The coexistence of complete carotico-clinoid bridge (CCB), an ossification between the anterior (ACP) and the middle clinoid (MCP), and an interclinoidal osseous bridge (ICB), between the ACP and the posterior clinoid (PCP), represents an uncommonly reported anatomic variant. If not adequately recognized, osseous bridges may complicate open or endoscopic surgery, along with the pneumatization of the ACP, especially when performing anterior or middle clinoidectomies.

Three-column osteotomy (3CO) offers substantial spinal deformity correction. Thoracic neurovascular bundle sacrifice is often required, and anterior spinal artery (ASA) perfusion can be compromised. Spinal angiography allows localization of variable ASA vascular contribution. This study's objective was to describe a series of patients who underwent preoperative spinal angiography and discuss the impact on surgical planning and execution of thoracic 3CO for deformity correction.

Accurate intraoperative assessment of coronal alignment is critical to achieving favorable clinical outcomes in adult spinal deformity surgery. However, surgical positioning creates challenges in predicting standing coronal alignment. Gravity-based plumblines require an upright posture and are not possible intraoperatively. Intraoperative stitched radiography (ISR) is increasingly being used to evaluate coronal balance as an alternative to 36-inch films, which can be cumbersome. However, ISR does not allow for the measurement of absolute distances, which limits the intraoperative assessment of the coronal plane. We propose a novel angle to assess coronal balance on ISR: the T-bar angular offset (TAO). We evaluate TAO as a measure of coronal balance and assess the degree to which TAO measured on ISR can predict postoperative coronal balance.

IDH-wildtype glioblastoma multiforme (GBM) and grade 4 IDH-mutant astrocytoma are challenging to manage in oncology. This study explores the contrast between gross total resection (GTR) and supratotal resection (SupTR) for IDH-wildtype GBM and grade 4 IDH-mutant astrocytoma, aiming to summarize their influence on crucial clinical outcomes.

A typical workflow for deep brain stimulation (DBS) surgery consists of head frame placement, followed by stereotactic computed tomography (CT) or MRI before surgical implantation of the hardware. At some institutions, this workflow is prolonged when the imaging scanner is located far away from the operating room, thereby increasing workflow times by the addition of transport times. Recently, the intraoperative O-arm has been shown to provide accurate image fusion with preoperative CT or MR imaging, suggesting the possibility of obtaining an intraoperative localization scan and postoperative confirmation. In this article, we aim to evaluate the compatibility of the stereotactic frame system with the intraoperative O-arm system regarding lead accuracy and surgical flow.

Transcranial magnetic resonance-guided focused ultrasound (MRgFUS) has revolutionized ablative treatment of essential tremor in recent years. However, limitations in precision targeting may account for suboptimal efficacy and significant side effects. We describe a simple intraprocedural three-dimensional image-guided lesion shaping technique that can improve overall outcomes of MRgFUS for essential tremor and facilitate expansion to novel indications.