{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T15:51:24Z","timestamp":1789573884256,"version":"build-2803163510"},"reference-count":52,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Surgical treatment of spinal dural arteriovenous fistulas (DAVFs) has been reported to be superior to endovascular treatment in terms of occlusion of the fistula. Despite the increased availability of digital 3D exoscopes, the potential benefits of using an exoscope in spinal DAVF surgery have not been studied. The purpose of this study was to report and compare the results of exoscope- and microscope-assisted surgery for spinal DAVFs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>All consecutive adult patients (\u2265 18 years of age) treated surgically for spinal DAVFs from January 2016 to January 2023 in a tertiary neurosurgical referral center were included. All patients were operated on by one neurosurgeon. Their pre- and postoperative clinical findings, imaging studies, and intra- and postoperative events were evaluated and surgical videos from the operations were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Altogether, 14 patients received an operation for spinal DAVF during the study period, 10 (71%) with an exoscope and 4 (29%) with a microscope. The DAVFs were most commonly located in the lower parts of the thoracic spine in both groups. The duration of exoscopic surgeries was shorter (141 vs 151 minutes) and there was less blood loss (60 vs 100 ml) than with microscopic surgeries. No major surgical complications were observed in either group. Of the 14 patients, 10 had gait improvement postoperatively: 7 (78%) patients in the exoscope group and 3 (75%) in the microscope group. None of the patients experienced deterioration following surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Exoscope-assisted surgery for spinal DAVFs is comparable in safety and effectiveness to traditional microscopic surgery. With practice, experienced neurosurgeons can adapt to using the exoscope without major additional risks to the patient.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2023.12.focus23756","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T07:00:52Z","timestamp":1709276452000},"page":"E13","source":"Crossref","is-referenced-by-count":11,"title":["Digital exoscope versus surgical microscope in spinal dural arteriovenous fistula surgery: a comparative series"],"prefix":"10.3171","volume":"56","author":[{"given":"Anna Maria","family":"Auricchio","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;"},{"name":"Department of Neurosurgery, University Polyclinic Hospital A. Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Calvanese","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ville","family":"Vasankari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Raj","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille Louise Claudine","family":"Gall\u00e9","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;"},{"name":"Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Niemel\u00e4","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Lehecka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Stroke","first-page":"1455","article-title":"Trends in incidence of intracranial and spinal arteriovenous shunts: hospital-based surveillance in Okayama, Japan","volume":"52","author":"Murai S","year":"2021","unstructured":"Murai S, Hiramatsu M, Suzuki E,  Trends in incidence of intracranial and spinal arteriovenous shunts: hospital-based surveillance in Okayama, Japan. Stroke. 2021;52(4):1455\u20131459."},{"issue":"5","key":"b2","series-title":"Neurosurgery","first-page":"1350","article-title":"Surgical treatment of spinal dural arteriovenous fistulae: a consecutive series of 154 patients","volume":"67","author":"Saladino A","year":"2010","unstructured":"Saladino A, Atkinson JLD, Rabinstein AA,  Surgical treatment of spinal dural arteriovenous fistulae: a consecutive series of 154 patients. Neurosurgery. 2010;67(5):1350\u20131358."},{"issue":"1","key":"b3","series-title":"J Neurosurg Spine","first-page":"85","article-title":"Timing, severity of deficits, and clinical improvement after surgery for spinal dural arteriovenous fistulas","volume":"29","author":"Safaee MM","year":"2018","unstructured":"Safaee MM, Clark AJ, Burkhardt JK, Winkler EA, Lawton MT. Timing, severity of deficits, and clinical improvement after surgery for spinal dural arteriovenous fistulas. J Neurosurg Spine. 2018;29(1):85\u201391."},{"issue":"1","key":"b4","series-title":"Curr Opin Neurol","first-page":"69","article-title":"Spinal dural arteriovenous fistula","volume":"19","author":"Koch C","year":"2006","unstructured":"Koch C. Spinal dural arteriovenous fistula. Curr Opin Neurol. 2006;19(1):69\u201375."},{"issue":"1","key":"b5","series-title":"Neurosurgery","first-page":"137","article-title":"Recurrence rates after surgical or endovascular treatment of spinal dural arteriovenous fistulas: a meta-analysis","volume":"77","author":"Bakker NA","year":"2015","unstructured":"Bakker NA, Uyttenboogaart M, Luijckx GJ,  Recurrence rates after surgical or endovascular treatment of spinal dural arteriovenous fistulas: a meta-analysis. 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