bluuebunny/crossref_metadata_2025_split huggingface dataset:
Idiopathic Ventral Spinal Cord Hernia—A Single-Center Case Series of 11 Patients
Authors: Jesse Christopher Marvin , Gallus Marco , Beck Jürgen , Ulrich Christian T. , Seidel Kathleen , Piechowiak Eike , Dobrocky Tomas , Häni Levin , Schär Ralph T. , Raabe Andreas 
Published: January 2023

BACKGROUND:
Idiopathic spinal cord herniations (ISCH) are rare defects of the ventromedial or mediolateral dura mater with herniation of the spinal cord through the defect with approximately 350 described cases worldwide. Patients usually become symptomatic with motor or sensory neurological deficits and gait disturbances.

OBJECTIVE:
To describe characteristic symptoms and clinical findings and to evaluate the postoperative course and outcomes of ISCH.

METHODS:
We present a single-center data analysis of a case series of 11 consecutive patients who were diagnosed with ISCH and underwent surgery in our department between 2009 and 2021.

RESULTS:
All herniations were located in the thoracic spine between T2 and T9. In most cases, gait ataxia and dysesthesia led to further workup and subsequently to the diagnosis of ISCH. A “far-enough” posterior-lateral surgical approach, hemilaminectomy or laminectomy with a transdural approach, was performed under intraoperative neurophysiological monitoring which was followed by adhesiolysis, repositioning of the spinal cord and sealing using a dura patch. After surgery, clinical symptoms improved in 9 of 11 patients (81.8%), while only 1 patient experienced deterioration of symptoms (9.1%) and 1 patient remained equal (9.1%). The median preoperative McCormick grade was 3 (±0.70), while the median postoperative grade was 2 (±0.98) (P = .0047).

CONCLUSION:
In our case series of ISCH, we found that in most patients, neurological deficits improved postoperatively. This indicates that surgery in ISCH should not be delayed in symptomatic patients.
Complications Related to Deep Brain Stimulation Lead Implantation: A Single-Surgeon Case Series
Authors: Powers Andrew Y. , Nguyen Michael , Phillips Katharine , Mackel Charles E. , Alterman Ron L. 
Published: January 2023

BACKGROUND:
Deep brain stimulation (DBS) is the mainstay of surgical treatment for movement disorders, yet previous studies have shown widely varying complication rates. Given the elective nature of DBS surgery, minimizing surgical complications is imperative.

OBJECTIVE:
To evaluate short-term and long-term complications related to DBS lead implantation surgeries performed by an experienced surgeon and provide an updated benchmark comparison for other DBS centers and alternative therapies.

METHODS:
A retrospective chart review of patients who underwent DBS lead implantation surgery by a single surgeon at our institution between 2012 and 2020 was conducted. Demographic and clinical data including surgical complications were collected. A Kaplan-Meier survival analysis was used to evaluate the cumulative risk of lead revision or removal over time. Associations between patient characteristics and various complications were evaluated.

RESULTS:
Four hundred fifty-one DBS leads were placed in 255 patients. Thirteen leads and 11 patients required revision. In total, 3.6% (95% CI [1.3%-5.9%]) of patients required revision at 1 year and 4.8% (95% CI [1.9%-7.6%]) at 5 years, with per-lead revision rates of 2.3% (95% CI [0.9%-3.6%]) and 3.3% (95% CI [1.5%-5.1%]), respectively. Less common diagnoses such as Tourette syndrome, post-traumatic tremor, and cluster headache trended toward association with lead revision or removal.

CONCLUSION:
DBS performed by an experienced surgeon is associated with extremely low complication rates.
Seventh Cervical Nerve (C7) Transection for Spastic Arm Paralysis After Cerebral Injury
Authors: Agarwal Pawan , Jana Sinjan , Sharma Dhananjaya , Parihar Vijay , Bajaj Jitin , Yadav Yad Ram , Dhakar Jagmohan Singh 
Published: January 2023

BACKGROUND:
Spastic limb paralysis because of cerebral injury can cause long-term disability. Its treatment varies from conservative to operative; however, the optimum treatment is yet to be found.

OBJECTIVE:
To test the hypothesis that patients with spastic arm paralysis who receive C7 nerve transection to their paralyzed side might have reduction in spasticity, pain, and improvement in arm function.

METHODS:
Four patients with spastic hemiparesis that had ceased to improve after 1 year of rehabilitation, having pain and poor function, were included. All 4 patients underwent C7 nerve transection plus rehabilitation. The outcome was assessed at 1, 3, and 6 months by the Fugl-Meyer upper extremity scale for motor recovery, by the Modified Ashworth Scale score for spasticity, and by the visual analogue score for pain. Functional use of the limb was also assessed by performance of activities such as dressing, tying shoe laces, wringing a towel, and operating a mobile phone.

RESULTS:
At the end of 6 months, there was a significant improvement in mean Fugl Meyer score, reduction in Modified Ashworth score, and Visual Analogue scale for pain. At the beginning of the study, none of the patients could perform any day-to-day activities; however, at the end of 6 months, 3/4 of the patients could perform at least 1 activity.

CONCLUSION:
C7 neurectomy leads to improved motor function, reduction of spasticity and pain, and improvement in function in patients with spastic arm paralysis because of cerebral injury.
Single-Position Transpsoas Corpectomy and Posterior Instrumentation in the Thoracolumbar Spine for Different Clinical Scenarios
Authors: Guiroy Alfredo , Thomas J. Alex , Bodon Gergely , Patel Ashish , Rogers Michael , Smith William , Seale Justin , Camino-Willhuber Gastón , Menezes Cristiano M. , Galgano Michael , Asghar Jahangir 
Published: January 2023

BACKGROUND:
The concept of single-position spine surgery has been gaining momentum because it has proven to reduce operative time, blood loss, and hospital length of stay with similar or better outcomes than traditional dual-position surgery. The latest development in single-position spine surgery techniques combines either open or posterior pedicle screw fixation with transpsoas corpectomy while in the lateral or prone positioning.

OBJECTIVE:
To provide, through a multicenter study, the results of our first patients treated by single-position corpectomy.

METHODS:
This is a multicenter retrospective study of patients who underwent corpectomy and instrumentation in the lateral or prone position without repositioning between the anterior and posterior techniques. Data regarding demographics, diagnosis, neurological status, surgical details, complications, and radiographic parameters were collected. The minimum follow-up for inclusion was 6 months.

RESULTS:
Thirty-four patients were finally included in our study (24 male patients and 10 female patients), with a mean age of 51.2 (SD ± 17.5) years. Three-quarter of cases (n = 27) presented with thoracolumbar fracture as main diagnosis, followed by spinal metastases and primary spinal infection. Lateral positioning was used in 27 cases, and prone positioning was used in 7 cases. The overall rate of complications was 14.7%.

CONCLUSION:
This is the first multicenter series of patients who underwent single-position corpectomy and fusion. This technique has shown to be safe and effective to treat a variety of spinal conditions with a relatively low rate of complications. More series are required to validate this technique as a possible standard approach when thoracolumbar corpectomies are indicated.
Use of 3-Dimensional Modeling and Augmented/Virtual Reality Applications in Microsurgical Neuroanatomy Training
Authors: Aydin Serdar Onur , Barut Ozan , Yilmaz Mehmet Ozgur , Sahin Balkan , Akyoldas Goktug , Akgun Mehmet Yigit , Baran Oguz , Tanriover Necmettin 
Published: January 2023

BACKGROUND:
Understanding the microsurgical neuroanatomy of the brain is challenging yet crucial for safe and effective surgery. Training on human cadavers provides an opportunity to practice approaches and learn about the brain's complex organization from a surgical view. Innovations in visual technology, such as virtual reality (VR) and augmented reality (AR), have immensely added a new dimension to neuroanatomy education. In this regard, a 3-dimensional (3D) model and AR/VR application may facilitate the understanding of the microsurgical neuroanatomy of the brain and improve spatial recognition during neurosurgical procedures by generating a better comprehension of interrelated neuroanatomic structures.

OBJECTIVE:
To investigate the results of 3D volumetric modeling and AR/VR applications in showing the brain's complex organization during fiber dissection.

METHODS:
Fiber dissection was applied to the specimen, and the 3D model was created with a new photogrammetry method. After photogrammetry, the 3D model was edited using 3D editing programs and viewed in AR. The 3D model was also viewed in VR using a head-mounted display device.

RESULTS:
The 3D model was viewed in internet-based sites and AR/VR platforms with high resolution. The fibers could be panned, rotated, and moved freely on different planes and viewed from different angles on AR and VR platforms.

CONCLUSION:
This study demonstrated that fiber dissections can be transformed and viewed digitally on AR/VR platforms. These models can be considered a powerful teaching tool for improving the surgical spatial recognition of interrelated neuroanatomic structures. Neurosurgeons worldwide can easily avail of these models on digital platforms.
Development of a Novel Device for Decompressive Craniectomy: An Experimental and Cadaveric Study and Preliminary Clinical Application
Authors: Berra Luigi Valentino , Cedrone Guido , Di Norcia Valerio , D'Angelo Luca , Brunetto Floriana , Familiari Pietro , Palmieri Mauro , Capobianco Mattia , Pappone Federica , Santoro Antonio 
Published: January 2023

BACKGROUND:
Decompressive craniectomy is an intervention of established efficacy in patients with intractable cerebral edema.

OBJECTIVE:
To evaluate a new device used in alternative to decompressive craniectomy. This device is designed to perform an augmentative craniotomy by keeping the bone flap elevated using specific cranial suspension titanium plates and giving the brain enough room to swell.

METHODS:
We tested the mechanical characteristics of the cranial brackets on dried skulls, on 3D-printed skull models, and on a preserved cadaver head. The resistance of the device was examined through dynamometric testing, and the feasibility of the surgical technique, including the suspension of the bone flap and the skin closure, was investigated on the cadaveric model. A preliminary clinical series of 2 patients is also reported.

RESULTS:
The laboratory tests have shown that this system allows an adequate expansion of the intracranial volume and it could withstand a force up to 637 ± 13 N in the synthetic model and up to 658 ± 9 N in the human skull without dislocation or failure of the brackets nor fractures of the bone ridges. Preliminary application in the clinical setting has shown that augmentative craniotomy is effective in the control of intracranial hypertension and could reduce the costs and complications associated with the classical decompressive craniectomy technique.

CONCLUSION:
Preliminary laboratory and clinical results show augmentative craniotomy to be a promising, alternative technique to decompressive craniectomy. Further clinical studies will be needed to validate its efficacy.
Comparison of Accessibility to Cavernous Sinus Areas Throughout Endonasal, Transorbital, and Transcranial Approaches: Anatomic Study With Quantitative Analysis
Authors: Santos Carlos , Guizzardi Giulia , Di Somma Alberto , Lopez Patricia , Mato David , Enseñat Joaquim , Prats-Galino Alberto 
Published: January 2023

BACKGROUND:
The cavernous sinus (CS) is accessed through several approaches, both transcranially and endoscopically. The transorbital endoscopic approach is the newest proposed route in the literature.

OBJECTIVE:
The aim is to quantify and observe the areas of the CS reach from 2 endoscopic and 1 transcranial approaches to the CS in the cadaver laboratory.

METHOD:
Six CSs were dissected through endoscopic endonasal, transorbital endoscopic, and transcranial pterional approaches, with previous implanted references for neuronavigation during the dissection. Point registration was used to mark the CS exposure and limits through each approach for later area and volume quantification through a computerized technique.

RESULTS:
The endoscopic endonasal approach reaches most of the CS except part of the sinus's superior, lateral, and posterior regions. The area exposed through this approach was 210 mm2, and the volume was 1165 mm3. The transcranial pterional approach reached the superior and part of the lateral sides of the sinus, not allowing good access to the medial side. The area exposed through this approach was 306 m2, whereas the volume was 815 m3. Finally, the transorbital endoscopic approach accessed the whole lateral side of the sinus but not the medial one. The area exposed was the greatest, 374 m2, but its volume was the smallest, 754 m3.

CONCLUSION:
According to our results, the endonasal endoscopic approach is the direct route to access the medial, inferior, and part of the superior CS compartments. The transorbital approach is for the lateral side of the CS. Finally, the transcranial pterional approach is the one for the superior side of the CS.
Bilateral Persistent Primitive Olfactory Arteries Observed During Resection of Olfactory Groove Meningioma: Technical Case Report
Authors: Ferreira Júnior Tancredo Alcântara , Dourado Jules Carlos , Medeiros Giulia De Leo Rodrigues , da Paz Matheus Gomes da Silva , Lima Thiago Vinícius de Oliveira , Alcântara Mariana Torres , de Avellar Leonardo Miranda 
Published: January 2023

BACKGROUND AND IMPORTANCE:
Resection of olfactory groove meningiomas is challenging because of their close proximity with the anterior cerebral circulation. It is important to recognize the vascular variants in procedures at the anterior skull base because inadvertent maneuvers may result in the rupture of these arteries and unexpected bleeding.

CLINICAL PRESENTATION:
We reported a type 2 persistent primitive olfactory artery with a dural branch of the elongated anterior cerebral artery directly to the ethmoid region, visualized during the surgical removal of an olfactory groove meningioma.

CONCLUSION:
This is the first report of bilateral persistent primitive olfactory artery demonstrated by operative visualization and confirmed with vascular study. Understanding and recognizing the possible variations of this vascular anatomy is of great importance for anterior skull base surgeries.
Ultra-High-Molecular-Weight Polyethylene Merlon Shape: Novel Fixation of Artificial Bone for Cranioplasty
Authors: Nagai Arata , Kimura Naoto , Uchida Hiroki , Yokosawa Michiko , Degawa Kazuki , Sugawara Takayuki , Tominaga Teiji 
Published: January 2023

BACKGROUND:
Cranioplasty is a surgical procedure widely performed for repairing cranial defects caused by external decompression surgery for cerebrovascular disease or traumatic brain injury. We devised a new cranioplasty method using artificial bone made up of ultra-high molecular-weight polyethylene, with serrated wings on the edge. We named this newly designed artificial bone as Merlon shape.

OBJECTIVE:
To describe our initial experience with the Merlon shape and evaluate its usefulness and safety in cranioplasty.

METHODS:
The serrated wings of the Merlon shape were preoperatively designed for solid fixation and improving cosmetic results by reducing the thickness of the artificial bone. We evaluated 25 patients who underwent cranioplasty with the Merlon shape between December 2018 and December 2021. The causes of bone defects in these patients (male: 9, female: 16; median age: 62 years) were subarachnoid hemorrhage (n = 14), cerebral infarction (n = 8), and traumatic brain injury (n = 3).

RESULTS:
There were no postoperative adverse events such as infection, bone resorption, implant exposure, or graft sinking in 24 patients during an average follow-up period of 19 months. One patient experienced acute epidural hemorrhage and required reoperation.

CONCLUSION:
This is the first report on the use of the ultra-high molecular-weight polyethylene Merlon shape. Our initial 4-year case series showed good outcomes with this method.
Novel Approach of Femur Shortening With Insertion of Expandable Rod to Achieve End-to-End Repair of Sciatic Nerve Laceration
Authors: Lubelski Daniel , Halsey Jordan , Suk Ian , Tuffaha Sami , Osgood Greg , Belzberg Allan J. 
Published: January 2023

BACKGROUND:
Sciatic nerve injuries are challenging for diagnosis and treatment. Particularly in proximally located high-grade injuries, neurorrhaphy often has poor outcomes. Most advocate autologous grafting and some more recently have suggested the value of knee flexion braces to facilitate end-to-end repair.

OBJECTIVE:
To describe a case of femur shortening to facilitate tension-free, end-to-end sciatic nerve neurorrhaphy.

METHODS:
The patient was a 17-year-old man who was injured by the propeller of a motor boat and suffered a series of lacerations to both lower extremities including transection of his right sciatic nerve in the proximal thigh. After extensive mobilization of the nerve, a greater than 7-cm gap was still present. The patient was treated with femur shortening to facilitate end-to-end coaptation. He subsequently had an expandable rod placed which was lengthened 1 mm per day until his leg length was symmetric.

RESULTS:
Within 7 months postoperatively, the patient had an advancing Tinel sign and paresthesias to the dorsum of his foot. Nine months postoperatively, he had early mobility in his plantarflexion.

CONCLUSION:
We present a novel method of femur shortening with insertion of an expandable rod to facilitate direct end-to-end and tension-free sciatic nerve neurorrhaphy in a proximally located injury. Furthermore, larger scale and comparative studies are warranted to further explore this and other techniques.
Accurate Deep Brain Stimulation Lead Placement Concurrent With Research Electrocorticography
Authors: Kons Zachary , Hadanny Amir , Bush Alan , Nanda Pranav , Herrington Todd M. , Richardson R. Mark 
Published: January 2023

BACKGROUND:
Using electrocorticography for research (R-ECoG) during deep brain stimulation (DBS) surgery has advanced our understanding of human cortical-basal ganglia neurophysiology and mechanisms of therapeutic circuit modulation. The safety of R-ECoG has been established, but potential effects of temporary ECoG strip placement on targeting accuracy have not been reported.

OBJECTIVE:
To determine whether temporary subdural electrode strip placement during DBS implantation surgery affects lead implantation accuracy.

METHODS:
Twenty-four consecutive patients enrolled in a prospective database who underwent awake DBS surgery were identified. Ten of 24 subjects participated in R-ECoG. Lead locations were determined after fusing postoperative computed tomography scans into the surgical planning software. The effect of brain shift was quantified using Lead-DBS and analyzed in a mixed-effects model controlling for time interval to postoperative computed tomography. Targeting accuracy was reported as radial and Euclidean distance errors and compared with Mann–Whitney tests.

RESULTS:
Neither radial error nor Euclidean distance error differed significantly between R-ECoG participants and nonparticipants. Pneumocephalus volume did not differ between the 2 groups, but brain shift was slightly greater with R-ECoG. Pneumocephalus volume correlated with brain shift, but neither of these measures significantly correlated with Euclidean distance error. There were no complications in either group.

CONCLUSION:
In addition to an excellent general safety profile as has been reported previously, these results suggest that performing R-ECoG during DBS implantation surgery does not affect the accuracy of lead placement.
Joint mobility as a bridge between form and function
Authors: Manafzadeh Armita R. 
Published: January 2023

ABSTRACT
Joints enable nearly all vertebrate animal motion, from feeding to locomotion. However, despite well over a century of arthrological research, we still understand very little about how the structure of joints relates to the kinematics they exhibit in life. This Commentary discusses the value of joint mobility as a lens through which to study articular form and function. By independently exploring form–mobility and mobility–function relationships and integrating the insights gained, we can develop a deep understanding of the strength and causality of articular form–function relationships. In turn, we will better illuminate the basics of ‘how joints work’ and be well positioned to tackle comparative investigations of the diverse repertoire of vertebrate animal motion.
Clinical efficacy of chemotherapy regimen combined with Levofloxacin in patients with Pulmonary Tuberculosis complicated with Type-2 Diabetes
Authors: Luo Pei-pei , Wu Li , Liu Fang , Tian Yan-hong , Chen Lai-yin , Liu Ya-lin 
Published: January 2023

Objective: To evaluate the clinical efficacy of a chemotherapy regimen combined with levofloxacin in patients with pulmonary tuberculosis complicated with Type-2 diabetes.
Methods: Total 80 patients with pulmonary tuberculosis complicated with Type-2 diabetes admitted to Baoding People’s Hospital from January, 2019 to January, 2022 were randomly divided into two groups: the experimental group and the control group, with 40 cases in each group. Patients in the control group were given the conventional 2HRZE/10HRE regimen, while those in the experimental group were given the chemotherapy regimen 2HRZEL/6HRE combined with levofloxacin. Sixty four slice spiral CT was used for chest plain scan before and after treatment, respectively, to evaluate the absorption of lesions based on the range of lung lesions; Venous blood was drawn to detect the changes of oxidative stress indicators, the incidence of adverse drug reactions and the negative conversion rate of sputum tuberculosis bacteria in the two groups.
Results: After treatment, the efficacy of the experimental group was 90%, which was significantly higher than that of the control group (67.5%), with a statistically significant difference (p=0.01). After treatment, CD3+, CD4+, CD4+/CD8+ and other indicators in the experimental group were significantly higher than those in the control group, with a statistically significant difference (CD3+, p=0.01; CD4+, p=0.01; CD4+/CD8+, p=0.00), while CD8+ did not change significantly (p=0.92); The incidence of adverse reactions was 52.5% in the experimental group and 47.5% in the control group, with no statistically significant difference (p=0.66); The negative conversion rate of patients in the experimental group was significantly higher than that in the control group at one month, three months and six months after treatment, with a statistically significant difference (p<0.05).
Conclusion: Chemotherapy combined with levofloxacin is a safe and effective regimen for patients’ pulmonary tuberculosis complicated with Type-2 diabetes, boasting a variety of benefits such as improved clinical efficacy, ameliorated cellular immune status, a high negative conversion rate of sputum tuberculosis bacteria, and no significant increase in adverse reactions.
doi: https://doi.org/10.12669/pjms.39.2.6364
How to cite this: Luo P, Wu L, Liu F, Tian Y, Chen L, Liu Y. Clinical efficacy of chemotherapy regimen combined with Levofloxacin in patients with Pulmonary Tuberculosis complicated with Type-2 Diabetes. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.6364
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.