bluuebunny/crossref_metadata_2025_split huggingface dataset:
1083 Investigating Quantitative Long-term Outcomes of Surgical Intervention in Patients With Adolescent Idiopathic Scoliosis and Cobb Angles Between 40 and 50 Degrees: A Retrospective Analysis of the Harms Study Group Scoliosis Outcomes Database Registry
Authors: Friedman Adam , Koneru Manisha , Gentile Pietro , Clements David 
Published: March 2024

INTRODUCTION:
Many patients with Adolescent Idiopathic Scoliosis (AIS) are successfully managed with conservative methods, and when indicated, with additional surgical intervention. However, current evidence is limited in supporting therapeutic recommendations for AIS patients with Cobb angles between 40-50 degrees.

METHODS:
De-identified patient data was acquired with permission from the Harms Study Group. Patients 10-21 years old with AIS and 40-50-degree Cobb angles at the time of baseline data collection were grouped based on whether they received operative (op) or nonoperative (non-op) management. Baseline and 2-year follow-up Scoliosis Research Society 22-item questionnaire (SRS-22) scores were analyzed using two-tailed Student’s t-tests and Chi-square tests. Significance level was set to alpha = 0.05.

RESULTS:
A total of 919 patients were analyzed; 863 patients in the op group, and 56 patients in the non-op group. There was no significant difference between op and non-op groups in the distribution of spinal curvature locations at baseline (p = 0.52). The op and non-op groups were found to be significantly different in both average baseline (3.9 vs. 4.1, p = 0.002), and average 2-year follow-up (4.4 vs. 4.0, p < 0.001) SRS-22 scores. The average change in pairwise SRS-22 scores over the 2-year period also significantly differed between op (+0.5) and non-op (-0.1) groups (p < 0.001).

CONCLUSIONS:
Our results showed significantly higher 2-year follow-up average SRS-22 scores, as well as a markedly positive pairwise score change for the operative group, when compared to the non-operative group. This demonstrates better long-term outcomes amongst patients who underwent surgery rather than conservative management alone. Our study provides novel evidence that supports recommending surgical intervention for AIS patients with Cobb angles between 40-50 degrees.
1085 Adjunctive Use of Bone Growth Stimulation in Cervical Spine Fusion in Patients at Risk for Nonunion
Authors: Wind Joshua James , Patel Vikas , Lansford Todd , Weinstein Marc , Campbell Peter , Vokshoor Amir A. , Beaumont Andrew , Hassanzadeh Hamid , Radcliff Kristen , Aleem Ilyas , Coric Domagoj , Cowgill Ian 
Published: March 2024

INTRODUCTION:
Prior failed fusion, multi-level disease, diabetes, nicotine usage, and osteoporosis are factors associated with nonunion, leading to prolonged pain, reduced function, and overall decreased quality of life. Previous studies have shown that pulsed electromagnetic field (PEMF) stimulation can improve fusion rates, particularly in subjects at risk for nonunion.

METHODS:
Data from a multi-center prospective study of subjects that underwent cervical spine fusion and were treated with PEMF was compared to a “matched” retrospective cohort that had fusion but were not treated with PEMF. The prospective cohort was enrolled based on having 1 or more of the following risk factors for nonunion: prior failed cervical spine fusion, multilevel fusion, diabetes, osteoporosis, or nicotine use. Fusion was assessed at 12 months postop using x-rays and/or CT. A cohort of cervical spine fusion patients that were prescribed PEMF, but did not receive PEMF treatment (e.g., insurance denial) were compared to PEMF treated subjects.

RESULTS:
At baseline, subjects in the PEMF treated group had a significantly higher average number of risk factors for nonunion (1.8 for treated group vs. 1.1 for control, p < 0.001), and significantly higher average number of surgical levels (2.8 for treated group vs. 2.0 for control, p < 0.005). At 12 months post-op, subjects in the PEMF group (n = 161) had a 90.1% fusion rate, compared to a 65.4% for the control group (n = 26) (p < 0.001).

CONCLUSIONS:
PEMF stimulation provides significant improvements in cervical spine fusion rates in subjects having risk factors for nonunion. Compared to control subjects, PEMF treated subjects had improved fusion outcomes despite being older, having more risk factors for pseudarthrosis, and undergoing more complex surgeries.
1087 Large Incidence and Risk Factors Meta-analysis of Dysphagia in Over 132,000 Anterior, Posterior, and Hybrid Surgeries for Cervical Spondylosis Myelopathy
Authors: Mohammadi Esmaeil , Khan Ali Fahim , Villeneuve Lance , Hameed Sanaa , Haynes Grace , Muhammad Fauziyya , Smith Zachary Adam 
Published: March 2024

INTRODUCTION:
Surgical management of Cervical Spondylotic Myelopathy (CSM) is associated with complications with devastating impacts. Dysphagia is one of these major complications with the incidence rate being not completely known in different surgical approaches.

METHODS:
PubMed/MEDLINE, SCOPUS, and Cochrane were systematically searched until January 2023. Rates and risk of complications were assessed. Meta-analysis of rates and risks was performed with generalized linear mixed model (GLMM) and inverse variance method, respectively, and compared between techniques.

RESULTS:
1196 citations were screened and 39 studies with 60 instances of dysphagia incidence/risk factors reports from over 132,442 patients were identified. Dysphagia’s overall incidence rate was 4.98%[95% confidence interval 3.23-7.61] and was significantly different between surgery groups (Chi2 p < 0.01). It was found in 7.97% [4.95–12.57] of anterior surgeries, 1.52% [0.94–2.45] of posterior ones, and 11.25% [3.38–31.44] of hybrid techniques (statistical comparison: P < A < H). Advanced age (>65) risked dysphagia significantly (OR 1.38 [95%CI 1.11-1.71]).

CONCLUSIONS:
Chances of posterior surgery being complicated with dysphagia is not negligible and should be discussed with patient before surgery, especially with older adults.
1139 Retrospective Review of Stereotactic Electroencephalogram Recordings in Temporal Lobectomy Patients Demonstrates the Predictive Value of Interictal Cross-frequency Correlations
Authors: Sathe Anish , Alizadeh Mahdi , Johannan Emily , Raimondo Christian , Sperling Michael , Sharan Ashwini Dayal , Kogan Michael 
Published: March 2024

INTRODUCTION:
Positive correlations between low and high frequency spectra in invasive electroencephalogram (EEG) have been implicated in pathological brain activity interictally and have been used for ictal detection in both focal and network models.

METHODS:
We retrospectively analyzed interictal signals from 22 patients who underwent SEEG at our institution between 12/2/14 to 12/8/20. We then analyzed significant HG/Beta cross-frequency correlations using similar processing to our previous publication. These signals were then separated based on temporal and extra-temporal locations. We further evaluated any statistical differences between the seizure free (SF) and non-seizure free (NSF) groups, and mesial (M) versus mesial temporal-plus (M+) onset location.

RESULTS:
1) Clinical recordings from SEEG electrodes can detect cross-frequency correlations between HG/Beta using our previous methodology. 2) Positive correlations are significantly increased in temporal versus other sampled areas. 3) Positive correlations are more predictive of seizure onset during asleep recordings. 4) NSF patients show a significantly higher proportion of positive electrodes in the resected temporal lobe than SF patients. 5) SF patients have a greater proportion of significant contacts in the mesial versus the lateral temporal lobe than NSF patients. 6) Significant HG/Beta correlations in the mesial versus lateral temporal lobe predict seizure freedom better than ictal SEEG localization of seizure onset to M or M+ locations.

CONCLUSIONS:
We present preliminary data that local HG/Beta correlations may be predictive for epilepsy focus and surgical outcome and may have utility as adjunct methods to conventional SEEG analysis. Further studies are needed to determine strategies for prospective studies and clinical use.
115 Time-driven Activity-based Costing for ACDF: An Automated and Scalable Solution
Authors: Ali Daniyal Mansoor , Tecce Eric , August Ari , Thalheimer Sara , O'Leary Matthew , Mandloi Shreya , Sarikonda Advith , Harrop James S. , Vaccaro Alexander R. , Jallo Jack , Prasad Srinivas K. , Heller Joshua E. , Sivaganesan Ahilan 
Published: March 2024

INTRODUCTION:
Understanding the true (intraoperative) cost to the hospital when neurosurgeons perform anterior cervical discectomy and fusion (ACDF) is critical as we move towards value-based purchasing.

METHODS:
Total cost was divided into direct and indirect costs. Individual costs were obtained by direct observation, electronic medical records, and through querying multiple departments (business operations, sterile processing, plant operations, and pharmacy). Timestamps for all involved personnel and material resources were documented. Total intraoperative costs were estimated for all ACDFs from 2017 and 2022.

RESULTS:
A total of 959 patients underwent anterior cervical fusions between 2017 and 2022 (one-level: n = 400, 41.7%; two-level: n = 407, 42.4%; three-level: n = 139, 14.5%; greater than three-level: n = 13, 1.4%). The most common pre-operative diagnosis was myelopathy (n=586, 61.1%), followed by radiculopathy (n = 256, 26.7%). The average total intraoperative cost per case was $5,970 ± $2,137; $7,542 ± $3,119; $8,958 ± $3,096; and $9,297 ± $2,633 for one-, two-, three-, and greater than three-level fusions, respectively. The major cost contributors were supply costs ($4,745, 66%) and personnel costs ($2,417; 34%). Total intraoperative costs displayed more variation with two-level ACDFs as compared to other fusions. Total supply cost, particularly implant cost ($3,399 ± $2,161), followed by total personnel cost (2,417 ± $917) was responsible for most of the observed total cost variability across all anterior cervical fusions.

CONCLUSIONS:
TDABC is a feasible and scalable methodology for understanding the true intraoperative costs of ACDF, without having to rely on proprietary third-party software. The most common reason for surgery was myelopathy, followed by radiculopathy. The major cost contributors were supply and personnel costs. Two-level ACDFs appeared to display more total cost variability as compared to other fusions. Implant costs, followed by personnel costs, appeared to be responsible for cost variation across all anterior cervical fusions.
1227 Superior Hypophyseal Artery Intraoperative Indocyanine Green Angiogram as a Predictor of Postoperative Visual Function After Endoscopic Endonasal Surgery
Authors: Osorio Robert , Aabedi Alexander Arash , El-Sayed Ivan , Gurrola Jose , Goldschmidt Ezequiel 
Published: March 2024

INTRODUCTION:
To date, there are no tools to intraoperatively predict postoperative visual function following endoscopic endonasal surgery (EES) for suprasellar lesions. The development of such a tool would impact postoperative care for patients at risk of new visual deficits.

METHODS:
Patients undergoing EES for resection of suprasellar lesions were administered 5 mg of ICG diluted in 10 mL of saline after tumor removal. Time between luminescence of the anterior cerebral artery and the superior hypophyseal artery branches enveloping the optic chiasm was noted, and the percentage of optic chiasm vessels that luminesced was recorded. Postoperative exams and imaging studies were then used to assess visual function. Patients with and without new deficits were compared to examine trends in ICG findings.

RESULTS:
A total of seven trials were performed on six patients. Mean time to chiasm peak luminescence was 3.8 seconds, and 81.8% of chiasm vessels luminesced. Patients with stable or improved vision after resection demonstrated over 90% chiasm luminescence in every case, and mean time to chiasm luminescence in these post-resection ICG administrations was 4.0 seconds. One patient experienced new postoperative visual deficits; on review of their ICG administration, 11.5% of chiasm vessels luminesced, and the chiasm itself failed to display robust luminescence after 30 seconds of direct observation.

CONCLUSIONS:
This pilot study showed the capability of intraoperative indocyanine green angiography to demonstrate perfusion of the optic chiasm during endoscopic endonasal surgery for resection of suprasellar lesions. Chiasm times under 5 seconds and over 90% chiasm vessel illumination may reflect adequate chiasm perfusion, while those with delayed or absent chiasm luminescence may have compromised chiasm perfusion.
1231 Inhibition of YAP With Vertoporfin Makes Chordomas Sensitive to Radiation in Vitro and in Vivo: New Therapies to Combat Radioresistance
Authors: Akinduro Oluwaseun , Suarez-Meade Paola , Schiapparelli Paula , Roberts Mckinley , Tzeng Stephany , Rosenfeld Steven , Krishnan Sunil , Gokaslan Ziya L. , Green Jordan , Quinones-Hinojosa Alfredo 
Published: March 2024

INTRODUCTION:
Chordomas are locally invasive tumors of notochordal origin with a propensity to resist radiotherapy and with no FDA approved therapies. Verteporfin is a photosensitizer with the ability to inhibit the yes-associated-protein (YAP) pathway which is upregulated in chordomas and enables their resistance to radiotherapy.

METHODS:
We used five primary chordoma cell lines (JHC7, UCH1, UCH2, MUG-CHOR1, UM-CHOR1) to perform in vitro and in vivo experiments with 64 mice using a xenograft subcutaneous model of chordoma. We then knocked down the YAP gene in chordoma cells and performed experiments to confirm our results were secondary to verteporfin effects on YAP.

RESULTS:
Verteporfin has additive and synergistic effects on chordoma cells when combined with radiation. Chordoma cells treated with verteporfin have significantly more double-stranded DNA damage after radiation therapy (p < 0.0001) and verteporfin prevents repair of that DNA damage. Verteporfin significantly reduces DNA damage repair proteins and genes in chordoma cells (ATM: p = 0.0007, ATR: p < 0.0001, RADS1: p = 0.0033, BRCA1: p < 0.0001, BRCA2: p = 0.0012, PPP2R4: p < 0.0001). Verteporfin leads to significantly increased frequency of cells in G2/M phase (MUG-CHOR1: p < 0.0001, UCH2: p = 0.0021). We then performed all the above experiments using chordoma cells with the YAP gene knocked down and found that YAP knockdown led to enhanced radiation induced DNA damage (p<0.0001), diminished yH2AX response (p = 0.0264), and increased frequency of cells in G2/M phase (p < 0.0001). In vivo verteporfin treatment significantly inhibited chordoma tumor growth (p < 0.0001) and microparticles were most effective at radiosensitization.

CONCLUSIONS:
Inhibition of YAP using verteporfin radiosensitizes chordoma via 1) inhibition of the DNA damage repair cascade and 2) increasing frequency of the G2/M cell cycle phase when cells are most sensitive to radiation.
1234 The Transposition Technique of Internal Carotid Artery in Endonasal Endoscopic Surgery: Beyond the Lateral Boundary of Middle Line Approach
Authors: Xiao Limin , Ding Han , Xie Shenhao , Tang Bin , Hong Tao 
Published: March 2024

INTRODUCTION:
There was no report regarding the transposition technique of ICA in endonasal endoscopic surgery (EES)

METHODS:
Six cadaveric heads (3 arterial and venous injected, 1 embalmed artery injected, 1 fresh artery injected) were prepared for dissection. The trabecular fiber (parasellar ligaments) in cavernous sinus(CS), small branches of ICA, dura, bony structures along ICA were meticulously dissected and photographed. The endoscopic dissections were performed using 0° (4-mm-diameter, 18-cm-long) rod lens endoscopes (Karl Storz). 36 cases (Jan 2014 to June 2022) underwent EES ICA transposition were reviewed.

RESULTS:
The trabecular fiber and small branches of ICA formed four sets of limiting structures around ICA: the medial, lateral, anterior, and posterior group. The medial group consisted of carotid clinoid ligaments (12/12), inferior hypophyseal artery (11/12), inferior parasellar ligament (6/12). The lateral groupcomprised inferolateral trunk (12/12), the sympathetic nerve plexus (12/12), the trabecular fibers between ICA and CN3 (6/12),CN4 (5/12), CN6 (12/12). The anterior group consisted of trabecular fibers between the proximal dural ring and the ICA (7/12). The posterior group was made of trabecual fibers (8/12) around the post genu and posterior wall of CS. Proximal and distal dura ring was the main dura structures impeding mobilizing ICA. The anterior clinoid and lingual process obstructed ICA lateral transposition. Grade 1 (inner CS limiting structures), Grade 2 (inner CS + dura ring open), Grade 3 (inner CS + dura ring + bony remove) transposition were used in 24 (66.7%), 9 (25%), 3 (8.3%) cases respectively. CSF leakage (2.7%), ICA injury (2.7%), new transient CN palsy (8.3%), permanent CN palsy (5.4%) were developed postoperatively.

CONCLUSIONS:
The EES ICA transposition technique is technically feasible and could be graded according to extent of freeing the limiting structures. It is a novel technique worth exploring in suitable cases to enlarge the working zone and surgical freedom in middle line approaches.
1243 FOXM1*3 Overexpression Correlates to Staging of Astrocytic Glioma
Authors: Salazar Ramirez Zita Elizabeth , Feria Romero Iris Angelica , Chavez Valderrama Isaura Z. , Otero Israel Grijalva , Rueda Barbara Nettel 
Published: March 2024

INTRODUCTION:
Diffuse gliomas are a group of primary brain tumors characterized by the presence of neoplastic glial-lineage cells. WHO 2021 classification of gliomas recognizes the mutational status of the isocitrate dehydrogenase-1(IDH-1,G395A) gene and the 1p/19q codeletion as identification of cell lineage and a prognosis marker. Transcription factors are binding proteins of genomic DNA and can activate or suppress gene expression. Forkhead box M1(FOXM1) is a transcription factor for Forkhead box(Fox) proteins, a superfamily which is defined by a conserved winged helix DNA binding domain. FOXM1 is a key regulator of both G1/S and G2/M phases of cell cycle and mitotic spindle integrity, it also plays an important role in angiogenesis, DNA damage repair and tissue regeneration. The human FOXM1 gene consists of 10 exons, two of them alternatively spliced. This splicing gives rise to three isoforms: FOXM1*1,*2 and *3. FOXM1*3 is the smallest isoform and is overexpressed in proliferative tissue such as malignant tumors.

METHODS:
A control group of 10 brain cortex, 22 A2, 13 O2, 11 A3, 3 O3, 6 A4 and 46 GBM with histological and molecular diagnosis of astrocytoma, oligodendroglioma and glioblastoma from 2011 to 2022 were included. The diagnosis correlated with patient outcome. mRNA FOXM1*3 and its housekeeping gen IPO8 was quantified by qPCR with Taqman probes. Data analysis was conducted by MannWhitney U test.

RESULTS:
There was a statistically significant difference between expression of mRNA FOXM1*3 in normal brain tissue compared to tumor tissue (p < 0.001). The transcript allowed differentiation between grade 2, 3 and 4 astrocytomas (p < 0.005), nevertheless there was no difference between astrocytic versus oligodendrocytic lineage, and grade 4 astrocytoma versus glioblastoma.

CONCLUSIONS:
The normalized expression of transcript FOXM1*3 allows differentiation of astrocytic gliomas grades.
1244 Immunotherapy With Autological Dendritic Cells in the Structure of Complex Treatment of Gliomas
Authors: Rynda Artemii Y. , Olyushin Victor , Rostovtsev Dmitry 
Published: March 2024

INTRODUCTION:
Malignant gliomas are the most common primary brain tumor. Despite the variety of modern treatments, it is still a fatal disease with an extremely poor prognosis. The use of immunotherapy as a technique for the treatment of malignant tumors has great promise, retraining and exploiting the patient's immune response against tumors.

METHODS:
Long-term results of treatment of 220 patients with malignant supratentorial gliomas (anaplastic astrocytomas, glioblastomas) were analyzed. Of these patients, 110 patients, in addition to standard methods of treatment (surgery, radiation therapy and chemotherapy), underwent specific antitumor immunotherapy with autologous dendritic cells. In 110 patients, only standard methods were used in the structure of complex treatment. The relapse-free period and median life expectancy were assessed.

RESULTS:
Conducting specific antitumor immunotherapy in patients with malignant gliomas was safe and did not lead to an increase in the number of complications compared with the control group. It was revealed that the use of immunotherapy based on autologous dendritic cells, in addition to standard methods of treating patients, increases the average life expectancy (in patients with anaplastic astrocytomas up to 40.5 months (p = 0.001), in patients with glioblastomas up to 21.8 months (p = 0.002)) and increases the relapse-free period (in patients with anaplastic astrocytomas up to 17.4 months (p = 0.002), in patients with glioblastomas up to 14.3 months (p = 0.003)) provided that three or more courses are taken. Conducting 1 or 2 courses of immunotherapy does not significantly affect the average life expectancy and median survival of patients.

CONCLUSIONS:
The development and use in clinical practice of specific antitumor immunotherapy based on autologous dendritic cells seems to be a very promising direction for further research, the development of which will improve the long-term results of patient treatment.
1246 The Impact of Latency Variations on the Predictive Value of Facial Nerve Proximal-to-distal Amplitude Ratio During Vestibular Schwannoma Surgery
Authors: Zohdy Youssef M. , Garzon-Muvdi Tomas , Ashram Yasmine A. 
Published: March 2024

INTRODUCTION:
Intraoperative facial nerve (FN) electromyographic (EMG) monitoring is now considered an essential part of vestibular schwannoma (VS) surgery and is used for both intraoperative monitoring and postoperative outcome prediction.

METHODS:
Forty-eight patients underwent FN stimulation at the brainstem (proximal) and the internal acoustic meatus (distal) using a current intensity of 2 mA. The proximal latency and the P/D amplitude ratio were assessed. House-Brackmann grades I-II indicated good FN function; and grades III-VI were considered fair/poor function. A P/D amplitude ratio >0.6 was used as a cutoff to indicate good FN function, while a ratio of =0.6 indicated fair/poor FN function.

RESULTS:
The P/D amplitude ratio was measured for all patients, and the calculated sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) were 85.2%, 85.7%, 88.5%, and 81.8% respectively. Then the CMAPs from the mentalis muscle were classified based on their proximal latency into: Group I (<6 msec); group II (6-8 msec); and group III (>8 msec). The SE, SP, PPV, and NPV became 90.5%, 90.9%, 95%, and 83.3% respectively in group II. In group I, SE and NPV increased whereas, SP and PPV decreased. While in group III, SP and PPV increased, whereas SE and NPV decreased.

CONCLUSIONS:
At a latency between 6-8msec, the P/D amplitude ratio was predictive of outcome with high SE and SP. When the latency was <6 msec or >8 msec, the same predictive ability was not observed. Knowing the impact of latency variations of P/D amplitude ratio measurement is important for a better understanding of the ability and limitations of this method in predicting postoperative FN function.