Journal of Korean Neurosurgical Society最新文献

{"title":"Corrigendum to \"Von Hippel-Lindau Disease : A Comprehensive Review of Diagnosis, Genetics, Clinical Challenges, and Surveillance\" by Jung et al. (J Korean Neurosurg Soc 68 : 338-349, 2025).","authors":"","doi":"10.3340/jkns.2025.0018.e1","DOIUrl":"10.3340/jkns.2025.0018.e1","url":null,"abstract":"","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"494"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Degradation Pattern of a Biodegradable and Photocurable Sealants Based on Hyaluronic Acid : A Serial Magnetic Resonance Imaging Observational Study in Rat Craniectomy Model.","authors":"Hyeseon Lee, Sijoon Lee, Seung Yun Yang, Dong Hwan Kim, Mahnjeong Ha, Kyoung Hyup Nam","doi":"10.3340/jkns.2024.0138","DOIUrl":"10.3340/jkns.2024.0138","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is evaluating in vivo degradation of photocrosslinkable hyaluronic acid (HA)-based dural sealant (HA photosealant) using magnetic resonance imaging (MRI) and histopathological analysis to assess its biodegradability and effectiveness in preventing cerebrospinal fluid (CSF) leakage.</p><p><strong>Methods: </strong>HA photosealants were applied to the incised dura in a rat craniectomy and durotomy. The HA photosealant quickly sealed the wound upon low-energy visible light exposure (405 nm, <5 seconds, < 1 J/cm2). The degradation of HA photosealants was tracked through serial MRI scans at 1, 2, and 4 weeks post-application. The remaining area of HA photosealants on the dura was measured using image processing program for volumetric analysis. Additionally, histopathological analyses were performed to evaluate the biocompatibility and effectiveness of the dural repair.</p><p><strong>Results: </strong>The MRI and histopathological analyses showed that the HA photosealant achieved progressive degradation while successfully preventing CSF leakage without any adverse tissue reactions. The residual area of HA photosealants measured at 2 weeks ranged from 41.35% to 94.88%, with an average of 66.57%. At 4 weeks, a more distinct degradation pattern was observed compared to 2 weeks, showing a residual area of 10.28% to 56.11%. The HA photosealant maintained structural integrity until dural regeneration was completed.</p><p><strong>Conclusion: </strong>HA photosealant showed gradual degradation in vivo while maintaining mechanical strength until the dura was repaired for preventing CSF leakage without inflammation and toxicity. HA photosealant has great potentials for clinical application for dural repair with biodegradable properties and biocompatibility.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"375-382"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769706","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":"Outcomes of Acute Subdural Hematoma in Adults with a Glasgow Coma Scale Score of 3 : An Analysis from Five Regional Trauma Centers.","authors":"Ji-Na Kim, Ki Seong Eom","doi":"10.3340/jkns.2024.0194","DOIUrl":"10.3340/jkns.2024.0194","url":null,"abstract":"<p><strong>Objective: </strong>Acute subdural hematoma (A-SDH) in patients with a Glasgow coma scale (GCS) score of 3 presents significant challenges in clinical decision-making owing to high mortality rates and the likelihood of severe disability. Here, we analyzed data to assess the number of surgical treatments and overall treatment outcomes for patients with A-SDH admitted in a comatose state and discussed the value of such aggressive surgical interventions based on these findings.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using data from five regional trauma centers in Korea registered with the Korean Neurotrauma Data Bank System. This study included adult patients (aged ≥19 years) admitted between January 2018 and June 2021 to a comatose state due to A-SDH. Patients were classified into death and survivor groups based on their outcomes, and their demographic, clinical, and radiological characteristics were compared. Additionally, patients were divided into a combined group of deaths and vegetative state survivors and a group of remaining survivors to compare the differences and assess the impact of death and vegetative state.</p><p><strong>Results: </strong>Among a total of 109 patients, the mean age was 59.28 years, and the mortality rate was 80.7%. Among the 21 survivors, 12 (57.1%) remained vegetative. Surgical treatment was performed in 42 patients (38.5%), resulting in a lower mortality rate (64.3%) than conservative treatment (91.0%). However, the rate of the vegetative state was higher in the surgical group (21.4%) than in the conservative group (4.5%). Pupil reactivity was a significant predictor, with mortality rates of 44.4%, 57.1 %, and 85.9% for reactive, unilaterally unreactive, and bilaterally unreactive pupils, respectively. The surgical group had a significantly longer hospital stay (23.69±29.15 days) compared to the conservative group (6.45±13.75 days).</p><p><strong>Conclusion: </strong>It is time to go one step further from death with the dignity law and have a comprehensive consideration and social consensus on 'how to end life.' A model that can more accurately predict situations in which decompressive surgery should be considered for patients in a comatose state due to A-SDH is required. Neurosurgeons must have a comprehensive understanding of the patient's progress, the anticipated prognosis, and the various financial and psychological burdens on the family and must be able to communicate this information thoroughly.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"456-464"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895418","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":"Deep brain Stimulation Generator Replacement Surgeries : Safety and Efficacy of PEAK Plasmablade TMX and Analysis of Wound Healing Complications.","authors":"Seung Woo Hong, So Hee Park, Dao Duy Phuong, Kyung Won Chang, Hyun Ho Jung, Jin Woo Chang","doi":"10.3340/jkns.2024.0133","DOIUrl":"10.3340/jkns.2024.0133","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the safety and efficacy of using the PEAK Plasmablade TMX (PBX) in deep brain stimulation (DBS) of implantable pulse generator (IPG) replacement surgeries, alongside identifying potential risk factors for postoperative complications.</p><p><strong>Methods: </strong>A prospective study was conducted on 50 patients undergoing IPG replacement with PBX, compared to 150 historical controls. Demographic data, surgical characteristics, and postoperative outcomes were analyzed. Logistic regression was used to identify predictors of surgical complications.</p><p><strong>Results: </strong>The demographic and clinical profiles of patients in the PBX group were comparable to those in the control group. PBX significantly reduced surgical duration (p=0.005) and did not result in impedance abnormalities. While wound complications did not significantly differ between groups, logistic regression identified diabetes as a significant predictor of wound dehiscence or delayed healing (p=0.012).</p><p><strong>Conclusion: </strong>The findings support the safety and efficacy of PBX in DBS IPG replacement surgeries, offering advantages such as reduced surgical duration and minimized risk of impedance abnormalities. However, diabetes emerged as a significant predictor of adverse wound outcomes, highlighting the need for tailored preoperative assessment and management strategies.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"473-479"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779944","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":"Risk Factors for Unfavorable Angiographic Outcomes after Reconstructive Endovascular Treatments of Unruptured Vertebral Artery Dissecting Aneurysms.","authors":"KunHee Han, Jai Ho Choi, Woo Cheul Cho, Hyeong Jin Lee, Yong Sam Shin","doi":"10.3340/jkns.2025.0076","DOIUrl":"https://doi.org/10.3340/jkns.2025.0076","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical and radiological features of unruptured vertebral artery dissecting aneurysms (uVADAs) treated with reconstructive endovascular techniques and to evaluate the risk factors associated with unfavorable radiological outcomes while focusing on the flow diversion effect.</p><p><strong>Methods: </strong>We retrospectively reviewed 86 patients with uVADAs treated at a single tertiary center between January 2009 and December 2022. The patients were categorized into the flow diversion group (patients with uVADAs treated with a flow diverter or multiple stents) and the non-flow diversion group (patients with less than a single stent insertion). Unfavorable angiographic outcomes were defined as 1) recurrence after coil insertion regardless of stent deployment or 2) no regression after stent insertion without coil packing. Univariate and multivariate analyses were performed to assess the related risk factors.</p><p><strong>Results: </strong>We observed 37 uVADAs in the flow diversion group. Recurrence or no regression occurred in 2 of 37 (9.1%) and 13 of 49 (27.7%) uVADAs in the flow and non-flow diversion groups, respectively. The treatment without flow diversion effect (non-flow diversion group; odds ratio [OR] = 8.04, 95% confidence interval [CI] = 1.23-52.57, p = 0.003) and hypertension (OR = 22.09, 95% CI = 2.51-194.2, p = 0.005) were significantly associated with unfavorable angiographic outcomes.</p><p><strong>Conclusion: </strong>The flow diversion effect using a flow diverter or multiple stents insertion, along with strict blood pressure control, may be an important factor in achieving favorable angiographic outcomes in uVADA treatment.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allergic Reaction to a Bovine-Derived Dural Graft Without Eosinophilic Meningitis: A Case Report and Literature Review.","authors":"Rose Fluss, Riana Lo Bu, Keyvan Ghadimi, Jason Yu, Maya Jurgens, Imane Abbas, Nagma Dalvi, Allison Martin, Andrew J Kobets","doi":"10.3340/jkns.2025.0092","DOIUrl":"https://doi.org/10.3340/jkns.2025.0092","url":null,"abstract":"<p><p>Bovine-derived dural substitutes are commonly used in cranial and spinal duraplasty. Although they are generally well tolerated, allergic reactions have been reported-almost all presented with eosinophilic meningitis. A 7-year-old girl with Li Fraumeni syndrome and diffuse pediatric glioma underwent a third salvage resection in which a bovine collagen dural onlay was placed. Ten days post operatively, she developed fever, lethargy, and a subcutaneous scalp fluid collection. Cultures and imaging were negative for infection; cerebrospinal fluid (CSF) revealed pleocytosis (elevated white blood cells and protein) without eosinophilia. High-dose dexamethasone produced transient clinical and radiographic improvement, but fever and fluid re accumulated whenever steroids were tapered. Given the steroid dependence and persistently negative infectious work up, the graft was explanted. Pathology demonstrated a foreign body giant cell reaction without eosinophils, and the patient's symptoms resolved permanently after removal. This report documents the first pediatric case of bovine-derived dural graft hypersensitivity without eosinophilic meningitis. Clinicians should consider graft-related allergy in children who develop recurrent fluid collections and fevers after duraplasty-even when CSF eosinophils are absent and cultures remain negative and should recognize that definitive treatment may require graft removal rather than prolonged steroid therapy.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editors' Pick in July 2025.","authors":"Hee-Jin Yang","doi":"10.3340/jkns.2025.0121","DOIUrl":"https://doi.org/10.3340/jkns.2025.0121","url":null,"abstract":"","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of Texture Analysis in Postoperative Recurrence of Chronic Subdural Hematoma.","authors":"Yu Yan, Jianchao Wang, Jincai Fang, Yunnong Song","doi":"10.3340/jkns.2024.0125","DOIUrl":"https://doi.org/10.3340/jkns.2024.0125","url":null,"abstract":"<p><strong>Objective: </strong>Texture analysis is widely used in all walks of life, and also in medicine. This paper aims to discuss the value of texture analysis in postoperative recurrence of chronic subdural hematoma (CSDH).</p><p><strong>Methods: </strong>A total of 173 patients with CSDH who were hospitalized in our hospital from January 2018 to August 2023 were selected . All the patients underwent magnetic resonance imaging (MRI) examinations before surgery. According to whether patients with CSDH have relapsed after surgery, the patients are divided into recurrence group and non-recurrence group. FireVoxel software (https://firevoxel.org) was used to manually delineate the region of interest on the largest level of the hematoma cavity during MRI plain scans and measure the texture parameters. The texture parameters with statistical difference were analyzed by receiver operating characteristic curve.</p><p><strong>Results: </strong>Heterogeneity and entropy texture parameters in the recurrence group were statistically different from those in the nonrecurrence group (p<0.05). When the cut-off point of the heterogeneity parameter was 0.284, the sensitivity, specificity, and accuracy of judging whether CSDH relapsed were 83.3%, 80.4%, and 80.7%, respectively.</p><p><strong>Conclusion: </strong>Texture analysis of CSDH can provide a new method to judge the recurrence of patients with CSDH.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lordosis Distribution Index in an Asymptomatic Elderly Population : The Role of Lower and Upper Lumbar Lordosis According to Individual Pelvic Incidence and Roussouly Type.","authors":"Seung-Jae Hyun, Sanghyun Han, Youngbae B Kim","doi":"10.3340/jkns.2025.0086","DOIUrl":"https://doi.org/10.3340/jkns.2025.0086","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to elucidate the normative upper and lower lumbar lordosis (ULL and LLL) based on individual pelvic and spinal morphology within an asymptomatic elderly population.</p><p><strong>Methods: </strong>Whole spine standing radiographs were obtained from asymptomatic elderly populations who had not undergone previous spinal surgery. The lumbar lordosis (LL), lower LL and upper LL were measured. Pelvic incidence (PI) and the lordosis distribution index for the upper and lower lumbar spine (ULDI and LDI, respectively) were calculated. Pearson correlation and linear regression analyses were performed, and the mean value for each parameter was obtained according to PI subgroup (PI < 40°, 40° ≤ PI < 50°, 50° ≤ PI < 60°, and 60° ≤ PI) and \"theoretical\" Roussouly type.</p><p><strong>Results: </strong>Overall, data from 150 male were retrospectively collected in the study, with an average age of 64.1 ± 6.4 years. The mean height was 167.0 ± 5.5 cm, weight was 67.3 ± 9.8 kg, and body mass index was 24.1 ± 3.1 kg/m2. The average LL was -57.5° ± 9.0°, LLL was -39.7° ± 6.8°, and PI was 48.6° ± 8.6°. PT tended to increase with ULL, PI-LL, PI-ULL, PI-LLL, and ULDI and decrease with LLL and LDI. However, PT was not significantly related to LL. The mean ULDI and LDI were 30.4% ± 11.7% and 69.7% ± 11.7%, respectively. The differences between PI and LL (PI-LL) and between PI and LLL (PI-LLL) were -8.9° ± 8.0° and 9.0° ± 9.3°, respectively. As PI increased from low (<40°) to high (≥60°), ULDI increased significantly from 25.9% to 38.9%, while LDI decreased from 74.1% to 61.1%. Additionally, LDI varied by Roussouly type, ranging from 62.6% to 81.0%. The LDIs of Roussouly types 1 and 4 were significantly higher and lower, respectively, than those of types 2 and 3 (p < 0.001).</p><p><strong>Conclusion: </strong>As PI and Roussouly type increase, the contribution of ULL to overall LL rises, reaching up to 38.9%. Conversely, LLL substantially impacts LL in patients with a low PI and those classified as Roussouly type 1. PT is significantly related to LLL instead of LL according to PI.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factor Analysis of Simple Drainage Followed by Instrumented Fusion in Patients with Pyogenic Spinal Infection.","authors":"Jong Tae Ko, Sang Hyub Lee, Tae Yong An, Dong Hwan Kim, Dong Ho Kang","doi":"10.3340/jkns.2025.0084","DOIUrl":"https://doi.org/10.3340/jkns.2025.0084","url":null,"abstract":"<p><strong>Objective: </strong>The first-line treatment for pyogenic spondylitis is conservative management with immobilization and systemic antibiotic therapy. However, in cases where conservative treatment fails or neurological deficits and spinal instability are present, surgical intervention is required. Surgical treatment helps manage spondylitis by decompressing neural structures through abscess drainage and maintaining spinal stability. It includes simple decompression via abscess removal, debridement of inflamed and necrotic tissues, and reconstruction with fixation. This study aims to analyze the risk factors associated with clinical outcomes in patients undergoing simple drainage followed by instrumented fusion.</p><p><strong>Methods: </strong>We retrospectively evaluated patients who underwent surgical treatment with intravenous antibiotics for pyogenic spondylitis at our hospital between March 2010 and November 2021. We categorized the study group into a group that underwent simple decompression and drainage and a group that was followed up until fusion. We compared the basic demographics, laboratory data, and radiological findings between the two groups.</p><p><strong>Results: </strong>Overall, 88 patients (50 males and 38 females) with a mean age of 63.8 years were included in this study. Of the 88 patients, 71 underwent simple abscess drainage and 17 underwent instrumented fusion. In the univariate logistic regression analysis based on demographic data, longer duration of antibiotic use (p=0.021), body signal change (p=0.001), facet inflammation (p=0.003), disc abscess (p<0.001), psoas abscess (p=0.003), disc space bone erosion (p=0.006), and hypertension (p=0.024) were significant risk factors for necessitation of fusion surgery after decompression and drainage surgery. Multivariate logistic regression analysis based on these risk factors revealed that the longer the period of total antibiotic use after decompression and drainage (p=0.019), the higher the risk of fusion surgery, as well as a higher risk of body signal change.</p><p><strong>Conclusion: </strong>When planning surgical treatment for pyogenic spondylitis, close observation is required because the necessity for instrumented fusion surgery increases when antibiotic use is prolonged or body signal changes are confirmed on magnetic resonance imaging.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}