Objectives: To assess the effect of oxygen-ozone therapy guided by percutaneous Computed Tomography (CT) compared to corticosteroids in individuals experiencing lower back pain (LBP) not attributed to underlying bone-related issues. Methods: A total of 321 patients (192 males and 129 females, mean age: 51.5 ± 15.1 years) with LBP were assigned to three treatment groups: group A) oxygen-ozone only, group B) corticosteroids only, group C) oxygen-ozone and corticosteroids. Treatment was administered via CT-guided injections to the intervertebral disc (i.e., intradiscal location). Clinical improvement of pain and functionality was assessed via self-reported pain scales and magnetic resonance (MR) and CT imaging. Results: At all follow-up times, the mean score of the numeric rating scale and the total global pain scale (GPS) of study groups receiving oxygen-ozone (groups A and C) were statistically significantly lower than the study group receiving corticosteroids only (group B), with p < 0.001. There was a statistically significant difference between groups A and C at 30 days for the numeric rating scale. Conclusions: The percutaneous application of oxygen-ozone in patients with LBP due to degeneration of the lumbosacral spine showed long-lasting significant pain reduction of up to two years post-treatment when compared to corticosteroids alone. Combination therapy of oxygen-ozone and corticosteroids can be useful as corticosteroids showed statistically significant improvement in LBP earlier than the oxygen-ozone-only treatment.

Background/Objectives: Brain arteriovenous malformations (AVMs) are rare but clinically significant lesions associated with hemorrhage, seizures, and neurological deficits. Microsurgical resection remains the gold standard for low- and intermediate-grade AVMs, though treatment of unruptured AVMs is still debated. To present functional outcomes of microsurgical treatment for intracranial AVMs in a high-volume neurosurgical center. Methods: We retrospectively analyzed 111 patients who underwent microsurgical AVM resection between 2010 and 2022 at the Clinical Center of Serbia. Demographic, clinical, radiological, and surgical data were collected. Functional outcomes were assessed using the modified Rankin Scale (mRS) at discharge and after nine months. Results: The mean patient age was 36 years (range 8–75); 54 (48.6%) were male. AVMs were most often supratentorial (91.9%), located in the frontal (26.1%) and temporal lobes (19.8%). Hemorrhage was the presenting symptom in 53.2% of patients. Postoperative complications included hematoma (10.8%), meningitis (13.5%), and wound infection (8.1%). The mean mRS at discharge was 2.10, improving significantly to 1.15 at nine months (p < 0.001). Favorable outcome (mRS ≤ 2) was achieved in 64.0% at discharge and 81.1% at nine months. Prognostic factors for poor outcome included AVM size larger than 6 cm, higher supplementary Spetzler–Martin grade, and combined venous drainage. Conclusions: Microsurgical resection provides an important component of multidisciplinary AVM management, especially in low- and selected intermediate-grade lesions, achieving favorable functional outcomes in the majority of patients. Careful patient selection, AVM grading, and venous drainage analysis remain essential for prognosis and treatment planning.

Background and Objectives: The management of unruptured brain arteriovenous malformations (ubAVMs) remains controversial, particularly following the ARUBA trial, which favored conservative management. However, concerns regarding the validity of its findings persist. This study aimed to evaluate the outcomes of microsurgical resection of ubAVMs in a high-volume neurosurgical center. Materials and Methods: This is a retrospective single-center study that analyzed 52 patients treated by microsurgical resection at the Cerebrovascular Department, University Clinical Center of Serbia, between January 2010 and January 2022. All patients were classified according to the supplementary Spetzler–Martin (suppl-SM) grading system and stratified into low-risk (suppl-SM ≤ 6) and high-risk (suppl-SM > 6) groups. Functional outcomes were assessed using the modified Rankin Scale (mRS) at discharge and 9-month follow-up. Results: The mean patient age was 38.8 years, with equal gender distribution. Epileptic seizure was the most common presenting symptom (80.4%). In the low-risk group, there were no deaths, and poor outcomes were rare (6.8% at discharge; 2.3% at 9 months). Conversely, the high-risk group demonstrated significantly worse outcomes (62.5% poor outcome at discharge, 28.6% at 9 months). The overall hemorrhagic stroke rate was 5.8%, with one fatality (12.5%) in the high-risk subgroup. Absence of superficial venous drainage and presence of combined/deep venous drainage were strongly associated with poor outcomes. Conclusions: Microsurgical resection of ubAVMs is a safe and effective treatment strategy for low-grade lesions, yielding excellent functional outcomes and minimal morbidity. Our findings, supported by other large series, reinforce microsurgery as the gold standard for low-grade ubAVMs in appropriately selected patients.

Introduction: Scaphocephaly, the most common form of craniosynostosis, is caused by the premature fusion of the sagittal suture, resulting in an elongated skull shape and constrained cranial growth. Material and methods: This retrospective study included all consecutive patients with sagittal synostosis who were operated at the Clinic of Neurosurgery, UCCS, in the 20-year period. Detailed patient data were obtained from medical records and neuroradiological diagnostics. The follow-up period for these patients ranged from 6 to 20 years. The acquired data were thoroughly statistically analyzed. Results: There were 93 children with a clear male preponderance. In the majority of children, there were no perinatal complications, and the majority of mothers didn't have any chronic illnesses. Three types of surgical treatment were used, with an almost equal distribution. The mean blood loss during surgery varied across the three operative techniques, with the lowest blood loss observed using the TSEO technique. Successful treatment was observed in only 57.1% patients who underwent strip-suturectomy, 96.6% patients treated with the π procedure, and all patients treated with the TSEO technique. Statistical analysis revealed a significantly higher success rate of the TSEO and π procedure compared to strip-suturectomy. Cranial index remained dolichocephalic in 6/28 children treated with strip-suturectomy alone, while in all cases treated with TSEO and π procedure, cranial index normalized. The majority of operated children had no complications. Conclusion: Successful treatment of scaphocephaly requires a case-specific approach that extends beyond the surgical procedure itself. This series emphasizes the need for individualized treatment plans and a multidisciplinary approach throughout the surgical process.

Background and Objectives: brain arteriovenous malformations (AVMs) are a leading cause of spontaneous intracranial hemorrhage in children and carry a disproportionately high lifetime hemorrhagic risk. Materials and Methods: We retrospectively analyzed clinical, morphological, and surgical factors associated with functional outcome in 30 consecutive pediatric patients (≤18 years) who underwent microsurgical AVM resection at a single tertiary neurosurgical center between January 2015 and December 2025. Results: Functional status was assessed with the modified Rankin Scale (mRS) at hospital discharge and at 6–9 months of follow-up; the Wilcoxon signed-rank test, Mann–Whitney U test, Fisher’s exact test, Spearman correlation, and univariable logistic regression were used for analysis. Complete resection on early postoperative CT angiography was documented in all 30 patients (100%). The proportion with a favorable outcome (mRS 0–2) improved significantly from 50.0% at discharge to 76.7% at follow-up (p < 0.0001); 80.8% of survivors improved by at least one mRS point, and none deteriorated. In univariable analysis, the variable most strongly associated with poor outcome was intraventricular hemorrhage (IVH; odds ratio [OR] 28.5, 95% CI 2.65–306.6; p = 0.002); the wide confidence interval reflects the small number of events and precludes a precise estimate of effect size. Lower admission Glasgow Coma Scale (GCS) score (p = 0.0006), higher Supplemented Spetzler–Martin (S–M) grade (p = 0.019), and postoperative complications (p = 0.016) were likewise associated with poor outcome. Because these associations are univariable and unadjusted for confounding, they should be regarded as exploratory and hypothesis-generating rather than as independent predictors. All four deaths occurred in malformations in eloquent locations (p = 0.037). Microsurgical resection achieved complete resection on early postoperative CT angiography in all patients; however, functional recovery appeared to be associated primarily with the severity of the initial hemorrhagic insult—particularly IVH—and with lesion complexity rather than with the achievement of angiographic resection alone. Conclusions: Given the small, surgically selected cohort and the limited follow-up, these findings require confirmation in larger multicenter studies.