Review
Oncology
Venkat Boddapati, Joseph M. Lombardi, Hikari Urakawa, Ronald A. Lehman
Summary: The operative management of adult spinal deformity has been increasing due to an aging society. The advancement of intraoperative image guidance, such as navigation and robotics systems, has contributed to the growth and safety of ASD surgery. However, further studies are needed to assess the efficacy of these technologies in deformity correction and to overcome challenges such as radiation exposure.
ANNALS OF TRANSLATIONAL MEDICINE
(2021)
Article
Clinical Neurology
Luke Mugge, Danielle DeBacker Dang, Andrew Caras, John Dang, Noah Diekemper, Barth A. Green, Joseph P. Gjolaj, Andrew A. Fanous
Summary: This study aimed to determine the effect of osteoporosis on spine instrumentation. The results showed that osteoporosis was significantly associated with increased blood volume loss, instrumentation failure, and the need for revision surgery. Additionally, patients with osteoporosis had a significantly higher risk of intraoperative blood volume loss and postoperative thromboembolic events.
Article
Oncology
Mirza Pojskic, Miriam H. A. Bopp, Benjamin Sass, Barbara Carl, Christopher Nimsky
Summary: The aim of surgery for skull base meningiomas is maximal resection with minimal damage to the involved cranial nerves and cerebral vessels. Neuronavigation and augmented reality (AR) technologies can improve surgical precision and orientation. Microscope-based AR facilitates the resection of skull base meningiomas by providing better intraoperative visualization and increasing surgical precision. The use of these technologies results in a high rate of successful gross total resection and a low rate of injuries to critical neurovascular structures.
Article
Radiology, Nuclear Medicine & Medical Imaging
Arjun Krishna, Shanmukha Yenneti, Ge Wang, Klaus Mueller
Summary: This study presents a framework to address the lack of labeled data problem in medical deep learning. By utilizing various learning methods, a large annotated dataset can be synthesized from a small annotated dataset, which can be used for model training and synthesizing images that do not exist in the input dataset. The effectiveness of the framework is demonstrated and it can be widely applied in deep learning applications for medical imaging.
Article
Clinical Neurology
Ulf Bertram, Tobias Philip Schmidt, Hans Clusmann, Walid Albanna, Christian Herren, Alexander Riabikin, Christian A. Mueller, Christian Blume
Summary: The study found that the accuracy of iCT navigated dorsal instrumentation for cervical spine was significantly higher than conventional instrumentation, especially in cases of degenerative spinal disorders and trauma. The use of CPSs with iCT navigation showed a tendency, enhancing the mechanical properties of the construct. iCT navigation appeared to be particularly beneficial in elective surgery cases of degenerative spinal disorders.
WORLD NEUROSURGERY
(2021)
Review
Clinical Neurology
Ryota Kimura, Norio Yamamoto, Jun Watanabe, Yuichi Ono, Michio Hongo, Naohisa Miyakoshi
Summary: This study compared the efficacy and safety of ultrasound-guided spinal nerve injections with fluoroscopic or CT-guided spinal nerve injections. The results showed that ultrasound-guided injections had similar pain reduction compared to traditional methods, but they reduced major adverse events, decreased procedure time, and possibly reduced minor adverse events. There was probably no significant difference in the change in functional disability score between the two methods.
EUROPEAN SPINE JOURNAL
(2023)
Article
Clinical Neurology
Jan-Helge Klingler, Yashar Naseri, Peter C. Reinacher, Herbert Hoedlmoser, Horst Urbach, Marc Hohenhaus
Summary: Intraoperative CT imaging results in higher radiation exposure for patients compared to 3D C-arm, highlighting the need for proper system selection and dose-saving protocols.
Article
Clinical Neurology
Marco Riva, Umberto A. Arcidiacono, Matteo Gambaretti, Lorenzo G. Gay, Tommaso Sciortino, Marco Rossi, Marco Conti Nibali, Lorenzo Bello
Summary: The study investigated the impact of AIRO Mobile Computer Tomography in frameless stereotactic procedures through a retrospective analysis of 12 patients. The results showed that AIRO-CT could enhance the efficacy of stereotactic procedures by reducing technical and physical sources of inaccuracy, improving safety, and allowing prompt detection and management of intraoperative complications.
BRITISH JOURNAL OF NEUROSURGERY
(2022)
Article
Engineering, Electrical & Electronic
Kai Hu, Hui Tan, Yuan Zhang, Wei Huang, Xieping Gao
Summary: Recently, accurate segmentation of COVID-19 infection from CT scans has become crucial for its diagnosis and treatment. To address the challenges posed by various infection characteristics, a novel multiscale wavelet guidance network (MWG-Net) is proposed, which integrates wavelet domain information into the CNN encoder and decoder. Experimental results demonstrate the superiority of MWG-Net in COVID-19 lung infection segmentation, outperforming state-of-the-art methods on different datasets.
IEEE TRANSACTIONS ON INSTRUMENTATION AND MEASUREMENT
(2023)
Article
Medicine, General & Internal
Yen-Yao Li, Shih-Hao Chen, Kuo-Chin Huang, Chien-Yin Lee, Chin-Chang Cheng, Ching-Yu Lee, Meng-Huang Wu, Tsung-Jen Huang
Summary: This study evaluated the accuracy and safety of iCT-navigation for screw placement in revision thoracolumbar spinal surgery, comparing the virgin site and the revision site. The results showed that the rate of accepted screws at the revision site was comparable to that at the virgin site. Additionally, iCT-navigation allowed for the immediate revision of unaccepted screws.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Juha I. Peltonen, Touko Kaasalainen, Mika Kortesniemi
Summary: A robust and quantitative method was developed to determine metal artifacts in CBCT. Changes in imaging parameters may have nonlinear effects on image quality, which are not anticipated based on physics.
BMC MEDICAL IMAGING
(2021)
Review
Clinical Neurology
Luke Dixon, Adrian Lim, Matthew Grech-Sollars, Dipankar Nandi, Sophie Camp
Summary: Accurate and reliable intraoperative neuronavigation is crucial for safe resection of brain tumors. Intraoperative MRI (iMRI) has limitations due to cost and logistics, whereas intraoperative ultrasound (ioUS) is an affordable and easily integrated tool with improved image quality and navigation features. Advanced techniques like contrast-enhanced ultrasound (CEUS) have also become clinically useful.
NEUROSURGICAL REVIEW
(2022)
Article
Multidisciplinary Sciences
Vanessa Hubertus, Lars Wessels, Anton Frueh, Dimitri Tkatschenko, Irini Nulis, Georg Bohner, Vincent Prinz, Julia Onken, Marcus Czabanka, Peter Vajkoczy, Nils Hecht
Summary: This study investigated the performance of 3D intraoperative imaging and navigation systems for CFRP pedicle screws in the thoraco-lumbar spine. The results showed that intraoperative CT had the highest navigation accuracy and image quality, while CBCT performed relatively poorly in CFRP materials.
SCIENTIFIC REPORTS
(2022)
Article
Clinical Neurology
Benjamin Fisher, Wai Cheong Soon, John Ong, Tin Chan, Yasir Chowdhury, James Hodson, Anwen White
Summary: This study compared the accuracy and complication rates of neuronavigation-guided, ultrasound-guided, and freehand techniques in EVD placement, and found that image-guided EVD placement significantly reduced the risk of suboptimal placement. Surgeon seniority and other procedural factors did not impact accuracy or complications of EVD placement.
WORLD NEUROSURGERY
(2021)
Article
Oncology
Edoardo Mazzucchi, Patrick Hiepe, Max Langhof, Giuseppe La Rocca, Fabrizio Pignotti, Pierluigi Rinaldi, Giovanni Sabatino
Summary: The study aimed to verify the accuracy of an automatic MRI-iUS fusion algorithm to improve MR-based neuronavigation accuracy. The results showed that the algorithm was successfully applied in most patients and significantly reduced navigation errors.
Article
Clinical Neurology
Jacob K. Greenberg, Stephen Shelby Burks, Christopher F. Dibble, Saad Javeed, Vivek P. Gupta, Alexander T. Yahanda, Roberto J. Perez-Roman, Vaidya Govindarajan, Andrew T. Dailey, Sanjay Dhall, Daniel J. Hoh, Daniel E. Gelb, Adam S. Kanter, Eric O. Klineberg, Michael J. Lee, Praveen Mummaneni, Paul Park, Charles A. Sansur, Khoi D. Than, Jon J. W. Yoon, Michael Y. Wang, Wilson Z. Ray
Summary: Minimally invasive surgery (MIS) techniques can effectively stabilize and decompress thoracolumbar injuries with decreased morbidity and tissue destruction. This study aimed to identify current practice patterns for thoracolumbar trauma and develop an updated treatment algorithm based on expert opinion and literature review.
JOURNAL OF NEUROSURGERY-SPINE
(2022)
Article
Clinical Neurology
Daipayan Guha, Harry M. Mushlin, Nallammai Muthiah, Lena L. Vodovotz, Nitin Agarwal, Nima Alan, D. Kojo Hamilton, David O. Okonkwo, Adam S. Kanter
Summary: This study investigated the relationship between CT Hounsfield units (HU) and subsidence and reoperation after standalone and multilevel lateral lumbar interbody fusion (LLIF). The study found that lower CT HU levels were associated with an increased risk of graft subsidence and reoperation after single-level LLIF.
WORLD NEUROSURGERY
(2022)
Article
Engineering, Biomedical
Clarissa M. LeVasseur, Samuel W. Pitcairn, David O. Okonkwo, Adam S. Kanter, Jeremy D. Shaw, William F. Donaldson, Joon Y. Lee, William J. Anderst
Summary: This study provides in vivo evidence that contradicts long-held beliefs that adjacent segment end-range motion increases appreciably after anterior cervical spine arthrodesis and that two-level arthrodesis exacerbates these effects. Mid-range motion appears to be more useful than end-range motion for detecting early changes in adjacent segment motion after cervical spine arthrodesis.
ANNALS OF BIOMEDICAL ENGINEERING
(2022)
Article
Clinical Neurology
Nima Alan, Lena Vodovotz, Nallammai Muthiah, Hansen Deng, Daipayan Guha, Nitin Agarwal, Alp Ozpinar, Harry M. Mushlin, Lauren Puccio, David K. Hamilton, David O. Okonkwo, Adam S. Kanter
Summary: In this study, the authors evaluated the rate of subsidence and reoperation in patients who underwent LLIF using a 3D-printed pTi interbody cage. The results showed that the subsidence rate was low and only one patient required reoperation.
JOURNAL OF NEUROSURGERY-SPINE
(2022)
Article
Clinical Neurology
Khoi D. Than, Vikram A. Mehta, Vivian Le, Jonah R. Moss, Paul Park, Juan S. Uribe, Robert K. Eastlack, Dean Chou, Kai-Ming Fu, Michael Y. Wang, Neel Anand, Peter G. Passias, Christopher Shaffrey, David O. Okonkwo, Adam S. Kanter, Pierce Nunley, Gregory M. Mundis, Richard G. Fessler, Praveen Mummaneni
Summary: Obesity can negatively affect radiographic correction, quality-of-life outcomes, and complications in patients undergoing MIS for ASD.
JOURNAL OF NEUROSURGERY-SPINE
(2022)
Article
Clinical Neurology
Juan S. Uribe, Robert M. Koffie, Michael Y. Wang, Gregory M. Mundis, Adam S. Kanter, Robert K. Eastlack, Neel Anand, Paul Park, Justin S. Smith, Douglas C. Burton, Dean Chou, Michael P. Kelly, Han Jo Kim, Shay Bess, Christopher Shaffrey, Frank J. Schwab, Lawrence G. Lenke, Praveen Mummaneni
Summary: There is significant variability in surgical approaches among spine surgeons treating adult spinal deformity (ASD), with no consensus on the extent of treatment. Surgeons performing minimally invasive surgery (MIS) versus open surgery also show differences in variability. This lack of consensus poses challenges for optimal surgical management of ASD.
WORLD NEUROSURGERY
(2022)
Article
Clinical Neurology
Stephen R. Chen, Clarissa M. LeVasseur, Samuel Pitcairn, Maria A. Munsch, Brandon K. Couch, Adam S. Kanter, David O. Okonkwo, Jeremy D. Shaw, William F. Donaldson, Joon Y. Lee, William J. Anderst
Summary: This prospective cohort study aimed to identify patient factors that affect adjacent segment kinematics after anterior cervical discectomy and fusion (ACDF). The study found that preexisting adjacent segment disc degeneration was associated with reduced adjacent segment motion after ACDF, while lack of preexisting adjacent disc degeneration was associated with increased adjacent segment motion after ACDF.
Article
Surgery
Alp Ozpinar, Jennifer L. Perez, Emily Hacker, Nima Alan, Nitin Agarwal, Hansen Deng, David O. Okonkwo, Adam S. Kanter, D. K. Hamilton
Summary: This study assessed factors that contribute to outcomes in elderly patients with cervical diffuse idiopathic skeletal hyperostosis (DISH) fractures. The results showed that preoperative ASIA grade, SLIC score, and ASA score were associated with 30-day mortality and ambulatory status at discharge in these patients.
INTERNATIONAL JOURNAL OF SPINE SURGERY
(2022)
Article
Clinical Neurology
Brian J. Neuman, Kevin Y. Wang, Andrew B. Harris, Micheal Raad, Richard A. Hostin, Themisctocles S. Protopsaltis, Christopher P. Ames, Peter G. Passias, Munish C. Gupta, Eric O. Klineberg, Robert Hart, Shay Bess, Khaled M. Kebaish
Summary: Most adults are able to return to full-time work after ASD surgery, with a lower proportion of patients in the HI group returning to full-time work at 6 weeks. Patients who were employed full-time before surgery are likely to return to full-time employment after the surgery.
Article
Clinical Neurology
Riza Bayoglu, Jens-Peter Witt, Gregoire P. Chatain, David O. Okonkwo, Adam S. Kanter, D. Kojo Hamilton, Lauren M. Puccio, Nima Alan, Dominika Ignasiak
Summary: This study aimed to validate a computational framework for predicting postoperative patient posture based on preoperative imaging and surgical data. The results showed that the framework had an accuracy of 81% to 94% in predicting postoperative spinopelvic malalignment and sagittal imbalance parameters. Patients treated with long fusion had relatively lower prediction errors and the overall model performance was superior.
Article
Clinical Neurology
Nima Alan, Hansen Deng, Nallammai Muthiah, Lena Vodovotz, Robert Dembinski, Daipayan Guha, Nitin Agarwal, Alp Ozpinar, Kojo Hamilton, Adam S. Kanter, David O. Okonkwo
Summary: This study compared the rates of subsidence and reoperation after LLIF between PEEK and 3D-printed porous titanium (pTi). The results showed that patients treated with pTi had a lower probability of subsidence compared to those treated with PEEK, but similar reoperation rates.
JOURNAL OF NEUROSURGERY-SPINE
(2023)
Article
Clinical Neurology
Peter G. Passias, Peter S. Tretiakov, Pierce D. Nunley, Michael Y. Wang, Paul Park, Adam S. Kanter, David O. Okonkwo, Robert K. Eastlack, Gregory M. Mundis Jr, Dean Chou, Nitin Agarwal, Richard G. Fessler, Juan S. Uribe, Neel Anand, Khoi D. Than, Gregory Brusko, Kai-Ming Fu, Jay D. Turner, Vivian P. Le, Breton G. Line, Christopher P. Ames, Justin S. Smith, Christopher I. Shaffrey, Robert A. Hart, Douglas Burton, Renaud Lafage, Virginie Lafage, Frank Schwab, Shay Bess, Praveen V. Mummaneni
Summary: Circumferential minimally invasive surgery (cMIS) may offer incremental benefits compared with open surgery for increasingly frail patients, reducing perioperative and postoperative complications.
JOURNAL OF NEUROSURGERY-SPINE
(2023)
Article
Clinical Neurology
Nitin Agarwal, Michael D. White, Souvik Roy, Alp Ozpinar, Nima Alan, Raj Swaroop Lavadi, David O. Okonkwo, D. Kojo Hamilton, Adam S. Kanter
Summary: This study aimed to evaluate whether early patient-reported outcome measures after stand-alone LLIF are sustained on long-term follow-up. The results showed that the improvements in ODI and EQ-5D at 6 weeks remained durable up to 5 years, while the improvement in VAS scores persisted up to 2 years but did not reach significance at 5 years.
Article
Clinical Neurology
Neel Anand, Praveen Mummaneni, Juan S. Uribe, Jay Turner, Khoi D. Than, Dean Chou, Pierce D. Nunley, Michael Y. Wang, Richard G. Fessler, Vivian Le, Jerry Robinson, Corey Walker, Sheila Kahwaty, Babak Khanderhoo, Robert K. Eastlack, David O. Okonkwo, Adam S. Kanter, Kai-Ming G. Fu, Gregory M. Mundis Jr, Peter Passias, Paul Park
Summary: The researchers developed a checklist called the Spinal Deformity Complexity Checklist (SDCC) to assess the difficulty in performing minimally invasive surgery for adult spinal deformity. The checklist includes radiographic and patient-related characteristics that can affect the complexity of the surgery. If a patient scores 4 in any characteristic, open surgery may be a better alternative.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Nitin Agarwal, Souvik Roy, Raj Swaroop Lavadi, Nima Alan, Alp Ozpinar, Thomas J. Buell, D. Kojo Hamilton, Adam S. Kanter, David O. Okonkwo
Summary: This study examines the impact of delayed posterior augmentation on outcomes in patients undergoing circumferential minimally invasive scoliosis surgeries. The results show that in select cases, patients may experience symptomatic improvement and not require posterior fixation. However, those who do require further fixation tend to have more severe coronal malalignment.