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Precision Medicine in Neurosurgery
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Precision Medicine in Neurosurgery

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: closed (25 September 2024) | Viewed by 4148

Special Issue Editors

Dr. Filippo Maria Polli

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Guest Editor
Spine Surgery Unit, Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00136 Rome, Italy
Interests: spine; spine surgery; spinal cord; microneurosurgery; cervical myelopathy; spine tumors; vertebral oncology; back pain
Special Issues, Collections and Topics in MDPI journals
Dr. Nicola Montano

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Guest Editor
Department of Neuroscience, Neurosurgery Section, Catholic University of the Sacred Heart, Rome, Italy
Interests: functional neurosurgery; trigeminal neuralgia; neuropathic pain; hemifacial spasm; neurovascular conflict; microvascular decompression; deep brain stimulation; epilepsy surgery; posterior fossa surgery; neuro-oncology; spine surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Precision medicine is an innovative approach for the prevention and treatment of diseases, which has the aim of identifying a tailored treatment for each patient at the right time. It uses different methodologies, such as big data collection, the various omics and pharmaco-omics, artificial intelligence, and the study of social and environmental factors. Furthermore, in precision medicine, all these data are integrated with preventive and population medicine.

Given the potential dramatic impact of neurosurgical diseases and treatments on patient quality of life and survival, neurosurgery has always been at the frontier of surgical research.

The personalized approach through precision medicine methods may significantly impact on different neurosurgical fields. For example, the integration of molecular information in brain tumor diagnosis and treatment and the study of genetic and biochemical factors in movement disorders, hydrocephalus, chronic pain, spinal degenerative and tumoral pathologies could significantly affect our understanding of the pathophysiology of diseases and improve the response to different neurosurgical treatments. Moreover, cutting-edge technologies and novel surgical instrumentation allow neurological surgeons to deliver effective treatments together with minimally invasive surgical approaches.

The aim of this Special Issue of the Journal of Precision Medicine is to collect outstanding original articles, reviews and communications highlighting innovative and personalized approaches to the diagnosis and surgical treatment of neurosurgical diseases.

Dr. Filippo Maria Polli
Dr. Nicola Montano
Guest Editors

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 Personalized Medicine is an international peer-reviewed open access monthly 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
  • surgical techniques
  • spine surgery
  • neuro-oncology
  • neurotraumatology
  • functional neurosurgery
  • traumatic brain injury
  • spinal cord
  • neuro-navigation
  • neuroimaging

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Published Papers (3 papers)

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18 pages, 4913 KiB  
Article
Endoscopic transfacet Decompression for Severe Lumbar Spinal Stenosis: A Technical Note, Illustrative Clinical Series, and Surgeon Survey Regarding Post-Decompression Instability
by Kai-Uwe Lewandrowski, Álvaro Dowling, Choll Kim, Brian Kwon, John Ongulade, Kenyu Ito, Paulo Sergio Terxeira de Carvalho and Morgan P. Lorio
J. Pers. Med. 2025, 15(2), 53; https://doi.org/10.3390/jpm15020053 - 28 Jan 2025
Viewed by 952
Abstract
Background: Lumbar spinal stenosis (LSS) remains a predominant cause of debilitating back and leg pain, affecting many aging populations. Traditional decompression surgeries can be invasive and pose significant risks and recovery time. This study elucidates the techniques and preliminary outcomes of endoscopic [...] Read more.
Background: Lumbar spinal stenosis (LSS) remains a predominant cause of debilitating back and leg pain, affecting many aging populations. Traditional decompression surgeries can be invasive and pose significant risks and recovery time. This study elucidates the techniques and preliminary outcomes of endoscopic transfacet decompression in treating severe LSS. Methods: A retrospective review was performed on 65 patients with severe LSS who underwent endoscopic transfacet decompression. The patient outcomes were analyzed using the VAS for leg pain and the modified Macnab criteria. Pre-operative and post-operative scores were compared, and any complications were analyzed. An online survey was administered to 868 surgeons using Likert-scale ratings to evaluate surgeons’ experience with endoscopic decompression in patients with painful spondylolisthesis. The survey responses were analyzed using descriptive statistics and Polytomous Rasch analysis to evaluate surgeon endorsement. Results: The study included 65 patients, of which 29 (44.6%) were female and 36 (55.4%) were male, with a mean age of 65.79 ranging from 38 to 84 years. The available mean post-operative follow-up period was 31.44 months, ranging from 24 to 39 months. The VAS score for leg pain reduced significantly from pre-operative 7.54 ± 1.67 to 2.20 ± 1.45 by 5.34 ± 2.03 (p < 0.001) with a large effect size (Cohen’s d = 2.626). At the final follow-up, functional Macnab outcomes were reported as excellent by 20 (30.8%), good by 37 (56.9%), fair by 5 (7.7%), and poor by 3 (4.6%) of patients. There were no incidental durotomies, nerve root injuries, wound complications, or instances of post-operative instability. Only five patients (7.7%) developed post-operative dysesthesia. Incomplete decompression led to fair and poor outcomes in 8 (12.3%) patients. No revision surgeries were performed. post-operative instability was not observed. The surgeon survey corroborated these observations, where the polytomous Rasch analysis showed consensus on the effectiveness of the percutaneous endoscopic decompression of low-grade spondylolisthesis. Differential item functioning (DIF) analysis showed no significant bias in item responses between orthopaedic and neurosurgeons. Conclusions: The endoscopic transfacet decompression technique delineated herein showcased excellent Macnab outcomes in managing severe LSS, with a combined success rate of 87.7%. Patients also experienced a statistically significant reduction in leg pain. Dysesthesia rates were lower than with the transforaminal approach, likely because of limited exiting and traversing nerve root manipulation. This technique might represent a viable, less invasive alternative to open microsurgical dissection and decompression for patients with severe LSS, where fusion may be required. This approach was found to be highly accepted among endoscopic spine surgeons. Full article
(This article belongs to the Special Issue Precision Medicine in Neurosurgery)
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9 pages, 230 KiB  
Article
The Role of Psychosomatic Traits in Tailored Workup for Anterior Cervical Discectomy and Fusion—A Case Series
by Marco Battistelli, Edoardo Mazzucchi, Mario Muselli, Filippo Maria Polli, Gianluca Galieri, Paola Bazzu, Fabrizio Pignotti, Alessandro Olivi, Giovanni Sabatino and Giuseppe La Rocca
J. Pers. Med. 2024, 14(5), 454; https://doi.org/10.3390/jpm14050454 - 25 Apr 2024
Cited by 2 | Viewed by 1595
Abstract
Study design: Prospective study. Objective: To evaluate the influence of preoperatively assessed psychosomatic traits on postoperative pain, disability, and quality of life outcomes. Summary of background data: Anterior cervical discectomy and fusion (ACDF) is a widely employed surgical procedure for treating cervical spondylosis. [...] Read more.
Study design: Prospective study. Objective: To evaluate the influence of preoperatively assessed psychosomatic traits on postoperative pain, disability, and quality of life outcomes. Summary of background data: Anterior cervical discectomy and fusion (ACDF) is a widely employed surgical procedure for treating cervical spondylosis. Despite its effectiveness, various studies have reported non-success rates in terms of alleviating disability and pain. Psychological factors have become increasingly recognized as critical determinants of surgical outcomes in various medical disciplines. The full extent of their impact within the context of ACDF remains insufficiently explored. This case series aims to assess the influence of preoperative psychological profiling on long-term pain, disability and quality of life outcomes. Methods: We conducted a prospective cohort study of prospectively collected data from 76 consecutive patients who underwent ACDF with PEEK inter-fixed cages from July 2019 to November 2021. The preoperative psychological traits were assessed using the Symptom Checklist 90 (SCL-90) questionnaire. The Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), Neck Disability index (NDI), EuroQol-5D (EQ-5D), and Short Form-36 (SF-36) were collected preoperatively, one month postoperatively, and at least one year after the surgical procedure. Results: The correlation analyses revealed associations between psychosomatic traits and multiple preoperative and postoperative outcome measures. The univariate analyses and linear regression analyses demonstrated the influence of the Global Severity Index (GSI) over the final follow-up scores for the ODI, VAS, NDI, EQ-5D, and SF-36. The GSI consistently exhibited a stronger correlation with the final follow-up pain, disability, and quality of life outcomes with respect to the correspondent preoperative values. Conclusion: This study highlights the importance of psychosomatic traits as predictive factors for ACDF outcomes and emphasizes their relevance in preoperative assessment for informing patients about realistic expectations. The findings underscore the need to consider psychological profiles in the preoperative workup, opening avenues for research into medications and psychological therapies. Recognizing the influence of psychosocial elements informs treatment strategies, fostering tailored surgical approaches and patient care. Full article
(This article belongs to the Special Issue Precision Medicine in Neurosurgery)

Other

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11 pages, 4090 KiB  
Systematic Review
Clinical Implication of Brain Metastases En-Bloc Resection: Surgical Technique Description and Literature Review
by Roberto Altieri, Sergio Corvino, Giuseppe La Rocca, Fabio Cofano, Antonio Melcarne, Diego Garbossa and Manlio Barbarisi
J. Pers. Med. 2024, 14(11), 1110; https://doi.org/10.3390/jpm14111110 - 19 Nov 2024
Cited by 1 | Viewed by 950
Abstract
Background: The role of brain metastases (BM) surgery is of paramount importance for patients’ progression-free and overall survival. “En-bloc” and “piecemeal” resection represent the main surgical techniques. Although en-bloc resection remains the best surgical option, it is not widely adopted or feasible as [...] Read more.
Background: The role of brain metastases (BM) surgery is of paramount importance for patients’ progression-free and overall survival. “En-bloc” and “piecemeal” resection represent the main surgical techniques. Although en-bloc resection remains the best surgical option, it is not widely adopted or feasible as the first choice. We describe our point of view about the en-bloc surgical technique with an illustrative case and discuss its indications with pros and cons through a comprehensive literature review. Materials and methods: A Medline search up to December 2023 in the Embase and PubMed online electronic databases was made and PRISMA statement was followed. An illustrative case of “en-bloc” resection from our surgical series was also added as a technical note. Results: We describe tips and tricks of our surgical technique and added a surgical video from our series. The literature review disclosed 19 studies. Resulting data suggested that “en-bloc” resection, when feasible, provides lesser risk of leptomeningeal dissemination, local recurrence rates, intraoperative bleeding occurrence and perioperative complications; in addition, it preserves the normal anatomy. Conclusions: En-bloc resection is the gold standard technique for surgical treatment of brain metastases especially for patients with superficial lesions that are small in size and far from eloquent areas. Full article
(This article belongs to the Special Issue Precision Medicine in Neurosurgery)
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