Journal of neurosurgical sciences最新文献_第7页

Assessing the predictive value of the Risk Analysis Index for short-term outcomes in acute spinal cord injury surgery. 评估风险分析指数对急性脊髓损伤手术短期疗效的预测价值。

IF 1.3 4区医学

Journal of neurosurgical sciences Pub Date : 2024-06-25 DOI: 10.23736/S0390-5616.24.06189-7

Evan Courville, Kranti C Rumalla, Joshua Marquez, Joanna M Roy, Meic H Schmidt, Christian A Bowers

{"title":"Assessing the predictive value of the Risk Analysis Index for short-term outcomes in acute spinal cord injury surgery.","authors":"Evan Courville, Kranti C Rumalla, Joshua Marquez, Joanna M Roy, Meic H Schmidt, Christian A Bowers","doi":"10.23736/S0390-5616.24.06189-7","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06189-7","url":null,"abstract":"Background: Acute traumatic spinal cord injury (tSCI) requires rapid surgical intervention to maximize neurological function. Older patients comprise an increasingly larger proportion of SCI patients annually, necessitating accurate preoperative risk stratification tools. This study utilized a frailty-based preoperative risk stratification score to predict adverse events following non-elective neurosurgical intervention for acute tSCI patients.Methods: The National Inpatient Sample (NIS) was queried for acute tSCI patients aged ≥18 who underwent spine surgery in 2019-2020. The Risk Analysis Index (RAI) was implemented with crosstabulation, to analyze frailty scores with the following binary outcome measures: overall complications, non-home discharge (NHD), extended length of stay (eLOS) (>75th percentile), and mortality. Area Under the Receiver Operating Characteristic (AUROC) analysis assessed the discriminative threshold of RAI compared to the modified 5-item Frailty Index (mFI-5) for NHD and 30-day mortality.Results: A total of 9995 SCI patients underwent non-elective spine surgery. There were 1525 perioperative complications (15.3%) and 510 (5.1%) mortalities. An increasing RAI score was significantly associated with increasing postoperative mortality rates: RAI 0-20 (1.5%, N.=45), RAI 21-30 (3.4%, N.=110), RAI 31-40 (6.8%, N.=115), and RAI>41 (11.8%, N.=240) (P<0.001). RAI demonstrated superior discrimination compared to the mFI-5 for mortality and NHD with a C-statistic >0.72.Conclusions: Increasing frailty, as measured by RAI, was a reliable predictor of non-home discharge and 30-day mortality for SCI patients who underwent non-elective spinal surgery and RAI demonstrated superior discrimination compared to the mFI-5 for NHD and mortality.","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446319","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}

引用次数: 0

Unraveling the controversy: high-dose steroids in spinal cord injury. Forty years of inquiry. 解开争议：脊髓损伤中的大剂量类固醇。四十年的探索

IF 1.9 4区医学

Journal of neurosurgical sciences Pub Date : 2024-06-01 Epub Date: 2024-03-14 DOI: 10.23736/S0390-5616.24.06238-6

Rossella Rispoli, Barbara Cappelletto

引用次数: 0

Interleukin-17 receptor D is a favorable biomarker of glioblastoma. 白细胞介素-17受体D是胶质母细胞瘤的一个有利的生物标志物。

IF 1.3 4区医学

Journal of neurosurgical sciences Pub Date : 2024-06-01 Epub Date: 2022-04-05 DOI: 10.23736/S0390-5616.22.05552-7

Yang Liu, Mingshui Xie, Ye Zhou, Lili Che, Bin Zhang

{"title":"Interleukin-17 receptor D is a favorable biomarker of glioblastoma.","authors":"Yang Liu, Mingshui Xie, Ye Zhou, Lili Che, Bin Zhang","doi":"10.23736/S0390-5616.22.05552-7","DOIUrl":"10.23736/S0390-5616.22.05552-7","url":null,"abstract":"Background: Glioblastoma (GBM) is the most frequent glioma in adults. The prognosis of GBM is very poor and new prognostic biomarkers are in urgent need to better select high-risk patients and guide the individual treatments.Methods: In our study, we compared the expression of interleukin-17 receptor D (IL17RD) between GBMs and normal tissues from TCGA database, and detected IL17RD mRNA in 17 fresh GBM pairs with qPCR. With immunohistochemistry, we investigated the expression of IL17RD in 156 GBM tissues and further evaluated its clinical significance. The associations between IL17RD and clinicopathological factors were assessed by Chi-square test. The prognostic significance of IL17RD was evaluated by univariate analysis with Kaplan-Meier method, and by multivariate analysis with Cox-regression Hazard model.Results: The TPMs and mRNAs of IL17RD in GBM were substantially lower than those in normal brain tissues. The rates of low or high expression of IL17RD accounted for 41.67% and 58.33% respectively. IL17RD was significantly associated with higher survival rates of GBM. The 3-year overall survival rates of patients with low and high IL17RD were 7.2% and 19.5% respectively. In the Cox-regression model, the IL17RD expression was defined as an independent prognostic biomarker of GBM. Patients with high IL17RD expression had a more favorable outcome than those with low IL17RD.Conclusions: High IL17RD expression was an independent prognostic indicator of GBM, suggesting a more favorable prognosis. Our results suggested that IL17RD detection may help find the high-risk patients which may receive more severe surveillance and more individual treatments.","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"1 1","pages":"320-326"},"PeriodicalIF":1.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41436628","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}

引用次数: 0

Is endovascular treatment alone as effective and safe as that with preceding intravenous thrombolysis for acute ischemic stroke? A meta-analysis of randomized controlled trials. 对于急性缺血性脑卒中，单纯血管内治疗是否与静脉溶栓治疗同样有效和安全？随机对照试验荟萃分析。

IF 1.9 4区医学

Journal of neurosurgical sciences Pub Date : 2024-06-01 Epub Date: 2023-06-30 DOI: 10.23736/S0390-5616.23.06058-7

Mohammad O Khan, Syeda A Shah, Samar Mahmood, Ashnah Aijaz, Nadia N Jatoi, Firzah Shakil, Khushboo Nusrat, Omer M Siddiqui, Ishaque Hameed

{"title":"Is endovascular treatment alone as effective and safe as that with preceding intravenous thrombolysis for acute ischemic stroke? A meta-analysis of randomized controlled trials.","authors":"Mohammad O Khan, Syeda A Shah, Samar Mahmood, Ashnah Aijaz, Nadia N Jatoi, Firzah Shakil, Khushboo Nusrat, Omer M Siddiqui, Ishaque Hameed","doi":"10.23736/S0390-5616.23.06058-7","DOIUrl":"10.23736/S0390-5616.23.06058-7","url":null,"abstract":"Introduction: This meta-analysis aimed to evaluate the safety and efficacy of direct endovascular therapy (EVT) and bridging therapy (EVT with preceding intravenous thrombolysis i.e. IVT), in acute anterior circulation, large vessel occlusion stroke.Evidence acquisition: Following the PRISMA guidelines, a systematic literature review of the English language literature was conducted using PubMed, Cochrane CENTRAL, SCOPUS and ClinicalTrials.gov. Outcomes of interest were measured by the modified Rankin Scale (mRS), and included: no disability (mRS0), no significant disability despite some symptoms (mRS1), slight disability (mRS2), moderate disability (mRS3), moderately severe disability (mRS4), severe disability (mRS5), mortality (mRS6). Additionally, we inspected patients having excellent outcome, functional independence outcome, and poor outcome, along with successful reperfusion and intracranial hemorrhage. We calculated pooled risk ratios (RRs) and their corresponding 95% confidence intervals (CI).Evidence synthesis: A total of seven RCTs involving 2,392 patients were finally included. The chances of achieving successful reperfusion were significantly more with IVT+EVT as compared to EVT alone (RR: 0.97; 95% CI: 0.94, 1.00; P=0.03) (I2=0%). There was no significant difference in the number of patients having outcomes ranging from mRS0 to mRS6, excellent outcome, functional independence, poor outcome or incidence of intracranial hemorrhage, who underwent either EVT alone or IVT+EVT.Conclusions: Additional trials are needed to determine if the absence of significant differences is due to insufficient sample size or if the combination therapy is truly not beneficial.","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"338-347"},"PeriodicalIF":1.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9690197","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}

引用次数: 0

Operator perceived advantage of virtual surgical rehearsal in pediatric neurosurgical oncology: a preliminary experience. 小儿神经外科肿瘤学中虚拟手术预演的操作者感知优势：初步经验。

IF 1.3 4区医学

Journal of neurosurgical sciences Pub Date : 2024-06-01 Epub Date: 2023-11-06 DOI: 10.23736/S0390-5616.23.06152-0

Roberto Premuselli, Carmen D'Amore, Matteo Barba, Alessandra Marasi, Giada Del Baldo, Alessandro DE Benedictis, Eleonora Piccirilli, Giovanna S Colafati, Angela Mastronuzzi, Carlo E Marras, Andrea Carai

引用次数: 0

A novel 3D anatomical visualization system to avoid injuries of nerves in retrosigmoid approach. 新颖的三维解剖可视化系统，避免后穹隆入路损伤神经。

IF 1.9 4区医学

Journal of neurosurgical sciences Pub Date : 2024-06-01 Epub Date: 2023-04-27 DOI: 10.23736/S0390-5616.23.05955-6

Domenico LA Torre, Attilio Della Torre, Antonino Germanò, Dorotea Pugliese, Erica Lo Turco, Paola Lacroce, Alberto Romano, Angelo Lavano, Francesco Tomasello

{"title":"A novel 3D anatomical visualization system to avoid injuries of nerves in retrosigmoid approach.","authors":"Domenico LA Torre, Attilio Della Torre, Antonino Germanò, Dorotea Pugliese, Erica Lo Turco, Paola Lacroce, Alberto Romano, Angelo Lavano, Francesco Tomasello","doi":"10.23736/S0390-5616.23.05955-6","DOIUrl":"10.23736/S0390-5616.23.05955-6","url":null,"abstract":"The retro-sigmoid approach (RA), widely used during different neurosurgical procedures, is burdened by the risk of injuries of the nerves that cross that region contributing to possible postoperative complications. By using, anatomage table (AT), a novel 3D anatomical visualization system, we described the nerves passing through the retromastoid area including the great occipital nerve (GON), the lesser occipital nerve (LON) and the great auricular nerve (GAN), and their courses from the origins, till terminal branches. Moreover, using dedicated software, we measured distances between the nerves and well-recognizable bony landmarks. After identifying the nerves and their distances from bony landmarks, we observed that the safest and risk-free skin incision should be made in an area delimited, superiorly from the superior nuchal line (or slightly higher), and inferiorly from a plane passing at 1-1.5 cm above the mastoid tip. The lateral aspect of such an area should not exceed 9.5-10 cm from the inion, while the medial one should be more than 7 cm far from the inion. This anatomical information has been useful in defining anatomical landmarks and reducing the risk of complications, mainly related to nerve injury, in RA. In-depth neuroanatomic knowledge of the cutaneous nerves of the retromastoid area is essential to minimize the complications related to their injury during different neurosurgical approaches. Our findings suggest that the AT is a reliable tool to enhance understanding of the anatomy, and thus contributing to the refinement of surgical techniques.","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"348-357"},"PeriodicalIF":1.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9358268","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}

引用次数: 0

Plica mediana dorsalis as a potential risk for spine surgery. 背内侧皱襞作为脊柱手术的潜在风险。

IF 1.3 4区医学

Journal of neurosurgical sciences Pub Date : 2024-06-01 Epub Date: 2023-10-25 DOI: 10.23736/S0390-5616.23.06097-6

Angelo Lavano, Attilio Della Torre, Giusy Guzzi, Domenico LA Torre

引用次数: 0

Environmental cold exposure precipitating Moyamoya disease. 环境寒冷暴露诱发烟雾病。

IF 1.3 4区医学

Journal of neurosurgical sciences Pub Date : 2024-06-01 Epub Date: 2023-11-06 DOI: 10.23736/S0390-5616.23.06149-0

Shambaditya DAS, Alak Pandit, Biman K Ray, Arindam Santra, Souvik Dubey

引用次数: 0

An understimated maneuver for oculomotor nerve palsy due to posterior communicating artery aneurysm: the opening of the anterior petroclinoid ligament. A technical note. 治疗后交通动脉瘤引起的眼球运动神经麻痹的低估手法：打开前瓣韧带。技术说明。

IF 1.3 4区医学

Journal of neurosurgical sciences Pub Date : 2024-06-01 Epub Date: 2023-05-15 DOI: 10.23736/S0390-5616.23.06020-4

Biagia LA Pira, Veronica Picotti, Alessandro Frati, Alessandro Pesce, Giancarlo D'Andrea

{"title":"An understimated maneuver for oculomotor nerve palsy due to posterior communicating artery aneurysm: the opening of the anterior petroclinoid ligament. A technical note.","authors":"Biagia LA Pira, Veronica Picotti, Alessandro Frati, Alessandro Pesce, Giancarlo D'Andrea","doi":"10.23736/S0390-5616.23.06020-4","DOIUrl":"10.23736/S0390-5616.23.06020-4","url":null,"abstract":"Posterior communicating artery aneurysms (PcomAs) present with oculomotor nerve (OMN) palsy in 20-30% of cases, and the sudden onset of OMN palsy has to raise the suspicion of rupture, until proven otherwise. The surgical technique is described in a stepwise fashion. An illustrative case is reported: a 57-year-old female was admitted to our department with the diagnosis of a right sided-PcomA. Three months before the admission, when she harbored with the acute onset of complete ptosis, diplopia, orbital pain, impairment of the medial, upward, and downward gaze, with no pupil dysfunction. The origin of the Pcom and the neck of the aneurysm were easily identified and the aneurysm was clipped. Then, we followed the OMN and cut for less than 4 mm the above-lying anterior petroclinoid ligament (APL) to obtain nerve release. Although few cases are described in the literature, and ours represents a single case, we support that this maneuver should be introduced in the clinical practice of expert neurosurgeons dealing with vascular pathologies, such as the opening of the falciform ligament occurs for the decompression of the optical nerve.","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"358-364"},"PeriodicalIF":1.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9467722","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}

引用次数: 0

Clear neuroimaging margin at the brain-tumor interface is associated with gross total resection and longer survival in non-enhancing diffuse gliomas. 在非增强型弥漫性胶质瘤中，脑瘤界面清晰的神经影像学边缘与大体全切除和较长的生存期有关。

IF 1.9 4区医学

Journal of neurosurgical sciences Pub Date : 2024-05-30 DOI: 10.23736/S0390-5616.24.06221-0

Anand A Dharia, Domenico A Gattozzi, Joseph S Domino, Adam G Rouse, Roukoz B Chamoun

{"title":"Clear neuroimaging margin at the brain-tumor interface is associated with gross total resection and longer survival in non-enhancing diffuse gliomas.","authors":"Anand A Dharia, Domenico A Gattozzi, Joseph S Domino, Adam G Rouse, Roukoz B Chamoun","doi":"10.23736/S0390-5616.24.06221-0","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06221-0","url":null,"abstract":"Background: This study aimed to determine whether the presence of distinct glioma margins on preoperative imaging is correlated with improved intraoperative identification of tumor-brain interfaces and overall improved surgical outcomes of non-enhancing gliomas.Methods: This is a retrospective study of all primary glioma resections at our institution between 2000-2020. Tumors with contrast enhancement or with final pathology other than diffuse infiltrative glial neoplasm (WHO II or WHO III) were excluded. Tumors were stratified into two groups: those with distinct radiographical borders between tumor and brain, and those with ill-defined radiographical margins. Multivariate analysis was performed to determine the impact of clear preoperative margins on the primary outcome of gross-total resection.Results: Within the study period, 59 patients met inclusion criteria, of which 31 (53%) had distinct margins. These patients were predominantly younger (37.6 vs. 48.1 years, P=0.007). Tumor and other patient characteristics were similar in both cohorts, including gender, laterality, size, location, tumor type, grade, and surgical adjuncts utilized (P>0.05). Multivariate regression identified that distinct preoperative margins correlated with increased rates of gross total resection (P=0.02). Distinct margins on preoperative neuroimaging also correlated positively with surgeon identification of intra-operative margins (P<0.0001), fewer deaths over the study period (P=0.01), and longer overall survival (P=0.03).Conclusions: Distinct glioma-parenchyma margins on preoperative imaging are associated with improved surgical resection for diffuse gliomas, as distinct margins may correlate with distinguishable glioma-brain interfaces intraoperatively. Further prospective studies may discover additional clinical uses for these findings.","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175505","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}

引用次数: 0