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Epilepsy surgery in children: Outcomes of patients with drug-resistant epilepsy at a paediatric hospital in Bogotá, Colombia, with 10 years of follow-up 儿童癫痫手术:哥伦比亚波哥大<e:1>一家儿科医院耐药癫痫患者随访10年的结果
Pub Date : 2025-11-01 DOI: 10.1016/j.neucie.2025.500701
Kevin José Navarro Jaime , Bryan Gómez Cristancho , David C. Gómez Cristancho , Nelson Andres Cuevas Morales , Armando Rojas Calderon , Oscar Fernando Zorro Guio

Introduction

Drug-resistant epilepsy is defined as the lack of response to two appropriately selected antiepileptic drugs that the patient has tolerated properly. Epilepsy is a common neurological disorder in the paediatric population, with an estimated prevalence ranging from 4.3 to 9.3 cases per 1000 children, affecting 1.2% of the global population. Despite pharmacological treatment, between 30% and 40% of patients fail to achieve adequate seizure control, and approximately half of these become candidates for epilepsy surgery.

Objective

To determine the incidence of seizure freedom, considering the Engel classification, in paediatric patients undergoing epilepsy surgery at a level IV paediatric hospital in Bogotá, Colombia.

Methodology

A retrospective observational cohort study was conducted with paediatric patients treated at a level IV paediatric hospital by the epilepsy surgery team between January 1, 2013, and July 31, 2024.

Results

Between 2013 and 2024, a total of 326 patients were evaluated through the epilepsy surgery programme. Of these, 154 underwent surgery. The median postoperative follow-up was 40 months. The type of surgery was significantly associated with a higher likelihood of achieving favourable outcomes at 6 months (RR = 3.54; 95% CI: 1.86–6.77; p < .001) and 12 months of follow-up (RR = 4; 95% CI: 1.96–8.08; p < .001). The presence of daily seizures and the need for treatment with more than three medications were associated with a lower likelihood of achieving favourable outcomes during the follow-up period.

Conclusions

The loss of years of healthy life since the diagnosis of epilepsy and the type of surgery performed (palliative or curative) were identified as independent factors strongly associated with favourable outcomes in the treatment of drug-resistant epilepsy.
耐药癫痫的定义是患者对两种适当选择的抗癫痫药物缺乏反应。癫痫是儿科人群中一种常见的神经系统疾病,估计患病率为每1000名儿童4.3至9.3例,影响全球人口的1.2%。尽管进行了药物治疗,仍有30%至40%的患者未能充分控制癫痫发作,其中约有一半患者需要进行癫痫手术。目的:确定在哥伦比亚波哥大一家四级儿科医院接受癫痫手术的儿童患者癫痫发作自由度的发生率,并考虑Engel分类。方法:对2013年1月1日至2024年7月31日在某四级儿科医院癫痫外科团队治疗的患儿进行回顾性观察队列研究。结果:2013年至2024年,共有326例患者通过癫痫手术项目进行了评估。其中,154人接受了手术。术后中位随访40个月。手术类型与6个月时获得良好结果的可能性显著相关(RR = 3.54;95% ci: 1.86-6.77;结论:自癫痫诊断以来健康生活年数的损失和手术类型(姑息性或治愈性)被确定为与耐药癫痫治疗的有利结果密切相关的独立因素。
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引用次数: 0
Fully percutaneous posterior transarticular C1-C2 stand-alone screw instrumentation: A case series and technical note 完全经皮后路经关节C1-C2独立螺钉内固定:一个病例系列和技术说明。
Pub Date : 2025-09-01 DOI: 10.1016/j.neucie.2025.500665
Ivan Lvov, Andrey Grin, Anton Kordonskiy, Zaali Barbakadze, Aleksandr Talypov, Aleksandr Tupikin
Magerl’s technique remains a widely accepted method for achieving C1-C2 fusion. Although two approaches using intermuscular corridors and biplanar X-ray guidance have been reported, there are no published studies dedicated to fully percutaneous techniques employing cannulated screws.

Objective

To demonstrate the feasibility of a fully percutaneous C1-C2 fixation technique using cannulated screws and to analyze the short- and long-term outcomes of the initial case series.

Material and methods

This case series included patients over 15 years of age who were presented with acute or subacute atlantoaxial instability at C1-C2 due to fractures of the odontoid process, C1 vertebra, or C2 vertebral body. Surgical details and fusion criteria were described. Due to the absence of comparison groups, only descriptive statistical methods were employed.

Results

A total of 11 patients (8 men, 3 women; mean age 41.5 ± 18.2 years) underwent fully percutaneous transarticular C1-C2 fixation. The mean operative time was 115.0 ± 30.8 min for patients stabilized using a Halo device and 80.6 ± 33.2 min for those immobilized with a Mayfield clamp. The mean blood loss across all cases was 38.8 ± 8.7 mL. One patient died from concurrent cardiac pathology. Two patients were lost to follow-up due to relocation, leaving 8 patients for final assessment. At final follow-up, the mean VAS score was 2 ± 1.5 and the mean NDI score was 5.3 ± 5.2. All patients with preoperative neurological deficits improved by one level on the ASIA scale. Fusion was achieved in 7 of 8 cases (87.5%), and 1 patient (12.5%) developed a stable C1-C2 pseudoarthrosis.

Conclusion

Our initial clinical experience demonstrated that fully percutaneous posterior transarticular C1-C2 stand-alone screw fixation using cannulated instruments could be a feasible and safe procedure. Critical requirements for this technique include complete reduction of atlantoaxial dislocation, compression in the lateral joint region, adequate intraoperative visualization, and strict adherence to specific screw trajectories.
Magerl技术仍然是一种被广泛接受的实现C1-C2融合的方法。虽然已经报道了两种采用肌间通道和双平面x线引导的入路,但没有发表的研究专门用于采用空心螺钉的全经皮技术。目的:论证使用空心螺钉进行全经皮C1-C2固定技术的可行性,并分析初步病例系列的短期和长期结果。材料和方法:本病例系列包括15岁以上因齿状突、C1椎体或C2椎体骨折而表现为C1-C2急性或亚急性寰枢椎不稳定的患者。描述了手术细节和融合标准。由于没有对照组,因此仅采用描述性统计方法。结果:共11例患者(男8例,女3例;平均年龄41.5±18.2岁)行全经皮经关节C1-C2固定。使用Halo装置稳定的患者平均手术时间为115.0±30.8分钟,使用Mayfield钳固定的患者平均手术时间为80.6±33.2分钟。所有病例的平均失血量为38.8±8.7 ml。1例患者死于并发心脏病理。2例患者因移位失访,8例患者待最后评估。末次随访时,平均VAS评分为2±1.5分,平均NDI评分为5.3±5.2分。所有术前神经功能缺损的患者在ASIA量表上均提高一个等级。8例患者中有7例(87.5%)实现融合,1例(12.5%)发展为稳定的C1-C2假关节。结论:我们的初步临床经验表明,使用空心器械完全经皮后路经关节C1-C2独立螺钉固定是可行且安全的手术。该技术的关键要求包括完全复位寰枢关节脱位,压迫外侧关节区域,术中充分的可视化,严格遵守特定的螺钉轨迹。
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引用次数: 0
ALIF in a Spanish female cohort: No urinary and sexual complications or a gender bias? ALIF在西班牙女性队列中:没有泌尿和性并发症还是性别偏见?
Pub Date : 2025-09-01 DOI: 10.1016/j.neucie.2025.500662
Cristina Romero-López , Santiago Rocha-Romero , María de los Ángeles Cañizares-Méndez , Julio Valencia-Anguita

Background

The objective of the present study is to analyze urinary and sexual functions in females treated with ALIF and to describe possible complications not previously reported in the literature.

Methods

We conducted a retrospective study of urinary and sexual functions in females treated with this technique in our hospital between 2019 and 2022. Inclusion criteria were: females treated with ALIF who provided informed consent.

Results

22 patients consented to participate. The median age was 51.5 years, the median follow-up was 11.5 months, and there was an improvement in low back pain of 4 points on the postoperative (postop) visual analogue scale (VAS). Overall, 36.3% of patients reported postoperative urinary deterioration, including 27.3% with new-onset urinary incontinence. The international consultation on incontinence questionnaire-short form score worsened by 3.5 points. 77.2% maintained an active sexual life; within this group, there was a worsening of 2.4 points in the postop female sexual function index and 35.2% described worsening in sexual function. We hypothesized that age, underlying lumbar pathology and changes in postoperative VAS scores could be confounding factors; however, only the relationship between age and postoperative urinary deterioration reached statistical significance (p = 0.034).

Conclusions

The present study describes deterioration in urinary function in 36.3% and in sexual function in 35.2% after the procedure, findings also supported by specific scales. In view of the above, we cannot discount a possible gender bias in the literature. Despite that, we believe that ALIF is still an adequate technique, but studies of higher level of evidence should be conducted to improve the information process of our patients.
背景:本研究的目的是分析接受ALIF治疗的女性的泌尿和性功能,并描述以前文献中未报道的可能的并发症。方法:对2019 - 2022年在我院接受该技术治疗的女性患者的泌尿和性功能进行回顾性研究。纳入标准为:经知情同意接受ALIF治疗的女性。结果:22例患者同意参与。中位年龄为51.5岁,中位随访时间为11.5个月,术后(术后)视觉模拟评分(VAS)腰痛改善4分。总体而言,36.3%的患者报告术后尿功能恶化,其中27.3%为新发尿失禁。国际咨询失禁问卷-简短形式得分下降3.5分。77.2%的人性生活活跃;在该组中,女性术后性功能指数恶化了2.4点,35.2%的人描述了性功能恶化。我们假设年龄、腰椎潜在病理和术后VAS评分的变化可能是混杂因素;但只有年龄与术后尿功能恶化的关系有统计学意义(p = 0.034)。结论:本研究描述了36.3%的患者术后尿功能恶化,35.2%的患者术后性功能恶化,这一发现也得到了特定量表的支持。鉴于上述情况,我们不能忽视文献中可能存在的性别偏见。尽管如此,我们认为ALIF仍然是一种足够的技术,但应该进行更高水平的证据研究,以改善我们患者的信息处理。
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引用次数: 0
Continuous sitting position during the postoperative period as an intervention to reduce risk of cerebrospinal fluid leak after endoscopic endonasal surgery 内镜鼻内窥镜手术后持续坐位作为降低脑脊液漏风险的干预措施。
Pub Date : 2025-09-01 DOI: 10.1016/j.neucie.2025.500658
José de Jesús Martínez-Manrique , Ricardo A. Palacios-Rodríguez , Luis A. Rodríguez-Hernández , Jorge F. Aragón-Arreola , Marcos V. Sangrador-Deitos , Juan Luis Gómez-Amador

Introduction/objectives

In recent decades, endoscopic endonasal surgery for skull base tumours has modified the way in which this region is approached. One of the most feared complications is the cerebrospinal fluid leak. It has been shown in different publications about CSF physiology that changes in the position modify the pressure of the CSF (pCSF). With this background, it is proposed as a viable, noninvasive, and very low-risk option, the continuous sitting position in patients during their hospital stay after endoscopic endonasal surgery as an adjuvant intervention to reduce the risk of CSF leak in patients considered to be at high risk. The objective is to demonstrate that the continuous sitting position in the postoperative period is a useful adjuvant intervention for the prevention of CSF leak in endoscopic endonasal surgery.

Methods

This is a retrospective, observational, cross-sectional, comparative study. It included patients over 18 years of either sex, intervened by endoscopic endonasal surgery with intraoperative CSF leak observed and with advanced reconstruction technique realized. A continuous sitting position (between 70 ° and 90 °) was considered when the patient remained in this position from the immediate postoperative period until the hospital discharge.

Results

A total of 60 patients were included. No statistically significant difference was found on all the variables studied, except when patients were stratified into sitting and non-sitting patients (p = 0.045). OR of 0.12 (95% CI 0.002–1.03) was observed. In the sitting group, only 1 patient (6.67%) had CSF leak, which was resolved with non-surgical treatment. The average length of hospital stay was 18 days (7–38) for sitting patients and 14 days (5–80) for non-sitting patients, with statistical significance stablished by the dispersion of the data (p = 0.023).

Conclusions

The continuous sitting position during the immediate postoperative period is an intervention that shows a decrease in the risk of CSF leak in patients intervened by endoscopic endonasal approach, included extended routes.
简介/目的:近几十年来,颅底肿瘤的鼻内窥镜手术已经改变了该区域的手术方式。最可怕的并发症之一是脑脊液泄漏。在不同的关于脑脊液生理学的出版物中已经表明,位置的变化会改变脑脊液的压力(pCSF)。在此背景下,我们提出了一种可行的、无创的、极低风险的选择,即患者在内镜鼻内窥镜手术后住院期间保持持续坐姿,作为一种辅助干预措施,以降低高风险患者脑脊液泄漏的风险。目的是证明术后持续坐姿是预防内镜鼻内手术脑脊液泄漏的一种有用的辅助干预。方法:回顾性、观察性、横断面、比较性研究。患者年龄≥18岁,男女不限,经鼻内窥镜手术干预,术中观察到脑脊液泄漏,并采用先进的重建技术。当患者从术后到出院一直保持该坐姿时,可考虑为连续坐姿(70°至90°之间)。结果:共纳入60例患者。除了将患者分层为坐着和不坐着外,所有研究变量均无统计学差异(p = 0.045)。OR为0.12 (95% CI 0.002-1.03)。坐位组仅有1例(6.67%)发生脑脊液漏,经非手术治疗后全部消失。坐位患者平均住院时间为18天(7 ~ 38天),非坐位患者平均住院时间为14天(5 ~ 80天),差异有统计学意义(p = 0.023)。结论:术后即刻持续坐位是一种干预措施,可降低经鼻内窥镜入路(包括延长入路)干预患者脑脊液泄漏的风险。
{"title":"Continuous sitting position during the postoperative period as an intervention to reduce risk of cerebrospinal fluid leak after endoscopic endonasal surgery","authors":"José de Jesús Martínez-Manrique ,&nbsp;Ricardo A. Palacios-Rodríguez ,&nbsp;Luis A. Rodríguez-Hernández ,&nbsp;Jorge F. Aragón-Arreola ,&nbsp;Marcos V. Sangrador-Deitos ,&nbsp;Juan Luis Gómez-Amador","doi":"10.1016/j.neucie.2025.500658","DOIUrl":"10.1016/j.neucie.2025.500658","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div><span>In recent decades, endoscopic endonasal surgery<span> for skull base tumours<span> has modified the way in which this region is approached. One of the most feared complications is the cerebrospinal fluid leak. It has been shown in different publications about </span></span></span>CSF<span> physiology that changes in the position modify the pressure of the CSF (pCSF). With this background, it is proposed as a viable, noninvasive, and very low-risk option, the continuous sitting position in patients during their hospital stay after endoscopic endonasal surgery as an adjuvant intervention to reduce the risk of CSF leak in patients considered to be at high risk. The objective is to demonstrate that the continuous sitting position in the postoperative period is a useful adjuvant intervention for the prevention of CSF leak in endoscopic endonasal surgery.</span></div></div><div><h3>Methods</h3><div>This is a retrospective, observational, cross-sectional, comparative study. It included patients over 18 years of either sex, intervened by endoscopic endonasal surgery with intraoperative CSF leak observed and with advanced reconstruction technique realized. A continuous sitting position (between 70 ° and 90 °) was considered when the patient remained in this position from the immediate postoperative period until the hospital discharge.</div></div><div><h3>Results</h3><div>A total of 60 patients were included. No statistically significant difference was found on all the variables studied, except when patients were stratified into sitting and non-sitting patients (p = 0.045). OR of 0.12 (95% CI 0.002–1.03) was observed. In the sitting group, only 1 patient (6.67%) had CSF leak, which was resolved with non-surgical treatment. The average length of hospital stay was 18 days (7–38) for sitting patients and 14 days (5–80) for non-sitting patients, with statistical significance stablished by the dispersion of the data (p = 0.023).</div></div><div><h3>Conclusions</h3><div>The continuous sitting position during the immediate postoperative period is an intervention that shows a decrease in the risk of CSF leak in patients intervened by endoscopic endonasal approach, included extended routes.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500658"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574985","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}
引用次数: 0
Ossification of posterior longitudinal ligament of the cervical spine: A review article 颈椎后纵韧带骨化:一篇综述文章。
Pub Date : 2025-09-01 DOI: 10.1016/j.neucie.2025.500668
Shengyu Cui , Jinze Li , Xiaoxu Yu , Hongyu Zhao , Fengzeng Jian
This article reviews the literature on the status of cervical OPLL in recent years, and reviews the etiology, clinical manifestations, imaging features, treatment and prognosis. Evidence was collected through PubMed and Google Scholar databases. After screening, weight removal and irrelevant articles, 57 articles were finally included in the review. Imaging is the only way to confirm the diagnosis, and CT and MRI are used to assess the patient's ossified material and spinal cord compression. Because there are hundreds of surgical approaches to cervical OPLL, each with advantages and disadvantages, clinicians must develop a personalized surgical plan based on the patient’s preoperative relevant factors to maximize prognosis. Clinicians should also actively follow up on discharged patients, carefully analyze cases with a poor prognosis, and summarize their experiences.
本文综述了近年来有关颈椎OPLL的文献,并对其病因、临床表现、影像学特征、治疗及预后进行了综述。证据是通过PubMed和谷歌Scholar数据库收集的。经筛选、去权重和不相关文献后,最终纳入57篇文献。影像学是确认诊断的唯一方法,CT和MRI用于评估患者的骨化物质和脊髓压迫。由于颈椎OPLL有数百种手术入路,各有优缺点,临床医生必须根据患者术前相关因素制定个性化的手术方案,以最大限度地提高预后。临床医生还应积极随访出院患者,认真分析预后差的病例,总结经验。
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引用次数: 0
The genesis of Academic Neurosurgery. Part II: The contribution of Johns Hopkins School of Medicine leaders 学术神经外科的起源。第二部分:约翰霍普金斯医学院领导的贡献。
Pub Date : 2025-09-01 DOI: 10.1016/j.neucie.2025.500672
Ramiro D. Lobato , Alfonso Lagares , Igor Paredes , Ana M. Castaño-Leon , Pablo M. Munarriz , Irene Panero
This paper describes the influence of the Jonhs Hopkins School of Medicine on the origin of academic neurosurgery in America. The impact, arising from two of the founders, W Osler and W Halsted, was vehiculated by their direct pupils Harvey Cushing and Walter Dandy. The relationships between all these pioneers (sometimes stormy) are analized along with the development of the primitive residency program and the efforts to create the first neurosurgical society (the Society of Neurological Surgeons).
本文描述了约翰霍普金斯医学院对美国学术神经外科学起源的影响。两位创始人W•奥斯勒(W Osler)和W•霍尔斯特德(W Halsted)产生的影响,由他们的直接学生哈维•库欣(Harvey Cushing)和沃尔特•丹迪(Walter Dandy)推动。随着原始住院医师计划的发展和创建第一个神经外科学会(神经外科医生协会)的努力,分析了所有这些先驱(有时是暴风雨)之间的关系。
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引用次数: 0
Topical and systemic effects of medical ozone therapy on epidural fibrosis: Experimental research 医用臭氧治疗硬膜外纤维化的局部和全身效应:实验研究。
Pub Date : 2025-09-01 DOI: 10.1016/j.neucie.2025.500663
Nur Balcin , Mine Ozsen , Pinar Eser , Tamer Kala , Gokhan Ocakoglu , Seref Dogan

Introduction

Epidural fibrosis (EF) causes adhesions in the epidural distance, resulting in chronic low back and leg pain symptoms during the postoperative period. Currently, ozone is used for treating lumbar disk herniation and low back pain. However, its effect on epidural fibrosis is largely unknown.

Material and methods

This rodent study examined the histopathological and biochemical effects of ozone therapy on epidural fibrosis. Forty-seven male Sprague–Dawley rats were divided into four groups, as follows: Control Group (CG) (n = 12): Laminectomy was performed, and no substance was applied. Saline Group (SG) (n = 11): Rats underwent intraoperative washing with 50 mL saline after laminectomy. Local Ozone Group (LOG) (n = 12): Rats underwent intraoperative washing with 50 mL ozonated distilled water after laminectomy. Systemic Ozone Group (SOG) (n = 12): Ozone was administered intraperitoneally (0.7 mg/kg) for 7 consecutive days postoperatively. At the end of 4 weeks, all subjects were sacrificed. Histopathological and biochemical data obtained from the tissues were analyzed in terms of EF.

Results

No statistically significant differences regarding EF, spinal cord retraction, inflammation, and fibroblast density were observed between the groups (p = 0.728; p = 0.813; p = 0.152; and p = 0.226, respectively). Hydroxyproline levels were higher in LOG than in SOG (p = 0.007); however, no statistically significant differences were observed among other groups (p > 0.05).

Conclusions

In our study, we could not record the positive effect of ozone therapy in terms of histopathology and biochemistry with the current doses and application methods. We think that caution should be exercised in the ozone dose and method of application in the clinical approach. In addition, we are of the opinion that statistically significant results can be obtained by creating a treatment protocol that includes different dose applications.
简介:硬膜外纤维化(EF)引起硬膜外粘连,导致术后出现慢性腰腿疼痛症状。目前,臭氧用于治疗腰椎间盘突出和腰痛。然而,其对硬膜外纤维化的影响在很大程度上是未知的。材料和方法:本实验研究臭氧治疗对硬膜外纤维化的组织病理学和生化影响。雄性Sprague-Dawley大鼠47只,随机分为4组:对照组(CG) (n = 12):行椎板切除术,不给药。生理盐水组(SG) (n = 11):椎板切除术后,术中用50 mL生理盐水冲洗大鼠。局部臭氧组(LOG) (n = 12):椎板切除术后,术中用50 mL臭氧蒸馏水冲洗大鼠。系统臭氧组(SOG) (n = 12):术后连续7天腹腔注射臭氧(0.7 mg/kg)。4周结束时,所有受试者均被处死。从组织中获得的组织病理学和生化数据根据EF进行分析。结果:两组间EF、脊髓回缩、炎症、成纤维细胞密度差异均无统计学意义(p = 0.728;P = 0.813;p = 0.152;p = 0.226)。LOG组羟脯氨酸水平高于SOG组(p = 0.007);其他组间差异无统计学意义(p < 0.05)。结论:在我们的研究中,在目前的剂量和应用方法下,我们无法从组织病理学和生物化学方面记录臭氧治疗的积极作用。我们认为在临床应用中,臭氧剂量和应用方法应谨慎。此外,我们认为,通过创建包括不同剂量应用的治疗方案,可以获得统计上显著的结果。
{"title":"Topical and systemic effects of medical ozone therapy on epidural fibrosis: Experimental research","authors":"Nur Balcin ,&nbsp;Mine Ozsen ,&nbsp;Pinar Eser ,&nbsp;Tamer Kala ,&nbsp;Gokhan Ocakoglu ,&nbsp;Seref Dogan","doi":"10.1016/j.neucie.2025.500663","DOIUrl":"10.1016/j.neucie.2025.500663","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Epidural fibrosis<span> (EF) causes adhesions in the epidural distance, resulting in chronic low back and leg pain symptoms during the </span></span>postoperative period<span>. Currently, ozone is used for treating lumbar disk herniation and low back pain. However, its effect on epidural fibrosis is largely unknown.</span></div></div><div><h3>Material and methods</h3><div><span>This rodent study examined the histopathological and biochemical effects of ozone therapy on epidural fibrosis. Forty-seven male Sprague–Dawley rats were divided into four groups, as follows: Control Group (CG) (</span><em>n</em><span> = 12): Laminectomy was performed, and no substance was applied. Saline Group (SG) (</span><em>n</em> = 11): Rats underwent intraoperative washing with 50 mL saline after laminectomy. Local Ozone Group (LOG) (<em>n</em> = 12): Rats underwent intraoperative washing with 50 mL ozonated distilled water after laminectomy. Systemic Ozone Group (SOG) (<em>n</em> = 12): Ozone was administered intraperitoneally (0.7 mg/kg) for 7 consecutive days postoperatively. At the end of 4 weeks, all subjects were sacrificed. Histopathological and biochemical data obtained from the tissues were analyzed in terms of EF.</div></div><div><h3>Results</h3><div>No statistically significant differences regarding EF, spinal cord retraction, inflammation, and fibroblast density were observed between the groups (<em>p</em> = 0.728; <em>p</em> = 0.813; <em>p</em> = 0.152; and <em>p</em><span> = 0.226, respectively). Hydroxyproline levels were higher in LOG than in SOG (</span><em>p</em> = 0.007); however, no statistically significant differences were observed among other groups (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>In our study, we could not record the positive effect of ozone therapy in terms of histopathology<span> and biochemistry with the current doses and application methods. We think that caution should be exercised in the ozone dose and method of application in the clinical approach. In addition, we are of the opinion that statistically significant results can be obtained by creating a treatment protocol that includes different dose applications.</span></div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500663"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588472","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}
引用次数: 0
Symptomatic thrombosed venous aneurysm after stereotactic radiosurgery for brain arteriovenous malformation: Case report of a late complication mimicking radiation necrosis 立体定向放射治疗脑动静脉畸形后的症状性血栓性静脉动脉瘤:一例模拟放射坏死的晚期并发症。
Pub Date : 2025-09-01 DOI: 10.1016/j.neucie.2025.500669
Gino A. Mendoza-Vega , Jason Riveros-Ruiz , Juan E. Basilio-Flores
Late complications of radiosurgery for brain arteriovenous malformation include cystic formation, chronic encapsulated hematoma and radiation-induced tumors. Other complications are rarely reported.
We present a case of an adult patient who received radiosurgery for treatment of an unruptured parietal arteriovenous malformation. He was followed-up for 10 years and angiographic cure was documented. Fifteen-years after radiosurgery, he complained of new-onset progressive focal seizures associated with a thrombosed venous aneurysm with persistent arteriovenous shunt angiographically occult but evidenced intraoperatively. After resection of the lesion, symptoms disappeared.
This case depicts a symptomatic thrombosed venous aneurysm presenting as a rare delayed complication of radiosurgery for the treatment of brain arteriovenous malformation, which can be associated with angiographically-occult persistent arteriovenous shunt.
脑动静脉畸形放射治疗的晚期并发症包括囊性形成、慢性囊性血肿和放射性肿瘤。其他并发症很少报道。我们提出一个病例的成人病人接受放射手术治疗未破裂的顶骨动静脉畸形。随访10年,血管造影治疗记录在案。放射手术后15年,他主诉新发进行性局灶性癫痫与血栓形成的静脉动脉瘤有关,并伴有持续的动静脉分流,血管造影上隐匿,但术中证实。病变切除后症状消失。这个病例描述了一个有症状的血栓性静脉动脉瘤,作为治疗脑动静脉畸形的放射手术中一种罕见的延迟并发症,它可能与血管造影隐匿的持续性动静脉分流有关。
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引用次数: 0
Removal of a giant musculocutaneous nerve schwannoma under intraoperative neurophysiological monitoring: Case report video and review of the literature 术中神经生理监测下切除巨大肌皮神经鞘瘤:病例报告录像及文献复习。
Pub Date : 2025-09-01 DOI: 10.1016/j.neucie.2025.500667
Edward Emerson Susanibar Mesías , Alba León Jorba , Antoni Raventós Estellé , Christian Abel Schinder , David Rodriguez Rubio
Schwannomas of the musculocutaneous nerve (MCN) are rare benign tumors of the peripheral nerve sheath. Due to their slow growth, they are often diagnosed late. In the upper limbs, schwannomas typically affect longer peripheral nerves at a distal level, making MCN cases uncommon. Ultrasound (US) and magnetic resonance imaging (MRI) are essential tools for early detection. While most schwannomas can be surgically removed without damaging the nerve, intraoperative neurophysiological monitoring (IONM) is critical if fascicular involvement exists.
We present a 73-year-old right-handed Jehovah's Witness with a history of mild polio affecting the right arm. MRI showed a slow-growing, cystic mass in the right biceps, originating from the MCN and suggestive of schwannoma. Surgery achieved gross total resection without nerve damage. Histopathology confirmed a cystic schwannoma.
In atypical proximal upper limb tumors, MCN schwannoma should be considered, with US/MRI crucial for diagnosis. IONM-assisted removal can minimize postoperative complications.
摘要肌皮神经鞘瘤是一种少见的外周神经鞘良性肿瘤。由于其生长缓慢,通常诊断较晚。在上肢,神经鞘瘤通常影响远端较长的周围神经,使得MCN病例不常见。超声(US)和磁共振成像(MRI)是早期发现的重要工具。虽然大多数神经鞘瘤可以手术切除而不损害神经,但如果存在神经束累及,术中神经生理监测(IONM)是至关重要的。​MRI显示右二头肌生长缓慢的囊性肿块,起源于MCN,提示神经鞘瘤。手术实现了大体全切除,无神经损伤。组织病理学证实为囊性神经鞘瘤。在非典型上肢近端肿瘤中,应考虑MCN神经鞘瘤,US/MRI对诊断至关重要。离子离子辅助切除可减少术后并发症。
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引用次数: 0
Intradural anastomoses between the cervical spinal nerves: Anatomical study 颈脊神经硬膜内吻合:解剖学研究。
Pub Date : 2025-09-01 DOI: 10.1016/j.neucie.2025.500666
Matilde Lissarrague , Franklin Miranda Solís , Fernando Martínez Benia

Introduction

Peripheral nerves can present anastomoses at different levels, with intraspinal anastomoses being relatively common, but little studied.

Objective

To study the presence and number of intradural anastomoses of the cervical spinal nerves in the Latin population.

Materials and methods

14 adult corpses of both sexes were dissected, fixed in formaldehyde solution. Sex of the corpse, existence of anastomosis, side, height of the anastomoses and sensory/motor origin were recorded.

Results

of the 14 corpses, 8 were male and 6 were female. Eleven cases presented anastomoses (79%), 8 of them bilaterally. In the total number of corpses, 52 anastomoses were found, 43 were between sensory roots (83%) and 9 between motor roots (17%). The levels where anastomoses were found most frequently were C1-C2 and C2-C3 (63% of the total).

Discussion and conclusions

intraspinal anastomoses between motor or sensory nerves can vary the clinical presentation of spinal cord injuries, radicular or medullar compressions, brachial plexus lesions or nerve root tumors, because the sensory or motor information of a given spinal cord level may be exiting the neuraxis with the adjacent spinal nerve.
周围神经可以出现不同程度的吻合,其中椎管内吻合较为常见,但研究较少。目的:探讨拉丁人群颈脊神经硬膜内吻合术的存在及数量。材料与方法:解剖成年男女尸体14具,用甲醛溶液固定。记录尸体的性别、吻合口的存在、吻合口的侧面、高度和感觉/运动来源。结果:14具尸体中,男8具,女6具。吻合11例(79%),其中8例为双侧吻合。其中感觉根间吻合43例(83%),运动根间吻合9例(17%)。吻合最常见的是C1-C2和C2-C3(占总数的63%)。讨论和结论:运动神经或感觉神经间的椎管内吻合可以改变脊髓损伤、神经根或髓质受压、臂丛病变或神经根肿瘤的临床表现,因为给定脊髓水平的感觉或运动信息可能与邻近的脊神经一起离开神经轴。
{"title":"Intradural anastomoses between the cervical spinal nerves: Anatomical study","authors":"Matilde Lissarrague ,&nbsp;Franklin Miranda Solís ,&nbsp;Fernando Martínez Benia","doi":"10.1016/j.neucie.2025.500666","DOIUrl":"10.1016/j.neucie.2025.500666","url":null,"abstract":"<div><h3>Introduction</h3><div>Peripheral nerves can present anastomoses at different levels, with intraspinal anastomoses being relatively common, but little studied.</div></div><div><h3>Objective</h3><div>To study the presence and number of intradural anastomoses of the cervical spinal nerves in the Latin population.</div></div><div><h3>Materials and methods</h3><div>14 adult corpses of both sexes were dissected, fixed in formaldehyde solution. Sex of the corpse, existence of anastomosis, side, height of the anastomoses and sensory/motor origin were recorded.</div></div><div><h3>Results</h3><div>of the 14 corpses, 8 were male and 6 were female. Eleven cases presented anastomoses (79%), 8 of them bilaterally. In the total number of corpses, 52 anastomoses were found, 43 were between sensory roots (83%) and 9 between motor roots (17%). The levels where anastomoses were found most frequently were C1-C2 and C2-C3 (63% of the total).</div></div><div><h3>Discussion and conclusions</h3><div>intraspinal anastomoses between motor or sensory nerves can vary the clinical presentation of spinal cord injuries, radicular or medullar compressions, brachial plexus lesions or nerve root tumors, because the sensory or motor information of a given spinal cord level may be exiting the neuraxis with the adjacent spinal nerve.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 5","pages":"Article 500666"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103302","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}
引用次数: 0
期刊
Neurocirugia (English Edition)
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