Worldwide, the novel coronavirus disease 2019 (COVID-19) has become a significant threat to global health. Worldwide, COVID-19 has affected the health service also in Slovenia. During this time, neurosurgery is facing difficulties in its service, both in emergency and elective surgeries. In the article, we describe the anti-COVID-19 measures taken at our neurosurgical department in a medical centre in Ljubljana, Slovenia, and analysed and compared the number of emergency and elective neurosurgical procedures during the time of the pandemic.

Background: Awake craniotomy with intraoperative mapping is the standard of care for gliomas located in language-eloquent regions, enabling maximal safe resection while preserving functional integrity. This study aimed to identify clinical and intraoperative predictors of postoperative language worsening and overall survival in patients undergoing awake surgery for malignant glioma. Methods: In this retrospective multicenter cohort study, 37 patients with malignant glioma in the dominant hemisphere underwent awake craniotomy with intraoperative mapping. Clinical, radiological, intraoperative, and postoperative variables were analyzed. Language outcome was classified as unchanged or worsened. Univariable and parsimonious multivariable logistic regression analyses were used to identify predictors of language worsening. Overall survival was assessed using univariable Cox regression. Results: Postoperative language worsening occurred in six patients (16.2%). Increasing age was associated with higher odds of postoperative language worsening in univariable logistic regression (OR 1.12 per year, 95% CI 1.02–1.23, p = 0.019). Due to the limited number of outcome events, multivariable logistic regression was not performed. In survival analysis, increasing age (HR 1.10, 95% CI 1.05–1.16, p < 0.001) and WHO grade 4 (HR 18.15, 95% CI 3.91–84.19, p < 0.001) were associated with shorter overall survival. No statistically significant association between extent of resection and overall survival was detected in this small cohort. Conclusions: Awake glioma surgery with intraoperative mapping was associated with favorable language outcomes in most patients at the 3-month follow-up. Increasing age was associated with postoperative language worsening in univariable analysis. These findings should be interpreted as exploratory because of the limited sample size and low number of outcome events. Larger prospective studies with standardized longitudinal language assessment are needed.

Intervertebral disc (IVD) degeneration is a major cause of chronic low back pain and disability worldwide. Although current treatment strategies effectively alleviate symptoms, they do not restore disc structure or reverse the underlying biological processes responsible for degeneration. Mesenchymal stromal cell (MSC)-based therapies have emerged as promising regenerative approaches owing to their immunomodulatory, anti-inflammatory, and extracellular matrix-regenerative properties, mediated predominantly through paracrine signalling rather than long-term cellular engraftment. Despite encouraging preclinical results, clinical translation remains limited by poor cell survival within the hostile disc microenvironment, protocol heterogeneity, and insufficient long-term clinical evidence. This review critically examines the current state of MSC-based therapy for IVD degeneration by integrating experimental findings, clinical evidence, and emerging translational strategies. Particular emphasis is placed on the biological mechanisms of MSC-mediated regeneration, comparison of different MSC sources, advances in extracellular vesicle- and exosome-based cell-free therapies, and the growing role of quantitative magnetic resonance imaging, molecular biomarkers, and precision diagnostics in patient selection and treatment monitoring. In addition, the review discusses the major biological, technical, manufacturing, and regulatory challenges that currently limit clinical implementation. Collectively, the evidence indicates that successful translation of MSC-based therapies will require not only optimised cell products but also standardised manufacturing, biomaterial-assisted delivery systems, advanced diagnostic biomarkers, and well-designed multicentre clinical trials. Integrating these advances will be essential for transforming MSC-based therapies into safe, standardised, and disease-modifying treatments for patients with intervertebral disc degeneration.