Artificial Intelligence for Neurosurgery : Current State and Future Directions

Artificial intelligence (AI) is a field of computer science that equips machines with human-like intelligence and enables them to learn, reason, and solve problems when presented with data in various formats. Neurosurgery is often at the forefront of innovative and disruptive technologies, which have similarly altered the course of acute and chronic diseases. In diagnostic imaging, such as X-rays, computed tomography, and magnetic resonance imaging, AI is used to analyze images. The use of robots in the field of neurosurgery is also increasing. In neurointensive care units, AI is used to analyze data and provide care to critically ill patients. Moreover, AI can be used to predict a patient’s prognosis. Several AI applications have already been introduced in the field of neurosurgery, and many more are expected in the near future. Ultimately, it is our responsibility to keep pace with this evolution to provide meaningful outcomes and personalize each patient’s care. Rather than blindly relying on AI in the future, neurosurgeons should gain a thorough understanding of it and use it to enhance their patient care.

Epidemiology of senile spinal diseases: a study based on the Health Insurance Review & Assessment Service database

According to the Statistics Korea in 2020, the elderly population aged 65 or older accounted for 15.7% of the total population, and by 2025 it will reach 20.3%, which will enter the super-aged society. In an aging society, many degenerative diseases occur with age. In particular, the spine is a structure that acts as a pillar of our body, and as we age, degenerative changes come. Representative senile spinal diseases include disc disease, spinal stenosis, spinal spondylolisthesis, scoliosis, kyphosis, and flat back syndrome. This study intends to examine the epidemiologic characteristics and trends of senile spinal diseases using Korean Health Insurance Review & Assessment Service database from 2010 to 2019. All of the senile spinal diseases have gradually increased in the number of patients and cost over the last 10 years. In addition, the proportion of those aged 60 and over increased among those diagnosed. And fusion surgery and discectomy also increased in the last 10 years, and the treatment cost and ratio of over 60 years old increased. Korea has already become an aging society. So, in the future, senile diseases will increase further, and among them, senile spinal diseases will steadily increase. As a result, the frequency and cost of surgery will continue to increase. Efforts are needed to understand this trend and to prevent senile spinal diseases. For example, regular exercise, proper posture and habits, adequate nutrition, and efforts such as quitting smoking should be required. When these efforts are made, more healthy old life will be achieved.

Changes in Trends of Spondylitis in Korea Based on a Nationwide Database

No abstract available.

Intracranial Hemangiopericytomas : A Retrospective Study of 15 Patients with a Special Review of Recurrence

OBJECTIVE: Although surgical resection is used to treat meningeal hemangiopericytoma (MHPC), there is a high risk of subsequent recurrence. This study investigated factors associated with treatment outcomes and recurrence in patients who had undergone surgical resection of intracranial MHPC. METHODS: Fifteen patients underwent surgical treatments performed by one senior neurosurgeon between 1997 and 2013. Clinical data, radiologic images, surgical outcomes, recurrence, and other relevant characteristics were reviewed and analyzed. RESULTS: Fifteen patients were included in the analysis, 12 (80%) of whom had tumors in the supratentorial region, and 3 (20%) of whom had tumors in the infratentorial region. Complete resection was achieved in all 15 patients, and 3 (20%) patients were administered radiosurgery and conventional radiotherapy after surgery as adjuvant radiotherapy. Three patients developed recurrence, 2 of whom had not received adjuvant radiotherapy. In 1 of the patients who had not received adjuvant radiotherapy, recurrence developed at the original tumor site, 81 months after surgery. The other 2 recurrences occurred at other sites, 78 and 41 months after surgery. The 5- and 10-year overall survival rates were 88.3%, while the 5- and 10-year recurrence-free survival rates were 83% and 52%, respectively. Additionally the mean Ki-67 index differed significantly between patients who did and did not develop recurrence (43% vs. 14%; p=0.001). CONCLUSION: Because of the high risk of MHPC recurrence, MHPC tumors should be completely resected, whenever feasible. However, even when complete resection is achieved, adjuvant radiotherapy might be necessary to prevent recurrence.

Vertebral Artery Dissect Injury with Brown-Sequard Syndrome by a Neural Foramen Penetrated Electric Screw Driver Bit : A Case Report

There are few reports in the literature of complete obstruction of the vertebral artery (VA) due to an electric screw driver bit penetration through the neural foramen into the spinal canal with Brown-Sequard syndrome (BSS). A 25-year-old man was admitted to the emergency department with a penetrated neck injury by an electric screw driver bit after a struggle. The patient presented the clinical features of BSS. Computed tomography scan revealed that the electric screw driver bit penetrated through the right neural foramen at the level of C3-4, and it caused an injury to the right half of the spinal cord. Emergent angiography revealed VA dissection, which was managed by immediate coil embolization at both proximal and distal ends of the injury site. After occlusion of the VA, the electric screw driver bit was extracted under general anesthesia. Bleeding was minimal and controlled without difficulties. No postoperative complications, such as wound dehiscence, CSF leakage, or infection, were noted. Endovascular approaches for occlusion of vertebral artery lesions are safe and effective methods of treatment.