Introduction: Intracranial collision tumors are rare diseases in which two distinct neoplasms are found at the same location. We present an unusual case of an intracranial collision tumor composed of atypical meningioma (WHO grade II) and glioblastoma. Presentation of case: The case was a 56-year-old woman hospitalized due to generalized weakness and dizziness. Imaging survey revealed a right frontal lobe extra-axial mass with significant perilesional edema. The patient underwent a one-stage craniotomy for tumor removal. The pathology revealed collision brain tumors of clear cell atypical meningioma (WHO grade II) and glioblastoma. The patient had an uneventful postoperative recovery. Clinical discussion: The mechanism behind collision brain tumors remains unclear, and some experts consider these tumors sporadic events. Further research is needed to optimize preoperative diagnosis and surgical strategy for collision brain tumor patients. Conclusion: Surgeon should consider intracranial collision tumors when brain image indicated unusual perilesional edema of meningioma. Though there is no standard treatment for these patients, it seems one-staged surgical treatment is feasible. To our knowledge this is the first case of collision tumors with clear cell atypical meningioma (WHO grade II) and glioblastoma. Highlights:

Aim: An estimated 88% of rheumatoid arthritis (RA) patients experience various degrees of cervical spine involvement. The excessive movement of the atlantoaxial joint, which connects the occiput to the upper cervical spine, results in atlantoaxial instability (AAI). AAI stabilization is usually achieved by C1 lateral mass‐to‐C2 pedicle screw‐rod fixation (LC1–PC2 fixation), which is technically challenging in RA patients who often show destructive changes in anatomical structures. This study aimed to analyze the clinical results and operative experiences of C1–C2 surgery, with emphasis on the advancement of image‐guided surgery and augmented reality (AR) assisted navigation.Methods: We presented our two decades of experience in the surgical management of AAI from April 2004 to November 2022.Results: We have performed surgery on 67 patients with AAI, including 21 traumatic odontoid fractures, 20 degenerative osteoarthritis, 11 inflammatory diseases of RA, 5 congenital anomalies of the os odontoideum, 2 unknown etiologies, 2 movement disorders, 2 previous implant failures, 2 osteomyelitis, 1 ankylosing spondylitis, and 1 tumor. Beginning in 2007, we performed LC1–PC2 fixation under C‐arm fluoroscopy. As part of the progress in spinal surgery, since 2011 we used surgical navigation from presurgical planning to intraoperative navigation, using the preoperative computed tomography (CT) ‐based image‐guided BrainLab navigation system. In 2021, we began using intraoperative CT scan and microscope‐based AR navigation.Conclusion: The technical complexities of C1–C2 surgery can be mitigated by CT‐based image‐guided surgery and microscope‐based AR navigation, to improve accuracy in screw placement and overall clinical outcomes, particularly in RA patients with AAI.

Despite advancement in surgical innovation, C1-C2 fixation remains challenging due to risks of screw malposition and vertebral artery (VA) injuries. Traditional image-based navigation, while useful, often demands that surgeons frequently shift their attention to external monitors, potentially causing distractions. In this article, we introduce a microscope-based augmented reality (AR) navigation system that projects both anatomical information and real-time navigation images directly onto the surgical field. In the present case report, we discuss a 37-year-old female who suffered from os odontoideum with C1-C2 subluxation. Employing AR-assisted navigation, the patient underwent the successful posterior instrumentation of C1-C2. The integrated AR system offers direct visualization, potentially minimizing surgical distractions. In our opinion, as AR technology advances, its adoption in surgical practices and education is anticipated to expand.

Background: This study evaluates the impact of hybrid dynamic stabilization using the Dynesys-Transition-Optima (DTO) system on adjacent segment disease (ASD) in lumbar spinal stenosis patients with spondylolisthesis. Methods: From 2012 to 2020, 115 patients underwent DTO stabilization at a single center by a single neurosurgeon. After exclusions for lack of specific stabilization and incomplete data, 31 patients were analyzed. Follow-up was conducted at 6, 12, and 24 months postoperatively, assessing disc height, listhesis distance, and angular motion changes at L2–L3, L3–L4, and L5–S1. Results: L3–L4 segment (the index level), demonstrated a delayed increase in listhesis distance, contrasting with earlier changes in other segments. At two years, L3–L4 exhibited less increase in listhesis distance and less disc height reduction compared to L2–L3 and L5–S1. Notably, the L3–L4 segment showed a significant reduction in angular motion change over two years. Conclusions: In conclusion, while ASD was not significantly prevented, the study indicates minor and delayed degeneration at the index level. The L3–L4 segment experienced reduced angular change in motion, suggesting a potential benefit of DTO in stabilizing this specific segment.

Augmented reality (AR) technology is revolutionising neurosurgery, with significant applications in intraoperative navigation, patient education, and medical training. AR enables real-time three-dimensional (3D) image projection into the surgical field, allowing surgeons to localise lesions precisely and avoid critical structures. This reduces intraoperative errors and enhances surgical safety. AR also offers intuitive 3D models that help patients understand disease mechanisms and surgical plans, thereby improving patient education, communication, and engagement. In medical training, AR simulations provide safe and interactive environments for medical students and residents to practice procedures, shortening their learning curve and improving their surgical skills. Despite these advancements, AR in neurosurgery still faces challenges such as image registration errors, hardware compatibility issues, and intraoperative latency. The integration of emerging technologies—such as artificial intelligence, 5G networks, and mixed reality—is expected to overcome these challenges and ensure more accurate and efficient AR systems. As these innovations progress, the role of AR in neurosurgery will expand. This will lead to safer, more precise surgical procedures and transform the landscape of surgical visualisation and education.