https://mpirozzo.com/en/ A publication on the neurosurgery of today and tomorrow. en https://mpirozzo.com/en/journal/minimally-invasive-spine/ https://mpirozzo.com/en/journal/minimally-invasive-spine/ Journal Most back pain never needs surgery. The cases that do are operated differently today: less muscle cut, shorter stays and better patient selection. https://mpirozzo.com/en/journal/radiosurgery-without-a-scalpel/ https://mpirozzo.com/en/journal/radiosurgery-without-a-scalpel/ Journal Hundreds of radiation beams, one millimetric point, no incision. Radiosurgery forces us to rethink what 'operating' means. https://mpirozzo.com/en/journal/stroke-time-is-brain/ https://mpirozzo.com/en/journal/stroke-time-is-brain/ Journal An ischaemic stroke costs two million neurons a minute. How that race is won, and why it is only won if the patient gets there in time. https://mpirozzo.com/en/cases/deep-tumor-endoscopy/ https://mpirozzo.com/en/cases/deep-tumor-endoscopy/ Cases Why the endonasal route changed the risk calculus in midline lesions, and what the endoscope reaches that the microscope could not see. https://mpirozzo.com/en/cases/hydrocephalus-ventriculostomy/ https://mpirozzo.com/en/cases/hydrocephalus-ventriculostomy/ Cases Creating a new natural drainage pathway instead of implanting a permanent shunt. https://mpirozzo.com/en/cases/trigeminal-neuralgia-decompression/ https://mpirozzo.com/en/cases/trigeminal-neuralgia-decompression/ Cases Trigeminal neuralgia: when the cause is a vessel, the answer is not a lifelong drug. https://mpirozzo.com/en/patients/brain-tumour-meningioma/ https://mpirozzo.com/en/patients/brain-tumour-meningioma/ For patients How many brain tumours are benign, what happens with a meningioma found by chance, and when surgery beats continued monitoring. https://mpirozzo.com/en/patients/cervical-disc-hand-numbness/ https://mpirozzo.com/en/patients/cervical-disc-hand-numbness/ For patients Why the hand goes numb, how many people improve without surgery, what cervical myelopathy is and which signs mean being seen quickly. Explained for patients. https://mpirozzo.com/en/patients/drug-resistant-epilepsy/ https://mpirozzo.com/en/patients/drug-resistant-epilepsy/ For patients What drug-resistant epilepsy means, what the randomised trials showed about surgery, the real risks, and why referral arrives so late. https://mpirozzo.com/en/patients/head-injury/ https://mpirozzo.com/en/patients/head-injury/ For patients Warning signs after a blow to the head in adults, children and older people. Why the myth about not letting them sleep is false, and how long to keep watch. https://mpirozzo.com/en/patients/hydrocephalus/ https://mpirozzo.com/en/patients/hydrocephalus/ For patients What enlarged ventricles mean, when it is hydrocephalus and when it is not, how a shunt works and what to expect. For babies and older adults. https://mpirozzo.com/en/patients/lumbar-herniated-disc/ https://mpirozzo.com/en/patients/lumbar-herniated-disc/ For patients How many herniated discs resorb on their own, how many need surgery, which warning signs cannot wait, and what to ask at the appointment. https://mpirozzo.com/en/patients/lumbar-spinal-stenosis/ https://mpirozzo.com/en/patients/lumbar-spinal-stenosis/ For patients Why the legs hurt on walking and settle on sitting, what “severe stenosis” in the report means, and when surgery is needed and when it is not. https://mpirozzo.com/en/patients/misshapen-head-in-babies/ https://mpirozzo.com/en/patients/misshapen-head-in-babies/ For patients How to tell a flat head from posture apart from craniosynostosis, what the only randomised trial says about helmet therapy, and when surgery is needed. https://mpirozzo.com/en/patients/numbness-in-the-hands/ https://mpirozzo.com/en/patients/numbness-in-the-hands/ For patients Which fingers go numb with each trapped nerve, how much tingling really is carpal tunnel, and what the evidence says about splints and surgery. https://mpirozzo.com/en/patients/tremor-in-the-hands/ https://mpirozzo.com/en/patients/tremor-in-the-hands/ For patients How essential tremor is told apart from Parkinson's, what treatments exist, and what deep brain stimulation and focused ultrasound really deliver. https://mpirozzo.com/en/patients/trigeminal-neuralgia/ https://mpirozzo.com/en/patients/trigeminal-neuralgia/ For patients Why it is mistaken for a dental problem, what actually causes it, which treatments work and in what order. Written for patients by a neurosurgeon. https://mpirozzo.com/en/patients/unruptured-brain-aneurysm/ https://mpirozzo.com/en/patients/unruptured-brain-aneurysm/ For patients The real risk of rupture by size and location, when treating beats watching, and how much ordinary life you can carry on with. With the figures. https://mpirozzo.com/en/technology/4k-3d-exoscope/ https://mpirozzo.com/en/technology/4k-3d-exoscope/ Technology It swaps the microscope's eyepieces for a screen the whole theatre can see: what it genuinely improves, and what patient outcome it does not change. https://mpirozzo.com/en/technology/artificial-intelligence/ https://mpirozzo.com/en/technology/artificial-intelligence/ Technology Link by link, what artificial intelligence actually does today along a neurosurgical patient's path, and where all it measures is speed. https://mpirozzo.com/en/technology/fluorescence-5-ala/ https://mpirozzo.com/en/technology/fluorescence-5-ala/ Technology The patient drinks a compound and the tumour glows pink under violet light. Almost everything that glows is tumour; the problem is what does not. https://mpirozzo.com/en/technology/intraoperative-imaging/ https://mpirozzo.com/en/technology/intraoperative-imaging/ Technology An MRI inside the operating room confirms whether tumour remains: it doubles complete resections, and also the time and the infection risk. https://mpirozzo.com/en/technology/neuronavigation-tractography/ https://mpirozzo.com/en/technology/neuronavigation-tractography/ Technology Navigation locates the tumour to within millimetres. The problem is that the brain, once the dura is opened, stops being where the image says. https://mpirozzo.com/en/technology/neurophysiological-monitoring/ https://mpirozzo.com/en/technology/neurophysiological-monitoring/ Technology Electrodes that watch the cord while you operate: it rules out very well, detects poorly, and no randomised trial will ever measure it. https://mpirozzo.com/en/future/adaptive-deep-brain-stimulation/ https://mpirozzo.com/en/future/adaptive-deep-brain-stimulation/ The future Deep brain stimulation that adjusts its own output in real time: what it promises, what has been proved, and what evidence is still missing. https://mpirozzo.com/en/future/brain-computer-interfaces/ https://mpirozzo.com/en/future/brain-computer-interfaces/ The future An implant that reads the cortex and turns it into words: what has left the laboratory, for how many patients worldwide, and what scaling would take. https://mpirozzo.com/en/future/digital-twins/ https://mpirozzo.com/en/future/digital-twins/ The future A computational replica of the patient to rehearse the procedure before touching them: how much has reached the clinic and how much is still an idea. https://mpirozzo.com/en/future/focused-ultrasound/ https://mpirozzo.com/en/future/focused-ultrasound/ The future A thousand ultrasound beams cross the skull and ablate a point a few millimetres across: what it is good for today, on what evidence, within what limits. https://mpirozzo.com/en/future/new-biomarkers/ https://mpirozzo.com/en/future/new-biomarkers/ The future Blood tests that help decide on a scan after a head injury and detect Alzheimer's pathology: what they measure and what they do not decide. https://mpirozzo.com/en/future/personalized-medicine/ https://mpirozzo.com/en/future/personalized-medicine/ The future Since 2021 the diagnosis of a brain tumour includes its molecular biology. What that changed in surgery, and what it has not yet changed in survival. https://mpirozzo.com/en/future/surgical-artificial-intelligence/ https://mpirozzo.com/en/future/surgical-artificial-intelligence/ The future More than a thousand authorised AI devices and almost no randomised trial: the distance between being cleared for use and being clinically validated. https://mpirozzo.com/en/future/surgical-robotics/ https://mpirozzo.com/en/future/surgical-robotics/ The future Where the robot is already the normal way to operate, what millimetres and minutes it really gains, and why patient benefit remains undemonstrated.