Journal of neurosurgery. Pediatrics最新文献

{"title":"Racial disparities in hydrocephalus mortality and shunt revision: a study from the Hydrocephalus Clinical Research Network.","authors":"Brandon G Rocque, Hailey Jensen, Ron W Reeder, Curtis J Rozzelle, Abhaya V Kulkarni, Ian F Pollack, Michael M McDowell, Robert P Naftel, Eric M Jackson, William E Whitehead, Jonathan A Pindrik, Albert M Isaacs, Jennifer M Strahle, Patrick J McDonald, Mandeep S Tamber, Todd C Hankinson, Samuel R Browd, Jason S Hauptman, Mark D Krieger, Jason Chu, Jay Riva-Cambrin, David D Limbrick, Richard Holubkov, John R W Kestle, John C Wellons","doi":"10.3171/2024.12.PEDS24371","DOIUrl":"https://doi.org/10.3171/2024.12.PEDS24371","url":null,"abstract":"<p><strong>Objective: </strong>Several studies of administrative data have noted higher mortality rates for Black/African American children with shunted hydrocephalus. A longitudinal study of children with hydrocephalus secondary to myelomeningocele showed lower lifetime rates of shunt revision in minority children compared to White children, indicating a possible disparity in hydrocephalus treatment. The goal of this study is to identify racial and ethnic disparities in mortality or in shunt revision rates by using the Hydrocephalus Clinical Research Network (HCRN) hydrocephalus registry sample.</p><p><strong>Methods: </strong>The HCRN registry was queried for patients with shunted hydrocephalus for whom data on all lifetime hydrocephalus procedures were available. Patients with a primary shunt placement prior to 2023 were included, with follow-up extending through March 19, 2024. A Cox proportional hazards model was created to determine the effect of race and ethnicity on mortality while controlling for age at initial shunt placement, sex, hydrocephalus etiology, gestational age at birth, and presence of complex chronic conditions. Similarly, a proportional means model was used to evaluate association with lifetime number of shunt revision surgeries. The authors' hypothesis was that when controlling for other variables, minority children would have higher mortality and fewer shunt revision surgeries than White children.</p><p><strong>Results: </strong>A total of 5656 children were included in the analysis of mortality. There were 579 deaths. Race and ethnicity were independently associated with mortality, with Black (HR 1.32, 95% CI 1.05-1.65), other non-White (HR 1.39, 95% CI 1.03-1.86), and Hispanic (HR 1.50, 95% CI 1.22-1.84) children having a higher mortality rate than White children. In the analysis of 4081 children with shunts, Hispanic ethnicity was also independently associated with fewer total shunt revisions (HR 0.84, 95% CI 0.72-0.98).</p><p><strong>Conclusions: </strong>In children with hydrocephalus, when controlling for other factors, there is a higher mortality rate among Hispanic, Black, and other non-White children, and fewer shunt revisions among Hispanic children. These findings highlight important potential disparities in hydrocephalus treatment.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of selective dorsal rhizotomy in the treatment of spasticity in children with cerebral palsy: a systematic review and meta-analysis.","authors":"Iris Otero-Luis, Arturo Martinez-Rodrigo, Iván Cavero-Redondo, Nerea Moreno-Herráiz, Felipe Araya-Quintanilla, Carla Geovanna Lever-Megina, Alicia Saz-Lara","doi":"10.3171/2024.11.PEDS24398","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24398","url":null,"abstract":"<p><strong>Objective: </strong>Spasticity is one of the most prevalent neurological disorders, affecting > 90% of patients with cerebral palsy (CP). Selective dorsal rhizotomy (SDR) is a permanent neurosurgical procedure indicated for the treatment of spasticity. This study aimed to analyze the efficacy of SDR in managing spasticity in children with CP and as well as the efficacy of this therapy over time after the intervention using different scales.</p><p><strong>Methods: </strong>A comprehensive systematic search was conducted across several databases, spanning from inception to November 5, 2023. Random-effects meta-analyses were used to calculate pooled mean differences and their corresponding confidence intervals to assess the efficacy of SDR using different scales.</p><p><strong>Results: </strong>All the included studies involved before-after single-arm studies, with the exception of four randomized clinical trials and one quasi-experimental study. The effect of SDR on spasticity, measured with the modified Ashworth scale (MAS) and the Gross Motor Function Measure (GMFM), was significantly improved in children with lower limb spasticity. The efficacy of the treatment was significant up to 12 months posttreatment.</p><p><strong>Conclusions: </strong>SDR has been demonstrated to be effective in treating children with CP. This efficacy is evidenced by notable improvements, as measured by both the MAS and GMFM. These improvements suggested enhanced mobility and overall quality of life.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-10"},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of surgical revascularization in a case series of moyamoya patients with severe brain atrophy.","authors":"Kautilya R Patel, Prathik Rudrappa, Soumya Ranjan Malla, Hima Pendharkar, Mithun G Sattur, Nupur Pruthi","doi":"10.3171/2024.12.PEDS24542","DOIUrl":"https://doi.org/10.3171/2024.12.PEDS24542","url":null,"abstract":"<p><strong>Objective: </strong>Patients with advanced moyamoya disease have chronic cerebrovascular insufficiency with superimposed acute ischemic insults, leading to brain atrophy and cognitive decline. The outcomes of revascularization procedures in moyamoya patients with marked brain atrophy are not yet clearly known.</p><p><strong>Methods: </strong>This retrospective study used an approach based on the global cerebral atrophy scale to identify patients with severe brain atrophy from a single-surgeon series of patients with moyamoya disease undergoing revascularization from January 2015 to January 2024. Clinical outcomes (modified Rankin Scale [mRS] score, improvement in symptoms and cognitive function) and radiological outcomes (arterial spin labeling [ASL] perfusion) were studied and compared between direct and indirect revascularization groups.</p><p><strong>Results: </strong>Of 153 patients in the series, 16 (mean age 8.9 years) had severe brain atrophy (cortical atrophy score ≥ 8). The presenting symptoms were recurrent transient ischemic attack in 6 patients (37.5%), major stroke in 7 patients (43.75%), and seizure in 3 patients (18.75%). Fourteen patients underwent surgeries for both hemispheres and 2 patients underwent surgery for 1 hemisphere. Of the 30 hemispheres, 17 (56.7%) were treated with direct revascularization and 13 (43.3%) with indirect revascularization. The mean follow-up duration was 38.8 months. The median mRS score improved from 3 (preoperative) to 1.5 (last follow-up), with 11 patients (68.75%) showing improvement in mRS score. Thirteen patients (81.25%) showed improvement in presenting symptoms. Overall, 12 of 16 patients (75%) showed improvement in cognitive function at the last follow-up. The mean preoperative and follow-up ASL scores improved for the lower-perfusion hemispheres from 7.9 to 8.9 and for the higher-perfusion hemispheres from 9.6 to 10.45, respectively. Differences between preoperative and postoperative ASL scores for both groups were statistically significant. There was no significant difference in clinical and radiological outcomes between the direct and indirect revascularization groups. Clinical outcomes were comparable across patient groups based on the distribution of brain atrophy (unilateral/bilateral, predominant left/right side, predominant vascular territory involved).</p><p><strong>Conclusions: </strong>Moyamoya patients with severe brain atrophy showed improvement in paroxysmal symptoms, cognitive function, and overall clinical functioning status, as well as radiological perfusion, after undergoing either direct or indirect revascularization. Comparative efficacy of direct and indirect revascularization in these patients needs further investigation.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Purely neuroendoscopic management of choroid plexus tumors in children.","authors":"Rinat A Sufianov, Albert A Sufianov, Pietro Spennato, Massimiliano Porzio, Ilshat A Gaysin, Maria Allegra Cinalli, Iurii A Iakimov, Giuseppe Cinalli","doi":"10.3171/2024.11.PEDS24322","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24322","url":null,"abstract":"<p><strong>Objective: </strong>The goal in this study was to retrospectively evaluate the safety and feasibility of purely neuroendoscopic removal of choroid plexus tumors (CPTs) in children using a monoportal or biportal technique.</p><p><strong>Methods: </strong>The clinical, radiological, and surgical data of all children with CPTs removed via purely endoscopic or microsurgical approaches in the last 12 years at two centers were retrospectively reviewed. Both centers were fully equipped with advanced neuroendoscopic technology, and surgical teams were fully trained in complex neuroendoscopic intraventricular surgical procedures.</p><p><strong>Results: </strong>The study involved 32 patients, divided into two groups: 13 undergoing endoscopic procedures and 19 undergoing microsurgical procedures. In the endoscopic group, the mean age was 2.11 years. Eight tumors were located in the lateral ventricles, and 5 in the third ventricle. The mean tumor volume was 6.59 cm3 (range 0.25-15.4 cm3); 9 patients had hydrocephalus at presentation. The monoportal technique was used in 9 patients, and the biportal technique was used in 4 patients. Gross-total removal was achieved in all patients-within a single procedure in 11 patients, and in a two-stage procedure in 2 patients. In the microsurgical group the mean age was 3.75 years. Seventeen tumors were located in the lateral ventricles, and 2 in the third ventricle. The mean tumor volume was 15.07 cm3 (range 1.2-84.35 cm3). The following microsurgical approaches were used: transcortical (n = 11), transcallosal (n = 5), and interhemispheric transprecuneal (n = 3). There was no statistically significant difference between the cases treated via microsurgical and endoscopic approaches with regard to CPT volume (p = 0.06), presence of hydrocephalus (p = 0.22), need for shunt surgery (p = 0.78), or complications (p = 0.06). Furthermore, a statistically significant difference was found in surgery time and blood loss: in endoscopic procedures there was significantly lower blood loss and a shorter surgery time (p < 0.005).</p><p><strong>Conclusions: </strong>The present study conducted at two hospitals has demonstrated that neuroendoscopic removal of the CPT is a safe and feasible alternative to the conventional microsurgical procedure. The lower blood loss, lower rates of serious complications, and full resolution of hydrocephalus are the main points in favor of neuroendoscopic surgery to obtain gross-total removal of intraventricular CPT in infants and children.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-13"},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased risk of neuroblastoma in Chinese children from Jiangsu province with NSUN4 gene rs10736428 A>C polymorphism.","authors":"Yong Lian, Mengzhen Zhang, Wenli Zhang, Jiaming Chang, Haixia Zhou, Xinxin Zhang, Jing He, Chunlei Zhou, Liping Chen","doi":"10.3171/2025.1.PEDS24527","DOIUrl":"https://doi.org/10.3171/2025.1.PEDS24527","url":null,"abstract":"<p><strong>Objective: </strong>Modification of 5-methylcytosine (m5C) exerts regulatory effects on RNA functionality, governing critical processes that include cell migration, survival, and differentiation. NSUN4, a demethylase responsible for generating the m5C modification, plays a pivotal role in carcinogenesis and cellular differentiation. To date, there have been no documented reports on the role of NSUN4 gene polymorphisms in neuroblastoma.</p><p><strong>Methods: </strong>The authors investigated 402 neuroblastoma patients and 473 control subjects and identified 4 potential functional polymorphisms (rs10736428 A>C, rs3737744 G>A, rs10252 G>A, and rs41294484 C>T) with the TaqMan assay. Logistic regression analysis assessed the correlation in terms of the OR and 95% CI. Furthermore, rs10736428 and rs41294484 were stratified to assess their potential associations with increased risk of neuroblastoma.</p><p><strong>Results: </strong>Individuals carrying the rs10736428 CC genotype exhibited a markedly increased risk of neuroblastoma development (adjusted OR 2.06, 95% CI 1.02-4.14, p = 0.044). Further stratified analyses revealed that individuals with the rs10736428 CC genotype exhibited heightened predisposition to neuroblastoma, particularly within the subgroups of male patients, patients with mediastinal tumors, and patients with tumors classified under the International Neuroblastoma Staging System as stages 3 and 4. Moreover, children with 1-4 risk genotypes also showed positive associations with mediastinal tumors.</p><p><strong>Conclusions: </strong>A strong association between the NSUN4 rs10736428 polymorphism and increased susceptibility to neuroblastoma has been identified.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-6"},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial. Utilization of advanced practice providers within neurosurgical practice.","authors":"Mari L Groves","doi":"10.3171/2024.11.PEDS24515","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24515","url":null,"abstract":"","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-3"},"PeriodicalIF":2.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced practice providers in pediatric neurosurgery: a single-institution analysis of clinical and surgical productivity.","authors":"Sarah A Layon, Kristina Marsack, Matthew J Parham, Heather R Burns, Emily E McClernon, Larry H Hollier, Howard L Weiner","doi":"10.3171/2024.10.PEDS24345","DOIUrl":"https://doi.org/10.3171/2024.10.PEDS24345","url":null,"abstract":"<p><strong>Objective: </strong>Advanced practice providers (APPs) have experienced remarkable growth in surgical fields, collaborating closely with surgeons to optimize patient care. Although several specialties have evaluated the roles and safety of APPs in team-based care models, few studies have explored their impact on clinical and surgical productivity, especially in pediatric settings. This study aimed to evaluate the influence of enhanced APP utilization within the division of neurosurgery at a leading academic pediatric institution in the United States.</p><p><strong>Methods: </strong>Productivity metrics were obtained from the Surgery Department Executive Committee annual reports from October 2011 to September 2023. Descriptive analyses were conducted to identify divisional trends in provider numbers, surgical and clinic volumes, total operating room (OR) hours, gross charges, and work relative value units.</p><p><strong>Results: </strong>Since 2012, the division of neurosurgery has witnessed consistent growth in clinic encounters per APP and in overall clinic volume, peaking in 2023. The MD surgical conversion rate was lowest in 2016 (1 OR case for every 6.39 encounters) and peaked in 2019 (1 OR case for every 3.57 encounters). Financial metrics, adjusted for inflation, demonstrated notable increases in work relative value units and gross charges over the decade.</p><p><strong>Conclusions: </strong>Increased utilization and autonomy of APPs within the division of neurosurgery have facilitated greater procedural productivity and access to patient care. This study emphasizes the importance of integrating well-trained APPs into patient care models, allowing them to leverage their full expertise and training, particularly in pediatric surgical settings.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of outcomes after spinal column shortening for secondary tethered cord syndrome in pediatric versus adult patients: the University of Oklahoma experience.","authors":"Burak Ozaydin, Kishore Balasubramanian, Andrew Jea","doi":"10.3171/2024.12.PEDS24523","DOIUrl":"https://doi.org/10.3171/2024.12.PEDS24523","url":null,"abstract":"<p><strong>Objective: </strong>Spinal column shortening (SCS) is an emerging alternative to traditional untethering in cases of secondary tethered cord syndrome. It was originally described and applied in adult patients with spinal dysraphism. In the more recent past, SCS has been used in pediatric patients. A comparison between pediatric and adult patients undergoing SCS has not been performed previously.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 19 patients (11 children, 8 adults) who underwent SCS procedures from November 30, 2020, to July 21, 2024, at the University of Oklahoma. Outcomes were assessed based on changes in pain, overall symptom burden, subjective bowel/bladder symptoms, and objective testing of urodynamic function. The median follow-up period was 30 months (range 10-41 months).</p><p><strong>Results: </strong>Most vertebral column resections were performed at the T12 level (79%), with T10-L2 being the most common fusion level (68%). There were no significant preoperative differences in clinical features between children and adults. Both children and adults experienced significant reductions in pain (p = 0.002 and p = 0.018, respectively) and overall symptom burden (p < 0.001 and p = 0.003, respectively). Complete symptom resolution was achieved in 63% of children and 25% of adults. Improvements in objective urodynamic function were observed but were not statistically significant in either group (p = 0.082 for children, p = 0.351 for adults). However, only children reported significant improvement in bowel/bladder function (p < 0.01). The difference in surgical metrics or postoperative clinical features was not significant between children and adults.</p><p><strong>Conclusions: </strong>SCS procedures appear to be effective in reducing pain and overall symptom burden in both pediatric and adult patients with complex tethered cord syndrome. SCS seems to improve bowel/bladder symptoms in children specifically. Further research with larger cohorts and longer follow-up periods is warranted to confirm these findings and assess long-term outcomes.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor. The young Chiari patient, an oft-forced hand?","authors":"Aaron M Yengo-Kahn, Douglas L Brockmeyer, Robert J Bollo","doi":"10.3171/2024.12.PEDS24645","DOIUrl":"https://doi.org/10.3171/2024.12.PEDS24645","url":null,"abstract":"","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-2"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of surgical approaches in nonsyndromic multiple-suture synostosis: a systematic review and meta-analysis.","authors":"Felipe Gutierrez Pineda, Brodus A Franklin, Anuraag Punukollu, Hsien-Chung Chen, Gustavo Giraldo Garcia, Anna Lydia Machado Silva, Mark Proctor, Esteban Quiceno","doi":"10.3171/2024.11.PEDS24364","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24364","url":null,"abstract":"<p><strong>Objective: </strong>Nonsyndromic multiple-suture synostosis (MSS) is one of the rarest types of craniosynostosis. While both endoscopic and open surgical approaches have demonstrated efficacy for MSS patients, a comprehensive comparison of perioperative outcomes between the two approaches has yet to be fully explored. The aim of this systematic review and meta-analysis was to assess the available evidence among the two surgical approaches to better inform the management of complex craniosynostosis.</p><p><strong>Methods: </strong>PubMed, Embase, and Scopus were searched for studies published from the first reports through February 2024 that reported surgical outcomes of either endoscopic or open surgery for nonsyndromic MSS. The main outcome was the reoperation rate, with secondary endpoints including transfusion rates, intraoperative complications, and overall complications, with a subgroup analysis conducted for patients with nonsyndromic bicoronal synostosis.</p><p><strong>Results: </strong>Sixteen studies involving 310 patients were analyzed. Patients undergoing open surgery were older than those treated with endoscopy (mean age 10.39 vs 3.21 months). The pooled analysis showed a reoperation rate of 11% (95% CI 4%-23%, I2 = 25%) for endoscopic surgery compared with 22% (95% CI 14%-31%, I2 = 0) for open surgery (p = 0.11). Transfusion rates were 26% (95% CI 13%-45%, I2 = 50%) for endoscopic surgery and 50% (95% CI 22%-78%, I2 = 71%) for open surgery (p = 0.18). Intraoperative complications were similar: 17% (95% CI 7%-34%, I2 = 0%) for endoscopic vs 15% (95% CI 4%-42%, I2 = 76%) for open surgery (p = 0.85). Overall complication rates were 15% (95% CI 7%-31%, I2 = 45%) for endoscopic surgery and 20% (95% CI 9%-38%, I2 = 65%) for open surgery (p = 0.59). In the subgroup analysis of bicoronal synostosis, the reoperation rate was 10% (95% CI 4%-21%, I2 = 0%) for endoscopic surgery versus 16% (95% CI 7%-32%, I2 = 0%) for open surgery (p = 0.39).</p><p><strong>Conclusions: </strong>While both surgical approaches are reasonable options for nonsyndromic MSS, this meta-analysis suggests that endoscopic surgery could be associated with lower morbidity when compared with open surgery. Future studies with longer follow-up periods will be needed to validate these findings and contribute to the understanding of complex craniosynostosis management.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}