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Neurosurgery and Spine Surgery: From Up-to-Date Practitioners
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Neurosurgery and Spine Surgery: From Up-to-Date Practitioners

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (31 May 2024) | Viewed by 2704

Special Issue Editor

Prof. Dr. Massimiliano Visocchi

E-Mail Website
Guest Editor
Institute of Neurosurgery, Medical School, Catholic University of Rome, 00513 Rome, Italy
Interests: general neurosurgery; craniovertebral junction; complex spine neurosurgery; neurotraumatology; functional neurosurgery

Special Issue Information

Dear Colleagues,

The Special Issue titled "Neurosurgery and Spine Surgery: From Up-to-Date Practitioners" provides a comprehensive overview of the latest advancements and best practices in the fields of neurosurgery and spine surgery. This collection of articles showcases cutting-edge research, techniques, and clinical experiences from leading experts in these disciplines.

The Special Issue focuses on research articles and reviews, emphasizing the exclusion of case reports to maintain a high level of scientific rigor. Topics covered include innovative surgical approaches, emerging technologies, perioperative care, patient outcomes, and interdisciplinary collaboration in the treatment of neurological and spinal disorders.

This compilation serves as a valuable resource for healthcare professionals, researchers, and students interested in staying current with the rapidly evolving landscape of neurosurgery and spine surgery. The contributions of seasoned practitioners shed light on the most pressing issues and promising developments in these crucial medical specialties.

Prof. Dr. Massimiliano Visocchi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neurosurgery
  • spine surgery
  • surgical techniques
  • research
  • advances
  • patient outcomes
  • interdisciplinary collaboration
  • healthcare
  • medical innovation
  • clinical practices

Published Papers (6 papers)

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Research

Jump to: Review, Other

12 pages, 422 KiB  
Article
Superinfections of the Spine: A Single-Institution Experience
by Anthony K. Chiu, Bibhas Amatya, Idris Amin, Amit S. Ratanpal, Alexandra Baker Lutz, Brian M. Shear, Ivan B. Ye, Robin Fencel, Louis J. Bivona, Eugene Y. Koh, Julio J. Jauregui, Steven C. Ludwig and Daniel L. Cavanaugh
J. Clin. Med. 2024, 13(10), 2739; https://doi.org/10.3390/jcm13102739 - 7 May 2024
Viewed by 462
Abstract
Background/Objectives: A superinfection occurs when a new, secondary organism colonizes an existing infection. Spine infections are associated with high patient morbidity and sometimes require multiple irrigations and debridements (I&Ds). When multiple I&Ds are required, the risk of complications increases. The purpose of this [...] Read more.
Background/Objectives: A superinfection occurs when a new, secondary organism colonizes an existing infection. Spine infections are associated with high patient morbidity and sometimes require multiple irrigations and debridements (I&Ds). When multiple I&Ds are required, the risk of complications increases. The purpose of this study was to report our experience with spine superinfections and determine which patients are typically affected. Methods: A retrospective case series of spine superinfections and a retrospective case–control analysis were conducted. Data were collected manually from electronic medical records. Spine I&Ds were identified. Groups were created for patients who had multiple I&Ds for (1) a recurrence of the same causative organism or (2) a superinfection with a novel organism. Preoperative demographic, clinical, and microbiologic data were compared between these two outcomes. A case series of superinfections with descriptive data was constructed. Lastly, two illustrative cases were provided in a narrative format. Results: A total of 92 patients were included in this analysis. Superinfections occurred after 6 out of the 92 (7%) initial I&Ds and were responsible for 6 out of the 24 (25%) repeat I&Ds. The preoperative erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) of the patients with a superinfection were significantly lower than those in the control group (p = 0.022 and p = 0.032). Otherwise, the observed differences in the preoperative variables were not statistically different. In the six cases of superinfection, the presence of high-risk comorbidities, a history of substance abuse, or a lack of social support were commonly observed. The superinfecting organisms included Candida, Pseudomonas, Serratia, Klebsiella, Enterobacter, and Staphylococcus species. Conclusions: Superinfections are a devastating complication requiring reoperation after initial spine I&D. Awareness of the possibility of superinfection and common patient archetypes can be helpful for clinicians and care teams. Future work is needed to examine how to identify, help predict, and prevent spine superinfections. Full article
(This article belongs to the Special Issue Neurosurgery and Spine Surgery: From Up-to-Date Practitioners)
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Review

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21 pages, 1191 KiB  
Review
Evolution, Current Trends, and Latest Advances of Endoscopic Spine Surgery
by Sharvari Gunjotikar, Malcolm Pestonji, Masato Tanaka, Tadashi Komatsubara, Shashank J. Ekade, Ahmed Majid Heydar and Huynh Kim Hieu
J. Clin. Med. 2024, 13(11), 3208; https://doi.org/10.3390/jcm13113208 - 29 May 2024
Viewed by 186
Abstract
Background: The aging of the population in developing and developed countries has led to a significant increase in the health burden of spinal diseases. These elderly patients often have a number of medical comorbidities due to aging. The need for minimally invasive [...] Read more.
Background: The aging of the population in developing and developed countries has led to a significant increase in the health burden of spinal diseases. These elderly patients often have a number of medical comorbidities due to aging. The need for minimally invasive techniques to address spinal disorders in this elderly population group cannot be stressed enough. Minimally invasive spine surgery (MISS) has several proven benefits, such as minimal muscle trauma, minimal bony resection, lesser postoperative pain, decreased infection rate, and shorter hospital stay. Methods: A comprehensive search of the literature was performed using PubMed. Results: Over the past 40 years, constant efforts have been made to develop newer techniques of spine surgery. Endoscopic spine surgery is one such subset of MISS, which has all the benefits of modern MISS. Endoscopic spine surgery was initially limited only to the treatment of lumbar disc herniation. With improvements in optics, endoscopes, endoscopic drills and shavers, and irrigation pumps, there has been a paradigm shift. Endoscopic spine surgery can now be performed with high magnification, thus allowing its application not only to lumbar spinal stenosis but also to spinal fusion surgeries and cervical and thoracic pathology as well. There has been increasing evidence in support of these newer techniques of spine surgery. Conclusions: For this report, we studied the currently available literature and outlined the historical evolution of endoscopic spine surgery, the various endoscopic systems and techniques available, and the current applications of endoscopic techniques as an alternative to traditional spinal surgery. Full article
(This article belongs to the Special Issue Neurosurgery and Spine Surgery: From Up-to-Date Practitioners)
19 pages, 3490 KiB  
Review
Efficacy and Safety of Intravenous Magnesium Sulfate in Spinal Surgery: A Systematic Review and Meta-Analysis
by Jorge Campos, Jose Luis Bas, Claudia Campos, Gonzalo Mariscal, Teresa Bas and Paloma Bas
J. Clin. Med. 2024, 13(11), 3122; https://doi.org/10.3390/jcm13113122 - 26 May 2024
Viewed by 331
Abstract
Optimizing pain management in spinal surgery is crucial for preventing adverse events due to delayed mobilization. Magnesium sulfate has potential benefits in spinal surgery because of its analgesic properties and modulation of neurotransmitters and autonomic nervous system. Existing evidence regarding the use of [...] Read more.
Optimizing pain management in spinal surgery is crucial for preventing adverse events due to delayed mobilization. Magnesium sulfate has potential benefits in spinal surgery because of its analgesic properties and modulation of neurotransmitters and autonomic nervous system. Existing evidence regarding the use of magnesium sulfate is partial and controversial, necessitating a comprehensive meta-analysis to evaluate its efficacy and safety. The aim of this study was to conduct a comprehensive meta-analysis to evaluate the efficacy and safety of magnesium sulfate in spinal surgery compared to other available options. This meta-analysis adhered to the PRISMA guidelines. Patients undergoing spinal surgery were included, with the intervention group receiving intravenous magnesium sulfate (MS) at various doses or combinations, whereas the comparison group received other alternatives or a placebo. The efficacy and safety outcomes were assessed. Data were collected from multiple databases and analyzed using Review Manager version 5.4. Heterogeneity was assessed and fixed- or random-effects models were applied. The meta-analysis included eight studies (n = 541). Magnesium sulfate demonstrated significant reductions in pain at 24 h (MD −0.20, 95% CI: −0.39 to −0.02) and opioid consumption (SMD −0.66, 95% CI: −0.95 to −0.38) compared to placebo. Additionally, a decrease in the use of muscle relaxants (SMD −0.91, 95% CI: −1.65 to −0.17) and remifentanil (SMD −1.52, 95% CI: −1.98 to −1.05) was observed. In contrast, an increase in extubation time (MD 2.42, 95% CI: 1.14 to 3.71) and verbal response (MD 1.85, 95% CI: 1.13 to 2.58) was observed compared to dexmedetomidine. In conclusion, magnesium sulfate administration in spinal surgery reduced pain and opioid consumption, and prolonged orientation and verbal response. No significant differences in blood pressure or heart rate were observed between the groups. Full article
(This article belongs to the Special Issue Neurosurgery and Spine Surgery: From Up-to-Date Practitioners)
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Other

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15 pages, 2741 KiB  
Systematic Review
Impact of Depression on Postoperative Medical and Surgical Outcomes in Spine Surgeries: A Systematic Review and Meta-Analysis
by Sepehr Aghajanian, Arman Shafiee, Mohammad Mobin Teymouri Athar, Fateme Mohammadifard, Saba Goodarzi, Fatemeh Esmailpur and Aladine A. Elsamadicy
J. Clin. Med. 2024, 13(11), 3247; https://doi.org/10.3390/jcm13113247 - 31 May 2024
Abstract
Introduction: The relationship between psychiatric disorders, including depression, and invasive interventions has been a topic of debate in recent literature. While these conditions can impact the quality of life and subjective perceptions of surgical outcomes, the literature lacks consensus regarding the association between [...] Read more.
Introduction: The relationship between psychiatric disorders, including depression, and invasive interventions has been a topic of debate in recent literature. While these conditions can impact the quality of life and subjective perceptions of surgical outcomes, the literature lacks consensus regarding the association between depression and objective perioperative medical and surgical complications, especially in the neurosurgical domain. Methods: MEDLINE (PubMed), EMBASE, PsycINFO, and the Cochrane Library were queried in a comprehensive manner from inception until 10 November 2023, with no language restrictions, for citations investigating the association between depression and length of hospitalization, medical and surgical complications, and objective postoperative outcomes including readmission, reoperation, and non-routine discharge in patients undergoing spine surgery. Results: A total of 26 articles were considered in this systematic review. Upon pooled analysis of the primary outcome, statistically significantly higher rates were observed for several complications, including delirium (OR:1.92), deep vein thrombosis (OR:3.72), fever (OR:6.34), hematoma formation (OR:4.7), hypotension (OR:4.32), pulmonary embolism (OR:3.79), neurological injury (OR:6.02), surgical site infection (OR:1.36), urinary retention (OR:4.63), and urinary tract infection (OR:1.72). While readmission (OR:1.35) and reoperation (OR:2.22) rates, as well as non-routine discharge (OR:1.72) rates, were significantly higher in depressed patients, hospitalization length was comparable to non-depressed controls. Conclusions: The results of this review emphasize the significant increase in complications and suboptimal outcomes noted in patients with depression undergoing spinal surgery. Although a direct causal relationship may not be established, addressing psychiatric aspects in patient care is crucial for providing comprehensive medical attention. Full article
(This article belongs to the Special Issue Neurosurgery and Spine Surgery: From Up-to-Date Practitioners)
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17 pages, 4952 KiB  
Systematic Review
Sex-Related Differences in Mortality, Delayed Cerebral Ischemia, and Functional Outcomes in Patients with Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis
by Sarah Berli, Massimo Barbagallo, Emanuela Keller, Giuseppe Esposito, Alberto Pagnamenta and Giovanna Brandi
J. Clin. Med. 2024, 13(10), 2781; https://doi.org/10.3390/jcm13102781 - 9 May 2024
Viewed by 557
Abstract
Background/Objective: Sex-related differences among patients with aneurysmal subarachnoid hemorrhage (aSAH) and their potential clinical implications have been insufficiently investigated. To address this knowledge gap, we conduct a comprehensive systematic review and meta-analysis. Methods: Sex-specific differences in patients with aSAH, including mortality, [...] Read more.
Background/Objective: Sex-related differences among patients with aneurysmal subarachnoid hemorrhage (aSAH) and their potential clinical implications have been insufficiently investigated. To address this knowledge gap, we conduct a comprehensive systematic review and meta-analysis. Methods: Sex-specific differences in patients with aSAH, including mortality, delayed cerebral ischemia (DCI), and functional outcomes were assessed. The functional outcome was dichotomized into favorable or unfavorable based on the modified Rankin Scale (mRS), Glasgow Outcome Scale (GOS), and Glasgow Outcome Scale Extended (GOSE). Results: Overall, 2823 studies were identified in EMBASE, MEDLINE, PubMed, and by manual search on 14 February 2024. After an initial assessment, 74 studies were included in the meta-analysis. In the analysis of mortality, including 18,534 aSAH patients, no statistically significant differences could be detected (risk ratio (RR) 0.99; 95% CI, 0.90–1.09; p = 0.91). In contrast, the risk analysis for DCI, including 23,864 aSAH patients, showed an 11% relative risk reduction in DCI in males versus females (RR, 0.89; 95% CI, 0.81–0.97; p = 0.01). The functional outcome analysis (favorable vs. unfavorable), including 7739 aSAH patients, showed a tendency towards better functional outcomes in men than women; however, this did not reach statistical significance (RR, 1.02; 95% CI, 0.98–1.07; p = 0.34). Conclusions: In conclusion, the available data suggest that sex/gender may play a significant role in the risk of DCI in patients with aSAH, emphasizing the need for sex-specific management strategies. Full article
(This article belongs to the Special Issue Neurosurgery and Spine Surgery: From Up-to-Date Practitioners)
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21 pages, 722 KiB  
Systematic Review
Optical Methods for Brain Tumor Detection: A Systematic Review
by Gustav Burström, Misha Amini, Victor Gabriel El-Hajj, Arooj Arfan, Maria Gharios, Ali Buwaider, Merle S. Losch, Francesca Manni, Erik Edström and Adrian Elmi-Terander
J. Clin. Med. 2024, 13(9), 2676; https://doi.org/10.3390/jcm13092676 - 2 May 2024
Viewed by 645
Abstract
Background: In brain tumor surgery, maximal tumor resection is typically desired. This is complicated by infiltrative tumor cells which cannot be visually distinguished from healthy brain tissue. Optical methods are an emerging field that can potentially revolutionize brain tumor surgery through intraoperative differentiation [...] Read more.
Background: In brain tumor surgery, maximal tumor resection is typically desired. This is complicated by infiltrative tumor cells which cannot be visually distinguished from healthy brain tissue. Optical methods are an emerging field that can potentially revolutionize brain tumor surgery through intraoperative differentiation between healthy and tumor tissues. Methods: This study aimed to systematically explore and summarize the existing literature on the use of Raman Spectroscopy (RS), Hyperspectral Imaging (HSI), Optical Coherence Tomography (OCT), and Diffuse Reflectance Spectroscopy (DRS) for brain tumor detection. MEDLINE, Embase, and Web of Science were searched for studies evaluating the accuracy of these systems for brain tumor detection. Outcome measures included accuracy, sensitivity, and specificity. Results: In total, 44 studies were included, covering a range of tumor types and technologies. Accuracy metrics in the studies ranged between 54 and 100% for RS, 69 and 99% for HSI, 82 and 99% for OCT, and 42 and 100% for DRS. Conclusions: This review provides insightful evidence on the use of optical methods in distinguishing tumor from healthy brain tissue. Full article
(This article belongs to the Special Issue Neurosurgery and Spine Surgery: From Up-to-Date Practitioners)
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