Frontiers in Surgery最新文献

{"title":"Long term clinical outcomes of minimally invasive transforaminal interbody fusion (MIS-TLIF) for lumbar spondylolisthesis in a geriatric (>65 years) population: a systematic review and meta-analysis.","authors":"Talgat Kerimbayev, Yerzhan Kuanyshbekov, Serik Akshulakov, Indira Karibayeva","doi":"10.3389/fsurg.2025.1517947","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1517947","url":null,"abstract":"<p><strong>Introduction: </strong>The minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) technique has become a popular and effective option for treating lumbar degenerative spondylolisthesis, especially in elderly patients. This systematic review and meta-analysis is to evaluate the long-term results of MIS-TLIF for patients with degenerative spondylolisthesis.</p><p><strong>Methods: </strong>We thoroughly reviewed and analyzed studies from databases like PubMed, Web of Science, Scopus, and Google Scholar, covering research published from 2015-2024. We used random-effects models to estimate overall prevalence, and we conducted sensitivity analyses and assessed publication bias to understand the variability in results. All analyses were done using the \"meta\" and \"metafor\" packages in RStudio.</p><p><strong>Results: </strong>According to the random-effects model, the pooled standardized mean difference of the VAS back score dynamics at 12 months post-operative in geriatric MIS-TLIF patients was -4.30, 95% CI [-10.02; 1.42]; the VAS leg pain score dynamics at 12 months post-operative was -2.46, 95% CI [-5.61; 0.68]; the ODI score dynamics at 12 months post-operative was -3.01, 95% CI [-6.02; -0.01]. The VAS back pain score dynamics at 24 months post-operative was -1.77, 95% CI [-2.33; -1.21]; the VAS leg pain score dynamics at 24 months post-operative was -2.29, 95% CI [-3.22; -1.37]; and the ODI score dynamics at 24 months post-operative was -1.92, 95% CI [-2.57; -1.27].</p><p><strong>Conclusion: </strong>Our study provides compelling evidence supporting the long-term efficacy of MIS-TLIF for managing lumbar spondylolisthesis in geriatric patients. The findings suggest that MIS-TLIF is associated with significant reductions in back and leg pain, as well as improvements in disability scores over 12 months post-operatively. However, these improvements in pain and functional disability decline at 24 months postoperatively, which could be explained by the physiological nature of degenerative changes in the geriatric population.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024538220, PROSPERO (CRD42024538220).</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1517947"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and complications of blocking screws fixation in the treatment of lower limb long bone fracture: a meta-analysis.","authors":"Zhaoguo Jin, Ding Wang","doi":"10.3389/fsurg.2025.1560150","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1560150","url":null,"abstract":"<p><strong>Background: </strong>Long bone fractures, especially in the lower limbs, are highly prevalent in orthopedic practice. These fractures can significantly impair patients' mobility and quality of life. Intramedullary nails are a mainstay treatment, offering reliable fracture fixation. However, the addition of blocking screws has introduced an element of uncertainty regarding surgical outcomes. This meta-analysis evaluated the efficacy and complications of blocking screw fixation for lower limb long bone fractures (LLLBF).</p><p><strong>Methods: </strong>A comprehensive and systematic search was conducted across eight databases, namely the Cochrane Library, PubMed, EMbase, Web of Science, CNKI, China Biomedical Literature Database (CBM), VIP, and WanFang, to identify relevant controlled trials. Before data analysis, the quality of each study was rigorously assessed. Subsequently, the data were analyzed using the Review Manager 5.3 (RevMan 5.3) software to ensure a reliable and accurate synthesis of the evidence.</p><p><strong>Results: </strong>A total of 15 studies were incorporated into the analysis. Compared with the control group, the experimental group demonstrated a significantly shorter fracture healing time (standardized mean difference, SMD = -2.18; 95% confidence interval, CI: -3.17 to -1.20; <i>P</i> < 0.001), suggesting a substantial effect in favor of the intervention. Additionally, the experimental group had a longer operation time (SMD = 15.81, 95% CI: 4.28, 27.34, <i>P</i> = 0.007), less intraoperative bleeding (SMD = -75.60, 95% CI: -127.93, -23.27, <i>P</i> = 0.005), and fewer complications (odds ratio, OR = 0.51, 95% CI: 0.31, 0.84, <i>P</i> = 0.008). However, no significant difference was observed in the fracture healing rates between the two groups (OR = 1.09, 95% CI: 0.98, 1.20, <i>P</i> = 0.098).</p><p><strong>Conclusion: </strong>The findings of this study suggest that the use of intramedullary nails in conjunction with blocking screws could potentially be an effective treatment option for patients with lower limb long bone fractures. However, to confirm this efficacy, additional high - quality research, preferably well-designed randomized controlled trials with large sample sizes and long-term follow - up, is warranted.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1560150"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Endovascular electrothrombosis treatment for carotid cavernous fistula caused by ruptured primitive trigeminal artery aneurysm.","authors":"Yuhui Wan, Zengjing Cheng, Ziyan Lu, Dehong Yang, Zhaoliang Li, Kai Yang, Binglin Chen, Ailin Chen, Qing Zhu","doi":"10.3389/fsurg.2025.1559977","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1559977","url":null,"abstract":"<p><p>Aneurysms of a persistent trigeminal artery (PTA) are exceptionally uncommon, and their rupture leading to a carotid-cavernous fistula (CCF) is even more extraordinary. The contemporary management of CCF predominantly revolves around endovascular approaches, with a variety of techniques such as detachable balloons or coils, coil embolization augmented with Onyx adhesive, and stent grafting. Herein, we report a successful intervention in a patient with a CCF instigated by a ruptured PTA aneurysm, employing a combination of detachable coils and endovascular electrothrombosis, yielding favorable outcomes.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1559977"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Changing backgrounds and groundbreaking changes: gynecological surgery in the third decade of the 21st century volume II.","authors":"Rafał Watrowski, Radmila Sparić","doi":"10.3389/fsurg.2025.1587048","DOIUrl":"10.3389/fsurg.2025.1587048","url":null,"abstract":"","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1587048"},"PeriodicalIF":1.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptomatic extraforaminal gas-containing pseudocyst treated with unilateral biportal endoscopic spinal surgery: a case report and literature review.","authors":"Ya-Wen Zhang, Bin Xu, Xu-Ke Wang, Ao-Te Zheng","doi":"10.3389/fsurg.2025.1521271","DOIUrl":"10.3389/fsurg.2025.1521271","url":null,"abstract":"<p><strong>Background: </strong>Gas-containing pseudocyst is an uncommon cause of lumbar radiculopathy and most lumbar gas-containing pseudocysts locate in the spinal canal. While, extraforaminal gas-containing pseudocysts are very rare. Here, we reported a case of extraforaminal gas-containing pseudocyst, which compressed L4 exiting nerve root and caused lumbar radiculopathy.</p><p><strong>Case presentation: </strong>A 62-year-old female presented with low back pain and radiation to anteromedial aspect of right thigh and anterior aspect of right calf. Computed tomography and magnetic resonance imaging of lumbar spine showed a gas-containing pseudocyst compressing in L4 exiting nerve root right extraforaminal area at L4-5 level. L4 exiting nerve root blocking was performed to confirm the responsible level. Then we performed BESS through a paraspinal approach to remove the gas-containing pseudocyst and release L4 exiting nerve root. Postoperatively, the patient achieved a good outcome and the pain was relieved.</p><p><strong>Conclusions: </strong>Lumbar gas-containing pseudocyst in extraforaminal area is rare and can cause lumbar radiculopathy. Paraspinal approach BESS is an alternative method to treat extraforaminal gas-containing pseudocyst and can provide good outcome.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1521271"},"PeriodicalIF":1.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Subgaleal drainage removal results in a fatal complication after burr-hole evacuation of chronic subdural hematoma.","authors":"Lydia Karamani, Donjetë Januzi, Niklas Eckard, Christian Senft, Peter Baumgarten","doi":"10.3389/fsurg.2025.1533629","DOIUrl":"10.3389/fsurg.2025.1533629","url":null,"abstract":"<p><p>Placement of a drain in subgaleal space in the management of chronic subdural hematomas is a common technique. Subgaleal drains are considered a safe, effective and minimally invasive technique with low-complication rate. In this report, we present a rare but tragic adverse complication following the removal of a subgaleal drainage in a patient who had undergone an evacuation of a subdural bleeding. Although existing data indicates that the risk of cortical surface damage during drain removal is minimal, one must be aware of rare complications such as inadvertent injury to subcutaneous vascular structures culminating in an acute subdural hematoma.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1533629"},"PeriodicalIF":1.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental venous anomaly coexisting with arteriovenous malformation: a case report.","authors":"Mei Li, JiangBo Ding, XiTao Zong, Chi Lin, QingLing Liu, XiaoPeng Chen, JiaXiong Wang","doi":"10.3389/fsurg.2025.1562013","DOIUrl":"10.3389/fsurg.2025.1562013","url":null,"abstract":"<p><p>We describe a rare case of a developmental venous anomaly associated with an arteriovenous malformation. A 20-year-old male presented with seizures and was diagnosed with left parietal arteriovenous malformation combined with developmental venous anomaly in the left frontal lobe, with the draining veins of both lesions converging into the same bridging vein despite the lesions affecting anatomically distinct areas. The patient underwent a craniotomy for resection of the arteriovenous malformation. However, progressive aphasia developed on the third postoperative day. Subsequent neuroimaging (CT and MRI) revealed thrombosis formation within the drainage vein of the developmental venous anomaly. The symptoms of aphasia gradually disappeared after anticoagulant therapy with low molecular weight heparin. This case adds to the current consensus that developmental venous anomalies have normal venous drainage. It also suggests that developmental venous anomalies are susceptible to hemodynamic changes.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1562013"},"PeriodicalIF":1.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Rheumatoid arthritis patient with hip joint infection and acetabular protrusion undergoing total hip arthroplasty: a case study and literature review.","authors":"Jun Zhou, Weijie Zhou, Peng Wang, Yinwei Zhang, Weitao Chu, Jun Fan, Hui Lu","doi":"10.3389/fsurg.2025.1534279","DOIUrl":"10.3389/fsurg.2025.1534279","url":null,"abstract":"<p><p>The chronic autoimmune disease rheumatoid arthritis (RA) affects primarily the synovial joints, leading to hip joint deformity and dysfunction manifestations such as acetabular protrusion and joint infection. We present the case of a female patient RA complicated by severe hip arthritis and acetabular protrusion syndrome. The disease progressed rapidly with elevated preoperative inflammatory markers, initially overlooking hip joint infection. The patient underwent total hip arthroplasty, and intraoperative synovial fluid bacterial culture revealed Gram-negative rod bacteria. Aggressive postoperative anti-infective therapy effectively controlled the infection. Therefore, early diagnosis and treatment of infections are particularly important.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1534279"},"PeriodicalIF":1.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elbow medial approach open reduction and internal fixation with absorbable cannulated screws for the treatment of Kilfoyle II and III type medial condyle fractures of the humerus in children.","authors":"Liuyang Li, Weiqiang Li, Hong Ma, Yugeng Zheng, Yongge Chen, Huarong Ke, Yueming Guo","doi":"10.3389/fsurg.2025.1538399","DOIUrl":"10.3389/fsurg.2025.1538399","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the clinical efficacy of elbow medial approach open reduction and internal fixation with absorbable cannulated screws for the treatment of Kilfoyle II and III type medial condyle fractures of the humerus in children.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 23 pediatric patients with medial condyle fractures of the humerus who underwent surgical treatment at the Department of Pediatric Orthopedics, Foshan Traditional Chinese Medicine Hospital, from June 2018 to December 2023. Among the patients, 15 were male and 8 were female, with ages ranging from 5 to 12 years (mean age: 9.0 ± 2.4 years). According to the Kilfoyle classification, there were 3 cases of type II fractures and 20 cases of type III fractures. Of these, 19 were fresh fractures and 4 were neglected fractures. The surgical treatment involved open reduction and internal fixation through an elbow medial approach using absorbable cannulated screws. Postoperatively, the elbow joint was fixed in a functional position using a plaster cast. Four weeks postoperatively, follow-up radiographic examination showed continuous callus formation across the fracture line. The plaster cast was then removed, and active flexion and extension exercises of the elbow joint were initiated. The final follow-up assessment was performed using the Broberg-Morrey elbow joint functional scoring system to evaluate treatment efficacy.</p><p><strong>Results: </strong>All patients were followed up for 3-12 months. All fractures achieved bony union without any breakage of the fixation devices. Among them, 2 cases had good functional scores for the elbow joint, while the others had excellent scores. None of the patients experienced complications such as infection, vascular or nerve injury, nonunion or malunion of fractures, heterotopic ossification, avascular necrosis of the medial epicondyle, or varus/valgus deformity of the elbow joint.</p><p><strong>Conclusion: </strong>Open reduction and internal fixation through an elbow medial approach using absorbable cannulated screws demonstrates favorable clinical efficacy in treating Kilfoyle II and III type medial condyle fractures of the humerus in children. It can avoid the harm of secondary surgery to children, alleviate their pain, improve elbow joint function, and is considered the preferred method for treating pediatric medial condyle fractures of the humerus, deserving promotion and application in clinical practice.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1538399"},"PeriodicalIF":1.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total hip arthroplasty, through the direct anterior approach, for a femoral neck fracture of ipsilateral transfemoral amputee: a case report.","authors":"Xiangde Zhao, Gangliang Wang, Yukang Wang, Jian Chen","doi":"10.3389/fsurg.2025.1556599","DOIUrl":"10.3389/fsurg.2025.1556599","url":null,"abstract":"<p><strong>Objective: </strong>Femoral neck fractures in transfemoral amputees are rare, and their management remains controversial, particularly in individuals with short residual limb lengths. Traditional approaches to total hip arthroplasty (THA), such as the anterolateral, Hardinge, and posterior methods, present significant challenges, including difficulties in residual limb manipulation, femoral exposure, and postoperative swelling. The direct anterior approach (DAA), a minimally invasive technique, has not been previously reported for THA in this patient population. This case report aims to evaluate the feasibility and outcomes of the DAA for THA in a transfemoral amputee with a femoral neck fracture.</p><p><strong>Methods: </strong>We present the case of a 64-year-old Han male with an ipsilateral transfemoral amputation who sustained a femoral neck fracture. The patient underwent THA using the direct anterior approach. The DAA was selected due to its minimally invasive nature and ability to navigate through the intermuscular interval, which facilitated improved manipulation of the residual limb and easier exposure of the femoral side. Standard surgical protocols were followed, and postoperative care included monitoring for complications such as infection, thrombosis, and dislocation.</p><p><strong>Results: </strong>The patient's postoperative recovery was uneventful, with no signs of infection, thrombosis, dislocation, or other complications. Notably, there was no significant residual limb swelling, which was attributed to the minimally invasive nature of the DAA. The patient achieved unrestricted hip mobility without postural restrictions and attained a Harris Hip Score of 84.78 at follow-up, indicating a favorable functional outcome.</p><p><strong>Conclusions: </strong>This case demonstrates the efficacy and safety of the direct anterior approach for total hip arthroplasty in patients with high above-knee amputations. The DAA effectively addresses many challenges associated with traditional approaches, such as residual limb manipulation, femoral exposure, and postoperative swelling. These findings suggest that the DAA is a viable alternative for managing femoral neck fractures in transfemoral amputees, warranting further investigation in larger studies to validate its broader applicability.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1556599"},"PeriodicalIF":1.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}