The Cobb angle measurement of the scoliotic spine is prone to inter- and intra-observer variations in the clinical setting. This paper proposes a deep learning architecture for detecting spine vertebrae from X-ray images to evaluate the Cobb angle automatically. The public AASCE MICCAI 2019 anterior-posterior X-ray image dataset and local images were used to train and test the proposed convolutional neural network architecture. Sixty-eight landmark features of the spine were detected from the input image to obtain seventeen vertebrae on the spine. The vertebrae locations obtained were processed to automatically measure the Cobb angle. The proposed method can measure the Cobb angle with accuracies up to 93.6% and has excellent reliability compared to clinicians’ measurement (intraclass correlation coefficient > 0.95). The proposed deep learning architecture may be used as a tool to augment Cobb angle measurement in X-ray images of patients with adolescent idiopathic scoliosis in a real-world clinical setting.

Objective Cranioplasty, commonly performed after decompressive craniectomy, is associated with significant complications. We aim to characterize the outcomes and complications post cranioplasty performed in Brunei Darussalam. Methods and Materials We conducted a nationwide retrospective study of the patients who underwent cranioplasty. Patients who underwent cranioplasty by the Neurosurgical Department from January 2014 to June 2019 were included. Patients were excluded if they did not have a minimum of 30-days follow-up or the initial cranioplasty was performed elsewhere. Outcomes including complications post cranioplasty and 30-day and 1-year failure rates were assessed. All statistical analyses were performed with SPSS version 20 (IBM Corporation, Armonk, New York, USA). The χ² test, Student's t-test, and the Mann–Whitney U test were performed for nominal, normally, and non-normally distributed variables, respectively. Multivariate logistic regression was used to assess predictors for complications and cranioplasty failure. Results Seventy-seven patients with a median age of 48 (interquartile range, 37–61) years were included. Most cranioplasties used autologous bone (70/77, 90.9%). Infection and overall complication rates were 3.9% and 15.6%, respectively. Cranioplasty failure (defined as removal or revision of cranioplasty) rate was 9.1%. Previous cranial site infection post craniectomy was associated with cranioplasty failure (odds ratio: 12.2, 95% confidence interval [1.3, 114.0], p=0.028). Conclusions Cranioplasty is generally associated with significant complications, including reoperation for implant failure. We highlighted that autologous bone cranioplasties can be performed with an acceptable low rate of infection, making it a viable first option for implant material. This paper was presented at Brunei Neuroscience, Stroke and Rehabilitation Centre Frontiers, Brunei Darussalam, on November 3 2019. Article published online: 01 September 2022 © 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

Objective Ventriculoperitoneal shunt surgery is commonly performed to treat hydrocephalus. We aimed to characterize the demographics, complications, and outcomes of patients who underwent ventriculoperitoneal shunt surgery in Brunei Darussalam. Materials and Methods We conducted a retrospective study on patients who underwent ventriculoperitoneal shunt surgery at the Neurosurgery Department of the Raja Isteri Pengiran Anak Saleha Hospital and Brunei Neuroscience Stroke and Rehabilitation Centre between January 2015 and June 2020. Statistical Analysis All statistical analyses were performed using the Statistical Package for the Social Sciences version 20 (IBM Corporation, Armonk, New York, United States). The χ² test, Student's t-test, and Mann–Whitney U test were performed for nominal, normally, and non-normally distributed variables, respectively. Multivariate logistic regression was used to assess the predictors of complications and shunt failure. Results 43 patients with a median age of 33 (interquartile range, 4–49) years were included. A total of 53 shunt operations were performed: 18 in the pediatric population and 35 in adults. The overall complication rate was 22.6%. Infection was the most common (9.4%) complication, with coagulase-negative staphylococci being the common organism causing the infection. The shunt failure rate (defined as removal or revision) was 20.8%. Univariate and multivariate analyses did not identify factors associated with complications or shunt failure. Conclusion Ventriculoperitoneal shunt surgery, a common and technically non-demanding neurosurgical procedure, is associated with significant complications. We highlighted that shunt infection remains a concern and advocate practices to negate this risk. The study was approved by the local ethics committee and conducted in accordance with the ethical principles outlined by the Declaration of Helsinki. Article published online: 13 September 2023 © 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

The authors have brought a few errors to the publisher's attention in the above article in the Asian Journal of Neurosurgery (Doi: 10.1055/s-0043-1774395). The value of patients in the Results section in Abstract should read as 53 instead of 43. The correct sentence is as follows: Fifty-three patients with a median age of 33 (interquartile range, 4–49) years were included. Additionally, the alignment of text and figures has also been corrected in Table 1 in the article. Article published online: 12 October 2023 © 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India