Objectives: The Goel–Harms technique provides rapid stabilization and high fusion rates for atlantoaxial instability but carries a risk of neurovascular injury during lateral mass and pedicle screw insertion. Recently, 3D printing has emerged as a cost-effective and increasingly accessible tool in various surgical fields. This study aimed to compare the clinical and radiological outcomes of C1–C2 fixation using a 3D-printed template versus the free-hand technique. Methods: This retrospective cohort study included patients who underwent C1–C2 fixation with the Goel–Harms technique at two tertiary neurosurgical centers between 2021 and 2023. Operative, radiological, and functional outcomes were reviewed in 21 patients who were operated using either a patient-specific 3D-printed template applied intraoperatively (Group 1; n = 10) or the free-hand technique (Group 2; n = 11). Postoperative screw accuracy was assessed using the Gertzbein–Robbins classification. Results: A total of 84 screws were placed (Group 1: 40; Group 2: 44). In Group 1, 38 of 40 screws (95%) were accurately placed, compared with 41 of 44 screws (93.1%) in Group 2. The mean fluoroscopy and operative times were significantly shorter in Group 1 than in Group 2 (21.90 ± 4.33 s vs. 27.09 ± 13.48 s, p = 0.012; 126.60 ± 28.70 min vs. 171.36 ± 40.44 min, p = 0.010, respectively). Conclusions: The 3D-printed template technique significantly reduced operative and fluoroscopy times compared with the free-hand technique. Three-dimensional printing offers a cost-effective alternative to conventional navigation systems by eliminating their time-consuming preoperative setup in the operating room.

Study design: Retrospective case series. Objectives: We aimed to describe with a novel surgical approach for the removal of posterior thoracolumbar implant in patients with symptomatic failure of the implant and present our preliminary results with this method. Methods: This retrospective, single-center study was performed in the neurosurgery department of a university hospital. Data were gathered from the medical files of 314 patients (243 women, 77.39%; 71 men, 22.61%) with symptomatic thoracolumbar implant failure that underwent implant removal operation using our novel technique between 2010 and 2020. Symptoms, radiological findings, intraoperative findings as well as clinical outcomes were evaluated. Results: In our series, the average age was 46.5 years (range: 21–84) with a mean follow-up duration of 7 years (range: 3 months to 10 years). Preoperatively, the most common symptoms were leg pain and numbness of the lower extremity. Postoperatively, no major complications were noted. Clinical progression of symptoms was avoided by surgery in all patients, while we came across removal difficulties due to screw–screwdriver mismatch in 15 of 314 surgeries (4.78%). Our novel approach allowed successful screw removal including these challenging cases. Conclusions: We suggest that our novel approach is a practical and effective for the removal of posterior thoracolumbar implant in cases with symptomatic failure attributed to screw–screwdriver mismatch. Further trials are warranted to assess the efficacy of this technique to overcome surgical problems associated with screw removal.

Study Design: Controlled experimental biomechanical study using a sheep cervical spine model. Objective: To biomechanically evaluate and compare skip laminectomy and laminoplasty in the lower cervical spine, focusing on their influence on spinal stability. Summary of Background Data: Skip laminectomy and laminoplasty are 2 posterior cervical surgical techniques widely used for spinal canal decompression. Although their clinical outcomes have been compared, no previous study has biomechanically analyzed and compared these techniques in the cervical region. Methods: Twenty-eight C2–T1 cervical spine specimens obtained from merino sheep were used in this study. Seven specimens underwent preliminary fracture testing to establish nondestructive loading parameters. The remaining specimens were assigned to 3 groups: intact control, laminoplasty, and skip laminectomy (n=7 per group). Bone mineral density (BMD) was measured to ensure baseline equivalence across specimens. Biomechanical testing was performed using an electromechanical actuator to evaluate displacement during flexion, extension, lateral bending, and axial rotation under standardized loading conditions. Statistical analysis was conducted to compare biomechanical behavior among the groups. Results: No statistically significant differences were observed among the control, laminoplasty, and skip laminectomy groups with respect to displacement during flexion ( P =0.755), extension ( P =0.546), right lateral bending ( P =0.359), left lateral bending ( P =0.415), or axial rotation ( P =0.690). Both surgical techniques demonstrated biomechanical behavior comparable to that of intact cervical spine specimens under the tested loading conditions. Conclusion: This study represents, to our knowledge, the first direct biomechanical comparison of skip laminectomy and laminoplasty in the cervical spine. Both procedures preserved immediate postoperative mechanical stability in this experimental ovine model, with no significant biomechanical differences identified between the techniques. Further biomechanical and long-term clinical studies are needed to determine the clinical relevance of these findings.

Candida parapsilosis is an exceedingly rare cause of ventriculoperitoneal (VP) shunt infection, even in patients who have a history of long‐term antibiotic use, immune‐compromised newborns, and intensive care unit patients. We hereby report a case of a 53‐year‐old male who presented with subarachnoid hemorrhage and had a complicated postoperative course due to C. parapsilosis infection, and we discuss the pertinent clinical aspects.