Journal of Korean Neurosurgical Society最新文献

{"title":"Preface : Invited Issue Editor, Professor Tai-Tong Wong and the Cancer Predisposition Syndrome.","authors":"Ji Hoon Phi, Tai-Tong Wong, Seung-Ki Kim","doi":"10.3340/jkns.2025.0063","DOIUrl":"10.3340/jkns.2025.0063","url":null,"abstract":"","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"249-251"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779952","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":"Utilizing the Ascending Pharyngeal Artery for Onyx Embolization in Cranial Dural Arteriovenous Fistulas : A Retrospective Analysis.","authors":"Hye Won Choi, Tae Keun Jee, Young Woon Lee, Je Young Yeon, Pyoung Jeon, Jong-Soo Kim, Keon Ha Kim","doi":"10.3340/jkns.2024.0168","DOIUrl":"https://doi.org/10.3340/jkns.2024.0168","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective study evaluates our experience with transarterial embolization (TAE) of dural arteriovenous fistulas (dAVFs) using the ascending pharyngeal artery (APA), considering its selective application as a route for the treatment.</p><p><strong>Methods: </strong>We performed a retrospective analysis of medical records and radiologic data of all patients who underwent transarterial embolization through the APA at our institution from January 2009 to April 2021.</p><p><strong>Results: </strong>We identified 305 patients with cranial dAVFs treated endovascularly at our center, focusing on 11 cases (3.6%) where the APA was used for Onyx embolization. Of the 11 dAVFs, 5 (45%) were completely occluded, 3 (27%) showed residual shunt but disappeared cortical venous reflux, and 3 (27%) showed decreased shunt flow but persistent cortical venous reflux. Cranial nerve palsy occurred in 2 of the cases in which TAE was performed with the jugular branch and hypoglossal branch of the neuromeningeal trunk, which partially improved over 4 to 6 months. No new instances of infarction or hemorrhage were noted on subsequent MRAs.</p><p><strong>Conclusions: </strong>Transarterial Onyx embolization through the APA could be a limited option reserved for cases where embolization using other branches is challenging or carries a high risk of incomplete treatment. While embolizing through the jugular and hypoglossal branches of the APA neuromeningeal trunk requires greater caution, selecting the posterior meningeal artery or pharyngeal trunk appears to be associated with a lower risk. A comprehensive understanding of angiography is crucial for identifying cases suitable for this approach and those with a higher risk of complications.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029930","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":"Comparison of the Lumbar Drain and the Hydroxyapatite Methods for Cerebrospinal Fluid Leakage after Endoscopic Skull Base Surgery.","authors":"Minho Yang, Gung Ju Kim, Juhee Jeon, Yukyeng Byeon, Chaejin Lee, Ji Heui Kim, Sang Woo Song, Chang-Ki Hong, Jeong Hoon Kim, Yong Hwy Kim, Doo-Sik Kong, Young-Hoon Kim","doi":"10.3340/jkns.2025.0027","DOIUrl":"https://doi.org/10.3340/jkns.2025.0027","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the clinical outcomes and risk of two skull base reconstruction methods after expanded endoscopic skull base approach (EEA), viz. postoperative cerebrospinal fluid (CSF) lumbar drainage (L-method) and injectable hydroxyapatite cement without lumbar drainage (H-method).</p><p><strong>Methods: </strong>We enrolled 211 consecutive patients with grade 2 or 3 intraoperative CSF leakage during EEA. The most common preoperative diagnoses were pituitary adenoma (n=62, 29%), meningioma (n=50, 24%), and craniopharyngioma (n=28, 13%). Vascularized nasoseptal flaps were used in most cases (98%). We used the L-method and H-method in 83 (39%) and 103 patients (49%), respectively.</p><p><strong>Results: </strong>The overall reconstruction-related complication and postoperative CSF leakage rates were 8% (18/211) and 6% (12/211), respectively. The complications included postoperative CSF leakage (n=12), infection (n=4), postoperative compression (n=2), and brain herniation (n=1). The postoperative complication and CSF leakage rates did not differ significantly between the L-method (12% and 10%, respectively) and H-method (8% and 4%, respectively) (p=0.326 and 0.112, respectively). Postoperative hospital stay was significantly shorter with the H-method (6.9 days) compared to the L-method (10.0 days) (p<0.001). However, the postoperative infection rate of the H-method (n=4) was higher than that of the L-method (n=0; p=0.070).</p><p><strong>Conclusion: </strong>Skull base reconstruction using hydroxyapatite effectively prevented postoperative CSF leakage and ensured patient comfort and shorter hospitalization without postoperative lumbar drainage, although postoperative infection requires consideration.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970394","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 May 2025.","authors":"Hee-Jin Yang","doi":"10.3340/jkns.2025.0080","DOIUrl":"https://doi.org/10.3340/jkns.2025.0080","url":null,"abstract":"","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996453","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":"Effectiveness of Continuous Intra-Arterial Nimodipine Infusion for the Treatment of Refractory Vasospasm after Aneurysmal Subarachnoid Hemorrhage.","authors":"Hyunbong Lee, Jongjoo Lee, Myung Sub Kim, Jiwook Ryu, Youngbo Shim, Yeongu Chung","doi":"10.3340/jkns.2025.0004","DOIUrl":"https://doi.org/10.3340/jkns.2025.0004","url":null,"abstract":"<p><strong>Objective: </strong>Delayed cerebral ischemia (DCI) is a severe complication following aneurysmal subarachnoid hemorrhage (aSAH), potentially leading to functional impairments. Cerebral vasospasm (CVS) is one of the primary mechanisms of DCI. In cases of medically refractory CVS, intra-arterial (IA) nimodipine is a rescue treatment, but its effectiveness can be insufficient. We hypothesized that continuous IA nimodipine infusion (CIAN) could serve as a salvage treatment, and we evaluated its effectiveness and safety.</p><p><strong>Methods: </strong>We evaluated 274 patients with aSAH admitted between October 2017 and February 2024, identifying those who received IA nimodipine and those who also received CIAN. The modified Rankin Scale (mRS) score at discharge was assessed in the CIAN group, and patient and disease characteristics, length of stay, and discharge mRS scores were compared between the conventional IA nimodipine and the CIAN groups.</p><p><strong>Results: </strong>Of the 274 patients, 15 received IA nimodipine, and five of those underwent CIAN. More females were observed in the medically refractory CVS group compared with the non-refractory group (87% [13/15] vs. 66% [171/259]), but there was no sex difference between the CIAN and conventional IA nimodipine groups. CIAN was initiated at a mean of 9 days after the onset of aSAH and continued for 21-81 hours. Two complications were noted, including severe brain edema and suspected heparin-induced thrombocytopenia. However, radiological assessments showed no new lesions. The CIAN group exhibited a longer duration of abnormal findings on transcranial Doppler compared to the conventional IA group (16.0±10.1 vs. 9.4±7.9 days), as well as longer NCU (17.4±10.1 vs. 14.1±7.0 days) and hospital stays (46.6±28.7 vs. 29.5±14.1 days). Nonetheless, more achieved a favorable outcome (mRS≤2) in the CIAN group (80% [4/5] vs. 70% [7/10]).</p><p><strong>Conclusion: </strong>CIAN is a viable salvage treatment for refractory CVS, providing a prolonged vasodilatory effect compared to conventional IA nimodipine, with favorable outcomes.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029005","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":"Competency-Based Neurosurgical Residency Training Program in Korea.","authors":"Kawngwoo Park, Sang-Don Kim, Seung-Won Choi, Dae-Hyun Kim, Eun Kyung Park, In-Suk Bae, Jin-Uk Baek, Kun Soo Lee, Sun-Ho Lee, Soo Bin Im, Youngjin Jung, Sung-Pil Joo, Man Kyu Choi, Bum-Joon Kim, Hyun Ho Choi, Junseok W Hur","doi":"10.3340/jkns.2024.0056","DOIUrl":"https://doi.org/10.3340/jkns.2024.0056","url":null,"abstract":"<p><p>A proposed program for competency-based neurosurgery training was presented for adaptation to a specialized project. The core of this training program is to reflect the contents of medicine that develop in the ordinary competency course necessary during the training period of residency and to systematize the training curriculum focused on competency. For that, the Development project of the competency-based training program for neurosurgical residency was conducted under the leadership of the Training Education Committee (TEC) under the Korean Neurosurgical Society (KNS), with the support of the Ministry of Health and Welfare. In this article, we introduce an educational program for a competency-oriented training system. The educational program sets the goal of the final competency that a neurosurgeon must possess and presents a list of core competencies and activities to perform for this purpose, called entrustable professional activity (EPA). The program structure includes the following domains: seven final competencies, four core competencies, ten EPAs, and 12 neurosurgical procedures. These educational programs will be uploaded to the KNS website in the future, and we would like to encourage each training hospital to reflect on them.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997513","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy Comparison of Multiplanar Deformity Reducer System and Direct Vertebral Rotation in Adolescent Idiopathic Scoliosis Corrective Surgery.","authors":"Sungjae An, Seung-Jae Hyun, Jae-Min Ahn, Byoung-Joo Park, Seong-Hyun Wui, Ki-Jeong Kim","doi":"10.3340/jkns.2024.0076","DOIUrl":"https://doi.org/10.3340/jkns.2024.0076","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the efficacy of the multiplanar deformity reducer (MDR) and direct vertebral rotation (DVR) techniques in surgically treating adolescent idiopathic scoliosis (AIS), focusing on surgical and radiographic outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on AIS patients who underwent surgery between December 2017 and August 2019, comparing the outcomes of those treated with MDR system and DVR technique. Data on demographics and surgical characteristics were collected, while radiographic parameters were measured manually by three spine surgeons and by EOS 3D analysis (EOS imaging, Paris, France).</p><p><strong>Results: </strong>Nine patients were surgically corrected with the MDR system and 13 with DVR, who were predominantly females with an average age in their late teens. Despite more fusion levels in the MDR group (12.3±1.0) compared to the DVR group (10.0±3.2), operation time, blood loss, overall radiographic correction, and patient-reported outcome was comparable. Moreover, only the interrater reliability for manual apical vertebral rotation measurements was below good, which necessitates the use of EOS 3D analysis.</p><p><strong>Conclusion: </strong>The MDR technique is effective and safe for AIS surgery, offering comparable corrective efficacy to the DVR technique. Furthermore, EOS 3D imaging was more reliable for assessing rotational deformities, which incorporates pelvic position.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753185","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":"Comparison of Surgical and Endovascular Treatments for Partially Thrombosed Intracranial Aneurysms : Insights into Recurrence and Residual Lesions.","authors":"Yong-Jun Lee, Woong-Beom Kim, You-Sub Kim, Sung-Pil Joo","doi":"10.3340/jkns.2025.0047","DOIUrl":"https://doi.org/10.3340/jkns.2025.0047","url":null,"abstract":"<p><strong>Objective: </strong>Partially thrombosed intracranial aneurysms (PTIAs) are known to occur for both large and small aneurysms; however, standardized treatment guidelines remain undefined. This study aimed to evaluate and compare the efficacy of surgical and endovascular strategies for managing PTIAs to identify the optimal treatment approach.</p><p><strong>Methods: </strong>A retrospective analysis was performed on patients diagnosed with PTIAs who underwent surgical or endovascular treatment at our institution from January 2005 to December 2022. Patients with intraluminal thrombi confirmed via brain imaging were categorized based on the treatment modality. A total of 45 patients were included. Clinical outcomes, including preoperative and postoperative modified Rankin Scale (mRS) scores, complication rates, and recurrent or remnant aneurysm rates, were reviewed to analyze the treatment results.</p><p><strong>Results: </strong>Of the 45 enrolled patients, 31 patients (68.9%) underwent surgical treatment, and 14 patients (31.1%) received endovascular treatment. Surgical approaches included direct clipping, trapping with bypass, and aneurysm wrapping. Multivariate analysis revealed a statistically significant association between the treatment modality and recurrent or remnant aneurysms (P < 0.001). However, no significant differences were identified between the two treatment groups in terms of complication rates or functional outcomes.</p><p><strong>Conclusion: </strong>In comparison to endovascular treatment, surgical management of PTIAs demonstrated superior efficacy in minimizing recurrent and remnant aneurysms. Considering the comparable rates of postoperative complications and functional outcomes, surgical treatment may be the preferred treatment strategy, particularly for younger patients with longer follow-up periods or for cases requiring decompression.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753182","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":"Surgical Correction for Adolescent Idiopathic Scoliosis : A Case Series of 139 Consecutive Patients Treated in Neurosurgical Department.","authors":"SungSoo Bae, Seung-Jae Hyun, Jae-Koo Lee, Dae-Jean Jo, Ki-Jeong Kim","doi":"10.3340/jkns.2024.0224","DOIUrl":"https://doi.org/10.3340/jkns.2024.0224","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the clinical and radiographic results of patients with adolescent idiopathic scoliosis (AIS) operated by a single neurosurgeon.</p><p><strong>Methods: </strong>A total of 139 consecutive patients with AIS who underwent corrective surgery by a single neurosurgeon were investigated between January 2011 and January 2024. Segmental instrumentation with pedicle screws was utilized for deformity correction. Demographic information, structural type of curve using Lenke classification, degree of correction achieved, total numbers of fusion levels, complications, and clinical/radiographic results were evaluated.</p><p><strong>Results: </strong>Most patients were adolescent girls (105 vs. 34) with an average age of 15.9 vs. 16.0, respectively. The average duration of follow-up was 4.5 years (0.1-13.0 years). Nine (6.6%) patients had levoscoliosis, and the remaining 130 had dextroscoliosis. Chiari malformation with syringomyelia was incidentally diagnosed in four (2.8%) patients. Of the patients having Chiari malformation, two (50%) had levoscoliosis. The mean number of fused levels was 11.2. The mean value of the Cobb angle at the major structural curvature was 63.4° (43°-125°). The major structural curve's average percentage of correction was 78.8%. The final postoperative SRS-22 average score significantly improved to 4.3±0.4 compared with the preoperative score of 3.8±0.5 (P < 0.001). After the surgery, there were no observed cases of neurological deficits or need for screw repositioning. Revision fusion extension surgery was performed on one patient to treat postoperative shoulder imbalance.</p><p><strong>Conclusion: </strong>Patients with AIS treated by a neurosurgeon had acceptable clinical and radiographic results. However, AIS surgery necessitates a fundamental comprehension of pediatric spinal deformities, which is crucial. Furthermore, spine surgeons should be careful with patients who have levoscoliosis.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663658","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}