Journal of Korean Neurosurgical Society最新文献

{"title":"Preface : Digital and Robotic Transformation of Pediatric Neurosurgery.","authors":"Ji Hoon Phi, Seung-Ki Kim","doi":"10.3340/jkns.2026.0115","DOIUrl":"10.3340/jkns.2026.0115","url":null,"abstract":"<p><p>This Pediatric Issue of the Journal of Korean Neurosurgical Society addresses the digital and robotic transformation of pediatric neurosurgery. It reviews the emerging applications of artificial intelligence and related technologies across diagnosis, monitoring, surgical practice, education, and communication, while also considering the unique scientific and ethical challenges of their use in children. Together, these articles offer a timely perspective on the future of safer, more precise, and more personalized pediatric neurosurgical care.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"326-328"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773937","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":"Robotic Surgery in Pediatric Epilepsy : Current Evidence, Clinical Impact, and Future Directions.","authors":"Seunghoon Lee","doi":"10.3340/jkns.2026.0052","DOIUrl":"10.3340/jkns.2026.0052","url":null,"abstract":"<p><p>Pediatric drug-resistant epilepsy remains a significant neurological challenge, with up to one-third of affected children failing to achieve seizure control with pharmacologic therapy. Surgical intervention offers the greatest likelihood of seizure reduction or freedom; however, precise localization and treatment of epileptogenic networks in pediatric patients are often complicated by multilobar onset patterns, evolving neurodevelopmental anatomy, and limitations of conventional invasive monitoring. Over the past two decades, stereoelectroencephalography (SEEG) has emerged as a preferred invasive diagnostic modality due to its minimally invasive approach, three-dimensional sampling capability, and favorable safety profile. Parallel advances in robotic stereotaxy have further enhanced the precision, efficiency, and reproducibility of electrode implantation and stereotactic interventions. Robotic assistance has expanded beyond diagnostic SEEG implantation to include stereotactic ablative therapies, such as radiofrequency thermocoagulation and magnetic resonance-guided laser interstitial thermal therapy, as well as neuromodulation procedures including deep brain stimulation and responsive neurostimulation. These technologies enable precise targeting of deep and distributed epileptogenic networks while minimizing surgical morbidity. Pediatric clinical studies demonstrate that robotic-assisted SEEG achieves high diagnostic yield, excellent safety profiles, and accuracy comparable to or exceeding conventional stereotactic techniques. Similarly, robot-assisted ablative and neuromodulation procedures show promising efficacy in carefully selected pediatric populations, although complete seizure freedom remains less common in neuromodulatory approaches. Despite increasing adoption, the pediatric robotic epilepsy surgery literature remains predominantly retrospective and heterogeneous, with limited prospective comparative data. This review synthesizes current evidence regarding robotic applications in pediatric epilepsy surgery, including SEEG implantation, stereotactic ablation, and neuromodulation. We highlight technical considerations, clinical outcomes, and safety profiles, while identifying critical gaps in evidence related to long-term outcomes, and the direct clinical impact of robotic accuracy. Continued prospective and multicenter investigations are essential to define the optimal role of robotic assistance in improving outcomes for pediatric patients with drug-resistant epilepsy.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"371-381"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773887","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":"Extended Reality in Neurosurgery : Surgical Planning, Navigation, Education, and Patient Communication.","authors":"Tae Hoon Roh, Seonah Choi, Ju Hyung Moon, Eui Hyun Kim, Seok-Gu Kang, Jong Hee Chang","doi":"10.3340/jkns.2026.0047","DOIUrl":"10.3340/jkns.2026.0047","url":null,"abstract":"<p><p>Extended reality (XR), encompassing virtual reality, augmented reality (AR), and mixed reality, has emerged as a transformative technology in neurosurgery. This narrative review examines the current applications of XR technologies across four major domains : surgical planning and visualization, intraoperative navigation, medical education and training, and patient/caregiver communication. The integration of artificial intelligence-based lesion segmentation with XR platforms has enabled precise three-dimensional visualization of complex intracranial pathologies. Modern AR navigation systems, utilizing both optical see-through and video see-through head-mounted displays, have demonstrated submillimeter accuracy in recent clinical studies. Educational applications of XR have shown significant improvements in anatomical understanding and surgical skill acquisition among neurosurgery trainees. Furthermore, XR-enhanced patient communication tools have improved comprehension of complex neurosurgical procedures and informed consent quality. Despite current limitations including hardware constraints, workflow integration challenges, and the need for larger validation studies, XR technologies hold substantial promise for advancing pediatric neurosurgical care. This review provides a critical analysis of current evidence, discusses the advantages and limitations of different XR modalities, and offers perspectives on future developments in this rapidly evolving field.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"349-360"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638926","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":"Artificial Intelligence in Neurocritical Care : Multimodal Biosignal Analysis for Prognosis, Monitoring, and Future Pediatric Applications.","authors":"Taehoon Kim, Ji Hoon Phi","doi":"10.3340/jkns.2026.0046","DOIUrl":"10.3340/jkns.2026.0046","url":null,"abstract":"<p><p>Neurocritical care relies on continuous assessment of neurological function and physiology under time pressure, yet bedside teams must interpret high-frequency, multimodal data that include hemodynamic waveforms, intracranial pressure (ICP), electroencephalography (EEG), near-infrared spectroscopy, neuroimaging, and electronic health record (EHR) context. Artificial intelligence (AI) and machine learning are increasingly used to fuse these biosignals, reduce interobserver variability, and generate dynamic risk estimates that can support monitoring, early warning, and prognostication. In pediatric and neonatal populations, where developmental physiology and smaller case volumes amplify uncertainty, AI-enabled tools have shown particularly strong performance in selected domains. Examples include prediction of impending intracranial hypertension using features from arterial blood pressure and ICP waveforms, automated EEG trend analysis for neurodevelopmental outcome prediction after perinatal asphyxia, magnetic resonance imagingbased neuroprognostication in neonatal hypoxic-ischemic encephalopathy, and interoperable EHR-based models for mortality and new morbidity risk stratification in the intensive care unit. However, many studies remain retrospective, and generalizability across institutions can be limited by differences in data capture, clinical practice, and outcome definitions. This review summarizes clinically relevant applications of multimodal biosignal analysis in neurocritical care, highlights validation and implementation considerations, and proposes priorities for future pediatric translation, including multisite evaluation, calibration, explainability, and prospective impact studies.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"382-391"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512962","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":"Biportal Endoscopic Transorbital Approach with an Accessory Lateral Orbital Port for Anterior Petrosal Corridor : A Cadaveric Feasibility Study [Seven-004].","authors":"Seonah Choi, Woo Hyun Kim, Soo Jeong Park, Tae Hoon Roh, Hong-Gyu Yoon, Chang-Ki Hong, Je Beom Hong","doi":"10.3340/jkns.2026.0049","DOIUrl":"https://doi.org/10.3340/jkns.2026.0049","url":null,"abstract":"<p><strong>Objective: </strong>The anterior transpetrosal approach (ATPA) is one of the useful methods for targeting the middle clival and ventrolateral pontine areas. Thanks to the advances in endoscopic skull base surgery, there have been increased attempts to perform anterior petrosectomy via the endoscopic transorbital approach (ETOA), although some limitations and drawbacks have also been suggested. This study aimed to analyze the contribution of the endoscopic biportal transorbital technique to anterior petrosectomy.</p><p><strong>Methods: </strong>A total of ten cadaveric heads (twenty sides) were dissected at the Surgical Neuroanatomy Laboratory. The biportal ETOA was established by combining the main transorbital port with an accessory lateral orbital port created beyond the lateral orbital rim. In each head, anterior petrosectomy through uniportal ETOA was performed on one side, followed by the biportal ETOA on the same side, while the transcranial subtemporal ATPA was done on the other side. The extent of exposure for each approach was documented using representative photographs obtained during dissection. The angle of attack (AOA) was measured at key surgical landmarks, including Meckel's cave, the root entry zone (REZ) of cranial nerves V, VI, VII, and VIII, and the internal acoustic porus. The drilled volume of the petrous apex was calculated by comparing pre- and post-dissection CT scans.</p><p><strong>Results: </strong>By utilizing the accessory port, it was possible to obtain a more medial trajectory, allowing wider exposure of CN V, CN VI, CN VII, CN VIII, and the ventrolateral pons than the uniportal approach. The angle of attack (AOA) increased with the biportal transorbital approach compared to the uniportal route by approximately 26.1-46.7% in the horizontal axis, 21.6-52.4% in the vertical axis. When measuring the drilled volume of the petrous apex, no statistically significant difference was observed between the biportal ETOA and the traditional transcranial craniotomy method. (0.9339 ± 0.1037 vs 0.9729 ± 0.0692 cm3, p = 0.067).</p><p><strong>Conclusion: </strong>This study demonstrates that the biportal ETOA can compensate for the limitations of the uniportal approach in performing anterior petrosectomy by providing a wider field of view and greater surgical freedom.m neurodevelopmental outcomes in vulnerable pediatric neurosurgical patients.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638511","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":"Hwan Yung Chung : Founder of Korean Spinal Neurosurgery.","authors":"Chun Kee Chung, Byeong-Jin Ha, Koang Hum Bak, Jae Min Kim, Choong Hyun Kim, Yong Ko, Suck Jun Oh","doi":"10.3340/jkns.2025.0062","DOIUrl":"10.3340/jkns.2025.0062","url":null,"abstract":"<p><p>Professor Chung, an Emeritus Professor at Hanyang University School of Medicine, was a pioneering figure in Korean neurosurgery. After serving as an Army Surgeon during the Korean War, he specialized in neurosurgery, training under Professor Joo Geol Lee at Capital Medical College. Throughout his career, Professor Chung introduced numerous innovations in spinal surgery, including lumbar interbody fusion with metal support, anterior cervical foraminotomy, and the early adoption of microsurgery and motorized drills. In 1972, he became the first Chairman of the Department of Neurosurgery at Hanyang University Hospital, where he established a leading neurosurgical center. His contributions extended beyond clinical practice-he founded the Korean Spinal Neurosurgery Society in 1987 and served as President of Hanyang University Hospital from 1986 to 1987. Even after retirement, he remained active in the field, practicing and contributing to neurosurgery until his passing in 2016. He strongly emphasized continuous learning and international collaboration, fostering relationships with global spine surgery leaders and actively participating in international conferences. His dedication to minimally invasive techniques and surgical innovation profoundly impacted Korean neurosurgery, inspiring future generations and significantly advancing the field.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"314-319"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186184","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":"Enhancing Spinal Cord and Canal Segmentation in Degenerative Cervical Myelopathy : The Role of Interactive Learning Models with manual Click.","authors":"Sangmin Han, Jae Keun Oh, Wonwoo Cho, Tae Joon Kim, Noah Hong, Sung Bae Park","doi":"10.3340/jkns.2025.0033","DOIUrl":"10.3340/jkns.2025.0033","url":null,"abstract":"<p><strong>Objective: </strong>We aim to develop an interactive segmentation model that can offer accuracy and reliability for the segmentation of the irregularly shaped spinal cord and canal in degenerative cervical myelopathy (DCM) through manual click and model refinement.</p><p><strong>Methods: </strong>A dataset of 1444 frames from 294 magnetic resonance imaging records of DCM patients was used and we developed two different segmentation models for comparison : auto-segmentation and interactive segmentation. The former was based on U-Net and utilized a pretrained ConvNeXT-tiny as its encoder. For the latter, we employed an interactive segmentation model structured by SimpleClick, a large model that utilizes a vision transformer as its backbone, together with simple fine-tuning. The segmentation performance of the two models were compared in terms of their Dice scores, mean intersection over union (mIoU), Average Precision and Hausdorff distance. The efficiency of the interactive segmentation model was evaluated by the number of clicks required to achieve a target mIoU.</p><p><strong>Results: </strong>Our model achieved better scores across all four-evaluation metrics for segmentation accuracy, showing improvements of +6.4%, +1.8%, +3.7%, and -53.0% for canal segmentation, and +11.7%, +6.0%, +18.2%, and -70.9% for cord segmentation with 15 clicks, respectively. The required clicks for the interactive segmentation model to achieve a 90% mIoU for spinal canal with cord cases and 80% mIoU for spinal cord cases were 11.71 and 11.99, respectively.</p><p><strong>Conclusion: </strong>We found that the interactive segmentation model significantly outperformed the auto-segmentation model. By incorporating simple manual inputs, the interactive model effectively identified regions of interest, particularly in the complex and irregular shapes of the spinal cord, demonstrating both enhanced accuracy and adaptability.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"176-185"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149316","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":"Pain and Functional Outcome of Supraclavicular Decompression of the Brachial Plexus for Neurogenic Thoracic Outlet Syndrome.","authors":"Byung-Chul Son","doi":"10.3340/jkns.2024.0232","DOIUrl":"10.3340/jkns.2024.0232","url":null,"abstract":"<p><strong>Objective: </strong>The efficacy of brachial plexus decompression through a supraclavicular approach for neurogenic thoracic outlet syndrome (TOS) and its impact on surgical outcomes were investigated.</p><p><strong>Methods: </strong>The outcomes of pain reduction and functional improvement were evaluated in 31 patients with neurogenic TOS who underwent a supraclavicular decompression. These patients were followed for at least 12 months. Pain reduction was quantified using a numerical rating scale-11 (NRS-11) score and percentage pain relief before and after the last follow-up. Functional and symptomatic outcomes were assessed using the QuickDASH (Disability of the Arm, Shoulder, and Hand 11-item version) questionnaire, and changes in functional disability were measured by the percentage change in QuickDASH scores. Success was defined as at least a 50% reduction in pain as measured by the NRS-11, and factors influencing surgical success were also explored.</p><p><strong>Results: </strong>At a follow-up of 31.7±11.7 months, supraclavicular brachial plexus decompression was successful in 24 of 31 patients (77.4%), with a mean pain relief rate of 54.3±29.0. Functional outcomes assessed by QuickDASH scores improved significantly (from 52.7±12.6 to 23.6±17.9), with a percentage reduction of 56.36±31.56. There were no neurological complications associated with the surgery, although one reoperation was required due to postoperative chyle leakage.</p><p><strong>Conclusion: </strong>Brachial plexus decompression through a supraclavicular approach proved effective in alleviating pain and functional disability in patients with neurogenic TOS.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"238-246"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911944","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":"The Biomarkers and Underlying Mechanisms of Mitochondrial and Programmed Cell Death Related Genes in Epilepsy by Combining Transcriptome and Single-Cell Sequencing.","authors":"Wang Xiaoqiang, Wang Ren, Zhang Jianglong","doi":"10.3340/jkns.2024.0230","DOIUrl":"10.3340/jkns.2024.0230","url":null,"abstract":"<p><strong>Objective: </strong>Reactive oxygen species generated by mitochondria contribute to the induction of programmed cell death (PCD), but their involvement in epilepsy remains uncertain. The present study investigates the biomarkers and underlying mechanisms of mitochondriarelated genes (MRGs) and PCD-related genes (PCDRGs) in epilepsy.</p><p><strong>Methods: </strong>The MRGs and PCDRGs were respectively intersected with differentially expressed genes in epilepsy and control samples within the GSE134697. Afterwards, Spearman correlation analysis was implemented to select candidate genes. Thereafter, candidate biomarkers were identified through intersection of eight algorithm results in cytoHubba plugin. The receiver operating characteristic curve analysis and expression validation in GSE134697 and GSE168375 were implemented to select biomarkers. Moreover, functional analysis, drug prediction and molecular docking were carried out to explore the mechanism of biomarkers in epilepsy, as well as single cell RNA sequencing analysis. Finally, the expression of biomarkers in clinical sample was validated by reverse transcription quantitative polymerase chain reaction (RT-qPCR).</p><p><strong>Results: </strong>LTBR and IRF1 were down-regulated in epilepsy samples in both GSE134697 and GSE168375 datasets, Therefore, they were identified as biomarkers for epilepsy related to PCD and mitochondria. IRF1 formed a hydrogen bond interaction with the recombinant cytokine, indicating recombinant cytokine was an effective drug target, while LTBR was not a suitable drug target. The macrophage was observed to engage in more frequent and intensive interactions with other cells. RT-qPCR showed that both biomarkers also low expression in epilepsy clinical samples.</p><p><strong>Conclusion: </strong>LTBR, IRF1 were identified as biomarkers associated with mitochondria and PCD in epilepsy, providing novel perspectives on the management of this condition.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"196-214"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186220","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":"Correlation between Erythrocyte Sedimentation Rate/C-Reactive Protein Ratio and Procalcitonin Values in Postoperative Spondylodiscitis : Potential Biomarker Comparison.","authors":"Ömer Faruk Şahin, Oğuzhan Uzlu, Bekir Tunç, Ali Yılmaz, Mağruf İlkay Yapakcı, Ahmet Burak Gürpınar","doi":"10.3340/jkns.2025.0067","DOIUrl":"10.3340/jkns.2025.0067","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative spondylodiscitis is a rare but serious complication of spinal surgery. The difficulty in establishing an early diagnosis necessitates the evaluation of novel biomarkers. This study aims to determine the diagnostic value of procalcitonin (PCT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ESR/CRP, and ESR/PCT ratios in the diagnosis of postoperative spondylodiscitis and to compare the sensitivity and specificity of these parameters.</p><p><strong>Methods: </strong>This retrospective study was conducted by evaluating 55 patients who underwent two-level lumbar instrumentation (foraminotomy-medial facetectomy and microdiscectomy, autologous graft with fusion) between 2019 and 2023. Laboratory values of 28 patients diagnosed with postoperative spondylodiscitis and 27 control patients with no signs of infection were analyzed. The cut-off values, sensitivity, specificity, positive and negative predictive values, and area under the curve (AUC) of CRP, ESR, PCT, ESR/CRP, and ESR/PCT ratios were calculated using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>CRP, ESR, and PCT levels were significantly elevated in patients with spondylodiscitis (p<0.05). The ESR/PCT ratio demonstrated 96% specificity and was considered a supportive marker for the diagnosis of spondylodiscitis. However, the ESR/CRP ratio did not show a significant difference between the two groups (p=0.222). The cut-off value for CRP was determined as 43.7 mg/L, with a specificity of 100%. The cut-off value for ESR was 46 mm/hr, with a sensitivity of 92.9%. The cut-off value for PCT was found to be 0.034 ng/mL, with a sensitivity of 96.2%.</p><p><strong>Conclusion: </strong>CRP and ESR/PCT ratios were found to be effective in supporting the diagnosis of postoperative spondylodiscitis due to their high specificity. On the other hand, ESR and PCT demonstrated higher sensitivity, making them more successful in distinguishing non-infected individuals. However, no single biomarker was deemed sufficient on its own, emphasizing the necessity of clinical evaluation alongside laboratory findings. Prospective studies are needed in the future to enhance the diagnostic accuracy of these biomarkers.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"225-230"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040356","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}