Background and Objectives: Recent advancements in spinal navigation methodologies, particularly augmented reality (AR) techniques, have significantly enhanced the precision of spinal instrumentation procedures. This study aimed to evaluate the efficacy of AR-assisted navigation in spinal instrumentation surgery for thoracolumbar scoliosis. Materials and Methods: This retrospective observational study included 10 patients with thoracolumbar scoliosis who met specific inclusion criteria and were recruited at a single medical center. Two neurosurgeons and one neuroradiologist used the Gertzbein–Robbins scale (GRS) for radiological evaluation. Preoperative and postoperative Cobb angles were measured to assess the correction of scoliosis. Overall, 257 screws were placed using the AR-assisted navigation system during thoracic and lumbar spinal deformity surgeries. Results: Among the 257 screws, 197 were placed in the thoracic spine and 60 in the lumbar spine, achieving an overall instrumentation accuracy of 98%. The preoperative Cobb angle of 69.5 ± 22.2° significantly improved to 10.1 ± 4.1° postoperatively. Regarding first-attempt screw placement accuracy, 97.4% of the screws in the thoracic spine (graded as GRS A or B) and 100% in the lumbar spine were placed with precision. Five grade C thoracic screws were identified, one of which required re-instrumentation. Conclusions: The AR navigation technique substantially improved the precision of spinal deformity surgery, with a high screw placement accuracy rate and significant scoliosis correction. The benefits of reduced attention diversion and an intuitive surgical experience suggest that AR technology could significantly improve spinal surgery practices and training programs, indicating potential for broader applicability in the future.

Introduction: Spindle cell oncocytoma (SCO) of the pituitary gland is increasingly established with improvements in histological and immunohistochemical examination. However, the diagnosis was often mistaken based on imaging studies and nonspecific clinical manifestations.Purpose: This case is presented to provide an overview of the characteristics of the rare tumor as well as to demonstrate the difficulties in diagnosis and current treatments.Clinical discussion: The pathogenesis of SCO remains unclear, and a possible origin was described. Further research is needed to optimize pre-operative diagnosis and surgical strategy.Conclusion: SCO should be considered when images indicate some features. Gross total resection (GTR) after surgery seems to have better long-term tumor control, and radiotherapy may help decrease tumor progression in patients with non-GTR. Regular follow-up is advised because of the higher recurrence rate.

Background/Objectives: In recent years, stereotactic aspiration followed by fibrinolysis has been accepted as being a less invasive and more effective treatment for spontaneous intracerebral hemorrhage (ICH). The aim of this study was to evaluate the safety and clinical outcomes of frameless stereotactic aspiration and fibrinolysis using urokinase in a single medical center. Methods: This study included 123 patients with spontaneous supratentorial ICH who were treated with stereotactic aspiration and subsequent fibrinolysis using urokinase. Their clinical status, radiological images, and functional outcomes were assessed. Results: Unfavorable outcomes at discharge were associated with each patient’s preoperative Glascow Coma Score, as well as their initial and residual volumes of hematoma. Low mortality and minimal complications of rebleeding were also recorded. Conclusions: The results revealed that stereotactic aspiration and subsequent fibrinolysis with urokinase appeared to be a safe and feasible treatment modality for treating ICH. Further studies are still needed in order to better assess the optimal therapeutic window, thrombolytic dosage, long-term evaluation, and controlled comparisons of mortality, as well as disability outcomes in treated and untreated patients.

Study Design: Clinical original research. Objectives: The objectives of this study were to identify the risk factors and incidence of anterior bone loss (ABL) after 2-level Baguera C cervical disc arthroplasty (CDA), as well as the impact of hybrid surgery on ABL. Background: ABL commonly occurs after CDA. Despite recent research on ABL, data on its incidence after 2-level CDA remain limited. Methods: In this retrospective cohort study, we reviewed patients who underwent 2-level Baguera C CDA in a medical center. We recorded the extent of ABL and radiologic parameters, including the segmental and global alignment angles, lordotic angle (or functional spinal unit angle), shell angle, global range of motion (ROM), and ROM of the index level. Results: We found that all patients had at least grade 1 ABL in 1 or 2 surgical segments. Of the 216 surgical segments analyzed, 66 (30.5%) had grade 2 ABL, 141 (65.3%) had grade 1 ABL, and only 9 (4.2%) had no bone loss at all. Patients with grade 2 ABL tended to have larger segmental and global alignment angles, and shell angle during extension than did those with grade 1 or grade 0 ABL. Conclusions: ABL is a common phenomenon found in essentially all patients receiving 2-level CDA. The extent and prevalence of ABL were greater in 2-level CDA than in 1-level CDA. Larger segmental and global alignment angles, and shell angle during extension were associated with grade 2 ABL, which is extensive bone loss with implant exposure. The exact mechanism of ABL remains to be elucidated.