bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oxidative Stress Level in Patients with Subarachnoid Hemorrhage
Authors: Abdallah Anas , Guler Eray Metin , Çınar İrfan , Papaker Meliha Gündağ , Yapar Selçuk , Ozer Omer Faruk , Yurtsever Ismail , Dündar Tolga Turan 
Published: December 2021

Abstract
Background One of the antioxidant mechanisms is the dynamic balance between thiol and disulfide, which, in subarachnoid hemorrhage and other chronic diseases, is disrupted in favor of the latter. The two most commonly used oxidative stress (OS) biochemical markers are the oxidative stress index (OSI) value, which indicates the total oxidant status (TOS) and total antioxidant status (TAS) balance, and the thiol–disulfide (TDS) value, which indicates the total thiol (TT) and native thiol (NT) balance. High OS levels require further investigations. We aimed to investigate the OS level in aneurysmal SAH (aSAH) patients.
methods In this clinical prospective study, blood samples were collected from 50 consecutively treated patients with aSAH and 50 volunteers. Serum TOS, TAS, TT, and NT levels were measured using Erel's method via a spectrophotometer. The Glasgow Coma Scale (GCS) scores, Fisher grades, length of hospital stay (LOS), and the Glasgow Outcome Scale (GOS) scores were recorded. Consequently, the OSI and TDS values were calculated in all participants.
Results A statistically significant difference was observed in the TAS, TOS, OSI, and TDS values between the aSAH patients and the controls. The TT and NT values were significantly lower in aSAH patients than in the controls. A correlation was identified between the OSI values and the GCS scores. Although a correlation was observed between the TDS values and the LOS, no correlation was found between the OSI and the TDS values.
Conclusion The OSI and TDS, which are OS indicators, might serve as the additional objective nominal data to evaluate the treatment efficacy and follow-up for SAH patients. Moreover, decreasing the OSI values and increasing the TT values can be used as improvement indicators in the treated aSAH patients. If we can reduce the OS at the early stage of SAH, it could improve the prognosis by reducing both the morbidity and mortality rates. Further randomized investigations are required to prove the findings in this prospective study.
Ruptured Aneurysm of the Anterior Communicating Artery in a Newborn: A Case Report and Review of the Literature
Authors: Frič Radek , Nedregaard Bård , Heimdal Ketil Riddevold , Weber Clemens , Due-Tønnessen Bernt Johan 
Published: December 2021

AbstractWe report the case of a 3-week-old neonate who presented with massive subarachnoid and intraventricular hemorrhage from a ruptured aneurysm of the anterior communicating artery (ACommA). An attempt on endovascular treatment ended up with therapeutic closure of the parent artery. However, since further investigation revealed a disastrous supratentorial cerebral infarction as a result of the hemorrhage, active treatment was terminated and the neonate died a few days after the initial stroke. To the best of our knowledge and after reviewing available literature, this is one of only five cases of ACommA aneurysm in newborns reported to date. Bleeding from an ACommA aneurysm in a neonate thus represents an extreme clinical rarity. There are no available data comparing the efficacy and safety of microsurgical versus endovascular treatment in neonates and small infants, but the latter option may at least reduce the risk associated with open surgery and further blood loss in this age group.
Cortical Bone Trajectory Pedicle Screw Fixation in Surgical Treatment of Monosegmental Pyogenic Lumbar Spondylodiskitis
Authors: Shin Jae-Hyuk , Kim Sang-II , Jung Jiyoung , Rhyu Kee-Won 
Published: December 2021

Abstract
Background and Study Object Pedicle screw fixation has been widely used in surgical treatment for infective lumbar spondylodiskitis to prevent instability and deformity. The cortical bone trajectory pedicle screw (CBTPS) fixation is a minimally invasive posterior spinal fixation system that runs from the pedicle's entry point of the caudiomedial region toward the cephalad-divergent direction. Successful results with CBTPS fixation have been reported to treat degenerative and osteoporotic spinal diseases. This study aims to investigate the clinical feasibility of CBTPS in the surgical treatment of pyogenic lumbar spondylodiskitis.
Patient and Methods We retrospectively retrieved 20 consecutive patients from two academic centers who were surgically treated for monosegmental lumbar pyogenic spondylodiskitis. The primary surgical treatment was the anterior lumbar interbody fusion with decompression, debridement, and reconstruction using an autogenous iliac strut bone graft. One to 2 weeks after the primary surgery, patients underwent a second surgery for posterior instrumentation using conventional pedicle screws (CPS; group I) and CBTPS (group II). Radiographic parameters of the deformity angle at the fusion segment and clinical parameter of visual analog scale (VAS) scores were assessed preoperatively, postoperatively, and at the last follow-up.
Results There were 10 patients in each group. The mean follow-up periods of groups I and II were 51.10 ± 6.95 and 28.60 ± 9.31 months, respectively. Intergroup analysis indicated the two groups area age-matched (p = 0.38), but initial C-reactive protein (CRP; mg/dL, p = 0.04), CRP normalization (months, p = 0.00), and follow-up duration (months, p = 0.00) were heterogeneous. Meanwhile, deformity angles (segmental lordosis) between the two groups were not significantly different preoperatively (p = 0.25), postoperatively (p = 0.13), and at last follow-up (p = 0.38). The intragroup analysis indicated a significant postoperative increase of lordosis in both group I and II (p = 0.00 and 0.04, respectively) with subsequent subsidence. Lordosis remained increased at the last follow-up with or without significance (group I, p = 0.02; group II, p = 0.62). Both groups showed significant improvement in VAS scores (group I, p = 0.00; group II, p = 0.00).
Conclusion In monosegmental lumbar spondylodiskitis, posterior stabilization of the anterior strut bone graft by CBTPS and CPS was comparable via the radiographic parameter of segmental lordosis or deformity angle. Our observation suggests the clinical feasibility of CBTPS in the treatment of relatively mild monosegmental pyogenic lumbar spondylodiskitis.
Temporal Flaps in Head and Neck Reconstructive Surgery: A Systematic Review of Surgical Techniques
Authors: Gagliardi Filippo , Snider Silvia , Pompeo Edoardo , Medone Marzia , Piloni Martina , Giordano Leone , De Domenico Pierfrancesco , Roncelli Francesca , Mortini Pietro 
Published: December 2021

AbstractThe temporal region is a great source of vascularized flap, providing extremely variable and versatile options for reconstruction in head and neck surgery. Its popularity has led to the conception of a large variety of different flaps, in terms of contents and design. Temporal flaps are highly pliable and flexible, providing adequate bulk to obliterate dead spaces and improving engraftment, thus facilitating wound healing. The need to access different anatomical compartments, often far from the original flap anatomical site, has led surgeons to develop techniques to enlarge pedicles and bulk, by reverting and splitting flaps' contents, as well as through partial mandibular and zygomatic resection. To further increase versatility, a multilayered combination of different regional tissues and muscle segmentation techniques has been described. Historically, each flap has had its own proponents and opponents, but a pointy review systematizing techniques and comparatively analyzing different flaps was still missing in the literature. The field of use of some flaps has been progressively limited by the increasing relevance of free tissue transfers, which nowadays may provide success rates up to 95% with a constrained morbidity, thus offering an effective alternative, when available. Given the wide range of reconstructive strategies based on temporal flaps, there is still a great debate on nomenclature and surgical techniques. The present study systematizes the topic, classifying regional flaps according to contents and indications. Harvesting techniques are described stepwise and schematically illustrated, thus offering an indispensable tool to the armamentarium of reconstructive surgeons.
Vertebral Body Infarction after Transarterial Preoperative Embolization of a Vertebral Hemangioma
Authors: Fiore Giorgio , Bertani Giulio A. , Tariciotti Leonardo , Borsa Stefano , Paolucci Aldo , Taramasso Lucia , Locatelli Marco , Pluderi Mauro 
Published: December 2021

Abstract
Background Vertebral hemangioma resection can be a real challenge for spine surgeons, given the high potential of massive intraoperative bleeding. For this reason, preoperative transarterial embolization of this tumor is supported by the available literature. Here, we discuss our difficulties in interpreting an unusual clinical and radiologic picture related to the endovascular procedure.
Methods and Results A 45-year-old man was referred to our department due to chronic back pain and progressive lower extremity weakness. Radiologic assessment was obtained by means of spinal computed tomography (CT) and magnetic resonance imaging (MRI), which showed an aggressive vertebral hemangioma in T7, compressing the spinal cord. The patient underwent a combined therapeutic approach consisting of preoperative transarterial embolization followed by tumor resection, spinal cord decompression, and posterior thoracic arthrodesis. The patient was dismissed with neither strength nor sensory deficits. Two weeks later, he returned to our department with fever. A new MRI demonstrated multiple areas of altered signal in almost all vertebral bodies from T6 down to the sacrum. After a deep diagnostic process, including new MRI and infectious disease evaluations, the definitive diagnosis of multiple vertebral bone infarction was suggested.
Conclusion Vertebral infarctions are an extremely rare complication of spinal endovascular procedures. To our knowledge, this is the first case of multiple postembolization vertebral infarctions, without spinal cord involvement. This peculiarity was explained by the presence of direct anastomoses between a posterior intercostal artery and the underlying vertebral bodies.
Growth Analysis of Untreated Meningiomas under Observation
Authors: Opalak Charles F. , Sima Adam P. , Carr Matthew Thomas , Rock Andrew , Somasundaram Aravind , Workman Kathryn G. , Dincer Alper , Chandra Vyshak , Vega Rafael A. , Broaddus William C. 
Published: December 2021

AbstractBackground When meningiomas are small or asymptomatic, the decision to observe rather than treat requires balancing the growth potential of the lesion with the outcome and side effects of treatment. The aim of this study is to characterize the growth patterns of untreated meningiomas to better inform the clinical decision-making process.Methods Patients with meningiomas were identified from 2005 to 2015. Those without treatment who had been followed for 1.5 years, with three magnetic resonance imaging (MRI) scans, were identified. Scans were measured with orthogonal diameters, geometric mean diameters, and volumes using the ABC/2 method. Regression modeling determined what growth pattern these parameters best approximated.Results Two hundred and fifteen MRI scans for 34 female (82.9%) and 7 male (17%) patients with 43 tumors were evaluated. Initial tumor volumes ranged from 0.13 to 9.98 mL. The mean and median initial volumes were 2.44 and 1.52 mL, respectively. Follow-up times ranged from 21 to 144 months, with a median of 70 months. There were 12 tumors (28%) whose growth rates were significantly greater than zero. For all tumors, use of a linear regression model allowed accurate prediction of the future size using prior data.Conclusion Three-quarters of presumptive meningiomas managed conservatively do not grow significantly. The remainder have significant growth over time, and the behavior could be approximated with linear regression models.
Intraneural Nodular Fasciitis of the Dorsal Scapular Nerve: Case Report and Review of the Literature
Authors: Domazet Ivan , Njiric Niko , Jakovcevic Antonia , Bitunjac Andrija , Domazet Krešimir , Pašalić Ivan , Mrak Goran 
Published: December 2021

Abstract
Background Nodular fasciitis is a benign neoplasm occurring predominantly in the subcutaneous tissue. There have been nine intraneural occurrences described in the literature.
Case report A 37-year-old woman presented with numbness and tenderness in her left shoulder and scapula and a slightly dropped left shoulder, without history of trauma. A magnetic resonance imaging (MRI) of the cervical spine showed a well-circumscribed oval mass deep to the levator scapula muscle. Due to persisting symptoms and an unknown nature of the process, surgical excision was performed, and histopathologic analysis confirmed diagnosis of a benign fibroblastic/myofibroblastic neoplasm, nodular fasciitis. The postoperative course was uneventful and the patient was without symptoms at 4 months of follow-up.
Methods We reviewed the available literature (PubMed, Google Scholar), with nine published cases of intraneural nodular fasciitis. The reported clinical, radiologic, and histopathologic parameters were evaluated and compared.
Discussion Most of the cases reported in the literature were symptomatic, with tenderness and palpability being the main symptoms. Six of the reported cases occurred in the forearm, whereas three were in the leg. To the best of our knowledge, ours is the first reported case of nodular fasciitis occurring in the trunk. Ours is the only case to display desmin positivity, which supports the reactive hypothesis of nodular fasciitis.
Conclusion Intraneural nodular fasciitis is an extremely rare diagnosis. Due to its benign natural course, a multidisciplinary approach with this extremely rare diagnosis in mind is needed to avoid overtreatment.
Alternative Dorsal Root Ganglion Neuromodulation Electrode Implantation: A Report of 2 Cases with 3 Different Techniques
Authors: Schultheis Björn Carsten , Wille Christian , Ross-Steinhagen Nikolas Eugenio , De Ridder Dirk , Vancamp Tim , Weidle Patrick A. 
Published: December 2021

Abstract
Background and Study Aims The traditional percutaneous placement of dorsal root ganglion (DRG) electrodes may not be eligible for every patient. In this tertiary spine surgery and interventional pain therapy center, alternative neurostimulation implantation techniques were developed and applied where standard percutaneous approaches failed or were contraindicated.
Case presentation Three alternative implantation techniques can be used: (1) open surgical placement of DRG leads, (2) two-lead insertion via a lateral to medial transforaminal approach (level L3), and (3) percutaneous approach with two leads close to the spinal nerves L4 (peripheral nerve stimulation).
Results The placement of the leads occurred without complications and resulted in similar expected outcomes as with the common percutaneous technique with long-term stable pain suppression at 7 months and 1 year.
Conclusions In patients in whom the DRG cannot be approached by the standard percutaneous approach, at least three alternatives may be used in experienced hands resulting in stable pain suppression of similar magnitude.
The Contralateral Approach to intra- and Extraforaminal Lumbar Disk Herniations: Surgical Technique and Review of Surgical Procedures
Authors: Jesse Christopher Marvin , Raabe Andreas , Ulrich Christian T. 
Published: December 2021

Abstract
Background Surgery for intra-/extraforaminal disk herniations (IEDH) is technically demanding due to the hidden location of the compressed nerve root section. Ipsilateral approaches (medial and lateral) are accompanied by extended resection of the facet joint and inadequate visualization of the pathology, especially at the L5–S1 level.
Methods We describe a microsurgical interlaminar contralateral approach (MICA) suitable for IEDH at the lumbosacral junction that can also be used at L4–L5 and L3–L4.
Conclusion The MICA provides access and sufficient intraforaminal visualization for IEDH in the lumbosacral region without resection of stability-relevant structures or manipulation of the nerve root ganglion.
Clinical Practice in Spine Surgery: An International Survey
Authors: Pérez-Bovet Jordi , Buxó Maria , Rimbau Muñoz Jordi 
Published: December 2021

Abstract
Background The availability of diverse and sophisticated surgical options to treat spine conditions is compounded by the scarcity of high-level evidence to guide decision-making. Although studies on discrete treatments are frequently published, little information is available regarding real-world surgical practice. We intended to survey spine surgeons to assess clinical management of common spine diagnosis in day-to-day settings.
Methods An online survey was distributed among neurosurgeons and orthopaedic surgeons worldwide. The obtained assessment of common surgical practice is contextualized in a review of the best available evidence.
Results The survey was answered by more than 310 members of several European, Australasian, and South African professional societies. The submitted responses translate a surgical practice generally grounded on evidence, favoring well-tried techniques, providing comprehensive treatment for the most severe diagnoses. Such practice comes mostly from neurosurgeons focused on spine surgery, practicing in teaching hospitals.
Conclusion We believe that the pragmatic, day-to-day approach to spine conditions captured in the present survey offers an informative insight to involved surgeons.
Declining Numbers of Neurosurgical Emergencies at a German University Medical Center during the Coronavirus Lockdown
Authors: Falter Johannes , Schebesch Karl-Michael , Schmidt Nils Ole 
Published: December 2021

Abstract
Background The coronavirus pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is posing unprecedented challenges to health care systems around the globe. Consequently, various lockdown scenarios have been politically imposed to get control over the spread of this disease. We examined the impact of the lockdown situation on the number of neurosurgical emergency patients admitted to our tertiary care center with a catchment area of ∼2.2 million inhabitants in the south of Germany to ensure adequate neurosurgical emergency care during a pandemic lockdown.
Methods All emergency admissions (with consecutive inpatient treatment) to the Department of Neurosurgery at the University Medical Center Regensburg, Germany, between March 1 and May 8 (69 days) of the years 2018, 2019, and 2020 were retrospectively identified and reviewed for this study. Demographic data, diagnoses, urgency of surgery, and duration of the journey to the emergency room were examined.
Results Between March 1 and May 8, 2020, 59 emergency patients were neurosurgically treated at our department. Compared with 2018 and 2019, emergency admissions in 2020 had thus declined by 37.2 and 27.1%, respectively. Regarding the year 2020, we found a significant drop from 1.71 and 1.52 emergency patients per day in January and February 2020, respectively, to 0.86 during lockdown (p < 0.001). The decline especially concerned nontraumatic spinal cases and also patients with other neurosurgical diagnoses such as intracranial hemorrhage. Evaluation of the overall disease severity of admitted patients by means of the urgency of surgery showed no difference between the baseline years and the lockdown period.
Conclusion Our findings are in line with other observational studies of neurosurgical, neurologic, and cardiologic centers in Europe that have described a drop in emergency cases. The reasons for this drop that seems to affect various medical fields and countries across Europe are still unidentified. Morbidity and mortality rates are still unknown, and efforts should be made to facilitate neurosurgical emergency care during a pandemic lockdown.
Comparative Analysis of Acute Levodopa Challenge Test and the Outcomes of Deep Brain Stimulation in Parkinson's Disease
Authors: Chen Yusheng , Zu Jie , Zhang Wei , Xu Chuanying , Cui Guiyun , Cui Chenchen , Xiao Qihua 
Published: December 2021

Abstract
Background We study the correlation between the preoperative levodopa challenge test and the efficacy of deep brain stimulation (DBS) surgery in Parkinson's disease (PD).
Methods Fifty patients with PD who underwent DBS treatment in our hospital from October 2016 to October 2017 were enrolled in this study. Using the Unified Parkinson Disease Rating Scale-III (UPDRS-III) as an indicator, we analyzed the improvement in motor symptoms on the levodopa challenge test and by DBS surgery. We also discussed the correlation between the effects of the levodopa challenge test and DBS surgery.
Results There was no correlation between the results of the levodopa challenge test and DBS surgery. There was a linear correlation between muscle rigidity and bradykinesia, whereas the linear correlation between other symptoms was weak.
Conclusion The levodopa challenge test can be used as a screening tool for patients undergoing DBS surgery, and can predict the degree of improvement in muscle rigidity and bradykinesia surgery. However, the prediction of the degree of improvement of total motor symptoms is poor.
Subjective and Objective Quality-of-Life Assessment of Outcome Measures in Cervical Spine Surgery for Degenerative Changes
Authors: Prokopienko Marek , Sobstyl Michał 
Published: December 2021

AbstractCervical spine diskectomy is a commonly used procedure in degenerative disease of cervical spine surgery. However, it is difficult to assess the quality of life after this widely applied and variously modified procedure. This literature review presents cervical diskectomy results, according to various scales and measures in multidirectional surgical strategies. Using relevant databases, we tried to find the best treatment options for degenerative disk disease and the best method of quality-of-life assessment, searching for modalities that may influence the outcome.
Preoperative ODI and Intake of Analgesics Predict Outcome after Lumbar Microdiskectomy: Results from a Prospective Register
Authors: Revollo Yessika De Leon Benito , Atassi Hermien , Fandino Javier , Kienzler Jenny C. 
Published: December 2021

Abstract
Background Lumbar disk herniation (LDH) typically causes leg pain and neurologic deficits, but can also be a source of low back pain (LBP). Lumbar microdiskectomy (LMD) is among the most common neurosurgical procedures to relieve radicular symptoms. It is important for both surgeon and patient to understand potential predictors of outcome after LMD. The aim of this study was to investigate if the presence and intensity of preoperative LBP, the ODI score, and analgesic intake can predict the outcome of patients undergoing LMD.
Methods This is a single-center retrospective study based on the analysis of prospectively acquired data of patients in the SwissDisc Registry. A total of 685 surgeries on 640 patients who underwent standardized LMD at our institution to treat LDH were included in this study. We performed multivariable linear regression analysis to determine preoperative predictors for patient outcomes based on the Oswestry Disability Index (ODI) scores, recorded on average 39.77 (±33.77) days after surgery.
Results Our study confirmed that surgery overall improves patient degree of disability as measured by ODI score. Following model selection using Aikake Information Criterion (AIC), we observed that higher preoperative ODI scores (β: 0.020 [95% CI: 0.008 to 0.031]) and higher number of analgesic medication usage by patients prior to surgery (β: 0.236 [95% CI: 0.057 to 0.415]) were both associated with an increased postoperative ODI score.
Conclusion LDH surgery generally improves patient degree of disability. The analysis of patients with a high preoperative ODI score and increased intake of analgesics before surgery predicted a worsening of patients' disability after LMD in this subgroup.