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4. Cervical Spondylotic Myelopathy: World Federation of Neurosurgical Societies (WFNS) to the Italian Neurosurgical Society (SINch) Recommendations

Author

Francesco Costa, Carla Daniela Anania, Umberto Agrillo, Assietti Roberto, Bernucci Claudio, Bistazzoni Simona, Bongetta Daniele, Brembilla Carlo, Cappelletto Barbara, Cocciaro Ardico, Costella Giovanni Battista, De Falco Raffaele, De Rosa Andrea, Del Vecchio Carlo, Dobran Mauro, Fiorenza Vito, Garbossa Diego, Guizzardi Giancarlo, Iaccarino Corrado, Irace Claudio, Incerti Michele, Gualtiero Innocenzi, Landi Alessandro, Lastrucci Giancarlo, Maida Giuseppe, Mastrantuoni Ciro, Maugeri Rosario, Meglio Vincenzo, Montemurro Nicola, Nina Pierpaolo, Parlangeli Andrea, Pinna Giovanni, Pretti Pier Federico, Rapanà Armando, Ricci Alessandro, Rispoli Rossella, Romoli Stefano, Per Filippo Sbaffi, Somma Teresa, Tessitore Enrico, Vitali Matteo, Alberto Zerbi, Zona Gianluigi, and Andrea Barbanera

Subjects
cervical spondylotic myelopathy, recommendations, guidelines, evidence-based medicine, Neurology. Diseases of the nervous system, RC346-429
Abstract

Cervical spondylotic myelopathy (CSM) is a progressively growing pathology to afford by a spinal surgeon due to the aging of the population, associated with better treatment management and the best diagnosis and treatment solutions are greatly discussed. Nowadays that scientific literature is progressively increasing to identify the gold standard in diagnosis and treatment can be very challenging. This is particularly evident in spinal surgery with many different indications not only in different countries but also in the same local reality. In this scenario, many neurosurgical societies works to identify some guideline or recommendations to help spinal surgeons in daily practice. Furthermore, in an era in which legal issues are increasingly present in clinical practice to have some indications globally accepted can be very useful. World Federation of Neurosurgical Societies (WFNS) few years ago starts this process creating a list of recommendations originating from a worldwide steering committee to respect all the local reality. The spinal section of Italian Neurosurgical Society decides to adopt the WFNS recommendations with some revision basing on Italian scenario. The steering committee of the Spinal Section of Italian Neurosurgical Society identify 7 groups to review the literature of the last 10 years about different topics on CSM and to analyses the WFNS recommendations to adapt it to the Italian daily practice. The statements were discussed and voted in 2 sessions to obtain the final version. A list of recommendations on natural course and clinical presentation; diagnostic tests; conservative and surgical treatment; anterior, posterior and combined surgical treatment; role of neurophysiological monitoring and follow-up and outcome was created with only few new or revised statements respect the ones of WFNS. The Spine Section of Italian Neurosurgical Society create a list of recommendations that represent the more contemporary treatment concepts for CSM as presented in the highest quality clinical literature and best clinical practices available on this subject.

Published
2023
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5. Relationship between lumbar lordosis, pelvic parameters, PI-LL mismatch and outcome after short fusion surgery for lumbar degenerative disease. Literature review, rational and presentation of public study protocol: RELApSE study (registry for evaluation of lumbar arthrodesis sagittal alignEment)

Author

Tartara, Fulvio, Garbossa, Diego, Armocida, Daniele, Di Perna, Giuseppe, Ajello, Marco, Marengo, Nicola, Bozzaro, Marco, Petrone, Salvatore, Giorgi, Pietro Domenico, Schirò, Giuseppe Rosario, Legrenzi, Simona, Boeris, Davide, Piazzolla, Andrea, Passarelli, Anna Claudia, Longo, Alessandro, Ducati, Alessandro, Penner, Federica, Tancioni, Flavio, Bona, Alberto, Paternò, Giovanni, Tassorelli, Cristina, De Icco, Roberto, Lamaida, Giovanni Andrea, Gallazzi, Enrico, Pilloni, Giulia, Colombo, Elena Virginia, Gaetani, Paolo, Aimar, Enrico, Zoia, Cesare, Stefini, Roberto, Rusconi, Angelo, Querenghi, Amos M., Brembilla, Carlo, Bernucci, Claudio, Fanti, Andrea, Frati, Alessandro, Manelli, Antonio, Muzii, Vitaliano, Sedia, Mattia, Romano, Alberto, Baram, Ali, Figini, Silvia, Ballante, Elena, Gioia, Giuseppe, Locatelli, Marco, Pluderi, Mauro, Morselli, Carlotta, Bassani, Roberto, Costa, Francesco, and Cofano, Fabio

Published
2023
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12. Towards a common language in neurosurgical outcome evaluation: the NEON (NEurosurgical Outcome Network) proposal

Author

Ferroli, Paolo, Schiavolin, Silvia, Mariniello, Arianna, Acerbi, Francesco, Restelli, Francesco, Schiariti, Marco, LA Corte, Emanuele, Falco, Jacopo, Levi, Vincenzo, Dimeco, Francesco, Assietti, Roberto, Bongetta, Daniele, V Colombo, Elena, Bellocchi, Silvio, Sangiorgi, Simone, Bistazzoni, Simona, Polosa, Maria, I Orru, Maria, Spena, Giannantonio, Bernucci, Claudio, M Sicignano, Angelo, Fanti, Andrea, Brembilla, Carlo, Resmini, Bruno, Costi, Emanuele, Cenzato, Marco, Talamonti, Giuseppe, Bottini, Gabriella, Scarpa, Pina, Bollani, Alessandra, Querzola, Matteo, Palmas, Giulio, DE Gonda, Federico, Bosio, Lorenzo, Egidi, Marcello, Tardivo, Valentina, Fioravanti, Antonio, Subacchi, Sara, Fontanella, Marco, Biroli, Antonio, Cereda, Claudio, Paolo Panciani, Pier, Bergomi, Riccardo, Pertichetti, Marta, Tancioni, Flavio, Bona, Alberto, A Tartara, Fulvio, Fornari, Maurizio, Pessina, Federico, Lasio, Giovanni, Cardia, Andrea, Servadei, Franco, Riva, Marco, Casarotti, Alessandra, Giussani, Carlo, Fiori, Leonardo, Mazzoleni, Fabio, Vaiani, Simona, Carrabba, Giorgio, DI Cristofori, Andrea, P Sganzerla, Erik, Vimercati, Alberto, Isella, Valeria, Mauri, Ilaria, Incerti, Michele, Sicuri, Giovanni, Miramonti, Valentina, Stefini, Roberto, Spagnoli, Diego, Piparo, Maurizio, Grimod, Gianluca, Regazzoni, Rossana, Vismara, Daniela, Mazzeo, Lucio, Monti, Emanuele, Franzin, Alberto, Vivaldi, Oscar, Maietti, Alessandra, Pini, Elisa, Servello, Domenico, Zekaj, Edvin, DE Michele, Sara, Locatelli, Marco, Borsa, Stefano, Grimoldi, Nadia, Caroli, Manuela, Tariciotti, Leonardo, Abete-Fornara, Giorgia, Vitale, Mario, Leonardi, Matilde, Broggi, Morgan, Paolo Ferroli, Silvia Schiavolin, Arianna Mariniello, Francesco Acerbi, Francesco Restelli, Marco Schiariti, Emanuele LA Corte, Jacopo Falco, Vincenzo Levi, Francesco Dimeco, Roberto Assietti, Daniele Bongetta, Elena V Colombo, Silvio Bellocchi, Simone Sangiorgi, Simona Bistazzoni, Maria Polosa, Maria I Orru, Giannantonio Spena, Claudio Bernucci, Angelo M Sicignano, Andrea Fanti, Carlo Brembilla, Bruno Resmini, Emanuele Costi, Marco Cenzato, Giuseppe Talamonti, Gabriella Bottini, Pina Scarpa, Alessandra Bollani, Matteo Querzola, Giulio Palmas, Federico DE Gonda, Lorenzo Bosio, Marcello Egidi, Valentina Tardivo, Antonio Fioravanti, Sara Subacchi, Marco Fontanella, Antonio Biroli, Claudio Cereda, Pier Paolo Panciani, Riccardo Bergomi, Marta Pertichetti, Flavio Tancioni, Alberto Bona, Fulvio A Tartara, Maurizio Fornari, Federico Pessina, Giovanni Lasio, Andrea Cardia, Franco Servadei, Marco Riva, Alessandra Casarotti, Carlo Giussani, Leonardo Fiori, Fabio Mazzoleni, Simona Vaiani, Giorgio Carrabba, Andrea DI Cristofori, Erik P Sganzerla, Alberto Vimercati, Valeria Isella, Ilaria Mauri, Michele Incerti, Giovanni Sicuri, Valentina Miramonti, Roberto Stefini, Diego Spagnoli, Maurizio Piparo, Gianluca Grimod, Rossana Regazzoni, Daniela Vismara, Lucio Mazzeo, Emanuele Monti, Alberto Franzin, Oscar Vivaldi, Alessandra Maietti (ORCID:0000-0002-9819-7037), Elisa Pini, Domenico Servello, Edvin Zekaj, Sara DE Michele, Marco Locatelli, Stefano Borsa, Nadia Grimoldi, Manuela Caroli, Leonardo Tariciotti, Giorgia Abete-Fornara, Mario Vitale, Matilde Leonardi, Morgan Broggi, Ferroli, Paolo, Schiavolin, Silvia, Mariniello, Arianna, Acerbi, Francesco, Restelli, Francesco, Schiariti, Marco, LA Corte, Emanuele, Falco, Jacopo, Levi, Vincenzo, Dimeco, Francesco, Assietti, Roberto, Bongetta, Daniele, V Colombo, Elena, Bellocchi, Silvio, Sangiorgi, Simone, Bistazzoni, Simona, Polosa, Maria, I Orru, Maria, Spena, Giannantonio, Bernucci, Claudio, M Sicignano, Angelo, Fanti, Andrea, Brembilla, Carlo, Resmini, Bruno, Costi, Emanuele, Cenzato, Marco, Talamonti, Giuseppe, Bottini, Gabriella, Scarpa, Pina, Bollani, Alessandra, Querzola, Matteo, Palmas, Giulio, DE Gonda, Federico, Bosio, Lorenzo, Egidi, Marcello, Tardivo, Valentina, Fioravanti, Antonio, Subacchi, Sara, Fontanella, Marco, Biroli, Antonio, Cereda, Claudio, Paolo Panciani, Pier, Bergomi, Riccardo, Pertichetti, Marta, Tancioni, Flavio, Bona, Alberto, A Tartara, Fulvio, Fornari, Maurizio, Pessina, Federico, Lasio, Giovanni, Cardia, Andrea, Servadei, Franco, Riva, Marco, Casarotti, Alessandra, Giussani, Carlo, Fiori, Leonardo, Mazzoleni, Fabio, Vaiani, Simona, Carrabba, Giorgio, DI Cristofori, Andrea, P Sganzerla, Erik, Vimercati, Alberto, Isella, Valeria, Mauri, Ilaria, Incerti, Michele, Sicuri, Giovanni, Miramonti, Valentina, Stefini, Roberto, Spagnoli, Diego, Piparo, Maurizio, Grimod, Gianluca, Regazzoni, Rossana, Vismara, Daniela, Mazzeo, Lucio, Monti, Emanuele, Franzin, Alberto, Vivaldi, Oscar, Maietti, Alessandra, Pini, Elisa, Servello, Domenico, Zekaj, Edvin, DE Michele, Sara, Locatelli, Marco, Borsa, Stefano, Grimoldi, Nadia, Caroli, Manuela, Tariciotti, Leonardo, Abete-Fornara, Giorgia, Vitale, Mario, Leonardi, Matilde, Broggi, Morgan, Paolo Ferroli, Silvia Schiavolin, Arianna Mariniello, Francesco Acerbi, Francesco Restelli, Marco Schiariti, Emanuele LA Corte, Jacopo Falco, Vincenzo Levi, Francesco Dimeco, Roberto Assietti, Daniele Bongetta, Elena V Colombo, Silvio Bellocchi, Simone Sangiorgi, Simona Bistazzoni, Maria Polosa, Maria I Orru, Giannantonio Spena, Claudio Bernucci, Angelo M Sicignano, Andrea Fanti, Carlo Brembilla, Bruno Resmini, Emanuele Costi, Marco Cenzato, Giuseppe Talamonti, Gabriella Bottini, Pina Scarpa, Alessandra Bollani, Matteo Querzola, Giulio Palmas, Federico DE Gonda, Lorenzo Bosio, Marcello Egidi, Valentina Tardivo, Antonio Fioravanti, Sara Subacchi, Marco Fontanella, Antonio Biroli, Claudio Cereda, Pier Paolo Panciani, Riccardo Bergomi, Marta Pertichetti, Flavio Tancioni, Alberto Bona, Fulvio A Tartara, Maurizio Fornari, Federico Pessina, Giovanni Lasio, Andrea Cardia, Franco Servadei, Marco Riva, Alessandra Casarotti, Carlo Giussani, Leonardo Fiori, Fabio Mazzoleni, Simona Vaiani, Giorgio Carrabba, Andrea DI Cristofori, Erik P Sganzerla, Alberto Vimercati, Valeria Isella, Ilaria Mauri, Michele Incerti, Giovanni Sicuri, Valentina Miramonti, Roberto Stefini, Diego Spagnoli, Maurizio Piparo, Gianluca Grimod, Rossana Regazzoni, Daniela Vismara, Lucio Mazzeo, Emanuele Monti, Alberto Franzin, Oscar Vivaldi, Alessandra Maietti (ORCID:0000-0002-9819-7037), Elisa Pini, Domenico Servello, Edvin Zekaj, Sara DE Michele, Marco Locatelli, Stefano Borsa, Nadia Grimoldi, Manuela Caroli, Leonardo Tariciotti, Giorgia Abete-Fornara, Mario Vitale, Matilde Leonardi, and Morgan Broggi

Abstract

BACKGROUNDː To achieve a consensus on the minimum set of outcome measures and predictors to be used in the neurosurgical practice and on the timing of outcome assessment. METHODSː A consensus building approach was employed. All neurosurgical departments in Lombardy (Italy) were invited to participate by the Fondazione IRCCS Istituto Neurologico Carlo Besta. Three workshops were organized during which a multidisciplinary group called Neurosurgical Outcome Network (NEON) was created and the methodology to select outcome measures, predictors, and timing of outcome assessment was established. Eight working groups were created for the different neurosurgical diseases (neuro-oncological, skull base, vascular, traumatic, spinal, peripheral nervous system, malformation, functional) and 8 workshops were organized to identify the outcome measures and predictors specific for each of the neurosurgical diseases based on the experts’ clinical practice and the existing literature. RESULTSː A total of 20 neurosurgical departments participated in this study. Specific outcome measures, predictors and the timing of outcome assessment were identified for each of the 8 neurosurgical diseases. Moreover, a list of variables common to all pathologies were identified by the NEON group as further data to be collected. CONCLUSIONSː A consensus on the minimum set of outcome measures and predictors and the timing of outcome assessments for 8 neurosurgical diseases was achieved by a group of neurosurgeons of the Lombardy region, called NEON. These sets could be used in future studies for a more homogeneous data collection and as a starting point to reach further agreement also at national and international level.

Published
2023

13. Towards a common language in neurosurgical outcome evaluation: the NEON (NEurosurgical Outcome Network) proposal

Author

Ferroli, P, Schiavolin, S, Mariniello, A, Acerbi, F, Restelli, F, Schiariti, M, LA Corte, E, Falco, J, Levi, V, Dimeco, F, Assietti, R, Bongetta, D, Colombo, E, Bellocchi, S, Sangiorgi, S, Bistazzoni, S, Polosa, M, Orru, M, Spena, G, Bernucci, C, Sicignano, A, Fanti, A, Brembilla, C, Resmini, B, Costi, E, Cenzato, M, Talamonti, G, Bottini, G, Scarpa, P, Bollani, A, Querzola, M, Palmas, G, DE Gonda, F, Bosio, L, Egidi, M, Tardivo, V, Fioravanti, A, Subacchi, S, Fontanella, M, Biroli, A, Cereda, C, Panciani, P, Bergomi, R, Pertichetti, M, Tancioni, F, Bona, A, Tartara, F, Fornari, M, Pessina, F, Lasio, G, Cardia, A, Servadei, F, Riva, M, Casarotti, A, Giussani, C, Fiori, L, Mazzoleni, F, Vaiani, S, Carrabba, G, DI Cristofori, A, Sganzerla, E, Vimercati, A, Isella, V, Mauri, I, Incerti, M, Sicuri, G, Miramonti, V, Stefini, R, Spagnoli, D, Piparo, M, Grimod, G, Regazzoni, R, Vismara, D, Mazzeo, L, Monti, E, Franzin, A, Vivaldi, O, Maietti, A, Pini, E, Servello, D, Zekaj, E, DE Michele, S, Locatelli, M, Borsa, S, Grimoldi, N, Caroli, M, Tariciotti, L, Abete-Fornara, G, Vitale, M, Leonardi, M, Broggi, M, Ferroli, Paolo, Schiavolin, Silvia, Mariniello, Arianna, Acerbi, Francesco, Restelli, Francesco, Schiariti, Marco, LA Corte, Emanuele, Falco, Jacopo, Levi, Vincenzo, Dimeco, Francesco, Assietti, Roberto, Bongetta, Daniele, Colombo, Elena V, Bellocchi, Silvio, Sangiorgi, Simone, Bistazzoni, Simona, Polosa, Maria, Orru, Maria I, Spena, Giannantonio, Bernucci, Claudio, Sicignano, Angelo M, Fanti, Andrea, Brembilla, Carlo, Resmini, Bruno, Costi, Emanuele, Cenzato, Marco, Talamonti, Giuseppe, Bottini, Gabriella, Scarpa, Pina, Bollani, Alessandra, Querzola, Matteo, Palmas, Giulio, DE Gonda, Federico, Bosio, Lorenzo, Egidi, Marcello, Tardivo, Valentina, Fioravanti, Antonio, Subacchi, Sara, Fontanella, Marco, Biroli, Antonio, Cereda, Claudio, Panciani, Pier Paolo, Bergomi, Riccardo, Pertichetti, Marta, Tancioni, Flavio, Bona, Alberto, Tartara, Fulvio A, Fornari, Maurizio, Pessina, Federico, Lasio, Giovanni, Cardia, Andrea, Servadei, Franco, Riva, Marco, Casarotti, Alessandra, Giussani, Carlo, Fiori, Leonardo, Mazzoleni, Fabio, Vaiani, Simona, Carrabba, Giorgio, DI Cristofori, Andrea, Sganzerla, Erik P, Vimercati, Alberto, Isella, Valeria, Mauri, Ilaria, Incerti, Michele, Sicuri, Giovanni, Miramonti, Valentina, Stefini, Roberto, Spagnoli, Diego, Piparo, Maurizio, Grimod, Gianluca, Regazzoni, Rossana, Vismara, Daniela, Mazzeo, Lucio, Monti, Emanuele, Franzin, Alberto, Vivaldi, Oscar, Maietti, Alessandra, Pini, Elisa, Servello, Domenico, Zekaj, Edvin, DE Michele, Sara, Locatelli, Marco, Borsa, Stefano, Grimoldi, Nadia, Caroli, Manuela, Tariciotti, Leonardo, Abete-Fornara, Giorgia, Vitale, Mario, Leonardi, Matilde, Broggi, Morgan, Ferroli, P, Schiavolin, S, Mariniello, A, Acerbi, F, Restelli, F, Schiariti, M, LA Corte, E, Falco, J, Levi, V, Dimeco, F, Assietti, R, Bongetta, D, Colombo, E, Bellocchi, S, Sangiorgi, S, Bistazzoni, S, Polosa, M, Orru, M, Spena, G, Bernucci, C, Sicignano, A, Fanti, A, Brembilla, C, Resmini, B, Costi, E, Cenzato, M, Talamonti, G, Bottini, G, Scarpa, P, Bollani, A, Querzola, M, Palmas, G, DE Gonda, F, Bosio, L, Egidi, M, Tardivo, V, Fioravanti, A, Subacchi, S, Fontanella, M, Biroli, A, Cereda, C, Panciani, P, Bergomi, R, Pertichetti, M, Tancioni, F, Bona, A, Tartara, F, Fornari, M, Pessina, F, Lasio, G, Cardia, A, Servadei, F, Riva, M, Casarotti, A, Giussani, C, Fiori, L, Mazzoleni, F, Vaiani, S, Carrabba, G, DI Cristofori, A, Sganzerla, E, Vimercati, A, Isella, V, Mauri, I, Incerti, M, Sicuri, G, Miramonti, V, Stefini, R, Spagnoli, D, Piparo, M, Grimod, G, Regazzoni, R, Vismara, D, Mazzeo, L, Monti, E, Franzin, A, Vivaldi, O, Maietti, A, Pini, E, Servello, D, Zekaj, E, DE Michele, S, Locatelli, M, Borsa, S, Grimoldi, N, Caroli, M, Tariciotti, L, Abete-Fornara, G, Vitale, M, Leonardi, M, Broggi, M, Ferroli, Paolo, Schiavolin, Silvia, Mariniello, Arianna, Acerbi, Francesco, Restelli, Francesco, Schiariti, Marco, LA Corte, Emanuele, Falco, Jacopo, Levi, Vincenzo, Dimeco, Francesco, Assietti, Roberto, Bongetta, Daniele, Colombo, Elena V, Bellocchi, Silvio, Sangiorgi, Simone, Bistazzoni, Simona, Polosa, Maria, Orru, Maria I, Spena, Giannantonio, Bernucci, Claudio, Sicignano, Angelo M, Fanti, Andrea, Brembilla, Carlo, Resmini, Bruno, Costi, Emanuele, Cenzato, Marco, Talamonti, Giuseppe, Bottini, Gabriella, Scarpa, Pina, Bollani, Alessandra, Querzola, Matteo, Palmas, Giulio, DE Gonda, Federico, Bosio, Lorenzo, Egidi, Marcello, Tardivo, Valentina, Fioravanti, Antonio, Subacchi, Sara, Fontanella, Marco, Biroli, Antonio, Cereda, Claudio, Panciani, Pier Paolo, Bergomi, Riccardo, Pertichetti, Marta, Tancioni, Flavio, Bona, Alberto, Tartara, Fulvio A, Fornari, Maurizio, Pessina, Federico, Lasio, Giovanni, Cardia, Andrea, Servadei, Franco, Riva, Marco, Casarotti, Alessandra, Giussani, Carlo, Fiori, Leonardo, Mazzoleni, Fabio, Vaiani, Simona, Carrabba, Giorgio, DI Cristofori, Andrea, Sganzerla, Erik P, Vimercati, Alberto, Isella, Valeria, Mauri, Ilaria, Incerti, Michele, Sicuri, Giovanni, Miramonti, Valentina, Stefini, Roberto, Spagnoli, Diego, Piparo, Maurizio, Grimod, Gianluca, Regazzoni, Rossana, Vismara, Daniela, Mazzeo, Lucio, Monti, Emanuele, Franzin, Alberto, Vivaldi, Oscar, Maietti, Alessandra, Pini, Elisa, Servello, Domenico, Zekaj, Edvin, DE Michele, Sara, Locatelli, Marco, Borsa, Stefano, Grimoldi, Nadia, Caroli, Manuela, Tariciotti, Leonardo, Abete-Fornara, Giorgia, Vitale, Mario, Leonardi, Matilde, and Broggi, Morgan

Abstract

Background: The aim of this study was to achieve a consensus on the minimum set of outcome measures and predictors to be used in the neurosurgical practice and on the timing of outcome assessment. Methods: A consensus building approach was employed. All neurosurgical departments in Lombardy (Italy) were invited to participate by the Carlo Besta Neurologic Institute IRCCS Foundation. Three workshops were organized during which a multidisciplinary group called Neurosurgical Outcome Network (NEON) was created and the methodology to select outcome measures, predictors, and timing of outcome assessment was established. Eight working groups were created for the different neurosurgical diseases (neuro-oncological, skull base, vascular, traumatic, spinal, peripheral nervous system, malformation, functional) and 8 workshops were organized to identify the outcome measures and predictors specific for each of the neurosurgical diseases based on the experts' clinical practice and the existing literature. Results: A total of 20 neurosurgical departments participated in this study. Specific outcome measures, predictors and the timing of outcome assessment were identified for each of the 8 neurosurgical diseases. Moreover, a list of variables common to all pathologies were identified by the NEON group as further data to be collected. Conclusions: A consensus on the minimum set of outcome measures and predictors and the timing of outcome assessments for 8 neurosurgical diseases was achieved by a group of neurosurgeons of the Lombardy region, called NEON. These sets could be used in future studies for a more homogeneous data collection and as a starting point to reach further agreement also at national and international level.

Published
2023

14. Towards a common language in neurosurgical outcome evaluation: the NEON (NEurosurgical Outcome Network) proposal

Author

FERROLI, Paolo, primary, SCHIAVOLIN, Silvia, additional, MARINIELLO, Arianna, additional, ACERBI, Francesco, additional, RESTELLI, Francesco, additional, SCHIARITI, Marco, additional, LA CORTE, Emanuele, additional, FALCO, Jacopo, additional, LEVI, Vincenzo, additional, DIMECO, Francesco, additional, ASSIETTI, Roberto, additional, BONGETTA, Daniele, additional, COLOMBO, Elena V., additional, BELLOCCHI, Silvio, additional, SANGIORGI, Simone, additional, BISTAZZONI, Simona, additional, POLOSA, Maria, additional, ORRU, Maria I., additional, SPENA, Giannantonio, additional, BERNUCCI, Claudio, additional, SICIGNANO, Angelo M., additional, FANTI, Andrea, additional, BREMBILLA, Carlo, additional, RESMINI, Bruno, additional, COSTI, Emanuele, additional, CENZATO, Marco, additional, TALAMONTI, Giuseppe, additional, BOTTINI, Gabriella, additional, SCARPA, Pina, additional, BOLLANI, Alessandra, additional, QUERZOLA, Matteo, additional, PALMAS, Giulio, additional, DE GONDA, Federico, additional, BOSIO, Lorenzo, additional, EGIDI, Marcello, additional, TARDIVO, Valentina, additional, FIORAVANTI, Antonio, additional, SUBACCHI, Sara, additional, FONTANELLA, Marco, additional, BIROLI, Antonio, additional, CEREDA, Claudio, additional, PANCIANI, Pier Paolo, additional, BERGOMI, Riccardo, additional, PERTICHETTI, Marta, additional, TANCIONI, Flavio, additional, BONA, Alberto, additional, TARTARA, Fulvio A., additional, FORNARI, Maurizio, additional, PESSINA, Federico, additional, LASIO, Giovanni, additional, CARDIA, Andrea, additional, SERVADEI, Franco, additional, RIVA, Marco, additional, CASAROTTI, Alessandra, additional, GIUSSANI, Carlo, additional, FIORI, Leonardo, additional, MAZZOLENI, Fabio, additional, VAIANI, Simona, additional, CARRABBA, Giorgio, additional, DI CRISTOFORI, Andrea, additional, SGANZERLA, Erik P., additional, VIMERCATI, Alberto, additional, ISELLA, Valeria, additional, MAURI, Ilaria, additional, INCERTI, Michele, additional, SICURI, Giovanni, additional, MIRAMONTI, Valentina, additional, STEFINI, Roberto, additional, SPAGNOLI, Diego, additional, PIPARO, Maurizio, additional, GRIMOD, Gianluca, additional, REGAZZONI, Rossana, additional, VISMARA, Daniela, additional, MAZZEO, Lucio, additional, MONTI, Emanuele, additional, FRANZIN, Alberto, additional, VIVALDI, Oscar, additional, MAIETTI, Alessandra, additional, PINI, Elisa, additional, SERVELLO, Domenico, additional, ZEKAJ, Edvin, additional, DE MICHELE, Sara, additional, LOCATELLI, Marco, additional, BORSA, Stefano, additional, GRIMOLDI, Nadia, additional, CAROLI, Manuela, additional, TARICIOTTI, Leonardo, additional, ABETE-FORNARA, Giorgia, additional, VITALE, Mario, additional, LEONARDI, Matilde, additional, and BROGGI, Morgan, additional

Published
2023
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18. Clinical evaluation of hyponatremia and hypovolemia in critically ill adult neurologic patients: contribution of the use of cumulative balance of sodium

Author

Gritti, Paolo, Lanterna, Luigi Andrea, Rotasperti, Lidia, Filippini, Matteo, Cazzaniga, Simone, Brembilla, Carlo, Sarnecki, Tatyana, and Lorini, Ferdinando Luca

Subjects
Sodium in the body -- Physiological aspects -- Research, Hyponatremia -- Risk factors -- Diagnosis -- Research, Health
Abstract

Purpose Knowledge of the cumulative balance of sodium (CBS) is important for the diagnosis of salt disorders and water homeostasis and has the potential to predict hypovolemic status in acute neurological patients. However, an extensive application of the use of CBS is still lacking in the intensive care setting, where salt and water homeostasis represents a priority. Methods Records of consecutive series of acute neurological patients admitted to a neurointensive care unit over a 6-month period were retrospectively reviewed. CBS was calculated at the admission to the Emergency Department. Discrimination between cerebral salt-wasting syndrome (CSWS) and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was performed on the basis of the classical criteria. Additionally, we used the findings of a negative CBS exceeding 2 mEq/kg for the diagnosis of CSWS. Two independent clinicians who were blinded to the CBS results performed diagnosis of the causes of hyponatremia and estimated the daily volemic status of the patients on the basis of clinical parameters. Logistic regression analysis was used to determine the independent prognostic factors of hypovolemia. Results Thirty-five patients were studied for a total of 418 days. Four patients (11.4%) fitted the criteria of CSWS and three patients (8.5%) had SIADH. The unavailability of the CBS led to a wrong diagnosis in three of the eight hyponatremic patients (37.5%). The risk of developing hypovolemia in patients with negative CBS was 7.1 times higher (CI 3.86-13.06; p < 0.001). Multivariate analysis revealed that negative cumulative fluid balance, negative CBS > 2 mEq/kg, and CVP ≤ 5 cm [H.sub.2]O were independent prognostic factors for hypovolemia. Conclusions CBS is likely to be a useful parameter in the diagnosis of CSWS and a surrogate parameter for estimating hypovolemia in acute neurological patients. Keywords Cerebral salt-wasting syndrome * Syndrome of inappropriate antidiuretic hormone secretion * Cumulative balance of sodium * Hypovolemia, Introduction Critically ill adult neurologic patients have a high incidence of salt and water homeostasis disorders [1]. Hyponatremia is one of the most common of these disorders, and when associated [...]

Published
2014
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20. The use of inhaled nitric oxide and prone position in an ARDS patient with severe traumatic brain injury during spine stabilization

Author

Gritti, Paolo, Lanterna, Luigi Andrea, Re, Mariachiara, Martchenko, Svetlana, Olivotto, Paola, Brembilla, Carlo, and Agostinis, Cristina

Subjects
Injuries, Vecuronium, Nitric oxide, Brain injuries, Adult respiratory distress syndrome, Brain -- Injuries, Acute respiratory distress syndrome
Abstract

Author(s): Paolo Gritti [sup.1], Luigi Andrea Lanterna [sup.2], Mariachiara Re [sup.1], Svetlana Martchenko [sup.1], Paola Olivotto [sup.1], Carlo Brembilla [sup.2], Cristina Agostinis [sup.3], Guido Paganoni [sup.1], Ferdinando Luca Lorini [sup.4] [...], The use of inhaled nitric oxide in patients with traumatic brain injury, intracranial hypertension, and acute respiratory distress syndrome (ARDS) has been reported in an intensive care unit setting only in a few case reports. The use of the prone position for patients with traumatic brain injury and lung impairment has been reported only in selected cases. Here we report our experience with the use of both inhaled nitric oxide and the prone position together in the operating room in a patient with head injury and ARDS who underwent column stabilization.

Published
2013
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27. The importance and effectiveness of conservative treatment in Grisel's syndrome

Author

Viscone, Andrea, Brembilla, Carlo, and Gotti, Giacomo

Subjects
Nonsteroidal anti-inflammatory drugs -- Health aspects, Magnetic resonance imaging -- Usage, Dislocations -- Diagnosis -- Care and treatment -- Case studies, CT imaging -- Usage, Health
Abstract

Byline: Andrea. Viscone, Carlo. Brembilla, Giacomo. Gotti Dear Sir, Nontraumatic atlo-axial subluxation (AAS), known as well as Grisel's syndrome, is a rare condition occurring mainly in children as a result [...]

Published
2014

31. STA-MCA Bypass as a 'Bridge' to Pituitary Surgery in a Patient with an Adenoma Occluding the Internal Carotid Artery: Case Report and Review of the Literature

Author

Lanterna, Luigi A., Brembilla, Carlo, Signorelli, Antonio, Gritti, Paolo, Costi, Emanuele, Dorelli, Gianluigi, and Bernucci, Claudio

Subjects
Article Subject
Abstract

Occlusion of the intracranial internal carotid artery (ICA) by a pituitary adenoma with resulting cerebral ischemia is a very rare but devastating occurrence. The authors present a case in which a condition of symptomatic ICA occlusion due to a giant pituitary adenoma was successfully treated using a preliminary extraintracranial bypass as a “bridge” to the tumor removal. A 52-year-old patient presented with a minor stroke followed by pressure-dependent transient ischemic attacks consistent with a condition of hypoperfusion. MR imaging and a digital subtraction angiography revealed a pituitary adenoma occluding the ICA on the right side. He underwent a superficial temporal artery to middle cerebral artery (STA-MCA) bypass with the aim of revascularizing the ischemic hemisphere and reducing the risk of perioperative stroke or stroke evolution. The patient was subsequently operated on to remove the adenoma through a transsphenoidal approach. The postoperative course was uneventful and the patient has suffered no further ischemic events. When there are no emergency indications to decompress the optical pathways but the patient is at risk of impending stroke because of ICA occlusion, a two-step strategy consisting of a bypass and subsequent removal of the pituitary adenoma may be a valuable option.

Published
2015
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32. Disabling Orthostatic Headache after Penetrating Stonemason Pencil Injury to the Sacral Region

Author

Brembilla, Carlo, Lanterna, Luigi Andrea, Gritti, Paolo, Costi, Emanuele, Dorelli, Gianluigi, Moretti, Elena, and Bernucci, Claudio

Subjects
body regions, Article Subject
Abstract

Penetrating injuries to the spine, although less common than motor vehicle accidents and falls, are important causes of injury to the spinal cord. They are essentially of two varieties: gunshot or stab wounds. Gunshot injuries to the spine are more commonly described. Stab wounds are usually inflicted by knife or other sharp objects. Rarer objects causing incidental spinal injuries include glass fragments, wood pieces, chopsticks, nailguns, and injection needles. Just few cases of penetrating vertebral injuries caused by pencil are described. The current case concerns a 42-year-old man with an accidental penetrating stonemason pencil injury into the vertebral canal without neurological deficit. After the self-removal of the foreign object the patient complained of a disabling orthostatic headache. The early identification and treatment of the intracranial hypotension due to the posttraumatic cerebrospinal fluid (CSF) sacral fistulae were mandatory to avoid further neurological complications. In the current literature acute pattern of intracranial hypotension immediately after a penetrating injury of the vertebral column has never been reported.

Published
2015
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33. Extraintracranial Bypass as a Rescue Therapy for Symptomatic Flow Diverter Thrombosis

Author

Lanterna, Luigi A., Lunghi, Alessandro, Brembilla, Carlo, Gritti, Paolo, and Bernucci, Claudio

Subjects
Article Subject, cardiovascular diseases
Abstract

A 56-year-old female with a giant partially thrombosed unruptured carotid-ophthalmic aneurysm was treated with a Pipeline flow diverter. Three months after the procedure, in concomitance with the discontinuation of one of the antiplatelet medications, the patient suffered from a minor stroke and relapsing transient ischemic attacks. The angiography demonstrated the occlusion of the internal carotid artery, and a perfusion-weighted CT scan showed a condition of hypoperfusion. The patient underwent a double-barrel extraintracranial bypass. The postoperative course was uneventful and she has experienced no further ischemic events to date.

Published
2015
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34. Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection

Author

Brembilla, Carlo, Lanterna, Luigi Andrea, Risso, Andrea, Bonaldi, Giuseppe, Gritti, Paolo, Resmini, Bruno, and Viscone, Andrea

Subjects
Article Subject
Abstract

Candida osteomyelitis in the current literature is an emerging infection. The factors contributing to its emergence include a growing population of immunosuppressed patients, invasive surgeries, broad-spectrum antibiotics, injection drug users, and alcohol abuse. The diagnosis requires a high degree of suspicion. The insidious progression of infection and the nonspecificity of laboratory and radiologic findings may contribute to a delay in diagnosis. The current case concerns a 27-year-old man with a spinal cord injury who, after undergoing anterior cervical fixation and fusion surgery, developed postoperative systemic bacterial infection and required long-term antibiotic therapy. After six months, a CT scan demonstrated an almost complete anterior dislocation of the implants caused by massive bone destruction and reabsorption in Candida albicans infection. The patient underwent a second intervention consisting firstly of a posterior approach with C4–C7 fixation and fusion, followed by a second anterior approach with a corpectomy of C5 and C6, a tricortical bone grafting from the iliac crest, and C4–C7 plating. The antifungal therapy with fluconazole was effective without surgical debridement of the bone graft, despite the fact that signs of the bone graft being infected were seen from the first cervical CT scans carried out after one month.

Published
2014
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35. Spontaneous Regression after Extensive Recurrence of a Pediatric Cervical Spine Aneurysmal Bone Cyst

Author

Brembilla, Carlo, Lanterna, Luigi Andrea, Bosisio, Michela, Gritti, Paolo, Risso, Andrea, Signorelli, Antonio, and Biroli, Francesco

Subjects
Article Subject
Abstract

Aneurysmal bone cyst is a pseudotumoral lesion. Complete resection prior to selective arterial embolization seems to be the treatment of choice for the more extensive and destructive lesions. In these cases maintaining stability of the cervical spine is critical. This can be very challenging in children and adolescents in whom the axial skeleton is still growing. In this case a young girl presented with a voluminous cervical aneurysmal bone cyst encaging both vertebral arteries and spinal cord. The lesion was treated with aggressive surgical resection, followed by cervical vertebral fusion with instrumentation. After nine months the patient referred no pain and no neurological deficit. MRI scans showed an extensive local recurrence. The family of the young girl refused any other therapy and any other followup. The patients returned to our attention after five years with no pain and neurological deficit. Cervical spine radiographs and MRI scans showed a complete regression of the extensive local recurrence. In the literature, the possibility of spontaneous regression of residual part or local recurrence is reported. The case of this young girl provided the chance to attend a spontaneous regression in an extensive recurrence of aneurismal bone cyst.

Published
2014
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47. STA-MCA Bypass as a “Bridge” to Pituitary Surgery in a Patient with an Adenoma Occluding the Internal Carotid Artery: Case Report and Review of the Literature

Author

A. Lanterna, Luigi, Brembilla, Carlo, Signorelli, Antonio, Gritti, Paolo, Costi, Emanuele, Dorelli, Gianluigi, and Bernucci, Claudio

Abstract

Occlusion of the intracranial internal carotid artery (ICA) by a pituitary adenoma with resulting cerebral ischemia is a very rare but devastating occurrence. The authors present a case in which a condition of symptomatic ICA occlusion due to a giant pituitary adenoma was successfully treated using a preliminary extraintracranial bypass as a “bridge” to the tumor removal. A 52-year-old patient presented with a minor stroke followed by pressure-dependent transient ischemic attacks consistent with a condition of hypoperfusion. MR imaging and a digital subtraction angiography revealed a pituitary adenoma occluding the ICA on the right side. He underwent a superficial temporal artery to middle cerebral artery (STA-MCA) bypass with the aim of revascularizing the ischemic hemisphere and reducing the risk of perioperative stroke or stroke evolution. The patient was subsequently operated on to remove the adenoma through a transsphenoidal approach. The postoperative course was uneventful and the patient has suffered no further ischemic events. When there are no emergency indications to decompress the optical pathways but the patient is at risk of impending stroke because of ICA occlusion, a two-step strategy consisting of a bypass and subsequent removal of the pituitary adenoma may be a valuable option.

Published
2015
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48. Extraintracranial Bypass as a Rescue Therapy for Symptomatic Flow Diverter Thrombosis

Author

A. Lanterna, Luigi, Lunghi, Alessandro, Brembilla, Carlo, Gritti, Paolo, and Bernucci, Claudio

Abstract

A 56-year-old female with a giant partially thrombosed unruptured carotid-ophthalmic aneurysm was treated with a Pipeline flow diverter. Three months after the procedure, in concomitance with the discontinuation of one of the antiplatelet medications, the patient suffered from a minor stroke and relapsing transient ischemic attacks. The angiography demonstrated the occlusion of the internal carotid artery, and a perfusion-weighted CT scan showed a condition of hypoperfusion. The patient underwent a double-barrel extraintracranial bypass. The postoperative course was uneventful and she has experienced no further ischemic events to date.

Published
2015
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49. Updating superficial siderosis of the central nervous system: bleeding of a dorsal osteophyte into the subarachnoid space from a perforating artery.

Author

Brembilla C, Lanterna LA, Bonito V, Gardinetti M, Dorelli G, Rampini AD, Gritti P, and Bernucci C

Subjects
Arteries surgery, Central Nervous System surgery, Hemosiderin therapeutic use, Humans, Magnetic Resonance Imaging methods, Male, Middle Aged, Neurosurgical Procedures adverse effects, Osteophyte complications, Osteophyte diagnosis, Rupture, Siderosis diagnosis, Subarachnoid Space surgery, Osteophyte surgery, Siderosis surgery, Subarachnoid Hemorrhage etiology, Subarachnoid Hemorrhage surgery
Abstract

Superficial siderosis of the central nervous system (SSCNS) is an uncommon and often unrecognized disorder that results from recurrent and persistent bleeding into the subarachnoid space. Currently, there is no effective treatment for SSCNS. The identification and surgical resolution of the cause of bleeding remains the most reliable method of treatment, but the cause of bleeding is often not apparent. The identified sources of recurrent bleeding have typically included neoplasms, vascular malformations, brachial plexus or nerve root injury or avulsion, and previous head and spinal surgery. An association between recurrent bleeding in the CNS and dural abnormalities in the spine has recently been suggested. Dural tears have been identified in relation to a protruding disc or osteophyte. Also in these patients, the exact mechanism of bleeding remains unknown because of a lack of objective surgical data, even in patients who undergo neurosurgical procedures.The present case concerns a 48-year-old man who presented with longstanding symptoms of mild hearing loss and mild gait ataxia. A diagnosis of SSCNS was made in light of the patient's history and the findings on physical examination, imaging, and laboratory testing. MRI and CT detected a small calcific osteophyte in the anterior epidural space of T8-9. The patient underwent surgical removal of the bone spur and dural tear repair. During the surgery, the authors detected a perforating artery, which was on the osteophyte, that was bleeding into the subarachnoid space. This case shows a possible mechanism of chronic bleeding from an osteophyte into the subarachnoid space. In the literature currently available, a perforating artery on an osteophyte bleeding into the subarachnoid space has never been described in SSCNS.

Published
2018
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50. The use of a stand-alone interbody fusion cage in subaxial cervical spine trauma: a preliminary report.

Author

Brembilla C, Lanterna LA, Gritti P, Signorelli A, and Biroli F

Subjects
Adolescent, Adult, Cervical Vertebrae injuries, Female, Follow-Up Studies, Humans, Internal Fixators adverse effects, Male, Middle Aged, Treatment Outcome, Young Adult, Cervical Vertebrae surgery, Internal Fixators standards, Spinal Fusion methods
Abstract

Background: Anterior spinal surgery has a predominant role in the treatment of traumatic lesions of the subaxial cervical spine. Plating is considered indispensable to achieve stability but may cause dysphagia, dysphonia, and adjacent-level ossification. Zero-P (Synthes GmbH, Oberdorf, Switzerland), an anchored interdisc spacer, can be used without an associated plate. The present study aimed to test if this new implant would be associated with a low rate of dysphagia and other short-term complications compared with the standard for anterior spinal fusion surgery and would be able to achieve a solid fusion and maintain correct metamere alignment., Material and Methods: This is a preliminary presentation of a clinical case series of patients with subaxial cervical injuries who underwent anterior interbody fusion. From July 2009 until September 2011, 12 patients were treated with a Zero-P cage. The data for analysis included operating time compared with the standard for spinal fusion surgery with a cage plus plate construct, intraoperative blood loss, clinical and radiographic results, and complications., Results: In the postoperative period no patient had neurologic worsening. One patient experienced transient dysphonia and moderate dysphagia. All the patients were followed up for a minimum of 6 months (mean: 13 months; range: 6-27 months). Stability and fusion were obtained in all patients together with correct metamere alignment., Conclusion: We presented the preliminary results of a clinical case series. Our results support the initiation of prospective randomized trials with more patients and longer follow-up., (Georg Thieme Verlag KG Stuttgart · New York.)

Published
2015
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