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Article ; Online: Osteoporotic vertebral fractures: WFNS Spine Committee Recommendations.

Zileli, Mehmet / Fornari, Maurizio / Parthiban, Jutty / Sharif, Salman

2022 Volume 66, Issue 4, Page(s) 279–281

MeSH term(s)	Fractures, Compression ; Humans ; Osteoporotic Fractures/surgery ; Spinal Fractures/surgery ; Spine
Language	English
Publishing date	2022-09-25
Publishing country	Italy
Document type	Editorial
ZDB-ID	193139-8
ISSN	1827-1855 ; 0390-5616 ; 0026-4881
ISSN (online)	1827-1855
ISSN	0390-5616 ; 0026-4881
DOI	10.23736/S0390-5616.22.05771-X
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Article: Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations.

Zileli, Mehmet / Sharif, Salman / Fornari, Maurizio

Neurospine

2021 Volume 18, Issue 4, Page(s) 704–712

Abstract: This review aims to search the epidemiology and incidence rates of thoracolumbar spine fractures. A systematic review of the literature of the last 10 years gave 586 results with "incidence," and 387 results with "epidemiology," of which 39 papers were ... ...

Abstract	This review aims to search the epidemiology and incidence rates of thoracolumbar spine fractures. A systematic review of the literature of the last 10 years gave 586 results with "incidence," and 387 results with "epidemiology," of which 39 papers were analyzed. The review results were discussed and voted in 2 consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee. Out of 39 studies, 15 studies have focused on thoracolumbar trauma, remaining 24 studies have looked at all spine trauma. Most were retrospective in nature; few were prospective and multicenter. Some studies have focused on specific injuries. The annual incidence of TL fractures is about 30/100,000 inhabitants including osteoporotic fractures. There is a trend to increase the fractures in elderly population especially in developed countries, while an increase of motor vehicle accidents in developing countries. The mortality rate among male elderly patients is relatively high. The incidence of thoracolumbar spine fractures is increasing because of low-velocity falls in the elderly population. The main reasons are falls and traffic accidents. Learning the regional differences and some special forms of trauma such as extreme sports, war, and gunshot injuries will help the prevention of the thoracolumbar spine fractures.
Language	English
Publishing date	2021-12-31
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	3031654-6
ISSN	2586-6591 ; 2586-6583
ISSN (online)	2586-6591
ISSN	2586-6583
DOI	10.14245/ns.2142418.209
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Article ; Online: Predictive Factors of Long-Term Neurologic Outcome and Progression-Free Survival in Intramedullary Spinal Cord Tumors: A 10-year Single-Center Cohort Study and Review of the Literature.

Tropeano, Maria Pia / Rossini, Zefferino / Franzini, Andrea / Baram, Ali / Creatura, Donato / Raspagliesi, Luca / Pessina, Federico / Fornari, Maurizio

World neurosurgery

2024

Abstract: Background: Intramedullary spinal cord tumors (IMSCTs) are a rare subgroup of neoplasms, encompassing both benign, slow-growing masses, and malignant lesions; radical surgical excision represents the cornerstone of treatment for such pathologies ... ...

Abstract	Background: Intramedullary spinal cord tumors (IMSCTs) are a rare subgroup of neoplasms, encompassing both benign, slow-growing masses, and malignant lesions; radical surgical excision represents the cornerstone of treatment for such pathologies regardless of histopathology, which, on the other hand, is a known predictor of survival and neurologic outcome postsurgery. The present study aims to investigate the relevance of other factors in predicting survival and long-term functional outcomes. Methods: We conducted a review of current literature on functional outcomes of IMSCTs, as well as a 10-years prospective analysis of a wide cohort of patients with diagnosis of IMSCTs who underwent surgical resection at our institution. Results: Our series encompasses 60 patients with IMSCTS, among which 36 ependymomas, 6 cavernous angiomas, 5 hemangioblastomas, 6 WHO Grade I-IV astrocytomas, 3 intramedullary spinal metastases and 4 miscellaneous tumors. GTR was achieved in 76,67% of patients, with high preoperative McCormick grade, syringomyelia and changes at neurophysiologic monitoring being the strongest predictors at multivariate analysis (P = 0.0027, P = 0.0017 and P = 0.001 respectively). Conclusions: Consistently with literature, preoperative neurologic function is the most important factor predicting long-term functional outcome (0.17, CI 0.069-0.57 with P = 0.0018), advocating for early surgery in the management of IMSCTs, whereas late complications such as myelopathy and neuropathic pain were present regardless of preoperative function.
Language	English
Publishing date	2024-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2024.04.024
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Article ; Online: Lumbar Spinal Stenosis Recommendations of World Federation of Neurosurgical Societies Spine Committee.

Zileli, Mehmet / Fornari, Maurizio / Costa, Francesco

World neurosurgery: X

2020 Volume 7, Page(s) 100080

Language	English
Publishing date	2020-06-23
Publishing country	United States
Document type	Editorial
ISSN	2590-1397
ISSN (online)	2590-1397
DOI	10.1016/j.wnsx.2020.100080
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Article ; Online: Epidemiology, natural course, and preventive measures of osteoporotic vertebral fractures: WFNS Spine Committee Recommendations.

Zileli, Mehmet / Fornari, Maurizio / Costa, Francesco / Anania, Carla D / Parthiban, Jutty / Sharif, Salman

Journal of neurosurgical sciences

2022 Volume 66, Issue 4, Page(s) 282–290

Abstract: Introduction: This review aims to search for up-to-date information on epidemiology, natural course, and preventive measures of osteoporotic spine fractures.: Evidence acquisition: We reviewed the literature of the last ten years using keywords " ... ...

Abstract	Introduction: This review aims to search for up-to-date information on epidemiology, natural course, and preventive measures of osteoporotic spine fractures. Evidence acquisition: We reviewed the literature of the last ten years using keywords "natural course and osteoporotic vertebral fractures," "epidemiology and osteoporotic vertebral fractures" and "prevention and osteoporotic vertebral fractures." We then discussed the search results to reach an agreement in two consensus meetings on January and February 2021 of the World Federation of Neurosurgical Societies (WFNS) Spine Committee. Finally, we utilized the Delphi method to administer the questionnaire to preserve a high degree of validity. We summarized seven papers on the natural course, 15 articles on epidemiology, and 84 papers on preventing osteoporotic vertebral fractures. Finally, the consensus results after voting are presented. Evidence synthesis: Natural course of acute osteoporotic vertebral fractures is benign; many patients may have sufficient pain relief during the first three months with conservative treatment. At the end of one year of conservative treatment, 40% may still have pain with VAS-scores ≥4. Since the populations are aging, the incidence of OVF continues to rise. Although the prevalence varies across the globe, the highest rates are from North America and some countries of Asia. Preventive treatment of OVF must involve an active lifestyle, adequate nutrition, prevention of immobilization with physical therapy, and pharmacological therapy. Oral calcium and vitamin D are first-line interventions to prevent the bone mass loss, especially in postmenopausal women. There are many pharmacological treatment options; the decision must be made by fracture risk assessment (clinical factors + BMD + BMI) alone or along with DXA (dual-energy X-ray absorptiometry) or history of previous fragility fractures. The indication of one respect to the others is based on patient preference, compliance, and risk of discontinuation related to adverse events and administration method. Conclusions: The incidence of osteoporotic vertebral fractures increases with age and other factors. The natural course shows that most patients benefit from conservative therapy without any surgical intervention during the first three months. Preventive measures must include active lifestyle, adequate nutrition, prevention of immobilization with physical therapy, oral calcium, and vitamin D intake, and pharmacological therapy after fracture risk assessment.
MeSH term(s)	Calcium ; Female ; Humans ; Osteoporotic Fractures/epidemiology ; Osteoporotic Fractures/prevention & control ; Osteoporotic Fractures/surgery ; Pain ; Spinal Fractures/etiology ; Spinal Fractures/surgery ; Vitamin D
Chemical Substances	Vitamin D (1406-16-2) ; Calcium (SY7Q814VUP)
Language	English
Publishing date	2022-03-17
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	193139-8
ISSN	1827-1855 ; 0390-5616 ; 0026-4881
ISSN (online)	1827-1855
ISSN	0390-5616 ; 0026-4881
DOI	10.23736/S0390-5616.22.05643-0
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Article ; Online: Single-Stage Posterior Transpedicular Corpectomy and 360-Degree Reconstruction for Thoracic and Lumbar Burst Fractures: Technical Nuances and Outcomes.

Anania, Carla Daniela / Bono, Beatrice Claudia / Tropeano, Mariapia / Fornari, Maurizio / Servadei, Franco / Costa, Francesco

Journal of neurological surgery. Part A, Central European neurosurgery

2022 Volume 84, Issue 5, Page(s) 489–497

Abstract: Background: We evaluate the feasibility of a single-stage posterior corpectomy and circumferential arthrodesis with the aid of spinal navigation for the treatment of traumatic thoracolumbar burst fractures.: Methods: This was a single-center, ... ...

Abstract	Background: We evaluate the feasibility of a single-stage posterior corpectomy and circumferential arthrodesis with the aid of spinal navigation for the treatment of traumatic thoracolumbar burst fractures. Methods: This was a single-center, retrospective study. Demographics, clinical, and radiologic data of 19 patients who underwent surgery at our institution for thoracolumbar burst fractures between 2016 and 2019 were collected. All patients enrolled in the present study underwent surgery by means of posterior fixation and transpedicular corpectomy with the aid of an intraoperative image-guided neuronavigation system. Results: Postoperative correction of the vertebral height ratio was achieved in all cases, with an average increase of 23.6% ( Conclusion: Single-stage posterior corpectomy and fixation is a safe and effective approach for thoracic and lumbar burst fractures. It provides excellent 360-degree reconstruction in a single surgical stage with satisfactory results in terms of kyphosis reduction, biomechanical stability, and reduced invasiveness. Spinal navigation represents a fundamental tool to overcome some anatomical limits of the presented technique.
MeSH term(s)	Humans ; Retrospective Studies ; Treatment Outcome ; Decompression, Surgical/methods ; Lumbar Vertebrae/surgery ; Lumbar Vertebrae/injuries ; Thoracic Vertebrae/surgery ; Spinal Fractures/diagnostic imaging ; Spinal Fractures/surgery ; Spinal Fractures/complications ; Fracture Fixation, Internal/methods
Language	English
Publishing date	2022-04-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2651663-9
ISSN	2193-6323 ; 2193-6315
ISSN (online)	2193-6323
ISSN	2193-6315
DOI	10.1055/s-0042-1743515
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Article: Multimodal Intraoperative Neurophysiological Monitoring in Intramedullary Spinal Cord Tumors: A 10-Year Single Center Experience.

Tropeano, Maria Pia / Rossini, Zefferino / Franzini, Andrea / Capo, Gabriele / Olei, Simone / De Robertis, Mario / Milani, Daniela / Fornari, Maurizio / Pessina, Federico

Cancers

2023 Volume 16, Issue 1

Abstract: Objective: The study aimed at evaluating the efficacy and the ability of D-wave monitoring combined with somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) to predict functional outcomes in intramedullary spinal cord tumor (IMSCT) ...

Abstract	Objective: The study aimed at evaluating the efficacy and the ability of D-wave monitoring combined with somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) to predict functional outcomes in intramedullary spinal cord tumor (IMSCT) surgery. Methods: Between December 2011 and December 2020, all patients harboring IMSCT who underwent surgery at our institution were prospectively collected in a surgical spinal registry and retrospectively analyzed. Patient charts and surgical and histological reports were analyzed. The multimodal IONM included SSEPs, MEPs, and-whenever possible-D-waves. All patients were evaluated using the modified McCormick and Frankel grade at admission and 3, 6, and 12 months of follow-up. Results: Sixty-four patients were enrolled in the study. SSEP and MEP monitoring was performed in all patients. The D-wave was not recordable in seven patients (11%). Significant IONM changes (at least one evoked potential modality) were registered in 26 (41%) of the 64 patients. In five cases (8%) where the SSEPs and MEPs lost and the D-wave permanently dropped by about 50%, patients experienced a permanent deterioration of their neurological status. Multimodal IONM (SSEP, MEP, and D-wave neuromonitoring) significantly predicted postoperative deficits ( Conclusion: The use of multimodal IONM showed a statistically significant greater ability to predict postoperative deficits compared with SSEP, MEP, and D-wave monitoring alone. D-wave recording significantly increased the accuracy and clinical value of neurophysiological monitoring in IMSCT tumor resection.
Language	English
Publishing date	2023-12-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16010111
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Article ; Online: Minimally invasive microsurgical decompression of the lumbar spine using a novel robotised digital microscope: A preliminary experience.

Rossini, Zefferino / Tropeano, Maria Pia / Franzini, Andrea / Bono, Beatrice C / Raspagliesi, Luca / Fornari, Maurizio / Pessina, Federico

The international journal of medical robotics + computer assisted surgery : MRCAS

2023 Volume 19, Issue 2, Page(s) e2498

Abstract: Background: The operative microscope (OM) represents, to date, the standard for neurosurgical procedures. However, new technologies have been proposed during the latest years to overcome its limitations, from high-quality exoscopes to complex robotised ... ...

Abstract	Background: The operative microscope (OM) represents, to date, the standard for neurosurgical procedures. However, new technologies have been proposed during the latest years to overcome its limitations, from high-quality exoscopes to complex robotised visualisation systems. We report our preliminary experience with a novel digital robotised microscope, the BHS RoboticScope (RS), for minimally invasive spinal surgery. Methods: We employed the RS in five consecutive patients who underwent bilateral lumbar spine decompression through a monolateral approach. Patient outcomes, device technical characteristics and the surgeon's personal perspectives have been evaluated. Results: No complications occurred. All procedures were concluded without switching to the microscope. Image quality, lightning, depth perception and freedom of movement were judged satisfactory as compared to the standard microscope. Conclusion: The easy maneuverability and the high quality of pictures provided by the RS device improve the surgeon's comfort in deep fields, representing an effective option for minimally invasive spinal procedures.
MeSH term(s)	Humans ; Lumbar Vertebrae/surgery ; Neurosurgical Procedures/methods ; Decompression, Surgical/methods ; Minimally Invasive Surgical Procedures/methods ; Treatment Outcome
Language	English
Publishing date	2023-02-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2151860-9
ISSN	1478-596X ; 1478-5951
ISSN (online)	1478-596X
ISSN	1478-5951
DOI	10.1002/rcs.2498
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Article ; Online: Proposal of a new score system (Cervical Surgical Score) for management of degenerative cervical myelopathy.

Costa, Francesco / Restelli, Francesco / Mazzapicchi, Elio / Rubiu, Emanuele / Bonomo, Giulio / Schiariti, Marco / Innocenti, Niccolò / Anania, Carla D / Cardia, Andrea / Fornari, Maurizio

Journal of neurosurgical sciences

2024

Abstract: Background: To date, no shared algorithms with the aim of guiding surgical strategy in complex cases of degenerative cervical myelopathy (DCM) exist. Our purpose is to present the Cervical Surgical Score (CSS) which could help in identifying complex DCM ...

Abstract	Background: To date, no shared algorithms with the aim of guiding surgical strategy in complex cases of degenerative cervical myelopathy (DCM) exist. Our purpose is to present the Cervical Surgical Score (CSS) which could help in identifying complex DCM cases, suggesting a surgical strategy. Methods: We created the CSS based on multidisciplinary and literature-focused discussions, based on eight parameters including number of levels of cervical pathology and myelopathy, type and predominance of compression and grade of clinical myelopathy. We prospectively enrolled surgical DCM patients in a 15-months period, collecting clinical and radiological data. During outpatient clinic a specific surgical indication was offered to DCM patients. To validate the score, each outpatient clinic surgical indication was compared a posteriori to the one that resulted from multidisciplinary CSS scoring, focusing on patients for which both an anterior and posterior approach were considered suitable. Results: A total of 100 patients operated on for DCM at our Institution between December 2021 and February 2023 were prospectively enrolled. In 53% of patients the pathology was present at more than two levels. According to CSS calculation, 14% of patients resulted in the "grey zone", where both an anterior and posterior approach were deemed feasible. Among them, in 42.8% of cases the CSS allowed a modification of the originally planned surgery. Looking at outcome, an improvement of m-JOA score in 62% of patients was disclosed. Conclusions: This preliminary study showed the reliability and usefulness of CSS in detecting complex DCM cases, requiring further analysis by expert spine surgeons, suggesting a surgical strategy.
Language	English
Publishing date	2024-03-19
Publishing country	Italy
Document type	Journal Article
ZDB-ID	193139-8
ISSN	1827-1855 ; 0390-5616 ; 0026-4881
ISSN (online)	1827-1855
ISSN	0390-5616 ; 0026-4881
DOI	10.23736/S0390-5616.23.06165-9
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Article ; Online: Erratum to: Skull Base Meningiomas: Is Surgical Resection Enough? Outcome Evaluation and Prognostic Factors Analysis in a Single-Center Cohort.

Pessina, Federico / Navarria, Pierina / Rossini, Zefferino / Clerici, Elena / Fornari, Maurizio / Politi, Letterio S / Scorsetti, Marta / Servadei, Franco

Journal of neurological surgery. Part A, Central European neurosurgery

2022 Volume 83, Issue 6, Page(s) e1

Language	English
Publishing date	2022-01-31
Publishing country	Germany
Document type	Journal Article ; Published Erratum
ZDB-ID	2651663-9
ISSN	2193-6323 ; 2193-6315
ISSN (online)	2193-6323
ISSN	2193-6315
DOI	10.1055/s-0042-1742725
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