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

{"title":"Biology, Physics, and Genetics of Intracranial Aneurysm Formation: A Review.","authors":"Karolina Ćmiel-Smorzyk, Piotr Ładziński, Wojciech Kaspera","doi":"10.1055/a-1994-8560","DOIUrl":"10.1055/a-1994-8560","url":null,"abstract":"<p><p>Intracranial aneurysms (IAs) are persistent, localized dilatations of the arterial wall that are found in ∼3% of the general population. The most severe complication of IAs is rupture, which results in devastating consequences such as subarachnoid hemorrhage and brain damage with serious neurologic sequelae. Numerous studies have characterized the mechanisms underlying IA development and growth and identified several environmental modifiable (smoking, hypertension) and nonmodifiable risk factors (related to the histology of cerebral arteries and genetic factors) in its pathogenesis. Hemodynamic stress also likely plays a crucial role in the formation of IAs and is conditioned by the geometry and morphology of the vessel tree, but its role in the natural history of unruptured IAs remains poorly understood; it is believed that changes in blood flow might generate the hemodynamic forces that are responsible for damage to the vascular wall and vessel remodeling that lead to IA formation. This review summarizes the most relevant data on the current theories on the formation of IAs, with particular emphasis on the roles of special conditions resulting from the microscopic anatomy of intracranial arteries, hemodynamic factors, bifurcation morphometry, inflammatory pathways, and the genetic factors involved in IA formation.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"125-141"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10431125","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":"Combined One-Step Hybrid Treatment for a Pediatric Giant Internal Carotid Artery Aneurysm: A Case Report.","authors":"Giacomo Pavesi, Julian S Rechberger, Elena Millesi, Selene M Cavallo, Fabio Serpico, Adelaide Valluzzi, Stefano Vallone, Corrado Iaccarino, Stavros Dimitriadis","doi":"10.1055/a-2479-5297","DOIUrl":"10.1055/a-2479-5297","url":null,"abstract":"<p><p>Giant intracranial aneurysms require complex treatment strategies including clipping, coiling, stenting, parent artery occlusion, bypass, or combined procedures. Neurovascular hybrid operating rooms (h-OR) combine a conventional operating theatre with high-resolution digital subtraction angiography (DSA). We describe a one-step combined surgical and endovascular treatment in a h-OR for a pediatric internal carotid artery (ICA) giant aneurysm that can be an optimal solution to manage such challenging cases.An 11-year-old boy presented with rapid onset right hemiparesis and left eyelid ptosis. A 3-month history of headache associated with sporadic vomit was reported. A giant, unruptured, left ICA aneurysm was detected on imaging. The patient underwent surgical trapping of the aneurysm. Intraoperative DSA showed residual backflow from the posterior communicating artery and coils were placed to completely exclude the aneurysm. At 18-month follow-up, the patient showed a complete recovery and magnetic resonance imaging showed a progressive reduction of the sac aneurysm.Due to their morphological variability, intracranial giant aneurysms may require a different procedural strategy instead of direct clipping or coiling. The introduction of h-OR allows combined treatments to be performed simultaneously in the same room setting. The present case shows that combined treatment in a neurovascular h-OR can be an optimal solution to manage challenging cases, such as giant aneurysms, reducing operative time with the added benefit of selecting an appropriate strategy adjustment in a multidisciplinary effort.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"154-160"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716409","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":"Middle Meningeal Artery Embolization for Acute Epidural Hematomas: A Promising Alternative to Traditional Surgery.","authors":"Artem Stanishevskiy, Konstantin Babichev, Arevik Abramyan, Dmitriy Svistov, Alexander Savello, Roman Martynov, Djamalud Isaev","doi":"10.1055/a-2590-6108","DOIUrl":"10.1055/a-2590-6108","url":null,"abstract":"<p><p>Acute epidural hematoma (AEDH) is recognized as one of the most urgent neurosurgical conditions. Traditionally, the primary treatment for AEDH has involved craniotomy with surgical evacuation of the hematoma. However, with the widespread adoption of neurointerventional techniques, interest in their application to various forms of traumatic brain injuries has increased. Among these, embolization of the middle meningeal artery (MMA) has emerged as a minimally invasive treatment option for AEDH. This study evaluates the effectiveness of MMA embolization as a primary treatment for AEDH.We conducted a retrospective review of patients treated for AEDH with embolization of the MMA at our institution from January 2019 to July 2024. Patient demographics, clinical presentation, procedural details, and outcomes were analyzed.MMA embolization was successfully performed in 20 patients with AEDH, with only 2 cases requiring subsequent burr-hole evacuation. The thickness of the AEDH was 10 mm or more in 47.8% of cases, and a midline shift was observed in 65.2% of cases. The most common angiographic findings included arteriovenous fistulas (AVFs) and contrast extravasation. N-butyl cyanoacrylate was used as the embolic material in all cases. In one case, Squid 12 was added to enhance penetration at sites of extravasation. No patients experienced recurrent AEDH postintervention.MMA embolization is a promising minimally invasive treatment for AEDH, showing effectiveness as both a primary and adjuvant therapy. Future prospective multicenter studies are needed to validate preliminary findings and optimize treatment protocols for this high-risk patient population.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"92-98"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016132","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":"99-114"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912908/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Traumatic Subdural Hematomas-When (and Why) Do We Stop? The aSDH-stop Survey.","authors":"Lídia Nunes Dias, Paulo Jorge da Silva Nogueira, João Pedro Oliveira, José Cabral","doi":"10.1055/a-2558-5681","DOIUrl":"10.1055/a-2558-5681","url":null,"abstract":"<p><p>This study investigates the decision-making process among neurosurgeons regarding the surgical management of acute subdural hematomas (aSDH), focusing on the role of non-classical Brain Trauma Foundation (BTF) factors such as brainstem reflexes, hypocoagulation, and patient comorbidity, alongside traditional guidelines.We conducted an international survey that presented neurosurgeons with real-case scenarios, designed to assess the impact of both traditional and non-traditional prognostic indicators on their surgical decisions. The survey also collected demographic data to examine potential correlations with decision-making preferences.The survey garnered 67 responses from neurosurgeons across 22 countries, revealing a reliance on non-classical BTF factors in decision-making for aSDH cases with a potentially poor prognosis. No significant correlations were found between these decision-making practices and the surgeons' demographic characteristics.The findings highlight the complexity and nuanced nature of surgical decision-making in aSDH management, underlining the importance of non-traditional prognostic factors. The results advocate for further research to refine clinical guidelines, ensuring they encapsulate the breadth of factors considered in practice, thereby enhancing patient-centered care.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"77-84"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Application Value of Personalized 3D Printed Navigation Molds in Neurosurgery.","authors":"Lijie Hou, Jian Zhang, Ke Meng, Yunpeng Xue, Xin Feng","doi":"10.1055/a-2564-1309","DOIUrl":"10.1055/a-2564-1309","url":null,"abstract":"<p><p>Many neurosurgical procedures are expensive and technically demanding. The incidence of complications is high. Based on the advantages of three-dimensional (3D) technology in surgical procedures, it is necessary to develop personalized navigation molds that use 3D printing technology and to analyze the clinical application of this technology in intracerebral hemorrhage, hydrocephalus, and brain abscess.According to the patient-specific brain computed tomography imaging data, we reconstructed intracranial lesions or target structures and important brain regions. By this, neurosurgeons can accurately locate the intracranial lesions under conditions equivalent to direct vision, analyze the morphology and size of lesions, and perform precise lesion puncture. Based on patient-specific differences, we designed the best 3D printed navigation molds to improve the accuracy of intracranial lesion targeting, analyzed the sources of deviation, and provided clinical application basis.Five cases of intracerebral hematoma, two cases of hydrocephalus, and two cases of brain abscess were treated between September 2020 to January 2022. Lesion puncture and drainage were performed with 3D printed navigation molds. The average puncture error was 2.86 mm. All nine patients recovered well after surgery, and no infection or death occurred.The personalized 3D printed navigation molds used in this study are beneficial to accurately locate intracranial lesions or target 3D structures during surgery.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"85-91"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692431","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":"Cerebral Hemorrhage Volume Threshold and Shunt-Dependent Acute Hydrocephalus in Aneurysmal Subarachnoid Hemorrhage: A Semiautomated Measurement Study.","authors":"Gema Bravo-Garrido, Antonio José Vargas-Lopez, Miriam Fernández-Gómez, Mario Gomar-Alba, Gaizka Urreta-Juárez, Patricia Martínez-Sánchez","doi":"10.1055/a-2568-4732","DOIUrl":"10.1055/a-2568-4732","url":null,"abstract":"<p><p>Hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage (aSAH) that can adversely affect prognosis. This study investigates the association between semiautomatic measurement of cerebral hemorrhage volumes in aSAH patients and the onset of shunt-dependent acute hydrocephalus (SDAHC) within the first 72 hours. Furthermore, the study seeks to establish a bleeding volume threshold indicative of SDAHC.A retrospective observational analysis was conducted on a cohort of aSAH patients admitted to a specialized referral hospital between 2016 and 2021. Volumes of SAH, intraventricular hemorrhage (IVH), intraparenchymal hemorrhage (IPH), and total hemorrhage (TH) were computed from brain computed tomography scans utilizing Advantage Workstation Server analytical software. Receiver operating characteristic (ROC) curves and multivariate analyses were employed to determine the association between hemorrhage volumes and SDAHC.The study included 170 patients, of whom 111 (65.3%) were women, with a mean age of 58.5 years (standard deviation: 14.6). Fifty-five patients (32.4%) presented SDAHC. IVH volumes had an area under the ROC curve of 0.757 (95% confidence interval [CI]: 0.674-0.839; <i>p</i> < 0.001). An IVH volume > 2.7 cm³ showed a sensitivity of 70.9% and a specificity of 77.2% for predicting SDAHC, whereas TH volumes > 29.5 cm³ demonstrated a sensitivity of 69.1% and a specificity of 61.4%. Multivariate analysis revealed that IVH volumes > 2.7 cm³ (odds ratio [OR]: 5.373; 95% CI: 2.477-11.657), TH volumes > 29.5 cm³ (OR: 2.232; 95% CI: 1.008-4.942), and a bicaudate index ≥ 0.2 were significantly associated with SDAHC, adjusting for confounders.In aSAH patients, semiautomatic measurement of hemorrhage volumes using specialized software is independently associated with SDAHC. This method could facilitate early prediction and timely intervention.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Antibiotics-Impregnated Bone Cement in Reducing Surgical Site Infections in Spine Surgery: A Systematic Review.","authors":"Alexander E Purnomo, Yang Y E Arjuna, Jephtah F L Tobing","doi":"10.1055/a-2524-9910","DOIUrl":"10.1055/a-2524-9910","url":null,"abstract":"<p><p>Spine surgeries are one of the most widely performed operations in orthopaedic surgery and neurosurgery. However, one of the most common complications of spine surgeries is surgical site infection (SSI), which is associated with various postoperative morbidities. The use of antibiotics-impregnated bone cement (AIBC) is common in orthopaedic surgeries. Therefore, we aim to provide a comprehensive review of AIBC use in spine surgeries.Data were gathered from PubMed, Europe PMC, and ScienceDirect using keywords associated with AIBC and spine surgeries. We included all publications associated with AIBC and spine surgeries. Studies without full papers, non-English publications, review articles, and animal or cadaveric studies were excluded. The quality of each included studies were assessed using the Newcastle Ottawa Scale and the Joanna Briggs Institute Critical Appraisal for case reports, case series, and quasi-experimental studies.Fifteen studies of 322 patients using AIBC in spine surgery were included. Ten of 15 studies reported 100% infection-free events with AIBC administration with or without given systemic antibiotics. Two studies did not report 100% infection-free events due to methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) infections and technical causes. Three studies reported the use of AIBC without disclosing outcomes. Various types of bacteria ranging from methicillin-sensitive <i>Staphylococcus aureus</i> to MRSA have been discovered, with polymethylmethacrylate and vancomycin being the most frequently used AIBCs.AIBC can be used to prevent postoperative infections due to its high effectiveness, easy administration, and no side effects. Further studies are needed to determine the most appropriate antibiotics, dose, and type of cement.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"48-57"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052737","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":"Neurosurgery Residency Training and beyond in Turkey: A National Survey Study.","authors":"Taha Şükrü Korkmaz, Semih Can Çetintaş, Süleyman Akkaya, Süreyya Toklu","doi":"10.1055/a-2558-5909","DOIUrl":"10.1055/a-2558-5909","url":null,"abstract":"<p><p>Training neurosurgery specialists is a challenging and demanding process. This national survey study was conducted to evaluate the infrastructure of neurosurgery residency programs and training clinics in Turkey and to assess how these factors impact specialist practice.A national survey consisting of 32 questions was distributed to neurosurgeons who had been practicing as specialists for at least two years. The survey was divided into four sections: demographic information, residency training process, hospital where they currently work as specialists, and microsurgical experience. Statistical analyses, including chi-square and logistic regression, were conducted to examine factors influencing surgical performance in specialist practice.Regression analyses indicated that performing skin-to-skin surgeries during residency significantly and most effectively increased the likelihood of performing these procedures as a specialist. Additionally, working in anatomy laboratories, attending hands-on cadaver courses, and increased years of practice were all positively associated with surgical performance. It was also found that participants who graduated within the last 5 years were statistically significantly less likely to have attended hands-on courses or visited another clinic for observerships/fellowships compared with those who graduated more than 5 years ago.Findings suggest that neurosurgical training in Turkey is affected by disparities in clinical infrastructure and hands-on experience. Standardizing residency experiences and ensuring access to necessary equipment and training resources could enhance neurosurgical competency and consistency in specialist practice.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"39-47"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657552","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 Outcomes of Additional Posterior Lumbar Interbody Fusion for Adjacent Segment Disease after Posterior Lumbar Interbody Fusion Assessed with the Zurich Claudication Questionnaire.","authors":"Hironobu Sakaura, Takahito Fujimori, Tsuyoshi Sugiura, Shutaro Yamada, Sadaaki Kanayama, Daisuke Ikegami","doi":"10.1055/s-0044-1791975","DOIUrl":"10.1055/s-0044-1791975","url":null,"abstract":"<p><p>A retrospective analysis of prospectively collected data.The Zurich Claudication Questionnaire (ZCQ) has been recently reported to be the most responsive assessment tool for lumbar spinal stenosis among the ZCQ, the Oswestry Disability Index, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, the visual analog scale, the 8-Item Short Form Health Survey, and the EuroQol 5 dimensions 5 level. There has been no study comparing surgical outcomes of additional posterior lumbar interbody fusion (PLIF) for adjacent segment disease (ASD) after previous PLIF with those of primary PLIF.We compared the clinical outcomes of additional PLIF for unstable ASD after previous PLIF with those of primary PLIF assessed with the ZCQ to examine whether surgical outcomes of additional PLIF for ASD following previous PLIF are inferior to those of primary PLIF.Thirteen consecutive patients undergoing additional single-level PLIF for unstable ASD after previous PLIF (A group) and 61 consecutive patients undergoing primary single-level PLIF (P group) were included in the study. Clinical outcomes were assessed with the ZCQ before PLIF surgery and at 2 years postoperatively. Achievement rates of the minimum clinically important difference (MCID) of each domain (symptom severity [SS] and physical function [PF]) on the ZCQ were evaluated in each group.In the A group, the mean SS and PF before additional PLIF were 3.615 and 3.1, respectively, which significantly improved to 2.231 and 2.0, respectively, at 2 years after surgery. In the P group, the mean SS and PF before primary PLIF were 3.438 and 2.5, respectively, which also significantly improved to 2.194 and 1.6, respectively, at 2 years postoperatively. PF before additional PLIF in the A group was significantly inferior to that in the P group, but SS both before and after PLIF and PF at 2 years postoperatively showed no significant differences between the two groups. The achievement rates of the MCID of SS and PF were 92.3 and 76.9%, respectively, in the A group and 59.0 and 59.0%, respectively, in the P group. The MCID achievement rates of SS was significantly higher in the A group than in the P group.Assessed with the ZCQ at 2 years after surgery, the clinical outcomes of additional single-level PLIF for unstable ASD after previous PLIF were equivalent to those of primary single-level PLIF.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"18-22"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258289","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}