Pub Date : 2025-09-01DOI: 10.1016/j.inat.2025.102120
Anirudh N. Eranki , Christopher M. Uchiyama
Non-operative vs. operative management of type II odontoid fractures in the elderly remains a controversial and challenging topic. An abundance of literature exists concerning advantages and disadvantages of non-operative management vs. anterior or posterior surgical treatment options. However, there remains a paucity of literature concerning outcomes following posterior salvage surgery for failed anterior odontoid screw fixation surgery in the elderly. In this report we describe the case of a 71-year-old female initially treated with anterior screw fixation, who presented several months later with a recurrent symptomatic, non-healing fracture. A posterior instrumented C1-C2 fusion was performed 7 months following the initial injury. Subsequent fracture healing occurred despite increasing fracture diastasis following anterior screw fixation surgery with resolution of her recurrent neck pain.
{"title":"“Successful delayed fracture healing of a type-II odontoid fracture following posterior C1-C2 salvage fusion in an elderly patient: case report”","authors":"Anirudh N. Eranki , Christopher M. Uchiyama","doi":"10.1016/j.inat.2025.102120","DOIUrl":"10.1016/j.inat.2025.102120","url":null,"abstract":"<div><div>Non-operative vs. operative management of type II odontoid fractures in the elderly remains a controversial and challenging topic. An abundance of literature exists concerning advantages and disadvantages of non-operative management vs. anterior or posterior surgical treatment options. However, there remains a paucity of literature concerning outcomes following posterior salvage surgery for failed anterior odontoid screw fixation surgery in the elderly. In this report we describe the case of a 71-year-old female initially treated with anterior screw fixation, who presented several months later with a recurrent symptomatic, non-healing fracture. A posterior instrumented C1-C2 fusion was performed 7 months following the initial injury. Subsequent fracture healing occurred despite increasing fracture diastasis following anterior screw fixation surgery with resolution of her recurrent neck pain.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102120"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.inat.2025.102115
İdris Avcı , Onur Yaman , Mehmet Zileli , Francesco Costa , Artem O. Gushcha , Zan Chen , Mirza Pojskic , Corinna C. Zygourakis , Salman Sharif
Objectives
Primary vertebral tumors (PVT) are rare neoplastic lesions distinct from metastatic spinal tumors. Due to their diverse nature and complex management, the World Federation of Neurosurgical Societies (WFNS) Spine Committee aimed to establish a consensus on the classification, diagnosis, and treatment of PVT to standardize clinical practice and improve patient outcomes.
Material and methods
A systematic literature review including last 10 years was conducted using PubMed, Medline, and Google Scholar, focusing on PVT diagnosis and treatment. After applying exclusion criteria, 12 relevant articles were selected. Additionally, the WFNS Spine Committee convened two consensus meetings, employing the Delphi method. Spine experts participated in structured discussions and anonymous voting, with consensus defined as ≥66 % agreement. Core topics included classification, diagnostic modalities, and treatment strategies.
Results
PVT were categorized as benign or malignant, requiring distinct diagnostic and therapeutic approaches. MRI was recommended for tumor evaluation, while CT was preferred for assessing bony involvement. Biopsy was deemed essential for histopathological confirmation. Benign tumors were managed with curettage or en-bloc resection, with pharmacologic options for selected cases. Malignant PVT management included radiotherapy, chemotherapy for specific tumors, and en-bloc excision for resectable cases. Stereotactic body radiation therapy is suggested for unresectable tumors. The necessity of a multidisciplinary approach is emphasized.
Conclusions
Standardized classification, advanced imaging, and multidisciplinary approach are essentials for managing PVT. The WFNS Spine Committee’s recommendations provide a structured framework to guide diagnosis and treatment, improving decision-making and patient care.
{"title":"General evaluation and decision-making in primary vertebra tumors: WFNS spine committee recommendations","authors":"İdris Avcı , Onur Yaman , Mehmet Zileli , Francesco Costa , Artem O. Gushcha , Zan Chen , Mirza Pojskic , Corinna C. Zygourakis , Salman Sharif","doi":"10.1016/j.inat.2025.102115","DOIUrl":"10.1016/j.inat.2025.102115","url":null,"abstract":"<div><h3>Objectives</h3><div>Primary vertebral tumors (PVT) are rare neoplastic lesions distinct from metastatic spinal tumors. Due to their diverse nature and complex management, the World Federation of Neurosurgical Societies (WFNS) Spine Committee aimed to establish a consensus on the classification, diagnosis, and treatment of PVT to standardize clinical practice and improve patient outcomes.</div></div><div><h3>Material and methods</h3><div>A systematic literature review including last 10 years was conducted using PubMed, Medline, and Google Scholar, focusing on PVT diagnosis and treatment. After applying exclusion criteria, 12 relevant articles were selected. Additionally, the WFNS Spine Committee convened two consensus meetings, employing the Delphi method. Spine experts participated in structured discussions and anonymous voting, with consensus defined as ≥66 % agreement. Core topics included classification, diagnostic modalities, and treatment strategies.</div></div><div><h3>Results</h3><div>PVT were categorized as benign or malignant, requiring distinct diagnostic and therapeutic approaches. MRI was recommended for tumor evaluation, while CT was preferred for assessing bony involvement. Biopsy was deemed essential for histopathological confirmation. Benign tumors were managed with curettage or en-bloc resection, with pharmacologic options for selected cases. Malignant PVT management included radiotherapy, chemotherapy for specific tumors, and en-bloc excision for resectable cases. Stereotactic body radiation therapy is suggested for unresectable tumors. The necessity of a multidisciplinary approach is emphasized.</div></div><div><h3>Conclusions</h3><div>Standardized classification, advanced imaging, and multidisciplinary approach are essentials for managing PVT. The WFNS Spine Committee’s recommendations provide a structured framework to guide diagnosis and treatment, improving decision-making and patient care.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102115"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a rare case of thoracic spinal ancient schwannoma in a young adult and review confirmed spinal cases to highlight key clinicopathological features, imaging findings, surgical approaches, and outcomes, aiming to support accurate diagnosis and management.
Case presentation
A 25-year-old male presented with a three-month history of bilateral radicular pain and lower limb paresthesia, progressing to motor weakness. MRI revealed a 2.7 × 1.1 × 1.4 cm intradural-extramedullary cystic mass at the T8 vertebral level, compressing the spinal cord. The patient underwent T8 laminectomy and complete microsurgical excision. Histopathological and immunohistochemical analyses confirmed the diagnosis of ancient schwannoma. A pooled analysis of 23 reported cases was also conducted to evaluate demographics, tumor features, surgical approach, and outcomes. At the six-month follow-up, he showed significant clinical improvement. His ambulatory function improved markedly, and the radicular pain that had been prominent preoperatively had substantially diminished. Neurological examination revealed full motor strength (5/5) in both upper and lower extremities, indicating complete motor recovery. Sensory examination demonstrated residual hypesthesia in the right lower extremity, from the T8 dermatome distally. In 23 reported cases of spinal ancient schwannoma, the mean patient age was 47.2 years with a male predominance (73.9 %) and thoracic spine involvement being most common (43.5 %). MRI typically showed well-defined intradural or paraspinal lesions with degenerative features, and gross total resection was achieved in 95.7 % of cases, primarily via posterior laminectomy. Neurological outcomes were favorable in 78.3 %, with low complication (17.4 %) and recurrence (18.7 %) rates.
Conclusion
Spinal ancient schwannomas are rare, benign tumors with nonspecific symptoms and atypical imaging that can mimic malignancy. Despite their alarming histologic features, they behave indolently and respond well to surgical resection. Early recognition based on imaging and histopathology is essential to avoid misdiagnosis and ensure optimal outcomes.
{"title":"Ancient schwannomas of the spine: a case report and review of confirmed cases","authors":"Tommy Alfandy Nazwar , Nasim Amar , Farhad Bal’afif , Donny Wisnu Wardhana , Fachriy Bal’afif , Christin Panjaitan","doi":"10.1016/j.inat.2025.102116","DOIUrl":"10.1016/j.inat.2025.102116","url":null,"abstract":"<div><h3>Background</h3><div>We report a rare case of thoracic spinal ancient schwannoma in a young adult and review confirmed spinal cases to highlight key clinicopathological features, imaging findings, surgical approaches, and outcomes, aiming to support accurate diagnosis and management.</div></div><div><h3>Case presentation</h3><div>A 25-year-old male presented with a three-month history of bilateral radicular pain and lower limb paresthesia, progressing to motor weakness. MRI revealed a 2.7 × 1.1 × 1.4 cm intradural-extramedullary cystic mass at the T8 vertebral level, compressing the spinal cord. The patient underwent T8 laminectomy and complete microsurgical excision. Histopathological and immunohistochemical analyses confirmed the diagnosis of ancient schwannoma. A pooled analysis of 23 reported cases was also conducted to evaluate demographics, tumor features, surgical approach, and outcomes. At the six-month follow-up, he showed significant clinical improvement. His ambulatory function improved markedly, and the radicular pain that had been prominent preoperatively had substantially diminished. Neurological examination revealed full motor strength (5/5) in both upper and lower extremities, indicating complete motor recovery. Sensory examination demonstrated residual hypesthesia in the right lower extremity, from the T8 dermatome distally. In 23 reported cases of spinal ancient schwannoma, the mean patient age was 47.2 years with a male predominance (73.9 %) and thoracic spine involvement being most common (43.5 %). MRI typically showed well-defined intradural or paraspinal lesions with degenerative features, and gross total resection was achieved in 95.7 % of cases, primarily via posterior laminectomy. Neurological outcomes were favorable in 78.3 %, with low complication (17.4 %) and recurrence (18.7 %) rates.</div></div><div><h3>Conclusion</h3><div>Spinal ancient schwannomas are rare, benign tumors with nonspecific symptoms and atypical imaging that can mimic malignancy. Despite their alarming histologic features, they behave indolently and respond well to surgical resection. Early recognition based on imaging and histopathology is essential to avoid misdiagnosis and ensure optimal outcomes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102116"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.inat.2025.102119
Yao Christian Hugues Dokponou, Abdessamad El Ouahabi, Mahjouba Boutarbouch
Background
Computational fluid dynamics (CFD) models are crucial for examining blood flow and the morphology of brain aneurysms. These models are used to enhance the understanding of the formation, rupture, and post-treatment behavior of aneurysms. The three principal models are non-Newtonian, non-Kolmogorov, and modified Krieger. However, the extent to which these models differ in their ability to predict changes in blood flow within aneurysms remains unclear. This study aimed to compare these models to identify their differences and similarities and to determine which model is most effective for intracranial aneurysm geometry appraisal.
Methods
We conducted a qualitative systematic review according to the ENTREQ guidelines. Our search encompassed the MEDLINE/PubMed and American Mathematical Society/MathSciNet databases, from their inception until January 2025. We utilized terms such as “intracranial aneurysm” and “cerebral aneurysm,” along with keywords like non-Newtonian, non-Kolmogorov, modified Krieger CFD models, and IA dynamics.
Results
Seventy-four articles were included in this study.
Conclusion
CFD simulation accuracy depends on blood vessel mapping, boundary conditions, and fluid model assumptions. Non-Newtonian models, which consider blood shear-thinning behavior, provide better flow depictions compared to Newtonian models. Advanced models, such as non-Kolmogorov and modified Krieger, enhance understanding by capturing turbulence and predicting wall shear stress. Despite these advances, debate continues regarding optimal aneurysm blood flow modeling. The field requires standardized protocols, validation procedures, and uncertainty quantification methods for effective treatment planning.
{"title":"Qualitative meta-synthesis comparing non-Newtonian, non-Kolmogorov, and modified Krieger computational fluid dynamics models exploring the intracranial aneurysm dynamics: state of the art","authors":"Yao Christian Hugues Dokponou, Abdessamad El Ouahabi, Mahjouba Boutarbouch","doi":"10.1016/j.inat.2025.102119","DOIUrl":"10.1016/j.inat.2025.102119","url":null,"abstract":"<div><h3>Background</h3><div>Computational fluid dynamics (CFD) models are crucial for examining blood flow and the morphology of brain aneurysms. These models are used to enhance the understanding of the formation, rupture, and post-treatment behavior of aneurysms. The three principal models are non-Newtonian, non-Kolmogorov, and modified Krieger. However, the extent to which these models differ in their ability to predict changes in blood flow within aneurysms remains unclear. This study aimed to compare these models to identify their differences and similarities and to determine which model is most effective for intracranial aneurysm geometry appraisal.</div></div><div><h3>Methods</h3><div>We conducted a qualitative systematic review according to the ENTREQ guidelines. Our search encompassed the MEDLINE/PubMed and American Mathematical Society/MathSciNet databases, from their inception until January 2025. We utilized terms such as “intracranial aneurysm” and “cerebral aneurysm,” along with keywords like non-Newtonian, non-Kolmogorov, modified Krieger CFD models, and IA dynamics.</div></div><div><h3>Results</h3><div>Seventy-four articles were included in this study.</div></div><div><h3>Conclusion</h3><div>CFD simulation accuracy depends on blood vessel mapping, boundary conditions, and fluid model assumptions. Non-Newtonian models, which consider blood shear-thinning behavior, provide better flow depictions compared to Newtonian models. Advanced models, such as non-Kolmogorov and modified Krieger, enhance understanding by capturing turbulence and predicting wall shear stress. Despite these advances, debate continues regarding optimal aneurysm blood flow modeling. The field requires standardized protocols, validation procedures, and uncertainty quantification methods for effective treatment planning.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102119"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Microvascular anastomosis is vital in cerebrovascular surgery, particularly in bypass procedures for moyamoya disease. Conventional arteriotomy methods, such as a linear incision or fishmouth techniques, can prolong clamping time, increasing ischemic risk. To address this, the authors developed the “needle-landing arteriotomy” technique to reduce clamping time and improve arteriotomy efficiency.
Methods
We evaluated the efficacy of needle-landing arteriotomy through in vivo and in vitro investigations. Six patients with moyamoya disease underwent bypass surgery. Each of the three patients was treated with the conventional arteriotomy and needle-landing methods. Clamping time, patency, and complications were assessed intraoperatively and at a six-month follow-up. In the in vitro study, neurosurgeons and residents performed simulated arteriotomies to compare both techniques.
Results
The needle-landing technique significantly reduced clamping time in vivo by 55 % (176 ± 20.8 s vs. 97.3 ± 30.8 s, P < 0.02). All surgeries were successful with no complications. Follow-up angiography confirmed patent bypass grafts. The technique also shortened the clamping time in vitro.
Conclusion
The needle-landing technique simplifies recipient vessel preparation by improving visibility and reducing procedural complexity. This minimizes the risk of inadvertent suturing and shortens clamping time, which is crucial for preventing ischemic complications, while also reducing performance variability, making it especially helpful for less-experienced surgeons. It is particularly valuable in cerebrovascular bypass procedures for patients with moyamoya disease.
背景：微血管吻合在脑血管手术中是至关重要的，特别是在烟雾病的搭桥手术中。传统的动脉切开术，如线性切口或鱼口技术，可以延长夹紧时间，增加缺血性风险。为了解决这个问题，作者开发了“针落动脉切开术”技术，以减少夹紧时间，提高动脉切开术效率。方法通过体内和体外观察，评价针刺动脉切开术的疗效。6名烟雾病患者接受了搭桥手术。3例患者均采用常规动脉切开术和针刺法治疗。术中和6个月随访时评估夹紧时间、通畅度和并发症。在体外研究中，神经外科医生和住院医生进行了模拟动脉切开术来比较这两种技术。结果针着地技术可显著缩短体内夹持时间55%（176±20.8 s vs. 97.3±30.8 s, P < 0.02）。所有手术均成功，无并发症。随访血管造影证实血管搭桥通畅。该技术还缩短了体外夹紧时间。结论针入技术通过提高可视性和降低程序复杂性，简化了受体血管制备。这最大限度地减少了无意缝合的风险，缩短了夹紧时间，这对于预防缺血性并发症至关重要，同时也减少了性能变化，对经验不足的外科医生特别有帮助。它在烟雾病患者的脑血管搭桥手术中特别有价值。
{"title":"Needle-landing arteriotomy for microvascular anastomosis in patients with moyamoya disease: A technical note","authors":"Makoto Isozaki, Yoshifumi Higashino, Ayumi Akazawa, Hidetaka Arishima, Ken-ichiro Kikuta","doi":"10.1016/j.inat.2025.102117","DOIUrl":"10.1016/j.inat.2025.102117","url":null,"abstract":"<div><h3>Background</h3><div>Microvascular anastomosis is vital in cerebrovascular surgery, particularly in bypass procedures for moyamoya disease. Conventional arteriotomy methods, such as a linear incision or fishmouth techniques, can prolong clamping time, increasing ischemic risk. To address this, the authors developed the “needle-landing arteriotomy” technique to reduce clamping time and improve arteriotomy efficiency.</div></div><div><h3>Methods</h3><div>We evaluated the efficacy of needle-landing arteriotomy through <em>in vivo</em> and <em>in vitro</em> investigations. Six patients with moyamoya disease underwent bypass surgery. Each of the three patients was treated with the conventional arteriotomy and needle-landing methods. Clamping time, patency, and complications were assessed intraoperatively and at a six-month follow-up. In the <em>in vitro</em> study, neurosurgeons and residents performed simulated arteriotomies to compare both techniques.</div></div><div><h3>Results</h3><div>The needle-landing technique significantly reduced clamping time <em>in vivo</em> by 55 % (176 ± 20.8 s vs. 97.3 ± 30.8 s, P < 0.02). All surgeries were successful with no complications. Follow-up angiography confirmed patent bypass grafts. The technique also shortened the clamping time <em>in vitro</em>.</div></div><div><h3>Conclusion</h3><div>The needle-landing technique simplifies recipient vessel preparation by improving visibility and reducing procedural complexity. This minimizes the risk of inadvertent suturing and shortens clamping time, which is crucial for preventing ischemic complications, while also reducing performance variability, making it especially helpful for less-experienced surgeons. It is particularly valuable in cerebrovascular bypass procedures for patients with moyamoya disease.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102117"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-18DOI: 10.1016/j.inat.2025.102114
Francesco Costa , Francesco Restelli , Niccolò Innocenti , Corinna Zygourakis , Zan Chen , Mirza Pojskic , Onur Yaman , Artem Gushcha , Salman Sharif , Mehmet Zileli
Background
Benign primary vertebral tumors (PVTs) represent a diverse group of spinal lesions that, despite their non-malignant nature, can significantly impact patients’ quality of life. This review aimed to formulate the most current, evidence-based recommendations regarding the management strategies for benign PVTs.
Methods
To this aim, comprehensive search was conducted in PubMed/EMBASE/MEDLINE databases. Inclusion criteria included English-language publications between January 2012 and December 2023. The screening process involved reviewing abstracts, assessing full-text articles, and reviewing reference lists for additional studies. Eligibility criteria were applied to ensure the selection of relevant studies. Data extraction involved recording various variables. A total of 160 abstracts were screened, resulting in 99 articles being selected for further review. 57 articles met the inclusion criteria and were included in the study. The results were discussed and voted in two consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee, reaching a positive or negative consensus using the Delphi method.
Results
Imaging with MRI/CT is essential for diagnosis and treatment planning, with classification systems guiding surgical strategies; general condition, tumor histology, and life expectancy must be considered. En-bloc resection is the gold standard for malignant tumors, while vertebroplasty, radiotherapy, or minimally invasive ablation may be appropriate depending on lesion type. Specific management recommendations were confirmed for osteoid osteoma, osteoblastoma, ABCs, giant cell tumors, and hemangiomas, including the role of embolization, biopsy, and emerging percutaneous procedures.
Conclusions
The WFNS Spine Committee finalized multiple recommendation guidelines on the management of benign primary vertebral tumors. Further higher-quality studies are recommended to establish more substantial evidence and recommendations.
{"title":"Management of benign primary vertebral tumors: WFNS spine committee recommendations","authors":"Francesco Costa , Francesco Restelli , Niccolò Innocenti , Corinna Zygourakis , Zan Chen , Mirza Pojskic , Onur Yaman , Artem Gushcha , Salman Sharif , Mehmet Zileli","doi":"10.1016/j.inat.2025.102114","DOIUrl":"10.1016/j.inat.2025.102114","url":null,"abstract":"<div><h3>Background</h3><div>Benign primary vertebral tumors (PVTs) represent a diverse group of spinal lesions that, despite their non-malignant nature, can significantly impact patients’ quality of life. This review aimed to formulate the most current, evidence-based recommendations regarding the management strategies for benign PVTs.</div></div><div><h3>Methods</h3><div>To this aim, comprehensive search was conducted in PubMed/EMBASE/MEDLINE databases. Inclusion criteria included English-language publications between January 2012 and December 2023. The screening process involved reviewing abstracts, assessing full-text articles, and reviewing reference lists for additional studies. Eligibility criteria were applied to ensure the selection of relevant studies. Data extraction involved recording various variables. A total of 160 abstracts were screened, resulting in 99 articles being selected for further review. 57 articles met the inclusion criteria and were included in the study. The results were discussed and voted in two consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee, reaching a positive or negative consensus using the Delphi method.</div></div><div><h3>Results</h3><div>Imaging with MRI/CT is essential for diagnosis and treatment planning, with classification systems guiding surgical strategies; general condition, tumor histology, and life expectancy must be considered. En-bloc resection is the gold standard for malignant tumors, while vertebroplasty, radiotherapy, or minimally invasive ablation may be appropriate depending on lesion type. Specific management recommendations were confirmed for osteoid osteoma, osteoblastoma, ABCs, giant cell tumors, and hemangiomas, including the role of embolization, biopsy, and emerging percutaneous procedures<strong>.</strong></div></div><div><h3>Conclusions</h3><div>The WFNS Spine Committee finalized multiple recommendation guidelines on the management of benign primary vertebral tumors. Further higher-quality studies are recommended to establish more substantial evidence and recommendations.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102114"},"PeriodicalIF":0.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Spinal intramedullary tanycytic ependymoma (TE) is a rare variant of ependymoma with only about 60 cases reported till date. Radiological diagnosis is tedious and identification of its unique histopathology is required for definitive diagnosis. It is often misdiagnosed solely on radiology as well as intra-operative findings. Because of its exceedingly low incidence (1% of all spinal cord neoplasms), only a small number of cases of intramedullary TE have been recorded so far. We report an adult female who presented with dorsal intramedullary TE and underwent gross total resection under intraoperative nerve monitoring. Additionally, we have also reviewed the literature already published on this entity. Subtle radiological differentiations may assist in considering TE as a differential diagnosis. Long term survival in these cases is extremely favorable. Our case depicts one of the few cases of spinal intramedullary TE known in literature and one of the very few in Southern Asian region. We highlight the challenges involved in making an accurate diagnosis of this entity radiologically and intra-operatively.
{"title":"Understanding tanycytic ependymoma: A rare subtype of ependymoma","authors":"Mitrajit Sharma, Aanchal Datta, Chhitij Srivastava","doi":"10.1016/j.inat.2025.102111","DOIUrl":"10.1016/j.inat.2025.102111","url":null,"abstract":"<div><div>Spinal intramedullary tanycytic ependymoma (TE) is a rare variant of ependymoma with only about 60 cases reported till date. Radiological diagnosis is tedious and identification of its unique histopathology is required for definitive diagnosis. It is often misdiagnosed solely on radiology as well as intra-operative findings. Because of its exceedingly low incidence (1% of all spinal cord neoplasms), only a small number of cases of intramedullary TE have been recorded so far. We report an adult female who presented with dorsal intramedullary TE and underwent gross total resection under intraoperative nerve monitoring. Additionally, we have also reviewed the literature already published on this entity. Subtle radiological differentiations may assist in considering TE as a differential diagnosis. Long term survival in these cases is extremely favorable. Our case depicts one of the few cases of spinal intramedullary TE known in literature and one of the very few in Southern Asian region. We highlight the challenges involved in making an accurate diagnosis of this entity radiologically and intra-operatively.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102111"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-05DOI: 10.1016/j.inat.2025.102112
Junfeng Wang, Xiaoxia Li, Yuenong Zhang
Radiofrequency therapy for intervertebral discs is a minimally invasive technique that acts on the nucleus pulposus tissue of the intervertebral disc to achieve thermal coagulation, thereby treating pain. Compared to traditional surgery, its operation is more straightforward. It involves puncturing the intervertebral disc with a needle, causing minimal damage. After surgical treatment, pain can be quickly relieved, and it is completed under the guidance of fluoroscopy or CT without damaging the stable structure of the spine. This also improves the accuracy and safety of treatment. If the pain recurs, the patient can receive repeated radiofrequency therapy.
However, radiofrequency treatment for intervertebral discs also has some limitations and potential risks. Multiple radiofrequency treatments may be required for some patients to achieve the desired pain relief effect. Currently, there is no unified standard for radiofrequency treatment, which needs to be determined based on the specific situation of the patient and the experience of the doctor. Some complications may include intervertebral disc infection and vascular and nerve damage. Although the incidence of these complications is not high, once they occur, they may seriously impact the patients.
Overall, intervertebral disc radiofrequency therapy is an effective pain treatment method. However, it must be carried out under the guidance of a professional doctor and consider the patient’s specific situation and potential risks.
{"title":"Advantages and limitations of radiofrequency treatment for intervertebral disc herniation","authors":"Junfeng Wang, Xiaoxia Li, Yuenong Zhang","doi":"10.1016/j.inat.2025.102112","DOIUrl":"10.1016/j.inat.2025.102112","url":null,"abstract":"<div><div>Radiofrequency therapy for intervertebral discs is a minimally invasive technique that acts on the nucleus pulposus tissue of the intervertebral disc to achieve thermal coagulation, thereby treating pain. Compared to traditional surgery, its operation is more straightforward. It involves puncturing the intervertebral disc with a needle, causing minimal damage. After surgical treatment, pain can be quickly relieved, and it is completed under the guidance of fluoroscopy or CT without damaging the stable structure of the spine. This also improves the accuracy and safety of treatment. If the pain recurs, the patient can receive repeated radiofrequency therapy.</div><div>However, radiofrequency treatment for intervertebral discs also has some limitations and potential risks. Multiple radiofrequency treatments may be required for some patients to achieve the desired pain relief effect. Currently, there is no unified standard for radiofrequency treatment, which needs to be determined based on the specific situation of the patient and the experience of the doctor. Some complications may include intervertebral disc infection and vascular and nerve damage. Although the incidence of these complications is not high, once they occur, they may seriously impact the patients.</div><div>Overall, intervertebral disc radiofrequency therapy is an effective pain treatment method. However, it must be carried out under the guidance of a professional doctor and consider the patient’s specific situation and potential risks.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102112"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-05DOI: 10.1016/j.inat.2025.102110
Jian Wang , Jianbiao Huang , Jie Chen , Dongping Wang , Qunwei Dong , Hui Zhu , Jianxin Zhang , Jianxian Luo
Introduction
Lumbar spine infection caused by Candida albicans is a rare condition in clinical practice that often presents as chronic lower back pain. The combination of imaging and laboratory tests can aid in the accurate diagnosis of this disease.
Case report
A 75-year-old female patient reported to a physician with complaints of low back pain, numbness, and weakness in both lower extremities for one month. Despite receiving anti-inflammatory analgesia and nerve nutrition treatment, there was no improvement and the patient occasionally developed high fever and chills. After the surgical intervention and anti-infection treatment, the symptoms disappeared and the outcome was satisfactory.
Conclusion
Chronic low back pain is a characteristic symptom of lumbar spine infection caused by Candida albicans. Pathological biopsy remains the gold standard for its diagnosis. Conservative treatment using azoles is effective, while surgical management remains controversial.
{"title":"Lumbar spine infection caused by candida albicans: A case report","authors":"Jian Wang , Jianbiao Huang , Jie Chen , Dongping Wang , Qunwei Dong , Hui Zhu , Jianxin Zhang , Jianxian Luo","doi":"10.1016/j.inat.2025.102110","DOIUrl":"10.1016/j.inat.2025.102110","url":null,"abstract":"<div><h3>Introduction</h3><div>Lumbar spine infection caused by Candida albicans is a rare condition in clinical practice that often presents as chronic lower back pain. The combination of imaging and laboratory tests can aid in the accurate diagnosis of this disease.</div></div><div><h3>Case report</h3><div>A 75-year-old female patient reported to a physician with complaints of low back pain, numbness, and weakness in both lower extremities for one month. Despite receiving anti-inflammatory analgesia and nerve nutrition treatment, there was no improvement and the patient occasionally developed high fever and chills. After the surgical intervention and anti-infection treatment, the symptoms disappeared and the outcome was satisfactory.</div></div><div><h3>Conclusion</h3><div>Chronic low back pain is a characteristic symptom of lumbar spine infection caused by Candida albicans. Pathological biopsy remains the gold standard for its diagnosis. Conservative treatment using azoles is effective, while surgical management remains controversial.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102110"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-05DOI: 10.1016/j.inat.2025.102109
Faeze Sadat Ahmadi Tabatabaei , Mohammad Taghi Joghataei , Kiana Askarian , Leila Riahi Pour , Bita Kouhnavard Pour , Nooshin Ahmadirad
Objective
This review evaluates the therapeutic potential of high-frequency stimulation (HFS) and low-frequency stimulation (LFS) in deep brain stimulation (DBS) for drug-resistant epilepsy (DRE), focusing on mechanisms, target selection, and parameter optimization.
Methods
A synthesis of preclinical and clinical studies was conducted, analyzing electrode placement, stimulation parameters (frequency, pulse width, intensity), and outcomes across key DBS targets, including the centromedian thalamus, anterior thalamus, and hippocampus. Emerging non-invasive neuromodulation strategies, such as repetitive transcranial magnetic stimulation (rTMS), were contextualized within the broader therapeutic landscape.
Results
HFS (100–130 Hz) demonstrates robust antiepileptic effects by disrupting cortical synchronization and enhancing GABAergic inhibition, achieving sustained seizure reduction in 40–60 % of DRE patients. LFS 1–10 Hz shows variable efficacy, with risks of exacerbating seizures via cortical synchronization. Optimal pulse widths (60–240 μs) and amplitude (150–300 μA) require patient-specific calibration. rTMS (0.3–1 Hz) exhibits adjunctive potential for non-invasive modulation of epileptogenic networks, particularly when combined with neuroimaging.
Conclusion
While DBS remains a cornerstone for DRE, parameter optimization is critical to balancing efficacy and safety. Future research should prioritize closed-loop systems, biomarker-driven protocols, and synergies between invasive (DBS) and non-invasive (rTMS) neuromodulation.
{"title":"Optimizing high-frequency and low-frequency deep brain stimulation parameters for drug-resistant epilepsy: Mechanisms, clinical outcomes, and future directions","authors":"Faeze Sadat Ahmadi Tabatabaei , Mohammad Taghi Joghataei , Kiana Askarian , Leila Riahi Pour , Bita Kouhnavard Pour , Nooshin Ahmadirad","doi":"10.1016/j.inat.2025.102109","DOIUrl":"10.1016/j.inat.2025.102109","url":null,"abstract":"<div><h3>Objective</h3><div>This review evaluates the therapeutic potential of high-frequency stimulation (HFS) and low-frequency stimulation (LFS) in deep brain stimulation (DBS) for drug-resistant epilepsy (DRE), focusing on mechanisms, target selection, and parameter optimization.</div></div><div><h3>Methods</h3><div>A synthesis of preclinical and clinical studies was conducted, analyzing electrode placement, stimulation parameters (frequency, pulse width, intensity), and outcomes across key DBS targets, including the centromedian thalamus, anterior thalamus, and hippocampus. Emerging non-invasive neuromodulation strategies, such as repetitive transcranial magnetic stimulation (rTMS), were contextualized within the broader therapeutic landscape.</div></div><div><h3>Results</h3><div>HFS (100–130 Hz) demonstrates robust antiepileptic effects by disrupting cortical synchronization and enhancing GABAergic inhibition, achieving sustained seizure reduction in 40–60 % of DRE patients. LFS 1–10 Hz shows variable efficacy, with risks of exacerbating seizures via cortical synchronization. Optimal pulse widths (60–240 μs) and amplitude (150–300 μA) require patient-specific calibration. rTMS (0.3–1 Hz) exhibits adjunctive potential for non-invasive modulation of epileptogenic networks, particularly when combined with neuroimaging.</div></div><div><h3>Conclusion</h3><div>While DBS remains a cornerstone for DRE, parameter optimization is critical to balancing efficacy and safety. Future research should prioritize closed-loop systems, biomarker-driven protocols, and synergies between invasive (DBS) and non-invasive (rTMS) neuromodulation.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102109"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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