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  1. Article ; Online: Introduction. Proceedings of Spine Summit 2023.

    Turner, Jay D / Sansur, Charles A / Potts, Eric A / Kanter, Adam S

    Journal of neurosurgery. Spine

    2023  Volume 39, Issue 5, Page(s) 609

    Language English
    Publishing date 2023-08-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2158643-3
    ISSN 1547-5646 ; 1547-5654
    ISSN (online) 1547-5646
    ISSN 1547-5654
    DOI 10.3171/2023.6.SPINE23484
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: The Apple Vision Pro as a Neurosurgical Planning Tool: A Case Report.

    Olexa, Joshua / Trang, Annie / Cohen, Jonathan / Kim, Kevin / Rakovec, Maureen / Saadon, Jordan / Sansur, Charles / Woodworth, Graeme / Schwartzbauer, Gary / Cherian, Jacob

    Cureus

    2024  Volume 16, Issue 2, Page(s) e54205

    Abstract: With its recent release, the Apple Vision Pro (Apple Inc., Cupertino, CA) represents a promising technological advancement of mixed reality in the field of neurosurgery and medicine more broadly. With all new technologies, it is critical to facilitate ... ...

    Abstract With its recent release, the Apple Vision Pro (Apple Inc., Cupertino, CA) represents a promising technological advancement of mixed reality in the field of neurosurgery and medicine more broadly. With all new technologies, it is critical to facilitate early use and assessment of the technology to facilitate adoption by the larger medical community. A 44-year-old female with a history of ruptured intracranial aneurysm status post anterior communicating artery aneurysm clipping presented with worsened confusion and intermittent headache. CT imaging revealed evidence of hydrocephalus due to the malfunction of a previous right parietal ventriculoperitoneal (VP) shunt. Prior to the case, the Apple Vision Pro was used in the operating room to visualize and interact with a 3D model of the patient's anatomy for the patient undergoing a VP shunt placement. A visualization of the 3D model through the headset was used to plan the approach and entry point. At the conclusion of the procedure, all clinicians and operating staff who used the technology for planning completed a survey about their initial impressions of the headset. Overall, users felt the 3D models felt realistic (4.5/5), that the display of the user's real-world view felt natural (4.3/5), and that the headset did not cause eye strain or fatigue (4.5/5). The majority of users responded that they would continue to use the headset for cases (4/5). This represents one of the first known clinical uses of the Apple Vision Pro. It is a cutting-edge technology that will likely provide immense value for healthcare providers as it becomes more integrated into clinical care.
    Language English
    Publishing date 2024-02-14
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.54205
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Midpoint of C7 Lateral Mass Serves as an Accurate Reference Point for the Placement of T1 Pedicle Screws: An Anatomic Study.

    Kim, Kevin T / Panagos, Michael / Hentschel, Matthew / Sharma, Ashish / Han, Nathan / Chryssikos, Timothy / Schwartzbauer, Gary / Crandall, Kenneth M / Sansur, Charles A

    Operative neurosurgery (Hagerstown, Md.)

    2023  Volume 26, Issue 3, Page(s) 323–329

    Abstract: Background and objectives: Free-hand placement of T1 pedicle screws can often be challenging. A reliable free-hand technique for placement of T1 pedicle screws can overcome some of the difficulties associated with poor fluoroscopy in this region. The ... ...

    Abstract Background and objectives: Free-hand placement of T1 pedicle screws can often be challenging. A reliable free-hand technique for placement of T1 pedicle screws can overcome some of the difficulties associated with poor fluoroscopy in this region. The purpose of this study was to propose a novel anatomic landmark for accurate identification of the T1 entry point using the midpoint of the C7 lateral mass as a reference point. Our hypothesis is that the midpoint of the C7 lateral mass is within 1-2 mm of the center of the T1 pedicle.
    Methods: Using 3-dimensional reconstruction software, the pedicle of T1 and the lateral mass of C7 were isolated to assess the location of the T1 pedicle relative to the C7 lateral mass. Specifically, the distance between the center of the T1 pedicle and the center of the C7 lateral mass was measured on 40 computed tomography scans. Furthermore, a clinical validation of this technique was performed by assessing the postoperative computed tomography scans of 53 patients undergoing cervicothoracic instrumentation. The Gertzbein and Robbins classification system was used to grade the accuracy of T1 pedicle screw placements in all patients using this technique.
    Results: The average horizontal deviation + SD from centers of the T1 pedicle and the C7 lateral mass was 0.398 mm ± 0.953 mm. The T1 pedicle on average was slightly medial to the center of the C7 lateral mass. A total of 98.1% of T1 pedicle screws placed in vivo using the free-hand technique were of Grade A.
    Conclusion: In this article, we demonstrate that the center of the C7 lateral mass overlays the T1 pedicle and the optimal entry point is immediately below the midpoint of the C7 lateral mass. This approach provides a practical and accurate landmark in posterior cervicothoracic spine procedures that reduce the need for additional radiation exposure or increased operative time with image-guided techniques.
    MeSH term(s) Humans ; Pedicle Screws ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery ; Tomography, X-Ray Computed ; Fluoroscopy ; Spinal Fusion/methods
    Language English
    Publishing date 2023-10-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2767575-0
    ISSN 2332-4260 ; 2332-4252
    ISSN (online) 2332-4260
    ISSN 2332-4252
    DOI 10.1227/ons.0000000000000950
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Reviewer's comment concerning "direct repair of displaced anterior arch fracture of the atlas under microendoscopy: experience with seven patients" (DOI 10.1007/s00586-011-1965-5 R1 by Jian Wang).

    Sansur, Charles A

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

    2011  Volume 21, Issue 2, Page(s) 352

    MeSH term(s) Cervical Atlas/injuries ; Female ; Humans ; Male ; Spinal Fractures/surgery
    Language English
    Publishing date 2011-09-16
    Publishing country Germany
    Document type Journal Article ; Comment
    ZDB-ID 1115375-1
    ISSN 1432-0932 ; 0940-6719
    ISSN (online) 1432-0932
    ISSN 0940-6719
    DOI 10.1007/s00586-011-2022-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: The Utility of the Validated Intraoperative Bleeding Scale in Thoracolumbar Spine Surgery: A Single-Center Prospective Study.

    Smith, Ryan A / Pease, Tyler J / Chiu, Anthony K / Shear, Brian M / Sahlani, Mario N / Ratanpal, Amit S / Ye, Ivan B / Thomson, Alexandra E / Bivona, Louis J / Jauregui, Julio J / Crandall, Kenneth M / Sansur, Charles A / Cavanaugh, Daniel L / Koh, Eugene Y / Ludwig, Steven C

    Global spine journal

    2024  , Page(s) 21925682241228219

    Abstract: Study design: Prospective, single-center study.: Objective: To evaluate the clinical relevance of the validated intraoperative bleeding severity scale (VIBe) in thoracolumbar spine surgery.: Methods: Adult patients aged 18 through 88 undergoing ... ...

    Abstract Study design: Prospective, single-center study.
    Objective: To evaluate the clinical relevance of the validated intraoperative bleeding severity scale (VIBe) in thoracolumbar spine surgery.
    Methods: Adult patients aged 18 through 88 undergoing elective decompression, instrumentation, and fusion of the thoracolumbar spine were prospectively enrolled after informed consent was provided and written consent was obtained. Validated intraoperative bleeding severity scores were recorded intraoperatively. Univariate analysis consisted of Student T-tests, Pearson's χ
    Results: A total of N = 121 patients were enrolled and included in the analysis. After adjusting for confounders, VIBe scores were correlated with an increased likelihood of intraoperative blood transfusion (β = 2.46,
    Conclusion: The VIBe scale is associated with perioperative transfusion rates and EBL in patients undergoing thoracolumbar spine surgery. Overall, the VIBe scale has clinically relevant meaning in spine surgery, and shows potential utility in clinical research.
    Level of evidence: Level II.
    Language English
    Publishing date 2024-01-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2648287-3
    ISSN 2192-5690 ; 2192-5682
    ISSN (online) 2192-5690
    ISSN 2192-5682
    DOI 10.1177/21925682241228219
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  6. Article ; Online: Thoracic Discectomy Through a Unilateral Transpedicular or Costotransversectomy Approach With Intraoperative Ultrasound Guidance.

    Wessell, Aaron / Mushlin, Harry / Fleming, Charles / Lewis, Evan / Sansur, Charles

    Operative neurosurgery (Hagerstown, Md.)

    2018  Volume 17, Issue 3, Page(s) 332–337

    Abstract: Background: The disc location, extent of calcification, limited visualization of the ventral cord, and tenuous blood supply to the thoracic spinal cord pose unique technical challenges when surgically treating thoracic disc herniation.: Objective: To ...

    Abstract Background: The disc location, extent of calcification, limited visualization of the ventral cord, and tenuous blood supply to the thoracic spinal cord pose unique technical challenges when surgically treating thoracic disc herniation.
    Objective: To report our initial experience with a series of cases in which intraoperative ultrasound image guidance was used for thoracic discectomy through a unilateral transpedicular or costotransversectomy approach.
    Methods: Five patients (n = 5) underwent a transpedicular approach and five (n = 5) underwent costotransversectomy for thoracic discectomy. Pre- and postoperative clinical records, operative reports, disc location/calcification, and complications were reviewed.
    Results: There were 6 (n = 6) males and 4 (n = 4) females with an average age of 54 yr (range: 33-74). All patients had symptoms attributable to a single-level of thoracic disc herniation. Discs were classified as central (n = 5) and paracentral (n = 5). Preoperative CT and/or intraoperative visualization demonstrated calcified disc material in 6 (n = 6) patients. Final outcomes data at last follow-up was available for 9 of 10 patients. Eight of these nine patients experienced a return to normal baseline functional status. Postoperative imaging confirmed that no wrong-level surgeries were performed. The mean length of follow-up was 20.4 wk (range 4-48).
    Conclusion: Thoracic discectomy with ultrasound visualization via a unilateral transpedicular or costotransversectomy approach is safe and effective for treatment of central and paracentral calcified disc herniations. This tool improves the safety profile of thoracic discectomy and allows for treatment of thoracic discs through less invasive approaches.
    MeSH term(s) Adult ; Aged ; Diskectomy/methods ; Female ; Humans ; Intervertebral Disc Displacement/diagnostic imaging ; Intervertebral Disc Displacement/surgery ; Male ; Middle Aged ; Retrospective Studies ; Thoracic Vertebrae/diagnostic imaging ; Thoracic Vertebrae/surgery ; Treatment Outcome ; Ultrasonography, Interventional
    Language English
    Publishing date 2018-11-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2767575-0
    ISSN 2332-4260 ; 2332-4252
    ISSN (online) 2332-4260
    ISSN 2332-4252
    DOI 10.1093/ons/opy348
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: A 10-Year Retrospective Review on the Use of Prophylactic Spinal Reconstruction in Spinal Surgery Involving High-Risk Patients.

    Choudhry, Salman / Er, Seray / Ha, Michael / Brown, Madeline / Karwoski, Allison / Ludwig, Steven C / Cavanaugh, Daniel L / Sansur, Charles A / Crandall, Kenneth M / Rasko, Yvonne M

    Annals of plastic surgery

    2023  

    Abstract: Background: Spinal surgeries are being offered to a broader patient population who are both medically and surgically complex. History of prior spinal surgery, advanced age, and presence of comorbidities, such as obesity, malnutrition, steroid use, and ... ...

    Abstract Background: Spinal surgeries are being offered to a broader patient population who are both medically and surgically complex. History of prior spinal surgery, advanced age, and presence of comorbidities, such as obesity, malnutrition, steroid use, and tobacco use, are risk factors for postoperative complications. Prophylactic spinal reconstruction at the time of spinal surgery has been shown to have improved outcomes and decreased wound complications; however, outcomes focusing specifically on complex patients with a history of previous spinal surgery (or surgeries) have not been well described.
    Methods: This is a retrospective study performed at the University of Maryland Medical Center (Baltimore, MD) of high-risk patients who underwent complex spinal surgery with prophylactic spinal reconstruction from 2011 to 2022. One hundred forty-three consecutive surgeries from 136 patients were included in the study. Patients younger than 17 years or who had an incomplete medical record were excluded.
    Results: Most patients were female (63.6%) versus male (31.5%). The average American Society of Anesthesiologists score was 3. All but 6 patients (11%) had a history of at least 1 spinal surgery, with nearly half of patients having had between 2 and 5 spinal surgeries. Reconstruction was performed with paraspinous flaps in most cases (n = 133 [93%]). The overall complication rate was 10.5%, with surgical site infection being the most common complication. Seventeen patients (12.5%) underwent reoperation within 90 days of initial surgery. Average length of follow-up was 4.18 months (range, 0.03-40.53 months).
    Conclusions: In appropriately selected patients, prophylactic spinal reconstruction offers improved outcomes with decreased wound complications compared with salvage. For large defects, paraspinous flaps are recommended over other reconstructive options. Prolonged drain placement is felt to be protective against complications.
    Language English
    Publishing date 2023-11-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 423835-7
    ISSN 1536-3708 ; 0148-7043
    ISSN (online) 1536-3708
    ISSN 0148-7043
    DOI 10.1097/SAP.0000000000003535
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  8. Article ; Online: A unique case of

    Doub, James B / Greenfield, Adam / Bailey, Jennifer / Wessell, Aaron P / Olexa, Joshua / Sansur, Charles A

    British journal of neurosurgery

    2020  Volume 37, Issue 5, Page(s) 1281–1284

    Abstract: Here we present a case of a poorly controlled diabetic who developed extensive rhinocerebral mucormycosis. Systemic and intrathecal amphotericin were not able to improve his life threatening infection. Therefore, salvage therapy with intracavitary ... ...

    Abstract Here we present a case of a poorly controlled diabetic who developed extensive rhinocerebral mucormycosis. Systemic and intrathecal amphotericin were not able to improve his life threatening infection. Therefore, salvage therapy with intracavitary amphotericin B deoxycholate was used to instill antifungal therapy directly into the patient's brain abscess. For proper dosing of intracavitary amphotericin B deoxycholate, we devised a formula which can be theoretically applied for all intracavitary therapies. Unfortunately, the patient's family withdrew care 6 days after starting intracavitary amphotericin and efficacy of this therapy could not be evaluated.
    MeSH term(s) Humans ; Amphotericin B/therapeutic use ; Antifungal Agents/therapeutic use ; Brain Abscess/diagnostic imaging ; Brain Abscess/drug therapy ; Rhizopus oryzae ; Male ; Middle Aged
    Chemical Substances Amphotericin B (7XU7A7DROE) ; Antifungal Agents
    Language English
    Publishing date 2020-12-04
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 639029-8
    ISSN 1360-046X ; 0268-8697
    ISSN (online) 1360-046X
    ISSN 0268-8697
    DOI 10.1080/02688697.2020.1854685
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  9. Article ; Online: Focused Ultrasound Central Lateral Thalamotomy for the Treatment of Refractory Neuropathic Pain: Phase I Trial.

    Ahmed, Abdul-Kareem / Zhuo, Jiachen / Gullapalli, Rao P / Jiang, Li / Keaser, Michael L / Greenspan, Joel D / Chen, Chixiang / Miller, Timothy R / Melhem, Elias R / Sansur, Charles A / Eisenberg, Howard M / Gandhi, Dheeraj

    Neurosurgery

    2023  Volume 94, Issue 4, Page(s) 690–699

    Abstract: Background and objectives: Magnetic resonance-guided focused ultrasound (MRgFUS) central lateral thalamotomy (CLT) has not yet been validated for treating refractory neuropathic pain (NP). Our aim was to assess the safety and potential efficacy of ... ...

    Abstract Background and objectives: Magnetic resonance-guided focused ultrasound (MRgFUS) central lateral thalamotomy (CLT) has not yet been validated for treating refractory neuropathic pain (NP). Our aim was to assess the safety and potential efficacy of MRgFUS CLT for refractory NP.
    Methods: In this prospective, nonrandomized, single-arm, investigator-initiated phase I trial, patients with NP for more than 6 months related to phantom limb pain, spinal cord injury, or radiculopathy/radicular injury and who had undergone at least one previous failed intervention were eligible. The main outcomes were safety profile and pain as assessed using the brief pain inventory, the pain disability index, and the numeric rating scale. Medication use and the functional connectivity of the default mode network (DMN) were also assessed.
    Results: Ten patients were enrolled, with nine achieving successful ablation. There were no serious adverse events and 12 mild/moderate severity events. The mean age was 50.9 years (SD: 12.7), and the mean symptom duration was 12.3 years (SD: 9.7). Among eight patients with a 1-year follow-up, the brief pain inventory decreased from 7.6 (SD: 1.1) to 3.8 (SD: 2.8), with a mean percent decrease of 46.3 (SD: 40.6) (paired t -test, P = .017). The mean pain disability index decreased from 43.0 (SD: 7.5) to 25.8 (SD: 16.8), with a mean percent decrease of 39.3 (SD: 41.6) ( P = .034). Numeric rating scale scores decreased from a mean of 7.2 (SD: 1.8) to 4.0 (SD: 2.8), with a mean percent decrease of 42.8 (SD: 37.8) ( P = .024). Patients with predominantly intermittent pain or with allodynia responded better than patients with continuous pain or without allodynia, respectively. Some patients decreased medication use. Resting-state functional connectivity changes were noted, from disruption of the DMN at baseline to reactivation of connectivity between DMN nodes at 3 months.
    Conclusion: MRgFUS CLT is feasible and safe for refractory NP and has potential utility in reducing symptoms as measured by validated pain scales.
    MeSH term(s) Humans ; Middle Aged ; High-Intensity Focused Ultrasound Ablation ; Hyperalgesia ; Neuralgia/diagnostic imaging ; Neuralgia/surgery ; Prospective Studies ; Thalamus/diagnostic imaging ; Thalamus/surgery ; Treatment Outcome ; Adult
    Language English
    Publishing date 2023-11-10
    Publishing country United States
    Document type Clinical Trial, Phase I ; Journal Article
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1227/neu.0000000000002752
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  10. Article ; Online: Spinal arachnoiditis leading to recurrent reversible myelopathy: A case report.

    Jahja, Erol / Sansur, Charles / Gorman, Peter Howard

    The journal of spinal cord medicine

    2020  Volume 45, Issue 3, Page(s) 472–475

    Abstract: ... ...

    Abstract Context
    MeSH term(s) Arachnoid Cysts/complications ; Arachnoid Cysts/surgery ; Arachnoiditis/complications ; Arachnoiditis/congenital ; Arachnoiditis/diagnosis ; Humans ; Magnetic Resonance Imaging ; Spinal Cord Diseases/diagnosis ; Spinal Cord Diseases/etiology ; Spinal Cord Diseases/surgery ; Spinal Cord Injuries ; Wounds, Gunshot
    Language English
    Publishing date 2020-11-09
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1223949-5
    ISSN 2045-7723 ; 1079-0268
    ISSN (online) 2045-7723
    ISSN 1079-0268
    DOI 10.1080/10790268.2020.1830250
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