Novel planning pipeline utilizing the Surgical Theater system for pediatric epilepsy surgery

In a retrospective institutional experience with illustrative cases Shields LB et al. from the Norton Neuroscience Institute, Louisville published in Epilepsia Open to evaluate the role of the Surgical Theater (ST) 3D visualization system in enhancing presurgical planning for pediatric epilepsy surgery. The ST system enabled integration of multimodal imaging into immersive 3D models, improving collaborative surgical planning, enhancing intraoperative navigation, and allowing VR-based procedural rehearsal. It demonstrated utility across 85 cases and is posited as a promising adjunct for pediatric epilepsy surgical workflows 1)

This is a descriptive, non-comparative experience report centered on implementing the Surgical Theater (ST) system in a pediatric epilepsy context. While the authors present a visually compelling and potentially transformative workflow for presurgical planning, the study is methodologically weak—it lacks controls, quantifiable outcomes, or statistical rigor. The “results” are largely anecdotal, with 4 case examples insufficiently discussed in terms of surgical impact or clinical outcomes.

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AO Spine Knowledge Forum Deformity. Alignment Goals in Adult Spinal Deformity Surgery

In a narrative review Pizones et al. from La Paz Univ. Hosp, Madrid; additional centers in San Antonio, San Diego, Toronto, Barcelona, Charlottesville, New York published in the Global Spine Journal to critically examine evolving strategies in sagittal alignment targets for adult spinal deformity surgery, shifting focus from generic HRQoL goals to preventing mechanical complications Traditional alignment metrics (PI‑LL, SVA, TK) are limited for personalized planning; compensatory strategies (pelvic retroversion, knee flexion) are essential; individualized, structure-shape–based alignment (e.g., GAP, Roussouly, T4‑L1‑Hip‑Axis) reduces mechanical failure risk, though reoperation rates remain high 1).

The narrative review offers a comprehensive appraisal of alignment paradigms, yet:

Strengths: Integrates key classification systems; emphasizes pelvic and lower-extremity compensation; aligns recent evidence on shape-based vs. quality-of-life–based targets; timely discussion given recent advances (e.g., T4‑L1‑Hip‑Axis)

Weaknesses: Lacks systematic methodology or quantitative synthesis; conclusions primarily descriptive; limited critical appraisal of conflicting literature; evidence grade unclear

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