Journal of neurological surgery. Part A, Central European neurosurgery最新文献

{"title":"Posterior Fossa Decompression Followed by Duraplasty with Arachnoid-Preserving Technique for Primary and Recurrent Adult Chiari Malformation Type-1.5: A Comparative Retrospective Study.","authors":"Hüseyin Doğu, Anas Abdallah, Hidayet Akdemir","doi":"10.1055/a-2590-6183","DOIUrl":"10.1055/a-2590-6183","url":null,"abstract":"<p><p>Most studies on Chiari malformation (CM) are focused on CM Type-1. A new subtype, CM Type-1.5, lacks sufficient research. This study aims to evaluate the long-term surgical outcomes of posterior fossa decompression followed by duraplasty with arachnoid-preserving (PFDD-AP) technique for primary and recurrent CM Type-1.5.The medical charts of patients treated surgically for CM at our institute between January 2011 and January 2022 were reviewed retrospectively. Adult patients consecutively treated for CM Type-1.5 were selected as the core sample for the current study. Group A included primary cases (i.e., patients who had not previously been surgically treated), and Group B included recurrent cases. The surgical outcomes were compared by evaluating clinical and radiological findings.Thirty-four CM Type-1.5 cases out of 202 CM cases met the study criteria. Twenty-three and 11 cases represented Group A and Group B, respectively. The female-to-male ratio was 2/1. In Group B, the preoperative herniated tonsil extension and the obex position were statistically significantly longer, and retroversion and retroflexion angles were statistically considerably smaller ([<i>p</i> = 0.024; <i>Z</i> = - 2.26]; [<i>p</i> = 0.023; <i>Z</i> = - 2.27]; [<i>p</i> = 0.031; <i>Z</i> = - 2.29]; and [<i>p</i> = 0.0002; <i>Z</i> = - 3.72], respectively). For the cases presented with syringomyelia (SM) in both groups (<i>n</i> = 20), total and partial regression were recorded postoperatively in 65% and 15% of cases, respectively. The satisfactory recovery or improvement rate in neurological symptoms was 94.1%.Total or partial SM regression occurred following PFDD-AP in most adult patients with CM Type-1.5 who presented with SM. The PFDD-AP approach offers better results with fewer complications and recurrence rates.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"562-573"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016548","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":"Patient-Reported Olfactory and Sinonasal Outcomes following Endoscopic Transsphenoidal Pituitary Surgery: A Prospective Evaluation.","authors":"Geraint J Sunderland, Jonathan R Ellenbogen, Catherine E Gilkes, Ajay K Sinha","doi":"10.1055/a-2558-5750","DOIUrl":"10.1055/a-2558-5750","url":null,"abstract":"<p><p>Endoscopic endonasal transsphenoidal surgery (EETS) results in disturbance of nasal mucosa and airflow. Previous studies have demonstrated associated sinonasal morbidity but have not prospectively assessed olfactory function.To obtain prospective objective measure of sinonasal morbidity associated with EETS.We report our prospective patient-reported outcome study of 20 unselected, consecutive patients undergoing EETS. Baseline assessment of olfactory function was performed using the validated University of Pennsylvania Smell Identification Test alongside quality of life (QoL) assessments using the 22-item Sino-Nasal Outcomes Test (SNOT-22) and Anterior Skull Base Questionnaire (ASBQ) prior to surgery. Repeat olfactory function testing and QoL questionnaires were performed at 3 months and 12 months postoperatively. All patients underwent pituitary surgery and there was one extended anterior approach.Mean olfactory function score was worse at 3 months (25.9) compared with baseline (30.5), <i>p</i> = 0.02. This improved back toward baseline at 1 year (29.4). Three patients (15.8%) had significant residual olfactory impairment at 1 year. There were no significant differences in SNOT-22 score or ASBQ at 3-month or 1-year follow-up. EETS is associated with minor disturbances in olfactory and sinonasal QoL.Formal assessment of olfactory function has proven more sensitive in identifying deficiencies in olfaction following surgery; however, there is little or no correlation with QoL scores.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"544-552"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656734","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":"Partial Detachment of the Gluteus Maximus Muscle to Expose the Proximal Third of the Sciatic Nerve in the Infragluteal Approach: An Alternative Technique to Minimize Iatrogenic Muscle Deafferentation Damage.","authors":"Filippo Gagliardi, Pierfrancesco De Domenico, Marco Ometti, Carlo Mandelli, Elena Virginia Colombo, Pietro Mortini","doi":"10.1055/a-2649-7736","DOIUrl":"https://doi.org/10.1055/a-2649-7736","url":null,"abstract":"<p><p>Exposing the proximal extrapelvic sciatic nerve usually requires a partial transsection of the gluteus maximus muscle. The authors describe a modified infragluteal technique for mobilizing the gluteus maximus muscle, with only partial detachment of the muscle aponeurosis attaching to the femur.An illustrative case is reported to demonstrate the surgical feasibility of the approach. The present technique offers good operability, with only a slight decrease in the angle of the surgical corridor compared with the standard infragluteal and transgluteal techniques, while preventing muscle damage resulting from muscle deafferentation.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130778","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":"Collision Tumor of the Clivus: Chordoma and Chronic Lymphocytic Leukemia. Case report and literature review.","authors":"Marcos Ezequiel Yasuda, Shannon Hart, Jian-Qiang Lu, Almunder Algird","doi":"10.1055/a-2705-2937","DOIUrl":"https://doi.org/10.1055/a-2705-2937","url":null,"abstract":"<p><p>INTRODUCTION Collision tumours, defined as the simultaneous occurrence of two distinct neoplasms within the same anatomical location, are exceptionally rare in the clivus. The coexistence of chordoma and chronic lymphocytic leukemia (CLL) within the clivus has not been previously reported, making this case particularly noteworthy. CLINICAL PRESENTATION: We present the case of a 69-year-old woman with a known history of stable CLL who presented with a 3-month history of progressive right-sided horizontal diplopia and hemianopsia. Imaging revealed a large sellar/suprasellar lesion with significant involvement of both cavernous sinuses, prompting surgical intervention. An endoscopic endonasal transsphenoidal and transclival approach was utilized to achieve near-total mass resection, with a small remnant left in the right cavernous sinus due to its proximity to the internal carotid artery. Histopathological examination confirmed the presence of a collision tumour composed of chordoma and CLL. CONCLUSION: This case represents the first reported instance of a collision tumor involving a chordoma and CLL within the clivus. The patient's postoperative course was uneventful, and she remains stable at 3-month follow-up after receiving adjuvant radiotherapy. The rarity of such a collision tumor underscores the need for heightened clinical suspicion and thorough pathological evaluation in cases presenting with atypical skull base lesions. The involvement of a multidisciplinary team was crucial in the management and favorable outcome of this complex case.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092094","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":"Duraplasty with Autologous Blood: A Cost-Effective and Efficient Alternative to Medical Products.","authors":"Ersin Haciyakupoglu, Evren Yüvrük, Dervis Mansuri Yilmaz, Sait Polat, Sebahattin Haciyakupoglu","doi":"10.1055/a-2705-2876","DOIUrl":"https://doi.org/10.1055/a-2705-2876","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Objective The aim of this experimental study was to investigate the effects of autologous plasma used as an alternative to duraplasty Materials and Methods We operated 21 patients and 8 New Zealand Rabbits and performed duraplasty with autologous blood. First heparin was added to autologous blood withdrawn from the patient/ rabbit, The sample was then centrifuged to obtain plasma. protamine sulfate was added to the plasma This mixture was then applied to the dural space and tumor cavity, resulting in fibrin formation within 2-3 minutes. All 21 patient had MRI scans 1 month after surgery to show neodura formation. 3 of our patients and all rabbit subjects were operated at least a month later and the biopsie was taken to show the neodura formation microsopically. Results In MRI scans, as well as in biopsies, we have detected the neodura formation. In rabbits that underwent experimental craniotomy and duratomy, neodura had formed as a weak, thin membrane that did not show continuity into the defect area after one month. In the control group, the distribution of collagen fibers appeared relatively normal in areas close to the intact dura. However, further from this area, the regular structure was disrupted, edematous areas had formed in the fibrous layers, and bone fragments were separated from the endosteal layer Conclusion The hypothesis of this study was that plasma obtained from the patient's own arterial blood could serve as an alternative to traditional duraplasty materials. Plasma possesses many of the properties required for duraplasty material and can be a cost-effective, readily available option. Results demonstrate that autologous plasma does not induce significant histological changes and shows excellent biocompatibility with brain parenchyma. Therefore, autologous plasma can be considered a reliable and safe tissue sealant. It is easy to prepare and apply, remains stable in the operating room for 1-2 hours, and can be adjusted in size and thickness according to the dural defect and tumor cavity dimensions. SUMMARY Duraplasty is performed in the following cases: a.) When there are duramater tears of traumatic, spontaneous, or iatrogenic origin, or when associated with tumor invasion. b.) When primary suturing cannot be performed on the thinned duramater due to increased intracranial pressure, edema, contusion, or swelling. c.) When a drain is required for oozing bleeding of the parenchyma. d.) When compressive duratomy, craniotomy, or lobectomy has been performed. e.) In cases with pseudoencephalocele. f.) When constructive adaptation of the dura is required, such as in Chiari malformation. Since the 1800s, numerous allogeneic (homologous), xenogenic (heterologous), autologous, and biosynthetic graft materials have been used in duraplasty. However, none of these materials have proven to be superior to others. Therefore, the aim of this study was to use plasma obtained from the arterial blood of each subject as an alternative for dur","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092034","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":"Management and Outcomes of Ganglion Cysts of the Posterior Longitudinal Ligament: A Systematic Review of Diagnostic and Surgical Approaches.","authors":"Gianluca Scalia, Francesca Graziano, Salvatore Marrone, Gianluca Ferini, Eliana Giurato, Giovanni Federico Nicoletti, Gianluca Galvano, Giuseppe Emmanuele Umana","doi":"10.1055/a-2642-7869","DOIUrl":"https://doi.org/10.1055/a-2642-7869","url":null,"abstract":"<p><p>Ganglion cysts of the posterior longitudinal ligament (PLL) are a rare cause of lumbar radicular pain and claudication, primarily affecting young athletic males. These cysts are often linked to repetitive trauma and degenerative changes in the PLL, potentially aggravated by disc degeneration. Diagnosis is typically achieved through magnetic resonance imaging (MRI), with surgical excision being the preferred treatment in symptomatic cases. This systematic review consolidates the current knowledge on PLL ganglion cysts, examining clinical characteristics, diagnostic findings, and surgical outcomes to provide a basis for future research and clinical management.A systematic literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science, including studies from inception to June 2024. Search terms included \"ganglion cyst,\" \"posterior longitudinal ligament,\" \"PLL,\" and \"lumbar spine,\" among others. Studies published in English and French were reviewed if they reported on ganglion cysts of the PLL with clinical or radiological data. Data on demographics, symptoms, imaging findings, treatment approaches, outcomes, and follow-up were extracted. Due to the heterogeneity of the included studies, a narrative synthesis was performed, focusing on clinical presentation, diagnostic criteria, surgical techniques, and recurrence rates.A total of 14 studies comprising 20 patients were analyzed. The majority (90%) were male, with a mean age of 30.2 years (standard deviation [SD] = 11.47). The most common presenting symptom was radicular pain, primarily left-sided (70%). Disc degeneration was reported in 85% of cases, supporting a link between degenerative disc disease and PLL cyst formation. MRI revealed hypointense cysts on T1-weighted images and hyperintense on T2, aiding in differentiation from other intraspinal pathologies. Surgical excision was performed in all cases, with hemilaminectomy (50%) and interlaminar approaches (40%) being the most common techniques. Minimally invasive endoscopic methods were used in one case. Complete recovery was reported in 65% of patients, with a mean follow-up of 13.8 months (SD = 12.1). Recurrence data were limited due to inconsistent follow-up.This systematic review highlights the clinical and imaging characteristics of PLL ganglion cysts, with MRI as a critical tool for diagnosis. Surgical management, particularly hemilaminectomy and interlaminar approaches, is effective in providing symptom relief and preventing recurrence. Although minimally invasive techniques show promise, further research is needed to confirm their efficacy. Given the rarity of PLL cysts, tailored treatment and larger studies with standardized follow-up are essential to improve understanding and management of this condition.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086347","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":"Exosome-Derived circ0009910 Promotes Pituitary Adenoma Cell Proliferation, Invasion, Migration, and EMT through the miR-106b-5p/STAT3 Axis.","authors":"Zexu X Yang, Wenge G Zhang, Leiguo G Wei, Yufei F Qu, Jiazi Z Yin, Qi Liu","doi":"10.1055/a-2599-4212","DOIUrl":"10.1055/a-2599-4212","url":null,"abstract":"<p><p>This study aimed to explore whether exosome-derived circ0009910 can transcellularly regulate the growth of pituitary adenoma (PA) cells and to further explore the possible mechanisms of its action.Transmission electron microscopy and nanoparticle size analysis were used to observe the morphology and size of the exosomes. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to determine the expression of circ_0009910, miR-106b-5p, and signal transducer and activator of transcription3 (STAT3). Western blotting was used to assess the expression of exosomal marker proteins, p-STAT3, E-cadherin, N-cadherin, and vimentin. Cell Counting Kit-8 (CCK-8) and 5-Ethynyl-2-deoxyuridine (EdU) assays were used to determine the proliferative capacity of the cells. Transwell assays were performed to assess the migratory and invasive capacity of the cells. Enzyme-linked immunosorbent assays (ELISAs) were used to determine the expression level of growth hormone (GH). A nude mouse xenograft model was established to observe the effects of exosome-derived circ0009910 on transplanted tumors in nude mice.circ0009910 can be transferred to other cells via exosomes. Knocking down the expression of circ0009910 can inhibit the proliferation, invasion, and migration of PA cells, reduce GH expression, and regulate the expression of epithelial-mesenchymal transition (EMT)-associated proteins. miR-106b-5p is a molecular sponge of circ0009910 and can partially reverse the procarcinogenic effect of circ0009910 in PA. <i>STAT3</i> is a target gene of miR-106b-5p. In addition, circ0009910 knockdown inhibited tumor growth in vivo.Exosome-derived circ0009910 promotes PA progression and regulates EMT through the miR-106b-5p/STAT3 axis.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002644","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":"Meningioma and Cerebral Spindle Cell Sarcoma as Two Different Metachronous Tumor Entities Secondary to Medulloblastoma Treatment in Childhood: Case Report and Review of the Literature.","authors":"Anna Jung, Michael Brodhun, Andreas Lemmer, Rüdiger Gerlach","doi":"10.1055/a-2618-6807","DOIUrl":"10.1055/a-2618-6807","url":null,"abstract":"<p><p>The authors report on a 21-year-old clinically asymptomatic female patient, who was admitted with two supratentorial intradural lesions in her follow-up magnetic resonance imaging 17 years after treatment of a posterior fossa medulloblastoma. Sequential surgical removal was performed. The left parietal tumor with dural involvement was diagnosed as a transitional meningioma WHO (World Health Organization) grade 1. The right temporal lesion, which had also close relationship to the dura, was diagnosed as a spindle cell sarcoma. We therefore report a metachronous tumor development of a benign and a malignant intradural sarcomatous tumor as secondary neoplasms following childhood medulloblastoma treatment.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127904","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":"Operative Technique in a Resection of Solitary Fibrous Tumor within the Sigmoid Sinus: Technical Note and Case Presentation.","authors":"Akinari Yamano, Masahide Matsuda, Keiji Tabuchi, Eiichi Ishikawa","doi":"10.1055/a-2697-4122","DOIUrl":"https://doi.org/10.1055/a-2697-4122","url":null,"abstract":"<p><strong>Background: </strong>Intracranial solitary fibrous tumors (SFTs) are rare mesenchymal tumors often presenting with dural-based lesions. These tumors can exhibit aggressive characteristics with high recurrence rates and extracranial metastasis. While SFTs occasionally invade venous sinuses, cases where the tumor arises within the venous sinus are rare. This case explores the surgical strategy for removing SFT occupying the sigmoid sinus and the jugular bulb while preserving the flow of the vein of Labbe. Clinical Presentation and Surgical Techniques: A 59-year-old woman with progressive left hearing loss and facial nerve palsy was diagnosed with a left temporal bone tumor mainly located in the sigmoid sinus and the jugular bulb. Imaging revealed a vascularized tumor with occlusion of the left sigmoid sinus and the vein of Labbe was preserved via retrograde perfusion of the transverse sinus. After preoperative embolization, surgery was performed using a trans-sigmoid approach. The tumor was carefully extracted, and the sigmoid sinus was ligated distant from the transverse-sigmoid junction to avoid the occlusion of the vein of Labbe outlet. Subtotal resection was achieved, and the patient experienced full recovery from facial paralysis within three weeks. Postoperative radiotherapy was administered, and no recurrence was observed one year later.</p><p><strong>Conclusion: </strong>SFTs arising within venous sinuses are rare but require thorough surgical planning, especially near critical venous structures like the vein of Labbe. This case highlights the feasibility of the operative technique of extracting the tumor from venous sinuses and the importance of individualized strategies for maximizing resection while preserving neurological function and venous patency.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029975","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":"Clinical and Radiological Analysis of Anterior Cervical Discectomy and Fusion Involving One to Three Levels Without Additional Plate Fixation: A Single-Center Experience.","authors":"Alexander Romagna, Christoph Schwartz, Reuben Christopher, Martin Geroldinger, Dana Dinzenhofer-Kessler, David Schul, Andre Tomasino","doi":"10.1055/a-2697-4029","DOIUrl":"https://doi.org/10.1055/a-2697-4029","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate clinical and radiological outcomes of patients who underwent anterior cervical discectomy and fusion (ACDF) without additional anterior plate fixation.</p><p><strong>Methods: </strong>A retrospective single-center analysis was conducted. Clinical outcomes were assessed by the Visual Analog Scale (VAS) scores, Neck Disability Index (NDI), and Odom's criteria. Radiological outcomes were evaluated based on changes in segmental disc height (subsidence), and Cobb angle by X-ray. Fusion was defined as a consistent distance between spinous processes.</p><p><strong>Results: </strong>The study population consisted of 98 patients (mean age of 55.8 years) with a follow-up of 22.1 months. Procedures included 55 one-level, 33 two-level, and ten three-level surgeries. The study results demonstrated good clinical outcome, with statistically significant reductions in NDI scores with notable improvements in VAS (p<0.001). Radiologically, we recorded a subsidence and reduction in Cobb angle of 1.6mm/2.2° in one-level, 3.8mm/3.0° in two-level, and 2.5mm/2.4° in three-level surgeries, respectively. Complete postoperative fusion was recorded for 86.7% patients, comprising rates of 87.3% for one-level, 90.9% for two-level, and 70.0% for three-level procedures. No revision surgery had to be performed.</p><p><strong>Conclusion: </strong>ACDF without additional plating appears to be an effective procedure for surgical treatment of single- and multi-level degenerative cervical disease with good clinical outcome.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029938","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}