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129 results on '"Muzii, VITALIANO FRANCESCO"'

2. Minimally invasive management of cervical spondylodiscitis. A multicenter experience.

Author

Segbedji, Felix Kossi Kouma, Mallereau, Charles-Henry, Dannhoff, Guillaume, Dembour, Victoria, Cebula, Helene, Ganau, Mario, Todeschi, Julien, Cerase, Alfonso, Muzii, Vitaliano Francesco, Zalaffi, Alessandro, Carangelo, Biagio Roberto, Moruzzi, Franco, Spatola, Giorgio, Zaed, Ismael, Cardia, Andrea, Romano, Antonio, Castellani, Paola, Tarantino, Francesca, and Chibbaro, Salvatore

Subjects
EPIDURAL space, MEDICAL sciences, LONGITUDINAL ligaments, SPINAL instability, DISEASE relapse
Abstract

The urgent etiological diagnosis represents the main management objective of cervical spondylodiscitis (CSD) to start as soon as possible antibiotic treatment to prevent neurological deterioration. The present study aimed to evaluate a multicenter experience implementing a minimally invasive surgical approach (MISA) to manage CSD such pathology vs the most complex and aggressive surgical strategies currently used.This retrospective multicenter study used a database of 70 patients from five European neurosurgical centers. Patients with primary CSD underwent MISA via a limited funnel shaped cervical microdiscectomy with 4-mm anterior and 6-mm posterior longitudinal ligaments incision, PUS drainage, and extensive washing of the interbody and epidural space without fusion. Diagnosis was confirmed by clinical, imaging, laboratory, and perioperative histopathology and bacteriology.Of the 70 patients, 41 were men (58,5%), with an average age of 47.67 years. Severe neck pain affected 45 patients, while 51 had single-level cervical spondylodiscitis, 14 had double-level, and 5 had triple-level involvement. Staphylococcus aureus was identified in 49 cases. Each patient received a mean of three months of antibiotics. Inflammatory markers (C-reactive protein) were moderate for four weeks, then normalized by 8–12 weeks, except in one recurrence. After an average 48-month follow-up, all patients fully recovered without neurological deficit, spinal instability, or kyphotic deformity. Radiological exams confirmed bony fusion, with no recurrences of infection. MISA treatment offers a valuable, stable, and less invasive option for treating CSD, effectively identifying causative microorganisms and decompressing the spinal cord, leading to excellent patient outcomes. [ABSTRACT FROM AUTHOR]

Published
2025
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4. Effects of the COVID-19 Pandemic on Everyday Neurosurgical Practice in Alsace, France: Lessons Learned, Current Perspectives, and Future Challenges—Preliminary Results of a Longitudinal Multicentric Study Registry.

Author

Dannhoff, Guillaume, Mallereau, Charles-Henry, Ganau, Mario, Carangelo, Biagio Roberto, Spatola, Giorgio, Todeschi, Julien, Prisco, Lara, Maduri, Rodolfo, Santin, Marie des Neiges, Woelffel, Sandrine, Mastrobuono, Isabella, Voirin, Jimmy, Moruzzi, Franco, Nannavecchia, Beniamino, Muzii, Vitaliano Francesco, Zalaffi, Alessandro, Bruno, Carmen, and Chibbaro, Salvatore

Subjects
COVID-19 pandemic, TASK shifting, SURGICAL intensive care, INTENSIVE care units, LONGITUDINAL method, SPINAL surgery
Abstract

Background and Objectives: The global outbreak caused by the SARS-CoV-2 pandemic disrupted healthcare worldwide, impacting the organization of intensive care units and surgical care units. This study aimed to document the daily neurosurgical activity in Alsace, France, one of the European epicenters of the pandemic, and provide evidence of the adaptive strategies deployed during such a critical time for healthcare services. Materials and Methods: The multicentric longitudinal study was based on a prospective cohort of patients requiring neurosurgical care in the Neurosurgical Departments of Alsace, France, between March 2020 and March 2022. Surgical activity was compared with pre-pandemic performances through data obtained from electronic patient records. Results: A total of 3842 patients benefited from care in a neurosurgical unit during the period of interest; 2352 of them underwent surgeries with a wide range of pathologies treated. Surgeries were initially limited to neurosurgical emergencies only, then urgent cases were slowly reinstated; however, a significant drop in surgical volume and case mix was noticed during lockdown (March–May 2020). The crisis continued to impact surgical activity until March 2022; functional procedures were postponed, though some spine surgeries could progressively be performed starting in October 2021. Various social factors, such as increased alcohol consumption during the pandemic, influenced the severity of traumatic pathologies. The progressive return to the usual profile of surgical activity was characterized by a rebound of oncological interventions. Deferrable procedures for elective spinal and functional pathologies were the most affected, with unexpected medical and social impacts. Conclusions: The task shifting and task sharing approaches implemented during the first wave of the pandemic supported the reorganization of neurosurgical care in its aftermath and enabled the safe and timely execution of a broad spectrum of surgeries. Despite the substantial disruption to routine practices, marked by a significant reduction in elective surgical volumes, comprehensive records demonstrate the successful management of the full range of neurosurgical pathologies. This underscores the efficacy of adaptive strategies in navigating the challenges imposed by the largest healthcare crisis in recent history. Those lessons will continue to provide valuable insights and guidance for health and care managers to prepare for future unpredictable scenarios. [ABSTRACT FROM AUTHOR]

Published
2024
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