higher surgical success rates than two-dimensional fluoroscopy and freehand navigation. Included studies exhibited varying limitations, including no patient follow-up (n = 1), less than 10 patients (n = 6), various types of spinal disorders (n = 1), and varying comorbidities among participants (n = 2). Improving 3D navigation tools remains imperative to decrease operative time and radiation exposure.
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Meningiomas are neoplasms primarily originating from arachnoid cells and are classified into 3 grades (1, 2, and 3) based on histological features according to the World Health Organization classification. However, this classification system is imperfect especially for grade 1 and 2 meningiomas as many grade 1 tumors recur. Meningiomas are hence a histologically diverse class of tumors exhibiting more unpredictable behavior. Therefore, more improved classification is required, possibly using novel and more dependable biomarkers. In this study, we aim to investigate the role of the H3K27me3 and Ki-67 labeling index (LI) in assessing the biological behavior of meningiomas. The study was conceived, with the primary objective of examining the expression of H3K27me3 and Ki-67 LI in grade 1/2 meningiomas with atypical features to ascertain if this potentially impacts patient prognosis. ⋯ The study highlights the importance of the H3K27me3 and Ki-67 LI in assessing the biological behavior of meningiomas. The findings provide valuable insights into the prognosis and treatment of meningiomas, emphasizing the need for further research to validate these markers and develop targeted therapeutic strategies.