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Lofrese G, Cultrera F, Ricciardi L, Visani J, Tosatto L, Ruggiero M, Haznedari N, Menetti F. Preoperative elastoplasty of aggressive vertebral hemangiomas in elderly patients: a new strategy for reducing intraoperative bleeding and complications. Eur Spine J 2024:10.1007/s00586-024-08201-0. [PMID: 38491218 DOI: 10.1007/s00586-024-08201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Preoperative elastoplasty could be an alternative strategy for treating aggressive vertebral hemangiomas (VHs) in frail patients needing for spinal cord decompression, combining the advantages of embolization and vertebroplasty. METHODS Three elderly patients with spinal cord compression from thoracic aggressive VHs underwent XperCT-guided percutaneous injection of silicone (VK100), filling the whole affected vertebra, followed by a decompressive laminectomy. At 12-months follow-up no recurrences, vertebral collapse or segmental kyphosis were noted at the CT scans, with patients reporting an improvement of preoperative neurological deficits, VAS and Smiley-Webster pain scale (SWPS) parameters. RESULTS With its elastic modulus, non-exothermic hardening, and lower viscosity than PMMA, VK100 allowed a preoperative augmentation of the affected vertebral body, pedicles, and laminae without complications, with a controlled silicone delivery even in part of VH's epidural components thanks to XperCT-guidance. CONCLUSION When facing highly bony erosive VH encroaching the spinal canal, VK100 combines the advantages of embolization and vertebroplasty especially in elderly patients, permeating the whole VH's angioarchitecture, significantly reducing tumor.
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Affiliation(s)
- Giorgio Lofrese
- Neurosurgery Division, "M. Bufalini" Hospital, Viale Ghirotti 286, 47521, Cesena, Italy
| | - Francesco Cultrera
- Neurosurgery Division, "M. Bufalini" Hospital, Viale Ghirotti 286, 47521, Cesena, Italy
| | - Luca Ricciardi
- Neurosurgery Division, Sapienza University, Via di Grottarossa 1035, Rome, Italy.
| | - Jacopo Visani
- Neurosurgery Division, "M. Bufalini" Hospital, Viale Ghirotti 286, 47521, Cesena, Italy
| | - Luigino Tosatto
- Neurosurgery Division, "M. Bufalini" Hospital, Viale Ghirotti 286, 47521, Cesena, Italy
| | - Maria Ruggiero
- Neuroradiology Division, "M. Bufalini" Hospital, Viale Ghirotti 286, 47521, Cesena, Italy
| | - Nicolò Haznedari
- Neuroradiology Division, "M. Bufalini" Hospital, Viale Ghirotti 286, 47521, Cesena, Italy
| | - Federico Menetti
- Neuroradiology Division, "M. Bufalini" Hospital, Viale Ghirotti 286, 47521, Cesena, Italy
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Milani D, Zaed I, Ricciardi L, Chibbaro S, Venier A, Marchi F, Ganau M, Cardia A. Defining the Learning Curve of the Exoscope in Spine Surgery. World Neurosurg 2024; 182:e1-e4. [PMID: 38097168 DOI: 10.1016/j.wneu.2023.12.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024]
Abstract
INTRODUCTION In recent years, introduction of the exoscope system has been responsible for a new era of optics in surgery. Such a system has started to be widely used in neurosurgery. More recently, the exoscope has also been increasingly used for spinal procedures. Thus, we aimed to explore the potential for exoscope-assisted spinal procedures and define the advantages and drawbacks of implementing the system into our daily routine. METHODS To achieve the aim of the study, we retrospectively reviewed the case series of patients treated by a senior surgeon and analyzed the results, complications, and operative time. The operating times were compared between the exoscope-assisted procedures and microscope-assisted procedures. RESULTS A total of 24 spinal procedure were performed with the exoscope in a 2-month period. In this first patient series performed by a single surgeon without experience with the exoscope, the learning curve seemed to be relatively low, with mastery of the instrument achieved after the performance of only a few cases. Comparing the cases after the plateau of the learning curve had been reached with those performed during the still active phase of the learning curve, a significant difference was found in the operative times. No statistically significant difference was detected in terms of blood loss or intraoperative complications. CONCLUSIONS Based on our first experience, use of the exoscope shows promising potential for opening up new frontiers in spinal microsurgery. In addition, it has a low learning curve for experienced surgeons.
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Affiliation(s)
- Davide Milani
- Deparment of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Ismail Zaed
- Deparment of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.
| | - Luca Ricciardi
- Department of Neuroscience, Mental Health and Sense Organs, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Salvatore Chibbaro
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - Alice Venier
- Deparment of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Francesco Marchi
- Deparment of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Mario Ganau
- Department of Neurosurgery, John Radcliffe Hospital, Headley Way, Oxford, UK
| | - Andrea Cardia
- Deparment of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
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Menegatti M, Del Villano N, Scerrati A, Travaglini F, Ricciardi L, Lofrese G, Cavallo MA, De Bonis P. The neurosurgical outpatient clinic: comparison between accesses in public and private activities. BMC Health Serv Res 2024; 24:137. [PMID: 38267935 PMCID: PMC10809444 DOI: 10.1186/s12913-024-10571-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 01/05/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Neurosurgical clinic assesses presence and extent of pathologies of central and peripheral nervous system or disorders affecting the spine, to identify most effective treatment and possible recourse to surgery. The aim of the study is to evaluate the appropriateness of request for a neurosurgical consult both in private and in public outpatient clinics. MATERIALS AND METHODS We collected and analyzed all the reports of outpatient visits of public and private clinic over a period between January and December 2018. RESULTS There were 0.62% real urgent visits in the public sector and 1.19% in the private sector (p = 0.05). Peripheral pathologies represented 12.53% and 6.21% of pathologies evaluated in public and private sector respectively (p < 0.00001). In addition, 15.76% of visits in public lead to surgery, while they represented 11.45% in private (p = 0.0003). CONCLUSIONS No study is available comparing accesses of patients in neurosurgical outpatient clinics. In public clinic, visits are booked as urgent on the prescription of the general practitioner: in reality, only 5% of these visits were really confirmed as urgent by the specialist. Peripheral pathologies are more frequent in public clinic, while cranial pathologies are more frequent in private one. Patients with cranial pathologies prefer to choose their surgeon by accessing private clinic.
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Affiliation(s)
- Marta Menegatti
- Neurosurgery Sant'Anna University Hospital of Ferrara, Ferrara, Italy.
- Department of Translational Medicine University of Ferrara, Ferrara, Italy.
| | | | - Alba Scerrati
- Neurosurgery Sant'Anna University Hospital of Ferrara, Ferrara, Italy
- Department of Translational Medicine University of Ferrara, Ferrara, Italy
| | - Francesco Travaglini
- Neurosurgery Sant'Anna University Hospital of Ferrara, Ferrara, Italy
- Department of Translational Medicine University of Ferrara, Ferrara, Italy
| | - Luca Ricciardi
- NESMOS Department Sapienza University of Rome, Rome, Italy
| | - Giorgio Lofrese
- Department of Neurosciences, Neurosurgery Division "M Bufalini" Hospital Cesena, Cesena, Italy
| | - Michele Alessandro Cavallo
- Neurosurgery Sant'Anna University Hospital of Ferrara, Ferrara, Italy
- Department of Translational Medicine University of Ferrara, Ferrara, Italy
| | - Pasquale De Bonis
- Neurosurgery Sant'Anna University Hospital of Ferrara, Ferrara, Italy
- Department of Translational Medicine University of Ferrara, Ferrara, Italy
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Miscusi M, Serrao M, Ricciardi L, Conte C, Castiglia SF, Ippolito G, Coppola G, Forcato S, Scerrati A, Raco A. Gait analysis, trunk movements, and electromyographic patterns after minimally invasive spine surgery for lumbar instability: An observational prospective study. World Neurosurg X 2024; 21:100262. [PMID: 38193093 PMCID: PMC10772388 DOI: 10.1016/j.wnsx.2023.100262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 11/28/2023] [Indexed: 01/10/2024] Open
Abstract
Objective The aim of the present study was to investigate trunk kinematics and spine muscle activation during walking after minimally invasive surgery in patients with L4-L5 degenerative spondylolisthesis suffering from lumbar instability (LI). Methods Eleven patients suffering from LI and 13 healthy controls (HC) were enrolled. Trunk kinematics and spine muscle activation patterns during walking were collected. Maximal trunk ranges of motion were also recorded from standing position. Assessments were performed pre-operatively (T0), 1 month (T1) and 3 months (T2) after MIS. Results We found significant improvement in spine muscle activation during walking at T2 compared to T0, mainly involving right/left symmetry at the operated level (L4-L5) and up-down synchronization from L3 to S1. Significant improvements in trunk rotation nearing to the HC group during walking were also found at T2 after surgery, though no changes were observed in the maximal range of motion of the trunk during standing. Furthermore, trunk rotation improvement correlated with a lower grade of residual disability. Conclusions Our findings indicate that trunk rotation improves after surgery, and impaired aspects of spine muscle activation can be improved with surgery. These biomechanical parameters could represent novel tools for monitoring the effect of surgery in LI and preventing impaired spine mobility and muscle activation.
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Affiliation(s)
- Massimo Miscusi
- Department of NESMOS, Sapienza University, via di Grottarossa 1035-1039, Rome, Italy
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza, University of Rome – Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
- Movement Analysis LAB, Policlinico Italia, Piazza del Campidano 6, 00162, Rome Italy
| | - Luca Ricciardi
- Department of NESMOS, Sapienza University, via di Grottarossa 1035-1039, Rome, Italy
| | - Carmela Conte
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza, University of Rome – Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
- Movement Analysis LAB, Policlinico Italia, Piazza del Campidano 6, 00162, Rome Italy
| | - Stefano Filippo Castiglia
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza, University of Rome – Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Giorgio Ippolito
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza, University of Rome – Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Gianluca Coppola
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza, University of Rome – Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Stefano Forcato
- UO di Neurochirurgia, Pia Fondazione di Culto e Religione Cardinale G. Panico, Via San Pio X 4, 73039, Tricase, Italy
| | - Alba Scerrati
- Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale, Università di Ferrara, via Luigi Borsari 46, 44121 Ferrara, Italy
| | - Antonino Raco
- Department of NESMOS, Sapienza University, via di Grottarossa 1035-1039, Rome, Italy
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Lembo S, Raimondo A, Balestrino A, Ricciardi L, Di Caprio R, Balato A, Stellato C. AUF-1 and skin inflammation: Atopic dermatitis and psoriasis. J Eur Acad Dermatol Venereol 2024; 38:e110-e112. [PMID: 37611276 DOI: 10.1111/jdv.19463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023]
Affiliation(s)
- Serena Lembo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Annunziata Raimondo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Alessia Balestrino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Luca Ricciardi
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Roberta Di Caprio
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Anna Balato
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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Salvato I, Ricciardi L, Nucera F, Nigro A, Dal Col J, Monaco F, Caramori G, Stellato C. RNA-Binding Proteins as a Molecular Link between COPD and Lung Cancer. COPD 2023; 20:18-30. [PMID: 36655862 DOI: 10.1080/15412555.2022.2107500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) represents an independent risk factor for lung cancer development. Accelerated cell senescence, induced by oxidative stress and inflammation, is a common pathogenic determinant of both COPD and lung cancer. The post transcriptional regulation of genes involved in these processes is finely regulated by RNA-binding proteins (RBPs), which regulate mRNA turnover, subcellular localization, splicing and translation. Multiple pro-inflammatory mediators (including cytokines, chemokines, proteins, growth factors and others), responsible of lung microenvironment alteration, are regulated by RBPs. Several mouse models have shown the implication of RBPs in multiple mechanisms that sustain chronic inflammation and neoplastic transformation. However, further studies are required to clarify the role of RBPs in the pathogenic mechanisms shared by lung cancer and COPD, in order to identify novel biomarkers and therapeutic targets. This review will therefore focus on the studies collectively indicating the role of RBPs in oxidative stress and chronic inflammation as common pathogenic mechanisms shared by lung cancer and COPD.
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Affiliation(s)
- Ilaria Salvato
- Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Italy
| | - Luca Ricciardi
- Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Italy
| | - Francesco Nucera
- Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Italy
| | - Annunziata Nigro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Jessica Dal Col
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Francesco Monaco
- Chirurgia Toracica, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Italy
| | - Gaetano Caramori
- Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Italy
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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Appanna R, Gargano D, Caputo A, De Bartolomeis F, Ricciardi L, Santonicola A, Stefanelli B, Caiazza L, Guarciariello M, D'Antonio A, D'Auria R, Conti V, Casolaro V, Iovino P. Changes in mucosal IgG4 +- and IL-10 +-cell frequencies in adults with eosinophilic esophagitis on a two-food elimination diet. Clin Immunol 2023; 257:109853. [PMID: 38013163 DOI: 10.1016/j.clim.2023.109853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
Eosinophilic esophagitis (EoE) is increasingly diagnosed in patients with dysphagia. Type-2 immunity can induce EoE histopathology via non-IgE-dependent mechanisms, possibly involving IgG4 and IL-10. To elucidate the contribution of this response to EoE pathogenesis, we examined its association with clinical and histologic endpoints in adult EoE patients given a two-food elimination diet. IgG4- and IL-10-expressing cells were counted in esophageal biopsies and serum food-specific IgG4 measured at baseline and follow-up. Variables were correlated with histologic measures of disease activity. Patients exhibited significant reduction in esophageal eosinophilia and overall histology. A significant decrease in IL-10+-cell frequencies correlated with histologic changes. In contrast, a decline in serum and esophageal IgG4, while substantial, did not correlate with IL-10+-cell frequencies or histologic parameters. These results suggest a critical role of IL-10 in EoE pathogenesis. Conversely, IgG4 expression, while reflecting exposure to food antigens, is not obviously related to EoE histopathology or IL-10 expression.
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Affiliation(s)
- Ramapraba Appanna
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | | | - Alessandro Caputo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy; San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | | | - Luca Ricciardi
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Antonella Santonicola
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy; San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Berenice Stefanelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Laura Caiazza
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | | | - Antonio D'Antonio
- San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Raffaella D'Auria
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy; San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Vincenzo Casolaro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy; San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy.
| | - Paola Iovino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy; San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy.
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Cecchini E, Schino S, Gambadoro N, Ricciardi L, Trio O, Biondi-Zoccai G, Sangiorgi G. Facing the pandemic with a smile: the case of Memedical and its impact on cardiovascular professionals. Minerva Cardiol Angiol 2023; 71:475-484. [PMID: 36305775 DOI: 10.23736/s2724-5683.22.06079-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
Since its outbreak, the Coronavirus disease 2019 (COVID-19) has profoundly changed the world we were acquainted with. After the first known contact with humankind in Wuhan, China, in December 2019, the reckless spread of such pathogen put the healthcare system to the test, leading to harmful consequences affecting human lives in every aspect. As of February 2022, the death toll amounts to almost 6 million deaths, but the pathogenic profile of SARS-CoV-2 goes way beyond the mere biological interaction between the viral particle and our organism. People had to deal with the severe psychological impact caused by the only available weapon to fight this infection, i.e., social distancing. The human psychological profile has been strained with repercussions we still are unaware of nowadays. Healthcare professionals were among the most hit categories, not only because of the quarantine but above all for the situations they had to bear every day, constantly facing desperation, death, isolation, and rage. In such circumstances, social media represented a powerful shelter, giving people the ability to keep in contact and to feel connected even if miles apart. In our country, the power of communication was strongly emphasized by launching an Italian Facebook group called "Memedical," where members can share ironic memes to feel closer and give a glimmer of happiness in such a challenging moment. Our review highlights the severity of this pandemic's impact, deteriorating the global population's physical and mental health, and shows how wise use of social media can benefit the quality of life.
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Affiliation(s)
| | - Sofia Schino
- Division of Cardiology, Tor Vergata University, Rome, Italy
| | - Nicola Gambadoro
- Division of Cardiology, G. Fogliani Hospital, Milazzo, Messina, Italy
| | - Luca Ricciardi
- Division of Neurosurgery, Department of NESMOS, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Olimpia Trio
- Division of Cardiology, University Hospital Gaetano Martino, Messina, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
- Mediterranea Cardiocentro, Naples, Italy
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Lofrese G, Trungu S, Scerrati A, De Bonis P, Cultrera F, Mongardi L, Montemurro N, Piazza A, Miscusi M, Tosatto L, Raco A, Ricciardi L. Two-Level Corpectomy and Fusion vs. Three-Level Anterior Cervical Discectomy and Fusion without Plating: Long-Term Clinical and Radiological Outcomes in a Multicentric Retrospective Analysis. Life (Basel) 2023; 13:1564. [PMID: 37511938 PMCID: PMC10381458 DOI: 10.3390/life13071564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/23/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) represent effective alternatives in the management of multilevel cervical spondylotic myelopathy (CSM). A consensus on which of these techniques should be used is still missing. METHODS The databases of three centers were reviewed (January 2011-December 2018) for patients with three-level CSM, who underwent three-level ACDF without plating or two-level ACCF with expandable cage (VBRC) or mesh (VBRM). Demographic data, surgical strategy, complications, and implant failure were analyzed. The Neck Disability Index (NDI), the Visual Analog Scale (VAS), and the cervical lordosis were compared between the two techniques at 3 and 12 months. Logistic regression analyses investigated independent factors influencing clinical and radiological outcomes. RESULTS Twenty-one and twenty-two patients were included in the ACDF and ACCF groups, respectively. The median follow-up was 18 months. ACDFs were associated with better clinical outcomes at 12 months (NDI: 8.3% vs. 19.3%, p < 0.001; VAS: 1.3 vs. 2.6, p = 0.004), but with an increased risk of loss of lordosis correction ≥ 1° (OR = 4.5; p = 0.05). A higher complication rate in the ACDF group (33.3% vs. 9.1%; p = 0.05) was recorded, but it negatively influenced only short-term clinical outcomes. ACCFs with VBRC were associated with a higher risk of major complications but ensured better 12-month lordosis correction (p = 0.002). No significant differences in intraoperative blood loss were noted. CONCLUSIONS Three-level ACDF without plating was associated with better clinical outcomes than two-level ACCF despite worse losses in lordosis correction, which is ideal for fragile patients without retrovertebral compressions. In multilevel CSM, the relationship between the degree of lordosis correction and clinical outcome advantages still needs to be investigated.
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Affiliation(s)
| | - Sokol Trungu
- NESMOS Department, "Sapienza" University of Rome, Sant'Andrea Hospital, 00185 Rome, Italy
- Neurosurgery Unit, Cardinale G. Panico Hospital, 73039 Tricase, Italy
| | - Alba Scerrati
- Department of Neurosurgery, S. Anna University Hospital, 44124 Ferrara, Italy
| | - Pasquale De Bonis
- Department of Neurosurgery, S. Anna University Hospital, 44124 Ferrara, Italy
| | | | - Lorenzo Mongardi
- Department of Neurosurgery, S. Anna University Hospital, 44124 Ferrara, Italy
| | | | - Amedeo Piazza
- NESMOS Department, "Sapienza" University of Rome, Sant'Andrea Hospital, 00185 Rome, Italy
| | - Massimo Miscusi
- NESMOS Department, "Sapienza" University of Rome, Sant'Andrea Hospital, 00185 Rome, Italy
| | | | - Antonino Raco
- NESMOS Department, "Sapienza" University of Rome, Sant'Andrea Hospital, 00185 Rome, Italy
| | - Luca Ricciardi
- NESMOS Department, "Sapienza" University of Rome, Sant'Andrea Hospital, 00185 Rome, Italy
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10
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Salvato I, Ricciardi L, Dal Col J, Nigro A, Giurato G, Memoli D, Sellitto A, Lamparelli EP, Crescenzi MA, Vitale M, Vatrella A, Nucera F, Brun P, Caicci F, Dama P, Stiff T, Castellano L, Idrees S, Johansen MD, Faiz A, Wark PA, Hansbro PM, Adcock IM, Caramori G, Stellato C. Expression of targets of the RNA-binding protein AUF-1 in human airway epithelium indicates its role in cellular senescence and inflammation. Front Immunol 2023; 14:1192028. [PMID: 37483631 PMCID: PMC10360199 DOI: 10.3389/fimmu.2023.1192028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction The RNA-binding protein AU-rich-element factor-1 (AUF-1) participates to posttranscriptional regulation of genes involved in inflammation and cellular senescence, two pathogenic mechanisms of chronic obstructive pulmonary disease (COPD). Decreased AUF-1 expression was described in bronchiolar epithelium of COPD patients versus controls and in vitro cytokine- and cigarette smoke-challenged human airway epithelial cells, prompting the identification of epithelial AUF-1-targeted transcripts and function, and investigation on the mechanism of its loss. Results RNA immunoprecipitation-sequencing (RIP-Seq) identified, in the human airway epithelial cell line BEAS-2B, 494 AUF-1-bound mRNAs enriched in their 3'-untranslated regions for a Guanine-Cytosine (GC)-rich binding motif. AUF-1 association with selected transcripts and with a synthetic GC-rich motif were validated by biotin pulldown. AUF-1-targets' steady-state levels were equally affected by partial or near-total AUF-1 loss induced by cytomix (TNFα/IL1β/IFNγ/10 nM each) and siRNA, respectively, with differential transcript decay rates. Cytomix-mediated decrease in AUF-1 levels in BEAS-2B and primary human small-airways epithelium (HSAEC) was replicated by treatment with the senescence- inducer compound etoposide and associated with readouts of cell-cycle arrest, increase in lysosomal damage and senescence-associated secretory phenotype (SASP) factors, and with AUF-1 transfer in extracellular vesicles, detected by transmission electron microscopy and immunoblotting. Extensive in-silico and genome ontology analysis found, consistent with AUF-1 functions, enriched RIP-Seq-derived AUF-1-targets in COPD-related pathways involved in inflammation, senescence, gene regulation and also in the public SASP proteome atlas; AUF-1 target signature was also significantly represented in multiple transcriptomic COPD databases generated from primary HSAEC, from lung tissue and from single-cell RNA-sequencing, displaying a predominant downregulation of expression. Discussion Loss of intracellular AUF-1 may alter posttranscriptional regulation of targets particularly relevant for protection of genomic integrity and gene regulation, thus concurring to airway epithelial inflammatory responses related to oxidative stress and accelerated aging. Exosomal-associated AUF-1 may in turn preserve bound RNA targets and sustain their function, participating to spreading of inflammation and senescence to neighbouring cells.
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Affiliation(s)
- Ilaria Salvato
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
- Respiratory Medicine Unit, Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging (BIOMORF), University of Messina, Messina, Italy
| | - Luca Ricciardi
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
- Respiratory Medicine Unit, Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging (BIOMORF), University of Messina, Messina, Italy
| | - Jessica Dal Col
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
| | - Annunziata Nigro
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
| | - Giorgio Giurato
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
| | - Domenico Memoli
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
| | - Assunta Sellitto
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
| | - Erwin Pavel Lamparelli
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
| | - Maria Assunta Crescenzi
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
| | - Monica Vitale
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
| | - Alessandro Vatrella
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
| | - Francesco Nucera
- Respiratory Medicine Unit, Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging (BIOMORF), University of Messina, Messina, Italy
| | - Paola Brun
- Department of Molecular Medicine, University of Padua, Padua, Italy
| | | | - Paola Dama
- Department of Biochemistry and Biomedicine, School of Life Sciences, University of Sussex, Brighton, United Kingdom
| | - Thomas Stiff
- Department of Biochemistry and Biomedicine, School of Life Sciences, University of Sussex, Brighton, United Kingdom
| | - Leandro Castellano
- Department of Biochemistry and Biomedicine, School of Life Sciences, University of Sussex, Brighton, United Kingdom
| | - Sobia Idrees
- Centre for Inflammation, Centenary Institute and University of Technology Sydney, Faculty of Science, School of Life Sciences, Sydney, NSW, Australia
| | - Matt D. Johansen
- Centre for Inflammation, Centenary Institute and University of Technology Sydney, Faculty of Science, School of Life Sciences, Sydney, NSW, Australia
| | - Alen Faiz
- Centre for Inflammation, Centenary Institute and University of Technology Sydney, Faculty of Science, School of Life Sciences, Sydney, NSW, Australia
| | - Peter A. Wark
- Immune Health, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Philip M. Hansbro
- Centre for Inflammation, Centenary Institute and University of Technology Sydney, Faculty of Science, School of Life Sciences, Sydney, NSW, Australia
- Immune Health, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Ian M. Adcock
- National Heart and Lung Institute, Imperial College London and the National Institute for Health and Care Research (NIHR) Imperial Biomedical Research Centre, London, United Kingdom
| | - Gaetano Caramori
- Respiratory Medicine Unit, Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging (BIOMORF), University of Messina, Messina, Italy
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Salerno, Italy
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Miscusi M, Trungu S, Ricciardi L, Forcato S, Piazza A, Ramieri A, Raco A. Stand-Alone Oblique Lumbar Interbody Fusion (OLIF) for the Treatment of Adjacent Segment Disease (ASD) after Previous Posterior Lumbar Fusion: Clinical and Radiological Outcomes and Comparison with Posterior Revision Surgery. J Clin Med 2023; 12:jcm12082985. [PMID: 37109321 PMCID: PMC10144531 DOI: 10.3390/jcm12082985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
Background: Radiological evidence of adjacent segment disease (ASD) has been reported to have a prevalence of more than 30% and several risk factors have been reported. The aim of this study is to evaluate the clinical and radiological outcomes of patients with symptomatic ASD treated with stand-alone OLIF and compare results with a posterior revision surgery cohort. Methods: This is a retrospective case-control study. Clinical-patient-reported outcomes were obtained at preoperative, postoperative and final follow-up visits using the Short Form (SF-36) scale, the Oswestry Disability Index (ODI) and the visual analog scale (VAS). Radiological measures include lumbar lordosis (LL), segmental lordosis (SL), pelvic incidence-lumbar lordosis (PI-LL) mismatch, segmental coronal Cobb angle and intervertebral disc height (DH). The data are compared with a retrospective series of patients that underwent a posterior revision surgery for ASD. Results: Twenty-eight patients in the OLIF group and 25 patients in the posterior group meet inclusion criteria. The mean ages at the time of the surgery are 65.1 years and 67.5, respectively. The mean follow-up time is 36.1 months (range of 14-56). The clinical outcomes significantly improve from preoperative values from the surgery in both groups. The radiological parameters are significantly improved postoperatively and were maintained at the last follow-up in both groups. A statistically significant difference is observed between the two groups for minor complication rate, length of surgery, blood loss and DH restoration. Conclusions: Stand-alone OLIF is an effective and safe technique with low morbidity and complication rates for the treatment of selected patients with symptomatic ASD following a previous lumbar fusion.
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Affiliation(s)
- Massimo Miscusi
- NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy
| | - Sokol Trungu
- NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy
- Neurosurgery Unit, Cardinale G. Panico Hospital, 73039 Tricase, Italy
| | - Luca Ricciardi
- NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy
| | - Stefano Forcato
- Neurosurgery Unit, Cardinale G. Panico Hospital, 73039 Tricase, Italy
| | - Amedeo Piazza
- NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy
| | - Alessandro Ramieri
- Department of Orthopedics, Faculty of Pharmacy and Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Antonino Raco
- NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy
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Sturiale CL, Scerrati A, Ricciardi L, Rustemi O, Auricchio AM, Norri N, Piazza A, Ranieri F, Benato A, Tomatis A, Albanese A, Mangiola A, Di Egidio V, Zotta DC, Farneti M, Marchese E, Raco A, Volpin L, Trevisi G. Comparison between intrasylvian and intracerebral hematoma associated with ruptured middle cerebral artery aneurysms: clinical implications, technical considerations, and outcome evaluation. World Neurosurg 2023; 173:e821-e829. [PMID: 36906087 DOI: 10.1016/j.wneu.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND Subarachnoid hemorrhage (SAH) due to a middle cerebral artery (MCA) aneurysms rupture is often associated with intracerebral (ICH) or intrasylvian hematomas (ISH). MATERIALS AND METHODS We reviewed 163 patients with ruptured MCA aneurysms associated with pure SAH or SAH+ICH/ISH. Patients were first dichotomized according to the presence of a hematoma (ICH/ISH). Then, we performed a subgroup analysis comparing ICH versus ISH in order to explore their relationship with the most relevant demographic, clinical, and angioarchitectural features. RESULTS Overall, 85 patients (52%) had a pure SAH, whereas 78 (48%) presented an associated ICH/ISH. No significant differences were observed in demographics and angioarchitectural features between the two groups, but Fisher grading and Hunt-Hess score were higher in patients with hematomas. A good outcome was observed in a higher percentage of patients with pure SAH compared with the others (76% Vs 44%), although mortality rates were comparable. Age, Hunt-Hess and treatment-related complications were the main outcome predictors at multivariate analysis. Patients with ICH appeared clinically worse than those with ISH. We also found that older age, higher Hunt-Hess, larger aneurysms, decompressive craniectomy and treatment-related complications were associated with poor outcome among patients with ISH, but not with ICH, which appeared per se as a more severe clinical condition. CONCLUSIONS Our study confirm that age, Hunt-Hess and treatment-related complications influence the outcome of patients with ruptured MCA aneurysms. However, in the subgroup analysis of patients with SAH associated with ICH or ISH, only the Hunt-Hess at onset appeared as an independent predictor of outcome.
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Affiliation(s)
- Carmelo Lucio Sturiale
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8 - 00168, Rome, Italy.
| | - Alba Scerrati
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Department of Neurosurgery, Sant'Anna University Hospital of Ferrara, Ferrara, Italy
| | - Luca Ricciardi
- NESMOS Department, Neurosurgical Unit, Sapienza University of Rome, Italy
| | - Oriela Rustemi
- Department of Neurosurgery, San Bortolo Hospital, Vicenza, Italy
| | - Anna Maria Auricchio
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8 - 00168, Rome, Italy
| | - Nicolò Norri
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Department of Neurosurgery, Sant'Anna University Hospital of Ferrara, Ferrara, Italy
| | - Amedeo Piazza
- NESMOS Department, Neurosurgical Unit, Sapienza University of Rome, Italy
| | - Fabio Ranieri
- Department of Neurosurgery, San Bortolo Hospital, Vicenza, Italy
| | - Alberto Benato
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8 - 00168, Rome, Italy
| | - Alberto Tomatis
- Neurosurgical Unit, Ospedale Generale Regionale "F. Miulli", Acquaviva delle Fonti, Italy
| | - Alessio Albanese
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8 - 00168, Rome, Italy
| | - Annunziato Mangiola
- Department of Neurosciences, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti-Pescara, Italy
| | | | | | - Marco Farneti
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Department of Neurosurgery, Sant'Anna University Hospital of Ferrara, Ferrara, Italy
| | - Enrico Marchese
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8 - 00168, Rome, Italy
| | - Antonino Raco
- NESMOS Department, Neurosurgical Unit, Sapienza University of Rome, Italy
| | - Lorenzo Volpin
- Department of Neurosurgery, San Bortolo Hospital, Vicenza, Italy
| | - Gianluca Trevisi
- Department of Neurosciences, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti-Pescara, Italy; Neurosurgical Unit, Ospedale Spirito Santo, Pescara, Italy
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Ricciardi L, Piazza A, Capobianco M, Della Pepa GM, Miscusi M, Raco A, Scerrati A, Somma T, Lofrese G, Sturiale CL. Lumbar interbody fusion using oblique (OLIF) and lateral (LLIF) approaches for degenerative spine disorders: a meta-analysis of the comparative studies. Eur J Orthop Surg Traumatol 2023; 33:1-7. [PMID: 34825987 DOI: 10.1007/s00590-021-03172-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/18/2021] [Indexed: 01/07/2023]
Abstract
STUDY DESIGN Systematic review and meta-analysis. OBJECTIVE Historically, posterior approaches to the lumbar spine have allowed surgeons to manage degenerative conditions affecting the lumbar spine. However, spinal muscles injury, post-surgical vertebral instability, cerebrospinal fluid (CSF) leakage, and failed back surgery syndrome (FBSS) represent severe complications that may occur after these surgeries. Lumbar interbody fusion using anterior (ALIF), oblique (OLIF), or lateral (LLIF) approaches may represent valuable surgical alternatives, in case fusion is indicated on single or multiple levels. METHODS The present study is a systematic review, conducted according to the PRISMA statement, of comparative studies on OLIF, and LLIF for degenerative spine disorders, and a meta-analysis of their clinical-radiological outcomes and complications. RESULTS After screening 1472 papers on PubMed, Scopus, and Cochrane Library, only 3 papers were included in the present study. 318 patients were included for data meta-analysis, 128 in OLIF group, and 190 in LLIF group. There were no significative differences in terms of surgical (intraoperative blood loss and surgical duration) and clinical (VAS-back, VAS-leg, and ODI scores) outcomes, or fusion rates at last follow-up (> 2 years). Significantly higher rates of abdominal complications, system failure, and vascular injuries were recorded in the OLIF group. Conversely, postoperative neurological symptoms and psoas weakness were significatively more common in LLIF group. CONCLUSIONS The meta-analysis suggests that OLIF and LLIF are both effective for lumbar degenerative disorders, although each of them presents specific complications and this should represent a relevant element in the surgical planning.
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Affiliation(s)
- Luca Ricciardi
- Department of NESMOS, Operative Unit of Neurosurgery, AOSA, Sapienza, Rome, Italy
| | - Amedeo Piazza
- Department of NESMOS, Operative Unit of Neurosurgery, AOSA, Sapienza, Rome, Italy
| | - Mattia Capobianco
- Department of NESMOS, Operative Unit of Neurosurgery, AOSA, Sapienza, Rome, Italy
| | | | - Massimo Miscusi
- Department of NESMOS, Operative Unit of Neurosurgery, AOSA, Sapienza, Rome, Italy
| | - Antonino Raco
- Department of NESMOS, Operative Unit of Neurosurgery, AOSA, Sapienza, Rome, Italy
| | - Alba Scerrati
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy.,Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy
| | - Teresa Somma
- Division of Neurosurgery, Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - Giorgio Lofrese
- Division of Neurosurgery, Ospedale Bufalini, Cesena, Italy. .,Dipartimento Neuroscienze, Unità Operativa Complessa di Neurochirurgia, Ospedale "M.Bufalini", Viale Ghirotti 286, 47521, Cesena, Italy.
| | - Carmelo Lucio Sturiale
- Operative Unit of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Ius T, Ricciardi L, Barbagallo GM, Thomé C, Raco A. Editorial: Updates on current protocols for the management of brain and spine malignancies. Front Neurol 2022; 13:1077973. [PMID: 36588895 PMCID: PMC9795207 DOI: 10.3389/fneur.2022.1077973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Tamara Ius
- Division of Neurosurgery, AOU Sant'Andrea, Department of NESMOS, Sapienza University, Rome, Italy,*Correspondence: Tamara Ius ✉
| | - Luca Ricciardi
- Division of Neurosurgery, AOU Sant'Andrea, Department of NESMOS, Sapienza University, Rome, Italy
| | - Giuseppe M. Barbagallo
- Department of Medical and Surgical Sciences and Advanced Technologies (G.F. Ingrassia), University of Catania, Catania, Italy,Department of Neurological Surgery, Policlinico “G. Rodolico - San Marco” University Hospital, University of Catania, Catania, Italy,Interdisciplinary Research Center on Brain Tumors Diagnosis and Treatment, University of Catania, Catania, Italy
| | - Claudius Thomé
- Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
| | - Antonino Raco
- Division of Neurosurgery, AOU Sant'Andrea, Department of NESMOS, Sapienza University, Rome, Italy
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Miscusi M, Ricciardi L, Piazza A, Capobianco M, Lofrese G, Acqui M, Trungu S, Raco A. Referencing for anterior atlantoaxial trans-articular osteosynthesis: a radiological study and proposal of a decisional algorithm. Eur Spine J 2022; 31:3410-3417. [PMID: 36114892 DOI: 10.1007/s00586-022-07380-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 07/14/2022] [Accepted: 09/04/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Anterior trans-articular C1-C2 screw placement can be considered as a surgical alternative in different conditions affecting the atlantoaxial region. While its rigidity is similar to posterior Magerl and Harms techniques, it also provides some surgical advantages. However, the literature lacks papers exhaustively describing indication criteria, surgical steps, and pitfalls. METHODS This is a radiological study on 100 healthy subjects. Thin-layer CT scans of the craniovertebral junction were retrieved from the institutional database. The coronal inclination of the C1-C2 joint rim and the depth of the entry point of the screw with respect to the anterior profile of C2 were measured. The antero-posterior and the medio-lateral surgical corridors for the screw placement, and the wideness of the target area on the upper surface of C1 were also measured. RESULTS The multivariate analysis showed that the coronal inclination of the C1-C2 articular joint rim strongly influences the surface extension of the C1 target area; the depth of the entry point and the C1-C2 articular rim inclination seem to be independent factors in influencing both the medio-lateral and the antero-posterior surgical corridors wideness. A decisional algorithm on whether to perform an anterior or posterior approach to the atlantoaxial region was also proposed. CONCLUSIONS We can conclude that, as much as the C1-C2 articular rim is tending to the horizontal line, and as deeper is the entry point of the screw on the anterior profile of C2, as easier the anterior C1-C2 trans-articular screw placement will result.
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Affiliation(s)
- Massimo Miscusi
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University, Rome, Italy
| | - Luca Ricciardi
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University, Rome, Italy
| | - Amedeo Piazza
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University, Rome, Italy
| | - Mattia Capobianco
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University, Rome, Italy
| | | | - Michele Acqui
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University, Rome, Italy
| | - Sokol Trungu
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University, Rome, Italy.
- UO di Neurochirurgia, AO Cardinal G. Panico, Via Fratelli Peluso 8, Tricase, 73039, Italy.
| | - Antonino Raco
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University, Rome, Italy
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Montemurro N, Ricciardi L, Scerrati A, Ippolito G, Lofrese G, Trungu S, Stoccoro A. The Potential Role of Dysregulated miRNAs in Adolescent Idiopathic Scoliosis and 22q11.2 Deletion Syndrome. J Pers Med 2022; 12:1925. [PMID: 36422101 PMCID: PMC9695868 DOI: 10.3390/jpm12111925] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 08/29/2023] Open
Abstract
Background: Adolescent idiopathic scoliosis (AIS), affecting 2-4% of adolescents, is a multifactorial spinal disease. Interactions between genetic and environmental factors can influence disease onset through epigenetic mechanisms, including DNA methylation, histone modifications and miRNA expression. Recent evidence reported that, among all clinical features in individuals with 22q11.2 deletion syndrome (DS), scoliosis can occur with a higher incidence than in the general population. Methods: A PubMed and Ovid Medline search was performed for idiopathic scoliosis in the setting of 22q11.2DS and miRNA according to PRISMA guidelines. Results: Four papers, accounting for 2841 individuals, reported clinical data about scoliosis in individuals with 22q11.2DS, showing that approximately 35.1% of the individuals with 22q11.2DS developed scoliosis. Conclusions: 22q11.2DS could be used as a model for the study of AIS. The DGCR8 gene seems to be essential for microRNA biogenesis, which is why we propose that a possible common pathological mechanism between scoliosis and 22q11.2DS could be the dysregulation of microRNA expression. In the current study, we identified two miRNAs that were altered in both 22q11.2DS and AIS, miR-93 and miR-1306, thus, corroborating the hypothesis that the two diseases share common molecular alterations.
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Affiliation(s)
- Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy
| | - Luca Ricciardi
- Department of NESMOS, Sapienza University of Rome, 00185 Roma, Italy
| | - Alba Scerrati
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Giorgio Ippolito
- Istituto Chirurgico Ortopedico Traumatologico (ICOT), DSBMC Sapienza Università di Roma-Polo Pontino, 04100 Latina, Italy
| | - Giorgio Lofrese
- Division of Neurosurgery, Ospedale Bufalini, 47023 Cesena, Italy
| | - Sokol Trungu
- Department of NESMOS, Sapienza University of Rome, 00185 Roma, Italy
| | - Andrea Stoccoro
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56100 Pisa, Italy
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Ricciardi L, Verboom W, Lange JP, Huskens J. Kinetic model for the dehydration of xylose to furfural from a boronate diester precursor. RSC Adv 2022; 12:31818-31829. [PMID: 36380937 PMCID: PMC9639369 DOI: 10.1039/d2ra06898b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 09/19/2023] Open
Abstract
A comprehensive kinetic model describes the dehydration of xylose starting from the boronate diester-protected xylose (PBA2X). The model incorporates (de)esterification of PBA2X, partitioning, and xylose dehydration, and aims to evaluate the effects of the solvent system on these steps. The model explores the effect of the water contents in monophasic solvent systems, and that of ionic strength and mixing in biphasic aqueous-organic systems. At low water content, hydrolysis of PBA2X is the rate-limiting step, while xylose dehydration is fast. Conversely, in a monophasic three-solvent system, where the water content is higher, complete hydrolysis of the diester is achieved quickly. Under biphasic conditions, xylose dehydration is fast at high ionic strengths, but the slower partitioning/hydrolysis of PBA2X results in an overall slower furfural production. Furthermore, the observed different but high, constant xylose-to-furfural selectivities observed experimentally are tentatively ascribed to a higher order of parallel side-product formation.
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Affiliation(s)
- Luca Ricciardi
- Molecular Nanofabrication Group, Department for Molecules & Materials, MESA+ Institute, University of Twente P.O. Box 217 7500 AE Enschede The Netherlands
| | - Willem Verboom
- Molecular Nanofabrication Group, Department for Molecules & Materials, MESA+ Institute, University of Twente P.O. Box 217 7500 AE Enschede The Netherlands
| | - Jean-Paul Lange
- Sustainable Process Technology Group, University of Twente P.O. Box 217 7500 AE Enschede The Netherlands
- Shell Global Solutions International B.V. Grasweg 31 1031 HW Amsterdam The Netherlands
| | - Jurriaan Huskens
- Molecular Nanofabrication Group, Department for Molecules & Materials, MESA+ Institute, University of Twente P.O. Box 217 7500 AE Enschede The Netherlands
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Rosa P, De Falco E, Pacini L, Piazza A, Ciracì P, Ricciardi L, Fiorentino F, Trungu S, Miscusi M, Raco A, Calogero A. Next-Generation Sequencing Comparative Analysis of DNA Mutations between Blood-Derived Extracellular Vesicles and Matched Cancer Tissue in Patients with Grade 4 Glioblastoma. Biomedicines 2022; 10:biomedicines10102590. [PMID: 36289852 PMCID: PMC9599233 DOI: 10.3390/biomedicines10102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/05/2022] [Accepted: 10/12/2022] [Indexed: 12/24/2022] Open
Abstract
The biological heterogeneity of glioblastoma, IDH-wildtype (GBM, CNS WHO grade 4), the most aggressive type of brain cancer, is a critical hallmark, caused by changes in the genomic mutational asset and influencing clinical progression over time. The understanding and monitoring of the mutational profile is important not only to reveal novel therapeutic targets in this set of patients, but also to ameliorate the clinical stratification of subjects and the prognostic significance. As neurosurgery represents the primary technique to manage GBM, it is of utmost importance to optimize alternative and less invasive methods to monitor the dynamic mutation profile of these patients. Extracellular vesicles (EVs) are included in the liquid biopsy analysis and have emerged as the biological mirror of escaping and surviving mechanisms by many tumors, including glioblastoma. Very few studies have investigated the technical feasibility to detect and analyze the genomic profile by Next-Generation Sequencing (UMI system) in circulating EVs of patients with grade IV glioblastoma. Here, we attempted to characterize and to compare the corresponding matched tissue samples and potential variants with pathogenic significance of the DNA contained in peripheral-blood-derived EVs. The NGS analysis has revealed that patients with grade IV glioblastoma exhibited lesser DNA content in EVs than controls and that, both in EVs and matched cancer tissues, the NF1 gene was consistently mutated in all patients, with the c.2568C>G as the most common pathogenic variant expressed. This study supports the clinical utility of circulating EVs in glioblastoma as an eligible tool for personalized medicine.
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Affiliation(s)
- Paolo Rosa
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so Della Repubblica 79, 04100 Latina, Italy
- Correspondence: (P.R.); (M.M.)
| | - Elena De Falco
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so Della Repubblica 79, 04100 Latina, Italy
- Mediterranea Cardiocentro, 80122 Naples, Italy
| | - Luca Pacini
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so Della Repubblica 79, 04100 Latina, Italy
| | - Amedeo Piazza
- Operative Unit of Neurosurgery, Department of NESMOS, Sapienza University of Rome, 00185 Rome, Italy
| | - Paolo Ciracì
- Operative Unit of Neurosurgery, Department of NESMOS, Sapienza University of Rome, 00185 Rome, Italy
| | - Luca Ricciardi
- Operative Unit of Neurosurgery, Department of NESMOS, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesco Fiorentino
- Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Sokol Trungu
- Operative Unit of Neurosurgery, Department of NESMOS, Sapienza University of Rome, 00185 Rome, Italy
- UO di Neurochirurgia, Azienda Ospedaliera Cardinal G. Panico, 73039 Tricase, Italy
| | - Massimo Miscusi
- Operative Unit of Neurosurgery, Department of NESMOS, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence: (P.R.); (M.M.)
| | - Antonino Raco
- Operative Unit of Neurosurgery, Department of NESMOS, Sapienza University of Rome, 00185 Rome, Italy
| | - Antonella Calogero
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so Della Repubblica 79, 04100 Latina, Italy
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Lofrese G, Scerrati A, Balsano M, Bassani R, Cappuccio M, Cavallo MA, Cofano F, Cultrera F, De Iure F, Biase FD, Donati R, Garbossa D, Menegatti M, Olivi A, Palandri G, Raco A, Ricciardi L, Spena G, Tosatto L, Visani J, Visocchi M, Zona G, De Bonis P. Surgical Treatment of Diffuse Idiopathic Skeletal Hyperostosis (DISH) Involving the Cervical Spine: Technical Nuances and Outcome of a Multicenter Experience. Global Spine J 2022; 12:1751-1760. [PMID: 33590802 PMCID: PMC9609533 DOI: 10.1177/2192568220988272] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
STUDY DESIGN Retrospective multicenter. OBJECTIVES diffuse idiopathic skeletal hyperostosis (DISH) involving the cervical spine is a rare condition determining disabling aero-digestive symptoms. We analyzed impact of preoperative settings and intraoperative techniques on outcome of patients undergoing surgery for DISH. METHODS Patients with DISH needing for anterior cervical osteophytectomy were collected. Swallow studies and endoscopy supported imaging in targeting bone decompression. Patients characteristics, clinico-radiological presentation, outcome and surgical strategies were recorded. Impact on clinical outcome of duration and time to surgery and different surgical techniques was evaluated through ANOVA. RESULTS 24 patients underwent surgery. No correlation was noted between specific spinal levels affected by DISH and severity of pre-operative dysphagia. A trend toward a full clinical improvement was noted preferring the chisel (P = 0.12) to the burr (P = 0.65), and whenever C2-C3 was decompressed, whether hyperostosis included that level (P = 0.15). Use of curved chisel reduced the surgical times (P = 0.02) and, together with the nasogastric tube, the risk of complications, while bone removal involving 3 levels or more (P = 0.04) and shorter waiting times for surgery (P < 0.001) positively influenced a complete swallowing recovery. Early decompressions were preferred, resulting in 66.6% of patients reporting disappearance of symptoms within 7 days. One and two recurrences respectively at clinical and radiological follow-up were registered 18-30 months after surgery. CONCLUSION The "age of DISH" counts more than patients' age with timeliness of decompression being crucial in determining clinical outcome even with a preoperative mild dysphagia. Targeted bone resections could be reasonable in elderly patients, while in younger ones more extended decompressions should be preferred.
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Affiliation(s)
- Giorgio Lofrese
- Neurosurgery Division, “M. Bufalini”
Hospital, Cesena, Italy
| | - Alba Scerrati
- Department of Neurosurgery, S. Anna
University Hospital, Ferrara, Italy,Department of Morphology, Surgery and
Experimental Medicine, University of Ferrara, Ferrara, Italy,Alba Scerrati, Faculty of Medicine and
Surgery, University of Ferrara, Via Aldo Moro, 8, Ferrara, Italy.
| | - Massimo Balsano
- Regional Spinal Department, UOC
Ortopedia A, AOUI, Verona, Italy
| | - Roberto Bassani
- Spine Surgery II, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Michele Cappuccio
- Department of Spine Surgery, Ospedale
Maggiore “C.A. Pizzardi,” Bologna, Italy
| | - Michele A. Cavallo
- Department of Neurosurgery, S. Anna
University Hospital, Ferrara, Italy,Department of Morphology, Surgery and
Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Fabio Cofano
- Department of Neuroscience “Rita Levi
Montalcini,” Neurosurgery Unit, University of Turin, Turin, Italy
| | | | - Federico De Iure
- Department of Spine Surgery, Ospedale
Maggiore “C.A. Pizzardi,” Bologna, Italy
| | | | - Roberto Donati
- Neurosurgery Division, “M. Bufalini”
Hospital, Cesena, Italy
| | - Diego Garbossa
- Department of Neuroscience “Rita Levi
Montalcini,” Neurosurgery Unit, University of Turin, Turin, Italy
| | - Marta Menegatti
- Department of Neurosurgery, S. Anna
University Hospital, Ferrara, Italy
| | - Alessandro Olivi
- Department of Neurosurgery, Fondazione
Policlinico Universitario A. Gemelli IRCCS, Rome, Italy,Department of Neuroscience,
Neurosurgery Section, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giorgio Palandri
- Department of Neurologic Surgery, Institute of Neurological Sciences of Bologna IRCCS, Bologna, Italy
| | - Antonino Raco
- UOC di Neurochirurgia, Azienda
Ospedaliera Sant’Andrea, Sapienza, Roma, Italy
| | - Luca Ricciardi
- UO di Neurochirurgia, Pia Fondazione
di Culto e Religione Cardinal G. Panico, Tricase, Italy
| | | | - Luigino Tosatto
- Neurosurgery Division, “M. Bufalini”
Hospital, Cesena, Italy
| | - Jacopo Visani
- Department of Neurosurgery, S. Anna
University Hospital, Ferrara, Italy
| | - Massimiliano Visocchi
- Department of Neurosurgery, Fondazione
Policlinico Universitario A. Gemelli IRCCS, Rome, Italy,Department of Neuroscience,
Neurosurgery Section, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluigi Zona
- Section of Neurosurgery, IRCCS
Ospedale Policlinico San Martino, Genoa, Italy
| | - Pasquale De Bonis
- Department of Neurosurgery, S. Anna
University Hospital, Ferrara, Italy,Department of Morphology, Surgery and
Experimental Medicine, University of Ferrara, Ferrara, Italy
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20
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Rapisarda A, Pennisi G, Montano N, Della Pepa GM, Ricciardi L, De-Giorgio F, Visocchi M, Olivi A, Polli FM. Atlantoaxial Joint Distraction and Fusion with DTRAX Intra-Articular Cages: A Cadaveric Feasibility Study and Review of the Pertinent Literature. World Neurosurg 2022; 166:153-158. [PMID: 35917923 DOI: 10.1016/j.wneu.2022.07.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 07/15/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Atlantoaxial joint distraction is a key procedure for the treatment of selected patients affected by basilar invagination (BI). In recent years, several authors have reported various techniques of distraction and fixation of the C1-C2 joint using different types of intra-articular spacers, with or without posterior fixation. We review the pertinent literature and propose a feasibility study on the use of a new device for the distraction of the C1-C2 joint aimed to the descent of the dens out of the foramen magnum suggesting its application on selected cases of BI. METHODS The GL-DTRAX Cervical Cage-SE is a cage approved by the Food and Drug Administration for distraction and fixation of subaxial cervical spine. Five adult cadaveric specimens were dissected surgically to evaluate the feasibility of DTRAX insertion inside the C1-C2 joint through a posterior approach. RESULTS The cages were uneventfully set into the C1-C2 intra-articular space of all samples without the need to sacrifice C2 nerve roots and ganglia. Postoperative cervical computed tomography scanning confirmed the correct fitting of the devices in every sample. CONCLUSIONS This cadaveric study highlights the feasibility of the DTRAX cage as a C1-C2 intra-articular device producing a substantial distraction of atlantoaxial complex and suggesting a possible therapeutic role in selected cases of BI.
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Affiliation(s)
- Alessandro Rapisarda
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Giovanni Pennisi
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nicola Montano
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Luca Ricciardi
- Department of Neurosurgery, Sant'Andrea Hospital, Rome, Italy
| | - Fabio De-Giorgio
- Department of Healthcare Surveillance and Bioethics, Section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione IRCSS Policlinico Universitario A. Gemelli, Rome, Italy
| | - Massimiliano Visocchi
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessandro Olivi
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Filippo Maria Polli
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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21
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De Luca P, Camaioni A, Marra P, Salzano G, Carriere G, Ricciardi L, Pucci R, Montemurro N, Brenner MJ, Di Stadio A. Effect of Ultra-Micronized Palmitoylethanolamide and Luteolin on Olfaction and Memory in Patients with Long COVID: Results of a Longitudinal Study. Cells 2022; 11:cells11162552. [PMID: 36010630 PMCID: PMC9406356 DOI: 10.3390/cells11162552] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022] Open
Abstract
In this study, we investigated whether treatment with palmitoylethanolamide and luteolin (PEA-LUT) leads to improvement in the quantitative or qualitative measures of olfactory dysfunction or relief from mental clouding in patients affected by long COVID. Patients with long COVID olfactory dysfunction were allocated to different groups based on the presence (“previously treated”) or absence (“naïve”) of prior exposure to olfactory training. Patients were then randomized to receive PEA-LUT alone or in combination with olfactory training. Olfactory function and memory were assessed at monthly intervals using self-report measures and quantitative thresholds. A total of 69 patients (43 women, 26 men) with an age average of 40.6 + 10.5 were recruited. PEA-LUT therapy was associated with a significant improvement in validated odor identification scores at the baseline versus each subsequent month; assessment at 3 months showed an average improvement of 10.7 + 2.6, CI 95%: 6–14 (p < 0.0001). The overall prevalence of parosmia was 79.7% (55 patients), with a significant improvement from the baseline to 3 months (p < 0.0001), namely in 31 patients from the Naïve 1 group (72%), 15 from the Naïve 2 group (93.7%), and 9 from the remaining group (90%). Overall, mental clouding was detected in 37.7% (26 subjects) of the cases, with a reduction in severity from the baseline to three months (p = 0.02), namely in 15 patients from the Naïve 1 group (34.8%), 7 from the Naïve 2 group (43.7%), and 4 from the remaining group (40%). Conclusions. In patients with long COVID and chronic olfactory loss, a regimen including oral PEA-LUT and olfactory training ameliorated olfactory dysfunction and memory. Further investigations are necessary to discern biomarkers, mechanisms, and long-term outcomes.
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Affiliation(s)
- Pietro De Luca
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy
- Otolaryngology Department, San Giovanni-Addolorata Hospital, 00184 Rome, Italy
| | - Angelo Camaioni
- Otolaryngology Department, San Giovanni-Addolorata Hospital, 00184 Rome, Italy
| | - Pasquale Marra
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy
| | - Giovanni Salzano
- ENT and Maxillofacial Surgery Unit, Istituto Tumori G. Pascale of Naples, 80131 Naples, Italy
| | | | - Luca Ricciardi
- Division of Neurosurgery, Sant’Andrea Hospital, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
| | - Resi Pucci
- Oral and Maxillofacial, San Camillo Hospital, 00152 Rome, Italy
- Department of Oral and Maxillofacial Science, Sapienza University of Rome, 00185 Rome, Italy
| | - Nicola Montemurro
- Department of Neurosurgery, Pisana University Hospital, University of Pisa, 56124 Pisa, Italy
| | - Michael J. Brenner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Arianna Di Stadio
- Department of GF Ingrassia, Via di Santa Sofia 87, University of Catania, 95123 Catania, Italy
- Neuroinflammation Lab, UCL Queen Square Neurology, London WC1N 1PJ, UK
- Correspondence:
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22
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Ricciardi L, Pucci R, Piazza A, Lofrese G, Scerrati A, Montemurro N, Raco A, Miscusi M, Ius T, Zeppieri M. Role of stem cells-based in facial nerve reanimation: A meta-analysis of histological and neurophysiological outcomes. World J Stem Cells 2022; 14:420-428. [PMID: 35949396 PMCID: PMC9244955 DOI: 10.4252/wjsc.v14.i6.420] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/21/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Treatments involving stem cell (SC) usage represent novel and potentially interesting alternatives in facial nerve reanimation. Current literature includes the use of SC in animal model studies to promote graft survival by enhancing nerve fiber growth, spreading, myelinization, in addition to limiting fibrotic degeneration after surgery. However, the effectiveness of the clinical use of SC in facial nerve reanimation has not been clarified yet.
AIM To investigate the histological, neurophysiological, and functional outcomes in facial reanimation using SC, compared to autograft.
METHODS Our study is a systematic review of the literature, consistently conducted according to the preferred reporting items for systematic reviews and meta-analyses statement guidelines. The review question was: In facial nerve reanimation on rats, has the use of stem cells revealed as effective when compared to autograft, in terms of histological, neurophysiological, and functional outcomes? Random-effect meta-analysis was conducted on histological and neurophysiological data from the included comparative studies.
RESULTS After screening 148 manuscript, five papers were included in our study. 43 subjects were included in the SC group, while 40 in the autograft group. The meta-analysis showed no significative differences between the two groups in terms of myelin thickness [CI: -0.10 (-0.20, 0.00); I2 = 29%; P = 0.06], nerve fibers diameter [CI: 0.72 (-0.93, 3.36); I2 = 72%; P = 0.6], compound muscle action potential amplitude [CI: 1.59 (0.59, 3.77); I2 = 89%; P = 0.15] and latency [CI: 0.66 (-1.01, 2.32); I2 = 67%; P = 0.44]. The mean axonal diameter was higher in the autograft group [CI: 0.94 (0.60, 1.27); I2 = 0%; P ≤ 0.001].
CONCLUSION The role of stem cells in facial reanimation is still relatively poorly studied, in animal models, and available results should not discourage their use in future studies on human subjects.
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Affiliation(s)
- Luca Ricciardi
- Division of Neurosurgery, AOU Sant’Andrea, Department of NESMOS, Sapienza University, Rome 00189, Italy
| | - Resi Pucci
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome 00161, Italy
| | - Amedeo Piazza
- Division of Neurosurgery, AOU Sant’Andrea, Department of NESMOS, Sapienza University, Rome 00189, Italy
| | - Giorgio Lofrese
- Division of Neurosurgery, Ospedale Bufalini, Cesena 47521, Italy
| | - Alba Scerrati
- Department of Neurosurgery, Sant'Anna University Hospital, S. Anna University Hospital, Ferrara 44121, Italy
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara 44121, Italy
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana, Pisa 56126, Italy
| | - Antonino Raco
- Division of Neurosurgery, AOU Sant’Andrea, Department of NESMOS, Sapienza University, Rome 00189, Italy
| | - Massimo Miscusi
- Division of Neurosurgery, AOU Sant’Andrea, Department of NESMOS, Sapienza University, Rome 00189, Italy
| | - Tamara Ius
- Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine 33100, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
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23
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Ricciardi L, Manini I, Cesselli D, Trungu S, Piazza A, Mangraviti A, Miscusi M, Raco A, Ius T. Carmustine Wafers Implantation in Patients With Newly Diagnosed High Grade Glioma: Is It Still an Option? Front Neurol 2022; 13:884158. [PMID: 35812101 PMCID: PMC9259966 DOI: 10.3389/fneur.2022.884158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/17/2022] [Indexed: 12/11/2022] Open
Abstract
BackgroundThe implantation protocol for Carmustine Wafers (CWs) in high grade glioma (HGG) was developed to offer a bridge between surgical resection and adjuvant treatments, such as radio- and chemotherapy. In the last years, however, a widespread use of CWs has been limited due to uncertainties regarding efficacy, in addition to increased risk of infection and elevated costs of treatment.ObjectiveThe aims of our study were to investigate the epidemiology of patients that underwent surgery for HGG with CW implantation, in addition to the assessment of related complications, long-term overall survival (OS), and associated prognostic factors.MethodsThree different medical databases were screened for conducting a systematic review of the literature, according to the PRISMA statement guidelines, evaluating the role of BCNU wafer implantation in patients with newly diagnosed HGG. The search query was based on a combination of medical subject headings (MeSH): “high grade glioma” [MeSH] AND “Carmustine” [MeSH] and free text terms: “surgery” OR “BCNU wafer” OR “Gliadel” OR “systemic treatment options” OR “overall survival.”ResultsThe analysis of the meta-data demonstrated that there was a significant advantage in using CWs in newly diagnosed GBM in terms of OS, and a very low heterogeneity among the included studies [mean difference 2.64 (95% CI 0.85, 4.44); p = 0.004; I2149 = 0%]. Conversely, no significant difference between the two treatment groups in terms of PFS wad detected (p = 0.55). The analysis of complications showed a relatively higher rate in Carmustine implanted patients, although this difference was not significant (p = 0.53).ConclusionsThis meta-analysis seems to suggest that CWs implantation plays a significant role in improving the OS, when used in patients with newly diagnosed HGG. To minimize the risk of side effects, however, a carful patient selection based mainly on patient age and tumor volume should be desirable.
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Affiliation(s)
- Luca Ricciardi
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University of Rome, Rome, Italy
| | - Ivana Manini
- Institute of Pathology, University Hospital of Udine, Udine, Italy
| | - Daniela Cesselli
- Institute of Pathology, University Hospital of Udine, Udine, Italy
- Department of Pathology, University Hospital of Udine, Udine, Italy
| | - Sokol Trungu
- UO di Neurochirurgia, Azienda Ospedaliera Cardinal G. Panico, Tricase, Italy
| | - Amedeo Piazza
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University of Rome, Rome, Italy
| | - Antonella Mangraviti
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University of Rome, Rome, Italy
| | - Massimo Miscusi
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University of Rome, Rome, Italy
| | - Antonino Raco
- UOC di Neurochirurgia, Department of NESMOS, Sapienza University of Rome, Rome, Italy
| | - Tamara Ius
- Neurosurgery Unit, Department of Neurosciences, S. Maria della Misericordia University Hospital, Udine, Italy
- *Correspondence: Tamara Ius
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24
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Costanzo G, Misaggi B, Ricciardi L, AlEissa SI, Tamai K, Alhelal F, Alqahtani Y, Alsobayel HI, Arand M, Balsano M, Blattert TR, Brayda-Bruno M, Busari JO, Campello M, Chhabra HS, Tamburrelli FC, Côté P, Darwono B, Kandziora F, La Maida GA, Muehlbauer EJ, Mulukutla RD, Pereira P, Rajasekaran S, Rothenfluh DA, Sullivan WJ, Truumees E, Dohring EJ, Pigott T, Shetty AP, Teli MGA, Wang JC, Ames C, Anema JR, Bang A, Cheung KMC, Gross DP, Haldeman S, Minisola S, Mullerpatan R, Negrini S, Salmi LR, Spinelli MS, Vlok A, Yankey KP, Zaina F, Alturkistany A, Franke J, Liljenqvist UR, Piccirillo M, Nordin M. SPINE20 recommendations 2021: spine care for people's health and prosperity. Eur Spine J 2022; 31:1333-1342. [PMID: 35391625 PMCID: PMC8989125 DOI: 10.1007/s00586-022-07194-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 12/18/2021] [Accepted: 03/19/2022] [Indexed: 02/07/2023]
Abstract
Purpose The focus of SPINE20 is to develop evidence-based policy recommendations for the G20 countries to work with governments to reduce the burden of spine disease, and disability. Methods On September 17–18, 2021, SPINE20 held its annual meeting in Rome, Italy. Prior to the meeting, the SPINE20 created six proposed recommendations. These recommendations were uploaded to the SPINE20 website 10 days before the meeting and opened to the public for comments. The recommendations were discussed at the meeting allowing the participants to object and provide comments. Results In total, 27 societies endorsed the following recommendations. SPINE20 calls upon the G20 countries: (1) to expand telehealth for the access to spine care, especially in light of the current situation with COVID-19. (2) To adopt value-based interprofessional spine care as an approach to improve patient outcomes and reduce disability. (3) To facilitate access and invest in the development of a competent rehabilitation workforce to reduce the burden of disability related to spine disorders. (4) To adopt a strategy to promote daily physical activity and exercises among the elderly population to maintain an active and independent life with a healthy spine, particularly after COVID-19 pandemic. (5) To engage in capacity building with emerging countries and underserved communities for the benefit of spine patients. (6) To promote strategies to transfer evidence-based advances into patient benefit through effective implementation processes. Conclusions SPINE20’s initiatives will make governments and decision makers aware of efforts to reduce needless suffering from disabling spine pain through education that can be instituted across the globe.
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Affiliation(s)
| | | | | | | | - Koji Tamai
- Department of Orthopedics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
| | | | | | | | - Markus Arand
- Medical Faculty, University of Ulm, Ulm, Baden-Württemberg, Germany
| | | | | | | | - Jamiu O Busari
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Marco Campello
- New York University Grossman School of Medicine, New York, NY, USA
| | | | | | | | | | - Frank Kandziora
- Center for Spinal Surgery and Neurotraumatology, Frankfurt, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jeffrey C Wang
- University of Southern California Spine Center, Los Angeles, CA, USA
| | | | | | - Anand Bang
- Society for Education, Action and Research in Community Health, Gadchiroli, Maharashtra, India
| | | | | | | | | | | | - Stefano Negrini
- University La Statale, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | | | - Adriaan Vlok
- Stellenbosch University, Cape Town, South Africa
| | | | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | - Ahmed Alturkistany
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Jörg Franke
- Klinikum Magdeburg gGmbH, Magdeburg, Germany
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Piazza A, Rosa P, Ricciardi L, Mangraviti A, Pacini L, Calogero A, Raco A, Miscusi M. Circulating Exosomal-DNA in Glioma Patients: A Quantitative Study and Histopathological Correlations—A Preliminary Study. Brain Sci 2022; 12:brainsci12040500. [PMID: 35448031 PMCID: PMC9028788 DOI: 10.3390/brainsci12040500] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 12/29/2022] Open
Abstract
Glial neoplasms are a group of diseases with poor prognoses. Not all risk factors are known, and no screening tests are available. Only histology provides certain diagnosis. As already reported, DNA transported by exosomes can be an excellent source of information shared by cells locally or systemically. These vesicles seem to be one of the main mechanisms of tumor remote intercellular signaling used to induce immune deregulation, apoptosis, and both phenotypic and genotypic modifications. In this study, we evaluated the exosomal DNA (exoDNA) concentration in blood samples of patients affected by cerebral glioma and correlated it with histological and radiological characteristics of tumors. From 14 patients with diagnosed primary or recurrent glioma, we obtained MRI imaging data, histological data, and preoperative blood samples that were used to extract circulating exosomal DNA, which we then quantified. Our results demonstrate a relationship between the amount of circulating exosomal DNA and tumor volume, and mitotic activity. In particular, a high concentration of exoDNA was noted in low-grade gliomas. Our results suggest a possible role of exoDNAs in the diagnosis of brain glioma. They could be particularly useful in detecting early recurrent high-grade gliomas and asymptomatic low-grade gliomas.
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Affiliation(s)
- Amedeo Piazza
- Operative Unit of Neurosurgery, Department of NESMOS, Sapienza University of Rome, 00185 Rome, Italy; (L.R.); (A.M.); (A.R.); (M.M.)
- Correspondence:
| | - Paolo Rosa
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (P.R.); (A.C.)
| | - Luca Ricciardi
- Operative Unit of Neurosurgery, Department of NESMOS, Sapienza University of Rome, 00185 Rome, Italy; (L.R.); (A.M.); (A.R.); (M.M.)
| | - Antonella Mangraviti
- Operative Unit of Neurosurgery, Department of NESMOS, Sapienza University of Rome, 00185 Rome, Italy; (L.R.); (A.M.); (A.R.); (M.M.)
| | - Luca Pacini
- Pathology Unit, I.C.O.T. Hospital, 04100 Latina, Italy;
| | - Antonella Calogero
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (P.R.); (A.C.)
| | - Antonino Raco
- Operative Unit of Neurosurgery, Department of NESMOS, Sapienza University of Rome, 00185 Rome, Italy; (L.R.); (A.M.); (A.R.); (M.M.)
| | - Massimo Miscusi
- Operative Unit of Neurosurgery, Department of NESMOS, Sapienza University of Rome, 00185 Rome, Italy; (L.R.); (A.M.); (A.R.); (M.M.)
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Trevisi G, Scerrati A, Rustemi O, Ricciardi L, Raneri F, Tomatis A, Piazza A, Auricchio AM, Stifano V, Dughiero M, DE Bonis P, Mangiola A, Sturiale CL. The role of the craniotomy size in the surgical evacuation of acute subdural hematomas in elderly patients: a retrospective multicentric study. J Neurosurg Sci 2022:S0390-5616.22.05648-X. [PMID: 35380204 DOI: 10.23736/s0390-5616.22.05648-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Elderly patients operated for an acute subdural hematoma (ASDH) frequently have a poor outcome, with a high frequency of death, vegetative status, or severe disability (Glasgow Outcome Score, GOS, 1-3). Minicraniotomy has been proposed as a minimally invasive surgical treatment to reduce the impact of surgery in the elderly population. The present study aimed to compare the influence of the size of the craniotomy on the functional outcome in patients undergoing surgical treatment for ASDH. METHODS We selected patients ≥70 years old admitted to 5 Italian tertiary referral neurosurgical for the treatment of a post-traumatic ASDH between January 1st 2016 and December 31st 2019. We collected demographic data, clinical data (GCS, GOS, Charlson Comorbidity Index-CCI, antiplatelet/anticoagulant therapy, neurological deficits, seizure, pupillary size, length of stay), surgical data (craniotomy size, dividing the patients into 3 groups based on the corresponding tertile, and surgery duration), radiological data (ASDH side and thickness, midline shift, other post-traumatic lesions, extent of ASDH evacuation) and we assessed the functional outcome at hospital discharge and 6-month follow-up considering GOS=1-3 as a poor outcome. ANOVA and Chi-squared tests and logistic regression models were used to assess differences in and associations between clinicalradiological characteristics and functional outcomes. RESULTS We included 136 patients (76 males) with a mean age of 78±6 years. Forty-five patients underwent a small craniotomy, 47 a medium size, and 44 a large craniotomy. Among the different craniotomy size groups, there were no differences in gender, anticoagulant/antithrombotic therapy, CCI, side of ASDH, ASDH thickness, preoperative GCS, focal deficits, seizures, and presence of other posttraumatic lesions. Patients undergoing small craniotomies were older than patients undergoing medium-large craniotomies; ASDH treated with medium size craniotomy were thinner than the others; patients undergoing large craniotomies showed greater midline shift and a higher rate of anisocoria. The three groups did not differ for functional outcome and postoperative midline shift, but the length of surgery and the rate of >50% of ASDH evacuation were lower in the small craniotomy group. CONCLUSIONS A small craniotomy was not inferior to larger craniotomies in determining functional outcomes in the treatment of ASDH in the elderly.
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Affiliation(s)
| | - Alba Scerrati
- Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Oriela Rustemi
- UOC Neurochirurgia 1, Azienda ULSS 8 Berica Ospedale San Bortolo, Vicenza, Italy
| | - Luca Ricciardi
- UOC di Neurochirurgia, Azienda Ospedaliera Sant'Andrea, Dipartimento NESMOS, Sapienza, Roma, Italy
| | - Fabio Raneri
- UOC Neurochirurgia 1, Azienda ULSS 8 Berica Ospedale San Bortolo, Vicenza, Italy
| | | | - Amedeo Piazza
- UOC di Neurochirurgia, Azienda Ospedaliera Sant'Andrea, Dipartimento NESMOS, Sapienza, Roma, Italy
| | | | - Vito Stifano
- Institute of Neurosurgery, Catholic University of the Sacred Heart, Rome, Italy
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Michele Dughiero
- Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy
| | - Pasquale DE Bonis
- Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Annunziato Mangiola
- Neurosurgical Unit, Ospedale Santo Spirito, Pescara, Italy
- Department of Neurosciences, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| | - Carmelo L Sturiale
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy -
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Trungu S, Scollato A, Ricciardi L, Forcato S, Polli FM, Miscusi M, Raco A. Clinical Outcomes of Shunting in Normal Pressure Hydrocephalus: A Multicenter Prospective Observational Study. J Clin Med 2022; 11:jcm11051286. [PMID: 35268376 PMCID: PMC8911143 DOI: 10.3390/jcm11051286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Normal pressure hydrocephalus (NPH) is characterized by the triad of dementia, gait disturbance and urinary incontinence, all potentially reversible following a ventriculoperitoneal shunt (VPS). This study aims to evaluate the clinical outcomes of shunting in normal pressure hydrocephalus following a new standardized protocol. Methods: This study is designed according to the STROBE guidelines. Demographical, clinical, surgical and radiological data were collected from May 2015 to November 2019. Gait, balance and incontinence data based on the NPH European scale were collected before and after one, six and twelve months of treatment with a VPS. Clinical symptoms and changes of the stoke volume, measured on phase-contrast MRI, were used to evaluate improvement after VPS surgery. Results: One hundred and eighty-one consecutive patients met the inclusion criteria. The mean age was 73.1 years (59−86) and mean follow-up was 38.3 months (13−50). The gait (58.5 ± 14.3 to 70.1 ± 13.4, p < 0.001), the balance (66.7 ± 21.5 to 71.7 ± 22.1, p = 0.001), continence domain (69.9 ± 20.5 to 76 ± 20, p = 0.002) scores and neuropsychological scales showed a statistically significant improvement over the follow-up. The overall improvement after 12 months was present in 91.2% of patients. An overall complication rate of 8.8% and a reoperation rate of 9.4% were recorded, respectively. Conclusions: Surgical treatment by VPS for NPH improves symptoms in most patients, when accurately selected. A standardized protocol and a multidisciplinary team dedicated to this disorder is needed to achieve an early and correct diagnosis of NPH. Follow-up with stroke volume measurement is a valuable tool for the early diagnosis of shunt malfunction or the need for valve adjustment.
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Affiliation(s)
- Sokol Trungu
- Neurosurgery Unit, Card. G. Panico Hospital, 73039 Tricase, Italy; (A.S.); (S.F.)
- Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy; (L.R.); (M.M.); (A.R.)
- Correspondence:
| | - Antonio Scollato
- Neurosurgery Unit, Card. G. Panico Hospital, 73039 Tricase, Italy; (A.S.); (S.F.)
| | - Luca Ricciardi
- Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy; (L.R.); (M.M.); (A.R.)
| | - Stefano Forcato
- Neurosurgery Unit, Card. G. Panico Hospital, 73039 Tricase, Italy; (A.S.); (S.F.)
| | | | - Massimo Miscusi
- Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy; (L.R.); (M.M.); (A.R.)
| | - Antonino Raco
- Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy; (L.R.); (M.M.); (A.R.)
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Ricciardi L, Sturiale CL, Scerrati A, Stifano V, Somma T, Ius T, Trungu S, Acqui M, Raco A, Miscusi M, Della Pepa GM. 5-Aminolevulinic Acid False-Positive Rates in Newly Diagnosed and Recurrent Glioblastoma: Do Pseudoprogression and Radionecrosis Play a Role? A Meta-Analysis. Front Oncol 2022; 12:848036. [PMID: 35252015 PMCID: PMC8891510 DOI: 10.3389/fonc.2022.848036] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/24/2022] [Indexed: 01/15/2023] Open
Abstract
Background Several studies have confirmed the impact of 5-aminolevulinic acid (5-ALA) on the extent of resection in newly diagnosed glioblastoma (GBM). However, there are controversies on the 5-ALA fluorescence status in recurrent GBM surgery, with specific reference to pseudoprogression or radionecrosis; therefore, the safety and accuracy of surgical planning in 5-ALA-assisted procedures in the recurrent context are still unclear. Materials and Methods This is a systematic review and meta-analysis of comparative studies on the use of 5-ALA in newly diagnosed and recurrent GBM, consistently conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Data on fluorescence status and correlation between fluorescence and histological findings were collected. We performed a meta-analysis of proportions to estimate the pooled rates of each outcome. Results Three online medical databases (PubMed, Scopus, Cochrane Library) were screened, 448 articles were evaluated, and 3 papers were finally included for data analysis. Fluorescence rate was not different between newly diagnosed and recurrent GBM [p = 0.45; odds ratio (OR): 1.23; 95% CI: 0.72–2.09; I2 = 0%], while the rate of 5-ALA fluorescence-positive areas not associated with histological findings of GBM cells was higher in recurrent GBM (p = 0.04; OR: 0.24; 95% CI: 0.06–0.91; I2 = 19%). Furthermore, there were no cases of radionecrosis in false-positive samples, while inflammation and signs of pseudoprogression were found in 81.4% of the cases. Discussion and Conclusions Therefore, a robust awareness of 5-ALA potentialities and pitfalls in recurrent GBM surgery should be considered for a cognizant surgical strategy. Further clinical trials could confirm the results of the present meta-analysis.
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Affiliation(s)
- Luca Ricciardi
- Division of Neurosurgery, Sant’Andrea Hospital, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Carmelo Lucio Sturiale
- Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
- Division of Neurosurgery, Catholic University of Rome, Rome, Italy
| | - Alba Scerrati
- Neurosurgery Department, S. Anna University Hospital, Ferrara, Italy
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Vito Stifano
- Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
- Division of Neurosurgery, Catholic University of Rome, Rome, Italy
| | - Teresa Somma
- Division of Neurosurgery, Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - Tamara Ius
- Division of Neurosurgery, Neuroscience Department, University Hospital of Udine, Udine, Italy
| | - Sokol Trungu
- Division of Neurosurgery, Sant’Andrea Hospital, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Neurosurgery Unit, Cardinal G. Panico Hospital, Tricase, Italy
- *Correspondence: Sokol Trungu,
| | - Michele Acqui
- Division of Neurosurgery, Sant’Andrea Hospital, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Antonino Raco
- Division of Neurosurgery, Sant’Andrea Hospital, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Massimo Miscusi
- Division of Neurosurgery, Sant’Andrea Hospital, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Giuseppe Maria Della Pepa
- Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
- Division of Neurosurgery, Catholic University of Rome, Rome, Italy
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Sturiale CL, Scerrati A, Ricciardi L, Rustemi O, Auricchio AM, Norri N, Piazza A, Ranieri F, Tomatis A, Albanese A, Di Egidio V, Farneti M, Mangiola A, Marchese E, Raco A, Volpin L, Trevisi G. Clipping versus coiling for treatment of middle cerebral artery aneurysms: a retrospective Italian multicenter experience. Neurosurg Rev 2022; 45:3179-3191. [PMID: 35665868 PMCID: PMC9492556 DOI: 10.1007/s10143-022-01822-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/30/2022] [Accepted: 05/29/2022] [Indexed: 02/03/2023]
Abstract
Endovascular treatment has emerged as the predominant approach in intracranial aneurysms. However, surgical clipping is still considered the best treatment for middle cerebral artery (MCA) aneurysms in referral centers. Here we compared short- and long-term clinical and neuroradiological outcomes in patients with MCA aneurysms undergoing clipping or coiling in 5 Italian referral centers for cerebrovascular surgery. We retrospectively reviewed 411 consecutive patients admitted between 2015 and 2019 for ruptured and unruptured MCA aneurysm. Univariate and multivariate analyses of the association between demographic, clinical, and radiological parameters and ruptured status, type of surgical treatment, and clinical outcome at discharge and follow-up were performed. Clipping was performed in 340 (83%) cases, coiling in 71 (17%). Clipping was preferred in unruptured aneurysms and in those showing collateral branches originating from neck/dome. Surgery achieved a higher rate of complete occlusion at discharge and follow-up. Clipping and coiling showed no difference in clinical outcome in both ruptured and unruptured cases. In ruptured aneurysms age, presenting clinical status, intracerebral hematoma at onset, and treatment-related complications were significantly associated with outcome at both short- and long-term follow-up. The presence of collaterals/perforators originating from dome/neck of the aneurysms also worsened the short-term clinical outcome. In unruptured cases, only treatment-related complications such as ischemia and hydrocephalus were associated with poor outcome. Clipping still seems superior to coiling in providing better short- and long-term occlusion rates in MCA aneurysms, and at the same time, it appears as safe as coiling in terms of clinical outcome.
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Affiliation(s)
- Carmelo Lucio Sturiale
- grid.8142.f0000 0001 0941 3192Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8 – 00168, Rome, Italy
| | - Alba Scerrati
- grid.8484.00000 0004 1757 2064Department of Translational Medicine, University of Ferrara, Ferrara, Italy ,grid.416315.4Department of Neurosurgery, Sant’Anna University Hospital of Ferrara, Ferrara, Italy
| | - Luca Ricciardi
- grid.7841.aNESMOS Department, Neurosurgical Unit, Sapienza University of Rome, Italy
| | - Oriela Rustemi
- grid.416303.30000 0004 1758 2035Department of Neurosurgery, San Bortolo Hospital, Vicenza, Italy
| | - Anna Maria Auricchio
- grid.8142.f0000 0001 0941 3192Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8 – 00168, Rome, Italy
| | - Nicolò Norri
- grid.8484.00000 0004 1757 2064Department of Translational Medicine, University of Ferrara, Ferrara, Italy ,grid.416315.4Department of Neurosurgery, Sant’Anna University Hospital of Ferrara, Ferrara, Italy
| | - Amedeo Piazza
- grid.7841.aNESMOS Department, Neurosurgical Unit, Sapienza University of Rome, Italy
| | - Fabio Ranieri
- grid.416303.30000 0004 1758 2035Department of Neurosurgery, San Bortolo Hospital, Vicenza, Italy
| | | | - Alessio Albanese
- grid.8142.f0000 0001 0941 3192Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8 – 00168, Rome, Italy
| | | | - Marco Farneti
- grid.8484.00000 0004 1757 2064Department of Translational Medicine, University of Ferrara, Ferrara, Italy ,grid.416315.4Department of Neurosurgery, Sant’Anna University Hospital of Ferrara, Ferrara, Italy
| | - Annunziato Mangiola
- Neurosurgical Unit, Ospedale Spirito Santo, Pescara, Italy ,grid.412451.70000 0001 2181 4941Department of Neurosciences, Imaging and Clinical Sciences, G. D’Annunzio University, Chieti-Pescara, Italy
| | - Enrico Marchese
- grid.8142.f0000 0001 0941 3192Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8 – 00168, Rome, Italy
| | - Antonino Raco
- grid.7841.aNESMOS Department, Neurosurgical Unit, Sapienza University of Rome, Italy
| | - Lorenzo Volpin
- grid.416303.30000 0004 1758 2035Department of Neurosurgery, San Bortolo Hospital, Vicenza, Italy
| | - Gianluca Trevisi
- Neurosurgical Unit, Ospedale Spirito Santo, Pescara, Italy ,grid.412451.70000 0001 2181 4941Department of Neurosciences, Imaging and Clinical Sciences, G. D’Annunzio University, Chieti-Pescara, Italy
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Scerrati A, Trevisi G, Sturiale CL, Salomi F, De Bonis P, Saletti A, Mangiola A, Tomatis A, Di Egidio V, Vigo V, Pedicelli A, Valente I, Rustemi O, Beggio G, Iannucci G, Milonia L, Ricciardi L, Cervo A, Pero G, Piano M. Radiological outcomes for endovascular treatment of posterior communicating artery aneurysms: a retrospective multicenter study of the occlusion rate. J Integr Neurosci 2021; 20:919-931. [PMID: 34997715 DOI: 10.31083/j.jin2004093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 11/06/2022] Open
Abstract
Although several innovations in techniques and implantable devices were reported over the last decades, a consensus on the best endovascular treatment for intracranial aneurysms originating from the posterior communicating artery is still missing. This work investigates radiological outcomes of different endovascular techniques for posterior communicating artery aneurysms treatment in a retrospective multi-centric cohort. We included patients endovascularly treated for posterior communicating artery aneurysms from 2015 through 2020 in six tertiary referral hospitals. We evaluated the relationship between patients and aneurysms characteristics, baseline neurological status, radiological outcomes, and the different endovascular techniques. Overall, 250 patients were included in this study. Simple coiling was the most frequent treatment in 171 patients (68%), followed by flow-diverter stenting in 32 cases (13%). Complete occlusion was reported in 163 patients (65%), near-complete occlusion in 43 (17%), and incomplete occlusion in 44 (18%). Radiological follow-up was available for 247 (98%) patients. The occlusion rate was stable in 149 (60%), improved in 49 (19%), and worsened in 51 (21%). No significant difference in exclusion rate was seen between ruptured and unruptured aneurysms at the last follow-up (p = 0.4). Posterior communicating artery thrombosis was reported in 25 patients (9%), transient ischemic attack in 6 (2%), and in 38 patients (15%), subsequent procedures were needed due to incomplete occlusion or reperfusion. Endovascular strategies for posterior communicating artery aneurysms represent effective and relatively safe treatments. Simple coiling provides a higher immediate occlusion rate, although recanalization has been frequently reported, conversely, flow-diversion devices provide good long-term radiological outcomes.
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Affiliation(s)
- Alba Scerrati
- Department of Neurosurgery, S. Anna University Hospital, 44121 Ferrara, Italy.,Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Gianluca Trevisi
- Neurosurgical Unit, Santo Spirito Hospital, 65121 Pescara, Italy
| | - Carmelo Lucio Sturiale
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00185 Rome, Italy
| | - Francesco Salomi
- Department of Neurosurgery, S. Anna University Hospital, 44121 Ferrara, Italy
| | - Pasquale De Bonis
- Department of Neurosurgery, S. Anna University Hospital, 44121 Ferrara, Italy.,Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Andrea Saletti
- Department of Interventional Neuroradiology, S. Anna University Hospital, 44121 Ferrara, Italy
| | | | - Alberto Tomatis
- Neurosurgical Unit, Santo Spirito Hospital, 65121 Pescara, Italy
| | | | - Vera Vigo
- Department of Neurosurgery, S. Anna University Hospital, 44121 Ferrara, Italy.,The Stanford Neurosurgical Training and Innovation Center, Department of Neurosurgery, Stanford University, 94305 Palo Alto, CA, USA
| | - Alessandro Pedicelli
- Department of Radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00185 Rome, Italy
| | - Iacopo Valente
- Department of Radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00185 Rome, Italy
| | - Oriela Rustemi
- Department of Neurosurgery, San Bortolo Hospital, 70300 Vicenza, Italy
| | - Giacomo Beggio
- Department of Neurosurgery, San Bortolo Hospital, 70300 Vicenza, Italy
| | - Giuseppe Iannucci
- Department of Neuroradiology, San Bortolo Hospital, 70300 Vicenza, Italy
| | - Luca Milonia
- Department of Neuroradiology, Niguarda Hospital, 20162 Milan, Italy
| | - Luca Ricciardi
- Department of Neurosurgery, Azienda Ospedaliera Sant'Andrea, Dipartimento NESMOS, 00186 Rome, Italy
| | - Amedeo Cervo
- Department of Neuroradiology, Niguarda Hospital, 20162 Milan, Italy
| | - Guglielmo Pero
- Department of Neuroradiology, Niguarda Hospital, 20162 Milan, Italy
| | - Mariangela Piano
- Department of Neuroradiology, Niguarda Hospital, 20162 Milan, Italy
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Somma T, DE Rosa A, Mastantuoni C, Esposito F, Meglio V, Romano F, Ricciardi L, DE Divitiis O, DI Somma C. Multidisciplinary management of osteoporotic vertebral fractures. An overview. Minerva Endocrinol (Torino) 2021; 47:189-202. [PMID: 34881854 DOI: 10.23736/s2724-6507.21.03515-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Vertebral fractures represent the most frequent complication associated with osteoporosis. Patients harboring a vertebral fracture complain physical impairment including low back pain and spine balance alteration, i.e., kyphosis, leading to subsequent systemic complication, with an increase in morbidity and mortality risk. Different strategies are available in the management of osteoporotic vertebral fractures: medical therapy acts as a prevention strategy while surgical vertebral augmentation procedures, when correctly indicated, aim to reduce pain and to restore the physiological vertebral height. Considering the growing prevalence and incidence of this condition and its socio-economic burden, prevention, diagnosis and treatment of osteoporotic vertebral fractures are of utmost importance. Our aim is to review the current strategies for the management of osteoporotic vertebral fractures providing an integrated multidisciplinary endocrinological, radiological and neurosurgical point of view.
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Affiliation(s)
- Teresa Somma
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Andrea DE Rosa
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy -
| | - Ciro Mastantuoni
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Felice Esposito
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Vincenzo Meglio
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Fiammetta Romano
- Unit of Endocrinology, Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy
| | - Luca Ricciardi
- Neurosurgery, Department NESMOS, Sapienza University of Rome, Rome, Italy
| | - Oreste DE Divitiis
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Carolina DI Somma
- Unit of Endocrinology, Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy
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Gallè F, Valeriani F, Marotta D, De Giorgi A, Bargellini A, Bianco A, Colucci ME, Coniglio MA, Dallolio L, De Giglio O, Di Giuseppe G, Diella G, Laganà P, Licata F, Liguori G, Marchesi I, Marini S, Montagna MT, Napoli C, Orsi GB, Pasquarella C, Pelullo CP, Ricciardi L, Romano Spica V, Sacchetti R, Tardivo S, Veronesi L, Vitali M, Protano C. What about Your Body Ornament? Experiences of Tattoo and Piercing among Italian Youths. Int J Environ Res Public Health 2021; 18:12429. [PMID: 34886155 PMCID: PMC8657262 DOI: 10.3390/ijerph182312429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND tattooing and piercing are increasingly common, especially among youths. However, several health complications may be associated with these practices if basic hygiene rules are not respected. This multicenter study was aimed at exploring tattoo and piercing experiences reported by a large sample of Italian undergraduate students through a public health perspective. METHODS tattooed and/or pierced students attending 12 Italian universities were asked to complete a web-based questionnaire regarding their body art experience. RESULTS out of 1472 respondents, 833 (56.6%) were tattooed and 1009 (68.5%) were pierced. The greatest proportion of tattooed students (93.9%) got her/his first tattoo in a tattoo studio, while most of the pierced were serviced in a jewelry store (48.0%). The pierced ones were less informed on health issues related to the procedure (56.0% versus 77.8% of tattooed p < 0.001), and tattooists were reportedly more attentive to hygiene rules (instrument sterilization 91.5% versus 79.1% of piercers, p < 0.001; use of disposable gloves 98.2% versus 71% of piercers, p < 0.001). CONCLUSIONS educational interventions for both professionals and communities are needed to improve the awareness and the control of health risks related to body art throughout the Italian territory.
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Affiliation(s)
- Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy;
| | - Federica Valeriani
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy;
| | - Daniela Marotta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.M.); (A.D.G.); (G.B.O.); (M.V.); (C.P.)
| | - Andrea De Giorgi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.M.); (A.D.G.); (G.B.O.); (M.V.); (C.P.)
| | - Annalisa Bargellini
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (I.M.)
| | - Aida Bianco
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy; (A.B.); (F.L.)
| | - Maria Eugenia Colucci
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (M.E.C.); (C.P.); (L.V.)
| | - Maria Anna Coniglio
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy;
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Sciences Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (L.D.); (S.M.)
| | - Osvalda De Giglio
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (O.D.G.); (G.D.); (M.T.M.)
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.D.G.); (C.P.P.)
| | - Giusy Diella
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (O.D.G.); (G.D.); (M.T.M.)
| | - Pasqualina Laganà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy;
| | - Francesca Licata
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy; (A.B.); (F.L.)
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy;
| | - Isabella Marchesi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (I.M.)
| | - Sofia Marini
- Department of Biomedical and Neuromotor Sciences Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (L.D.); (S.M.)
| | - Maria Teresa Montagna
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (O.D.G.); (G.D.); (M.T.M.)
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00139 Rome, Italy;
| | - Giovanni Battista Orsi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.M.); (A.D.G.); (G.B.O.); (M.V.); (C.P.)
| | - Cesira Pasquarella
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (M.E.C.); (C.P.); (L.V.)
| | - Concetta Paola Pelullo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.D.G.); (C.P.P.)
| | - Luca Ricciardi
- Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy;
| | - Vincenzo Romano Spica
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy;
| | - Rossella Sacchetti
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna, 40126 Bologna, Italy;
| | - Stefano Tardivo
- Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Italy;
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (M.E.C.); (C.P.); (L.V.)
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.M.); (A.D.G.); (G.B.O.); (M.V.); (C.P.)
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.M.); (A.D.G.); (G.B.O.); (M.V.); (C.P.)
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Mongardi L, Visani J, Mantovani G, Vitali C, Ricciardi L, Giordano F, Cavallo MA, Lofrese G, D'andrea M, Roblot P, De Bonis P, Scerrati A. Long term results of Dorsal Root Entry Zone (DREZ) lesions for the treatment of intractable pain: A systematic review of the literature on 1242 cases. Clin Neurol Neurosurg 2021; 210:107004. [PMID: 34739884 DOI: 10.1016/j.clineuro.2021.107004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Different Dorsal root entry zone (DREZ) lesion techniques have been reported as effective treatment for intractable painful conditions, though with contradictory results. Overall, good results were reported especially in specific conditions, such as pain due to brachial plexus avulsion, spinal cord injuries and oncological pain management. However, data on long term results in different clinical conditions are still missing. OBJECTIVE This study aims to systematically review the pertinent literature to evaluate indications, clinical outcomes, and complications of DREZ lesion (DREZotomy), in chronic pain management. METHODS A systematic literature review was conducted according to the PRISMA statement. Papers on DREZotomy for chronic pain in cancer, brachial plexus avulsion, spinal cord injury, post herpetic neuralgia, and phantom limb pain were considered for eligibility. For each category we further identified two sub-group according to the length of follow up: medium term and long term follow up (more than 3 years) respectively. RESULTS 46 papers, and 1242 patients, were included in the present investigation. When considering long term results DREZotomy provided favorable clinical outcomes in brachial plexus avulsion and spinal cord injury, in 60.8% and 55.8% of the cases respectively. Conversely, the success rate was 35.3% in phantom limb pain and 28.2% in post herpetic neuralgia. A poor clinical outcome was reported in over than 25% of the patients suffering from phantom limb pain, post herpetic neuralgia and spinal cord injury. The mean complications rate was 23.58%. While BPA and SCI patients presented stable improvement over time, good outcomes among PHN and PLP groups dropped by - 46.2%; and - 14.7% at long term follow up respectively. CONCLUSION DREZotomy seems to be an effective treatment for chronic pain conditions, especially for brachial plexus avulsion, spinal cord injury and intractable cancer/post-radiation pain. According to the low level of evidence of the pertinent literature, further studies are strongly recommended, to better define potential benefits and limitations of this technique.
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Affiliation(s)
- Lorenzo Mongardi
- Department of Neurosurgery, Sant'Anna University Hospital, Ferrara, Italy.
| | - Jacopo Visani
- Department of Neurosurgery, Sant'Anna University Hospital, Ferrara, Italy
| | - Giorgio Mantovani
- Department of Neurosurgery, Sant'Anna University Hospital, Ferrara, Italy
| | - Costanza Vitali
- Department of Morphology, Surgery and Experimental Medicine, Section of Anaesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Sant' Anna, University of Ferrara, Ferrara, Italy
| | - Luca Ricciardi
- UO di Neurochirurgia, Pia Fondazione di Culto e Religione Cardinal G. Panico, Tricase, LE, Italy
| | - Flavio Giordano
- Department of Neurosurgery, Children's Hospital A. Meyer, University of Florence, Florence, Italy
| | - Michele Alessandro Cavallo
- Department of Neurosurgery, Sant'Anna University Hospital, Ferrara, Italy; Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Italy
| | | | | | - Paul Roblot
- Department of Neurosurgery, University Hospital of Bordeaux, Bordeaux, France
| | - Pasquale De Bonis
- Department of Neurosurgery, Sant'Anna University Hospital, Ferrara, Italy; Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Italy
| | - Alba Scerrati
- Department of Neurosurgery, Sant'Anna University Hospital, Ferrara, Italy; Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Italy
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Umana GE, Pucci R, Palmisciano P, Cassoni A, Ricciardi L, Tomasi SO, Strigari L, Scalia G, Valentini V. Cerebrospinal Fluid Leaks After Anterior Skull Base Trauma: A Systematic Review of the Literature. World Neurosurg 2021; 157:193-206.e2. [PMID: 34637942 DOI: 10.1016/j.wneu.2021.10.065] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Anterior skull base (ASB) fractures are reported in 4% of head injuries and represent 21% of all skull fractures. Cerebrospinal fluid (CSF) leaks may follow, severely exacerbating outcomes. We systematically reviewed the literature to analyze and compare the roles of endoscopic surgery, open surgery, and combined approaches in the management of CSF leak repair after posttraumatic ASB fractures. METHODS PubMed, Web of Science, and Scopus databases were searched in accordance with the PRISMA guidelines. Studies reporting clinical data of patients with CSF leaks after ASB fracture were reviewed, focusing on management strategies and posttreatment outcomes. RESULTS We included 29 articles comprising 888 patients. The average age at diagnosis was 34 years (range, 18-91 years), with a male predominance (54%) and a male/female ratio of 2.9:1 (647:241). Clinical data were available for 888 patients with CSF leaks after ASB fracture, reporting a median follow-up time of 33.5 months (standard deviation, ±29; range, 0.5-330.0 months). Open surgical repair was the most common approach (67.9%), followed by endoscopic surgical repair (32.1%). The endoscopy cohort showed lower rates of complications (0.7% vs. 11.1%) and fistula recurrence (2.8% vs. 5.3%) compared with open surgery. CONCLUSIONS ASB fractures are frequently treated as late surgery, 24 hours from injury or later, especially for endoscopic surgery. Overall, the endoscopic approach is preferred, mostly because of its safety and effectiveness, offering lower failure rates than does open surgery.
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Affiliation(s)
- Giuseppe E Umana
- Department of Neurosurgery, Cannizzaro Hospital, Trauma Center, Gamma Knife Center, Catania, Italy.
| | - Resi Pucci
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Paolo Palmisciano
- Department of Neurosurgery, Cannizzaro Hospital, Trauma Center, Gamma Knife Center, Catania, Italy
| | - Andrea Cassoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Luca Ricciardi
- Division of Neurosurgery, Department of NESMOS, Sapienza University of Rome, Rome, Italy
| | - Santino O Tomasi
- Department of Neurological Surgery, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Laboratory for Microsurgical Neuroanatomy, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Lidia Strigari
- Department of Medical Physics, IRCCS University Hospital of Bologna, Bologna, Italy
| | - Gianluca Scalia
- Department of Neurosurgery, Highly Specialized Hospital and of National Importance "Garibaldi", Catania, Italy
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
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Trungu S, Ricciardi L, Forcato S, Miscusi M, Raco A. Percutaneous instrumentation with cement augmentation for traumatic hyperextension thoracic and lumbar fractures in ankylosing spondylitis: a single-institution experience. Neurosurg Focus 2021; 51:E8. [PMID: 34598149 DOI: 10.3171/2021.7.focus21308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/16/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The typical traumatic thoracolumbar (TL) fracture in patients with ankylosing spondylitis (AS) is a hyperextension injury involving all three spinal columns, which is associated with unfavorable outcomes. Although a consensus on the management of these highly unstable injuries is missing, minimally invasive surgery (MIS) has been progressively accepted as a treatment option, since it is related to lower morbidity and mortality rates. This study aimed to evaluate clinical and radiological outcomes after percutaneous instrumentation with cement augmentation for hyperextension TL fractures in patients with AS at a single institution. METHODS This cohort study was completed retrospectively. Back pain was assessed at preoperative, postoperative, and final follow-up visits using the visual analog scale (VAS). Patient-reported outcomes via the Oswestry Disability Index (ODI) and the new mobility score (NMS) were obtained to assess disability and mobility during follow-up. Radiological outcomes included the Cobb angle, sagittal index (SI), union rate, and implant failure. Intra- and postoperative complications were recorded. RESULTS A total of 22 patients met inclusion criteria. The mean patient age was 74.2 ± 7.3 years with a mean follow-up of 39.2 ± 17.4 months. The VAS score for back pain significantly improved over the follow-up period (from 8.4 ± 1.1 to 2.8 ± 0.8, p < 0.001). At the last follow-up, all patients had minor disability (mean ODI score 24.4 ± 6.1, p = 0.003) and self-sufficiency of mobility (mean NMS 7.5 ± 1.6, p = 0.02). The Cobb angle (5.2° ± 2.9° preoperatively to 4.4° ± 3.3° at follow-up) and SI (7.9° ± 4.2° to 8.8° ± 5.1°) were maintained at follow-up, showing no loss of segmental kyphosis. Bone union was observed in all patients. The overall complication rate was 9.1%, while the reoperation rate for implant failure was 4.5%. CONCLUSIONS Percutaneous instrumentation with cement augmentation for traumatic hyperextension TL fractures in AS demonstrated good clinical and radiological outcomes, along with a high bone union level and low reoperation rate. Accordingly, MIS reduced the complication rate in the management of these injuries of the ankylosed spine.
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Affiliation(s)
- Sokol Trungu
- 1Neurosurgery Unit, Cardinale G. Panico Hospital, Tricase; and.,2NESMOS Department, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Luca Ricciardi
- 1Neurosurgery Unit, Cardinale G. Panico Hospital, Tricase; and.,2NESMOS Department, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Stefano Forcato
- 1Neurosurgery Unit, Cardinale G. Panico Hospital, Tricase; and
| | - Massimo Miscusi
- 2NESMOS Department, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Antonino Raco
- 2NESMOS Department, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
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Scerrati A, Mongardi L, Cavallo MA, Labanti S, Simioni V, Ricciardi L, De Bonis P. Awake surgery for skills preservation during a sensory area tumor resection in a clarinet player. Acta Neurol Belg 2021; 121:1235-1239. [PMID: 32372400 DOI: 10.1007/s13760-020-01368-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/24/2020] [Indexed: 01/01/2023]
Abstract
Tumors in primary sensory area are challenging to remove without causing a neurological deficit, especially in musicians who present complex neuronal networks. Indeed, in this kind of patients, somatosensory evoked potentials (SSEPs) are not plenty. We describe our experience for sensory and proprioception preservation in a professional clarinet player undergoing surgery for a right parietal glioblastoma. The patient underwent surgery for a right parietal glioblastoma. Intraoperative monitoring and awake surgery while playing instrument, were performed. During resection, intraoperative stimulation caused a transient impairment of left hand movements, without SSEPs alteration. The resection was stopped anytime there was a movement impairment. We obtained a gross total tumor resection. Patient did not present neurological deficits. Standard neurophysiological monitoring is fundamental but cannot be sufficient. More complex strategies of monitoring, such as awake surgery and playing an instrument could be of help for preserving complex sensory-motor functions.
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Affiliation(s)
| | | | | | | | | | - Luca Ricciardi
- UOC di Neurochirurgia, Azienda Ospedaliera Sant'Andrea, Dipartimento NESMOS, Sapienza, Rome, Italy
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Scerrati A, Visani J, Ricciardi L, Dones F, Rustemi O, Cavallo MA, De Bonis P. To drill or not to drill, that is the question: nonsurgical treatment of chronic subdural hematoma in the elderly. A systematic review. Neurosurg Focus 2021; 49:E7. [PMID: 33002869 DOI: 10.3171/2020.7.focus20237] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 07/21/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Chronic subdural hematoma (CSDH) is one of the most common neurosurgical pathologies, typically affecting the elderly. Its incidence is expected to grow along with the aging population. Surgical drainage represents the treatment of choice; however, postoperative complications and the rate of recurrence are not negligible. For this reason, nonsurgical alternatives (such as middle meningeal artery embolization, steroids, or tranexamic acid administration) are gaining popularity worldwide and need to be carefully evaluated, especially in the elderly population. METHODS The authors performed a systematic review according to PRISMA criteria of the studies analyzing the nonsurgical strategies for CSDHs. They collected all papers in the English language published between 1990 and 2019 by searching different medical databases. The chosen keywords were "chronic subdural hematoma," "conservative treatment/management," "pharmacological treatment," "non-surgical," "tranexamic acid," "dexamethasone," "corticosteroid," "glucocorticoid," "middle meningeal artery," "endovascular treatment," and "embolization." RESULTS The authors ultimately collected 15 articles regarding the pharmacological management of CSDHs matching the criteria, and 14 papers included the endovascular treatment. CONCLUSIONS The results showed that surgery still represents the mainstay in cases of symptomatic patients with large CSDHs; however, adjuvant and alternative therapies can be effective and safe in a carefully selected population. Their inclusion in new guidelines is advisable.
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Affiliation(s)
- Alba Scerrati
- 1Department of Morphology, Anatomy and Experimental Medicine, University of Ferrara.,2Department of Neurosurgery, Sant'Anna University Hospital, Ferrara
| | - Jacopo Visani
- 2Department of Neurosurgery, Sant'Anna University Hospital, Ferrara
| | - Luca Ricciardi
- 3Department of Neurosurgery, Pia Fondazione di Culto e Religione Cardinal G. Panico, Tricase, Lecce; and
| | - Flavia Dones
- 2Department of Neurosurgery, Sant'Anna University Hospital, Ferrara
| | - Oriela Rustemi
- 4Department of Neurosurgery, San Bortolo Hospital, Vicenza, Italy
| | - Michele Alessandro Cavallo
- 1Department of Morphology, Anatomy and Experimental Medicine, University of Ferrara.,2Department of Neurosurgery, Sant'Anna University Hospital, Ferrara
| | - Pasquale De Bonis
- 1Department of Morphology, Anatomy and Experimental Medicine, University of Ferrara.,2Department of Neurosurgery, Sant'Anna University Hospital, Ferrara
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Lofrese G, Ricciardi L, De Bonis P, Cultrera F, Cappuccio M, Scerrati A, Martucci A, Musio A, Tosatto L, De Iure F. Use of the SpineJack direct reduction for treating type A2, A3 and A4 fractures of the thoracolumbar spine: a retrospective case series. J Neurointerv Surg 2021; 14:931-937. [PMID: 34433644 DOI: 10.1136/neurintsurg-2021-017682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/03/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Compression injuries of the thoracolumbar spine without neurological impairment are usually treated with minimally invasive procedures. Intravertebral expandable implants represent an alternative strategy in fractures with low fragments' displacement. METHODS Patients with A2, A3 and A4 fractures of the T10-L2 spinal segment without neurological impairment, fracture gap >2 mm, vertebra plana, pedicle rupture, pedicle diameter <6 mm, spinal canal encroachment ≥50%, and vertebral body spread >30% were treated with the SpineJack device. Patients with pathological/osteoporotic fractures were excluded. Demographic and fracture-related data were assessed together with vertebral kyphosis correction, vertebral height restoration/loss of correction and final kyphosis. The modified Rankin Scale (mRS), Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), Smiley-Webster Pain Scale (SWPS) and EuroQol-5D (EQ-5D) were evaluated at 1 (-post), 6 and 12 months (-fup) after surgery. Statistical analysis was performed and p values ≤0.05 were considered significant. RESULTS Fifty-seven patients were included in the study. Patients aged >60 years reported worse kyphosis correction (<4°) with more postoperative complications, while vertebral plasticity in younger patients, fragmentation-related greater remodeling in A3/A4 fractures, and treatments within 7 days of trauma determined superior wedging corrections, with better EQ-5D-post and mRS-fup. Cement leakages did not affect functional outcome, while female gender and American Society of Anesthesiologists (ASA) score of 3-4 were associated with worse ODI-fup and VAS-fup. Although fracture characteristics and radiological outcome did not negatively influence the clinical outcome, A2 fracture was a risk factor for complications, thus indirectly compromising both the functional and radiological outcome. CONCLUSION With spread of <30%, the SpineJack is an alternative to minimally invasive fixations for treating A3/A4 thoracolumbar fractures, being able to preserve healthy motion segments in younger patients and provide an ultra-conservative procedure for elderly and fragile patients.
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Affiliation(s)
- Giorgio Lofrese
- Department of Neurosciences, Neurosurgery Division - "M Bufalini" Hospital, Cesena, Emilia-Romagna, Italy
| | | | | | - Francesco Cultrera
- Department of Neurosciences, Neurosurgery Division - "M Bufalini" Hospital, Cesena, Emilia-Romagna, Italy
| | - Michele Cappuccio
- Department of Spine Surgery, Ospedale Maggiore "C.A. Pizzardi", Bologna, Italy
| | - Alba Scerrati
- Neurosurgery, University Hospital S.Anna, Ferrara, Italy
| | - Antonio Martucci
- Department of Spine Surgery, Ospedale Maggiore "C.A. Pizzardi", Bologna, Italy
| | - Antonio Musio
- Neurosurgery, University Hospital S.Anna, Ferrara, Italy
| | - Luigino Tosatto
- Department of Neurosciences, Neurosurgery Division - "M Bufalini" Hospital, Cesena, Emilia-Romagna, Italy
| | - Federico De Iure
- Department of Spine Surgery, Ospedale Maggiore "C.A. Pizzardi", Bologna, Italy
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Piazza A, Ricciardi L, Trungu S, Forcato S, di Bartolomeo A, Scerrati A, Miscusi M, Raco A. The Lone Star Retractor System in Neurosurgery. World Neurosurg 2021; 153:36-40. [PMID: 34186216 DOI: 10.1016/j.wneu.2021.06.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND We investigated the role of a self-retaining retractor system, commonly used in ear, abdominal, vascular, urologic and gynecologic surgeries: the Lone Star retractor system. We report our experience in using the Lone Star retractor in different brain surgeries, at a single neurosurgical department. METHODS In 2019, patients who underwent brain surgery and in which the Lone Star Retractor System was used were considered for inclusion. Clinical and surgical data of included patients were prospectively collected. Postoperative VAS for local pain, and a properly designed intraoperative retractor stability score, were collected. RESULTS Over 2019, the Lone Stare Retractor was used in 20 neurosurgical procedures: 9 high-grade glioma, 2 low-grade glioma, 4 cerebral metastases, and 5 meningiomas. Postoperative mean VAS score was 3.5 (range: 2-4). Intraoperative retractor stability score mean was 2 in frontal, 2 in pterional, 1.75 in subtemporal, 2 in interhemispheric, and 0.5 in suboccipital approaches. The Stony Brook Scar Evaluation Scale mean value was 4.4 (range: 3-5). CONCLUSIONS In our institutional experience, the Lone Star retractor showed many advantages in different brain procedures, when compared with standard fishhooks and other retractors.
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Affiliation(s)
- Amedeo Piazza
- Operative Unit of Neurosurgery, AOSA, Department of NESMOS, Sapienza, Rome, Italy; Department of Neurosurgery, IRCCS, Neuromed, La Sapienza, Pozzilli, Italy.
| | - Luca Ricciardi
- Operative Unit of Neurosurgery, AOSA, Department of NESMOS, Sapienza, Rome, Italy
| | - Sokol Trungu
- Department of Neurosurgery, "Cardinale G. Panico" Tricase Hospital, Tricase, Italy
| | - Stefano Forcato
- Department of Neurosurgery, "Cardinale G. Panico" Tricase Hospital, Tricase, Italy
| | | | - Alba Scerrati
- Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy
| | - Massimo Miscusi
- Operative Unit of Neurosurgery, AOSA, Department of NESMOS, Sapienza, Rome, Italy
| | - Antonino Raco
- Operative Unit of Neurosurgery, AOSA, Department of NESMOS, Sapienza, Rome, Italy
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Ricciardi L, Pucci R, Valentini V, Raco A. Letter: Internal Auditory Canal Variability: Anatomic Variation Affects Cisternal Facial Nerve Visualization. Oper Neurosurg (Hagerstown) 2021; 20:E252-E253. [PMID: 33372945 DOI: 10.1093/ons/opaa431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/23/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Luca Ricciardi
- Department of Neurosurgery AOSA, NESMOS Sapienza University of Rome Rome, Italy
| | - Resi Pucci
- Department of Oral and Maxillofacial Sciences Sapienza University of Rome Rome, Italy.,Oncological and Reconstructive Maxillo-Facial Surgery Unit Policlinico Umberto I Rome, Italy
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences Sapienza University of Rome Rome, Italy.,Oncological and Reconstructive Maxillo-Facial Surgery Unit Policlinico Umberto I Rome, Italy
| | - Antonino Raco
- Department of Neurosurgery AOSA, NESMOS Sapienza University of Rome Rome, Italy
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Di Bartolomeo A, Ricciardi L, Miscusi M, Serrao M, Raco A. Letter to the editor regarding "Representative dynamic ranges of spinal alignment during gait in patients with mild and severe adult spinal deformities" by Mar etal. Spine J 2021; 21:1042-1043. [PMID: 34053503 DOI: 10.1016/j.spinee.2021.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/01/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Alessandro Di Bartolomeo
- Division of Neurosurgery, AOU Sant'Andrea, Department of NESMOS, Sapienza University, Rome, Italy.
| | - Luca Ricciardi
- Division of Neurosurgery, AOU Sant'Andrea, Department of NESMOS, Sapienza University, Rome, Italy
| | - Massimo Miscusi
- Division of Neurosurgery, AOU Sant'Andrea, Department of NESMOS, Sapienza University, Rome, Italy
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza, University of Rome, Italy
| | - Antonino Raco
- Division of Neurosurgery, AOU Sant'Andrea, Department of NESMOS, Sapienza University, Rome, Italy
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Ricciardi L, Scerrati A, Bonis PD, Miscusi M, Trungu S, Visocchi M, Papacci F, Raco A, Proietti L, Pompucci A, Olivi A, Montano N. Long-term Radiologic and Clinical Outcomes after Three-level Contiguous Anterior Cervical Diskectomy and Fusion without Plating: A Multicentric Retrospective Study. J Neurol Surg A Cent Eur Neurosurg 2021; 82:556-561. [PMID: 34010980 DOI: 10.1055/s-0041-1726112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Anterior cervical diskectomy and fusion (ACDF) has been providing good surgical, clinical, and radiologic outcomes in patients suffering from cervical degenerative disk disease (DDD). However, the role of anterior plating is still debated, especially in three-level procedures. This study aimed to investigate long-term clinical and radiologic outcomes and complications after three-level contiguous ACDF without plating for cervical DDD. METHODS Two institutional databases were retrieved (January 2009-December 2014) for patients treated with three-level contiguous ACDF without plating. Minimum follow-up (FU) was 5 years. Demographical data, smoking status, implant types, Neck Disability Index (NDI), visual analog scale (VAS) for neck pain, complications, fusion rate, adjacent segment degeneration (ASD), cervical lordosis (CL), and residual segmental mobility were evaluated. RESULTS We enrolled 21 patients. Tantalum and carbon fiber cages were implanted, respectively, in 13 and 8 patients. The mean FU length was 5.76 ± 0.87 years. Mean NDI score was 78.29 ± 9.98% preoperatively and 8.29 ± 1.67% at last FU (p < 0.01), whereas mean VAS score decreased from 7.43 ± 1.14 preoperatively to 0.95 ± 0.95 at last FU (p < 0.01). Complications were one postoperative hematoma, one superficial wound infection, and five cases of postoperative dysphagia (recovered within 3 days). The fusion rate was 90% and ASD was reported in three (14%) cases. The mean CL was 6.33 ± 2.70 degrees preoperatively, 8.19 ± 1.97 degrees 3 months after surgery (p = 0.02), and 7.62 ± 1.96 degrees at latest FU. There was no residual mobility on every operated segment at last FU. The smoking status was an independent risk factor for nonfusion in this case series (p = 0.02). CONCLUSIONS Three-level contiguous ACDF without plating seems to be an effective treatment for cervical DDD. Properly designed comparative clinical trials are needed to further investigate this topic.
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Affiliation(s)
- Luca Ricciardi
- UO di Neurochirurgia, Pia Fondazione di Culto e Religione Cardinal G. Panico, Tricase, Italy
| | - Alba Scerrati
- UOC di Neurochirurgia, Azienda Ospedaliera Sant'Anna, Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale, Università di Ferrara, Ferrara, Italy
| | - Pasquale De Bonis
- UOC di Neurochirurgia, Azienda Ospedaliera Sant'Anna, Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale, Università di Ferrara, Ferrara, Italy
| | - Massimo Miscusi
- UOC di Neurochirurgia, Azienda Ospedaliera Sant'Andrea, Sapienza, Roma, Italy
| | - Sokol Trungu
- UO di Neurochirurgia, Pia Fondazione di Culto e Religione Cardinal G. Panico, Tricase, Italy.,UOC di Neurochirurgia, Azienda Ospedaliera Sant'Andrea, Sapienza, Roma, Italy
| | - Massimiliano Visocchi
- UOC di Neurochirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS, UCSC, Roma, Italy
| | - Fabio Papacci
- UOC di Neurochirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS, UCSC, Roma, Italy
| | - Antonino Raco
- UOC di Neurochirurgia, Azienda Ospedaliera Sant'Andrea, Sapienza, Roma, Italy
| | - Luca Proietti
- UOC di Chirurgia Vertebrale, Fondazione Policlinico Universitario A. Gemelli IRCCS, UCSC, Roma, Italy
| | - Angelo Pompucci
- UOC di Neurochirurgia, Ospedale Santa Maria Goretti, Latina, Italy
| | - Alessandro Olivi
- UOC di Neurochirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS, UCSC, Roma, Italy
| | - Nicola Montano
- UOC di Neurochirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS, UCSC, Roma, Italy
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Ricciardi L, Furci F, Gangemi S. Nickel sensitization influence on microbiota in allergic and non-allergic disorders: what's up? J BIOL REG HOMEOS AG 2021; 35:757-760. [PMID: 33910322 DOI: 10.23812/20-566-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L Ricciardi
- Allergy and Clinical Immunology Unit, Department of Clinical and Experimental Medicine, University Hospital G.Martino, University of Messina, Messina Italy
| | - F Furci
- Allergy and Clinical Immunology Unit, Department of Clinical and Experimental Medicine, University Hospital G.Martino, University of Messina, Messina Italy
| | - S Gangemi
- Allergy and Clinical Immunology Unit, Department of Clinical and Experimental Medicine, University Hospital G.Martino, University of Messina, Messina Italy
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Affiliation(s)
- Luca Ricciardi
- Dipartimento NESMOS, UOC di Neurochirurgia, AOU Sant'Andrea, Sapienza, Rome, Italy
| | - Giuseppe M Della Pepa
- UOC di Neurochirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy -
| | - Alba Scerrati
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy.,Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy
| | - Carmelo L Sturiale
- UOC di Neurochirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Trungu S, Ricciardi L, Forcato S, Scollato A, Minniti G, Miscusi M, Raco A. Percutaneous Carbon-PEEK instrumentation for spine tumors: a prospective observational study. J Neurosurg Sci 2021; 67:303-310. [PMID: 33870663 DOI: 10.23736/s0390-5616.21.05153-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Minimally invasive spine surgery (MISS) has been progressively accepted as a useful approach for spine tumors. Recently released carbon-PEEK implants have been already reported as effective in open surgeries for spine tumors. This study aimed to evaluate the feasibility, surgical, clinical and radiological outcomes of a new percutaneous carbon-PEEK instrumentations for spine tumors. METHODS This is a prospective case-control observational study. Demographical, clinical, surgical, and radiological data were collected from May 2018 to August 2019. Visual analogue scale for back pain (VAS), the Oswestry Disability Index (ODI) questionnaire, EORTC QLQ-C30 questionnaire for quality of life, and ASIA impairment scale (AIS) were collected before surgery and at 6 weeks and follow-up visits. Data were compared with the control group, a retrospective series of 23 metastatic patients that underwent titanium pedicle screw fixation. RESULTS Twenty-one patients met inclusion criteria. Mean age was 59.2 years (range, 35-78) and mean follow-up was 14.2 months (7-22). Thoracic spine was involved in 14 (66.7%) cases, lumbar spine in 7 (33.3%). The mean length of surgery was 75 (42-185) minutes, mean blood loss was 90ml (50-215) and every patient was mobilized within 24 hours after surgery. The VAS (8.3±1.1 to 2.9±1.0, p<0.05) and ODI (54.6±11.7 to 25.1±5.4, p<0.05) scores significantly improved over follow-up. AIS improved in 7 (33.3%) patients and remained unchanged in 14 (66.7%). The EORTC QLQ-C30 global health/QoL, functional and symptomatic scales significantly improved postoperatively and at the last follow-up. Only two minor complications (9.5%) were recorded. No statistically significant difference was observed between the two groups related to clinical, radiological outcomes, complications rate and implant failure. CONCLUSIONS Percutaneous Carbon/PEEK implants could be considered as alternative to standard titanium implants in oncological patients, according to their lower rate of MRI artifacts, facilitating radiological follow-up and adjuvant radiotherapy. Further clinical trials and biomechanical evaluations are needed to confirm our preliminary results.
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Affiliation(s)
- Sokol Trungu
- Neurosurgery Unit, Card. G. Panico Hospital, Tricase, Lecce, Italy - .,N.E.S.M.O.S. Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy -
| | - Luca Ricciardi
- Neurosurgery Unit, Card. G. Panico Hospital, Tricase, Lecce, Italy.,N.E.S.M.O.S. Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Stefano Forcato
- Neurosurgery Unit, Card. G. Panico Hospital, Tricase, Lecce, Italy
| | - Antonio Scollato
- Neurosurgery Unit, Card. G. Panico Hospital, Tricase, Lecce, Italy
| | - Giuseppe Minniti
- Radiation Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Massimo Miscusi
- N.E.S.M.O.S. Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Antonino Raco
- N.E.S.M.O.S. Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Scerrati A, Norri N, Mongardi L, Dones F, Ricciardi L, Trevisi G, Menegatti E, Zamboni P, Cavallo MA, De Bonis P. Styloidogenic-cervical spondylotic internal jugular venous compression, a vascular disease related to several clinical neurological manifestations: diagnosis and treatment-a comprehensive literature review. Ann Transl Med 2021; 9:718. [PMID: 33987416 PMCID: PMC8106058 DOI: 10.21037/atm-20-7698] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Internal jugular vein (IJV) stenosis is associated with several central nervous system disorders such as Ménière or Alzheimer’s disease. The extrinsic compression between the styloid process and the C1 transverse process, is an emerging biomarker related to several clinical manifestations. However, nowadays a limited number of cases are reported, and few information are available about treatment, outcome and complications. Our aim is to collect and identify clinical-radiological characteristics, diagnosis and treatment of the styloidogenic internal jugular venous compression. We performed a comprehensive literature review. Studies reporting patients suffering from extracranial jugular stenosis were searched. For every patient we collected: demography, clinical and radiological characteristics and outcome, type of treatment, complications. Thirteen articles reporting 149 patients were included. Clinical presentation was non-specific. Most frequent symptoms were headache (46.3%), tinnitus (43.6%), insomnia (39.6%). The stenosis was monolateral in 51 patients (45.9%) and bilateral in 60 (54.1%). Anticoagulants were the most common prescribed drug (57.4%). Endovascular treatment was performed in 50 patients (33.6%), surgery in 55 (36.9%), combined in 28 (18.8%). Improvement of general conditions was reported in 58/80 patients (72.5%). Complications were reported in 23% of cases. Jugular stenosis is a complex and often underestimated disease. Conservative medical treatment usually fails while surgical, endovascular or a combined treatment improves general conditions in more than 70% of patients.
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Affiliation(s)
- Alba Scerrati
- Neurosurgery Department, Sant'Anna University Hospital, Ferrara, Italy.,Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy
| | - Nicoló Norri
- Neurosurgery Department, Sant'Anna University Hospital, Ferrara, Italy
| | - Lorenzo Mongardi
- Neurosurgery Department, Sant'Anna University Hospital, Ferrara, Italy
| | - Flavia Dones
- Neurosurgery Department, Sant'Anna University Hospital, Ferrara, Italy
| | - Luca Ricciardi
- Neurosurgery, Azienda Ospedaliera Sant'Andrea, Sapienza, Rome, Italy
| | | | - Erica Menegatti
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy.,HUB Center Regione Emilia Romagna for Venous and Lymphatics Disorders, University Hospital of Ferrara, Ferrara, Italy
| | - Paolo Zamboni
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy.,HUB Center Regione Emilia Romagna for Venous and Lymphatics Disorders, University Hospital of Ferrara, Ferrara, Italy
| | - Michele Alessandro Cavallo
- Neurosurgery Department, Sant'Anna University Hospital, Ferrara, Italy.,Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy
| | - Pasquale De Bonis
- Neurosurgery Department, Sant'Anna University Hospital, Ferrara, Italy.,Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy
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Scerrati A, Pangallo G, Dughiero M, Mongardi L, Ricciardi L, Lofrese G, Dones F, Cavallo MA, De Bonis P. Influence of nutritional status on the clinical outcome of patients with chronic subdural hematoma: a prospective multicenter clinical study. Nutr Neurosci 2021; 25:1756-1763. [PMID: 33666524 DOI: 10.1080/1028415x.2021.1895480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Elderly patients present a higher risk of developing chronic subdural hematomas (CSDHs) together with increased risk of malnutrition. The nutritional status may affect outcomes, response to treatments, and prognosis. Influence on other kinds of diseases was investigated showing an increased risk of mortality, morbidity, and adverse outcomes. However, no studies are available on its possible role for the outcome of patients with CSDH. This study aims to evaluate a possible relationship between the nutritional status and the clinical outcome of patients who underwent CSDH surgery. METHODS This is a multicenter prospective study enrolling all patients treated for CSDH. Demographic and clinical data were collected. For nutritional status evaluation, we used the Mini Nutritional Assessment (MNA). Chi-square test was used for comparing clinical variables of patients and logistic regression analysis was used for defining the impact of the aforementioned variables on the clinical outcome. RESULTS We enrolled 178 patients. Modified Rankin scale (mRS) was 0-2 pre-operatively in 23.6% of patients and post-operatively in 61.2% of patients. Total assessment MNA score was >23.5 in 47.8% of patients. Ninety-three patients (52.2%) presented a normal nutritional status, 63 (35.4%) were at risk of malnutrition and 22 (12.4%) were malnourished. The mean follow-up was 2.6 months. Malnourished patients were at higher risk of a worse outcome (OR 81; CI = 9-750). CONCLUSION This study suggests that nutritional status represents a strong predictor of outcome. Our results, albeit preliminary, demonstrated malnutrition is correlated to the risk of worse clinical outcome for patients undergoing surgery for chronic subdural hematoma. Further investigations with wider casuistry and multiple nutritional scores are required to validate our data.
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Affiliation(s)
- Alba Scerrati
- Department of Neurosurgery, Sant' Anna University Hospital, Ferrara, Italy.,Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Giulia Pangallo
- Department of Neurosurgery, Sant' Anna University Hospital, Ferrara, Italy
| | - Michele Dughiero
- Department of Neurosurgery, Sant' Anna University Hospital, Ferrara, Italy
| | - Lorenzo Mongardi
- Department of Neurosurgery, Sant' Anna University Hospital, Ferrara, Italy
| | - Luca Ricciardi
- Neurosurgery Unit, Pia Fondazione di Culto e Religione Cardinal G. Panico, Tricase, Italy
| | - Giorgio Lofrese
- Neurosurgery Division, "M. Bufalini" Hospital, Cesena, Italy
| | - Flavia Dones
- Department of Neurosurgery, Sant' Anna University Hospital, Ferrara, Italy
| | - Michele Alessandro Cavallo
- Department of Neurosurgery, Sant' Anna University Hospital, Ferrara, Italy.,Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Pasquale De Bonis
- Department of Neurosurgery, Sant' Anna University Hospital, Ferrara, Italy.,Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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Affiliation(s)
- S J G Lewis
- Forefront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Sydney, Australia.
| | - L Ricciardi
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK; MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, Oxford, UK
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Ricciardi L, Trungu S, Scerrati A, Mongardi L, Flacco ME, Raco A, Miscusi M, De Bonis P, Sturiale CL. Surgical treatment of intracranial blister aneurysms: A systematic review. Clin Neurol Neurosurg 2021; 202:106550. [PMID: 33588360 DOI: 10.1016/j.clineuro.2021.106550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Intracranial blister aneurysms (BAs) are challenging vascular lesions related to high morbidity and mortality rates. Different surgical and endovascular techniques have been proposed to treat BAs; however, there is no consensus on a preferred treatment. OBJECTIVE To systematically review the pertinent literature on clinical and radiological outcomes of different surgical treatments for BAs management, to meta-analyze their clinical and radiological outcomes, and compare these results with those from recent meta-analyses on endovascular treatments for BAs. METHODS The present study was consistently conducted according to the PRISMA guidelines. Five different online medical databases (PubMed, Medline, EMBASE, Scopus, and Web-of-Science) were screened from 2010 through 2020. Papers reporting clinical and radiological outcomes of different surgical treatments for BAs were considered. Event rates were pooled across studies using random-effects meta-analysis. RESULTS A total of 35 studies reporting on 514 patients (534 aneurysms) were included. Aneurysm clipping in 223 patients (45.4%; 95% CI 21.9-53.8), bypass and trapping in 87 (17.7%; 95% CI 1.89-21.6), clipping and wrapping in 82 (16.7%; 95% CI 3.71-19.0), and wrapping in 33 (6.7%; 95% CI 0.0-4.87) were the mostly common performed treatments. Complete occlusion rate was reported in 90.7% of patients. The complication rate was as high as 61.1%, the mortality rate was 7.4%, and the mean mRS at follow-up was 2.5. CONCLUSIONS Our meta-analysis suggests that surgical treatments for BAs are related to higher occlusion, complications and mortality rate than endovascular strategies. However, there is a high-heterogeneity among the included studies and data are poorly reported; so comparing the two type of treatments is unreliable in order to establish which one is better.
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Affiliation(s)
- Luca Ricciardi
- UOC Di Neurochirurgia, Azienda Ospedaliera Sant'Andrea, Dipartimento NESMOS, Sapienza, Rome, Italy
| | - Sokol Trungu
- UOC Di Neurochirurgia, Azienda Ospedaliera Sant'Andrea, Dipartimento NESMOS, Sapienza, Rome, Italy; UO di Neurochirurgia, Pia Fondazione di Culto e Religione Cardinal G. Panico, Tricase, LE, Italy
| | - Alba Scerrati
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy; Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.
| | - Lorenzo Mongardi
- Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy
| | | | - Antonino Raco
- UOC Di Neurochirurgia, Azienda Ospedaliera Sant'Andrea, Dipartimento NESMOS, Sapienza, Rome, Italy
| | - Massimo Miscusi
- UOC Di Neurochirurgia, Azienda Ospedaliera Sant'Andrea, Dipartimento NESMOS, Sapienza, Rome, Italy
| | - Pasquale De Bonis
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy; Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy
| | - Carmelo Lucio Sturiale
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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De Bonis P, Cavallo MA, Sturiale CL, Martellucci C, Flacco ME, Dughiero M, Auricchio AM, Ricciardi L, Raco A, Bortolotti C, Tosatto L, D'Andrea M, Ruggiero M, Mongardi L, Zona G, Fiaschi P, Cofano F, Garbossa D, Scerrati A. Incidence of hemorrhagic cerebrovascular disease due to vascular malformations during the COVID-19 national quarantine in Italy. Clin Neurol Neurosurg 2021; 202:106503. [PMID: 33493878 DOI: 10.1016/j.clineuro.2021.106503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND hemorrhagic cerebrovascular disease due to vascular malformations represents an emergency for neurosurgery and neuro-interventional departments. During the COVID-19 pandemic, a dramatic reduction in the number of hospitalizations for acute myocardial infarction or stroke and a larger time interval from symptom onset to first medical contact have been reported. This study aims to verify the hypothesis that there would also have been a reduction of admissions for hemorrhagic cerebrovascular disease during the Italian lockdown. MATERIAL AND METHOD s A multicenter, observational survey was conducted to collect data on hospital admissions for hemorrhagic cerebrovascular disease due to vascular malformations throughout two-months (March 15th to May 15th); the years 2020 (COVID-19 Italian lockdown), 2019 and 2018 were compared. Cases were identified by ICD-9 codes 430, 431, 432.1, 432.9, 747.81 of each hospital database. The statistical significance of the difference between the event rate of one year versus the others was evaluated using Poisson Means test, assuming a constant population. RESULTS During the 2020 lockdown, the total number of admissions for hemorrhagic cerebrovascular disease was 92 compared with 116 in 2019 and 95 in 2018. This difference was not significant. GCS upon admission was 3-8 in 44 % of cases in 2020 (41 patients), 39.7 % in 2019 (46 patients) and 28 % in 2018 (27 patients). CONCLUSION Reduction of admissions for hemorrhagic cerebrovascular disease due to vascular malformations during the COVID-19 lockdown was not confirmed. Nevertheless, some patients reached the emergency rooms only several days after symptoms onset, resulting in a worse clinical condition at admission.
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Affiliation(s)
- Pasquale De Bonis
- Neurosurgery Department, S. Anna University Hospital, Ferrara, Italy; Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.
| | - Michele Alessandro Cavallo
- Neurosurgery Department, S. Anna University Hospital, Ferrara, Italy; Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | | | | | | | - Michele Dughiero
- Neurosurgery Department, S. Anna University Hospital, Ferrara, Italy
| | | | - Luca Ricciardi
- Neurosurgery, Department NESMOS, Sapienza University of Rome, Rome, Italy
| | - Antonino Raco
- Neurosurgery, Department NESMOS, Sapienza University of Rome, Rome, Italy
| | - Carlo Bortolotti
- Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | | | | | - Lorenzo Mongardi
- Neurosurgery Department, S. Anna University Hospital, Ferrara, Italy
| | | | | | - Fabio Cofano
- Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy
| | - Diego Garbossa
- Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy
| | - Alba Scerrati
- Neurosurgery Department, S. Anna University Hospital, Ferrara, Italy; Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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