Neurosurgical Review最新文献

{"title":"Incidence and predictors of Woven EndoBridge (WEB) shape modification following treatment of intracranial aneurysms in a large multicenter study.","authors":"Nimer Adeeb, Hamza Adel Salim, Basel Musmar, Assala Aslan, Christian Swaid, Miguel Cuellar, Mahmoud Dibas, Nicole M Cancelliere, Jose Danilo Bengzon Diestro, Oktay Algin, Sherief Ghozy, Sovann V Lay, Adrien Guenego, Leonardo Renieri, Joseph Carnevale, Guillaume Saliou, Panagiotis Mastorakos, Kareem El Naamani, Eimad Shotar, Markus Möhlenbruch, Michael Kral, Charlotte Chung, Mohamed M Salem, Ivan Lylyk, Paul M Foreman, Hamza Shaikh, Vedran Župančić, Muhammad U Hafeez, Joshua Catapano, Muhammad Waqas, Muhammet Arslan, Onur Ergun, James D Rabinov, Yifan Ren, Clemens M Schirmer, Mariangela Piano, Anna L Kühn, Caterina Michelozzi, Robert M Starke, Ameer Hassan, Mark Ogilvie, Anh Nguyen, Jesse Jones, Waleed Brinjikji, Marie T Nawka, Marios Psychogios, Christian Ulfert, Bryan Pukenas, Jan-Karl Burkhardt, Thien Huynh, Juan Carlos Martinez-Gutierrez, Muhammed Amir Essibayi, Sunil A Sheth, Diana Slawski, Rabih Tawk, Benjamin Pulli, Boris Lubicz, Pietro Panni, Ajit S Puri, Guglielmo Pero, Eytan Raz, Christoph J Griessenauer, Hamed Asadi, Adnan Siddiqui, Elad I Levy, Neil Haranhalli, David Altschul, Andrew F Ducruet, Felipe C Albuquerque, Robert W Regenhardt, Christopher J Stapleton, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Jared Knopman, Stavropoula I Tjoumakaris, Pascal M Jabbour, Frédéric Clarençon, Nicola Limbucci, Vivek Yedavalli, Max Wintermark, Vitor Mendes Pereira, Aman B Patel, Hugo H Cuellar-Saenz, Adam A Dmytriw","doi":"10.1007/s10143-025-03344-0","DOIUrl":"10.1007/s10143-025-03344-0","url":null,"abstract":"<p><p>The Woven EndoBridge (WEB) device is FDA-approved for the treatment of bifurcation aneurysms. Despite its wide popularity, it has been under scrutiny for its association with potential aneurysm recanalization and retreatment due to device shape modification. This study aims to analyze the shape modification rate of WEB devices and identify factors associated with this phenomenon, as well as its correlation with aneurysm retreatment. We conducted a retrospective review of the WorldWide WEB Consortium database, including adult patients treated for intracranial aneurysms with the WEB device. We assessed aneurysm occlusion using the WEB Occlusion Scale and defined WEB shape modification as a percentage reduction in the distance between two WEB markers. Logistic regression and Cox proportional hazards models were utilized to evaluate predictors of shape modification and retreatment. Kaplan-Meier curves were used to estimate the time-dependent probability of no or minor shape modification. A total of 405 patients were analyzed, with minor and major shape modification occurring in 31.4% and 10.1% of cases, respectively. Major shape modification was associated with lower rates of adequate occlusion (70.7%) compared to no or minor shape modification (86.6%) and a higher rate of retreatment (26.8% vs. 8.1%). Predictors of major shape modification included the presence of daughter sac, bifurcation aneurysms, absence of immediate flow stagnation, and a WEB width minus aneurysm width ratio ≤ 0.5. The probability of no or minor shape modification declined within the first 25 months and stabilized thereafter. WEB device shape modification is a significant predictor of aneurysm occlusion efficacy and retreatment. Recognizing the factors influencing shape modification can guide treatment decisions and follow-up protocols to improve patient outcomes.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"265"},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epilepsy as primary tumor manifestation correlates with patient status, age, and tumor volume but not with survival in elderly glioblastoma patients: a retrospective bicentric analysis.","authors":"Matthias Demetz, Constantin Hecker, Hamza Adel Salim, Aleksandrs Krigers, Jürgen Steinbacher, Lukas Machegger, Johannes Kerschbaumer, Melanie Buchta, Johannes Pöppe, Philipp Geiger, Antonio Spinello, Theo F J Kraus, Christoph J Griessenauer, Claudius Thomé, Christian F Freyschlag, Christoph Schwartz","doi":"10.1007/s10143-025-03397-1","DOIUrl":"10.1007/s10143-025-03397-1","url":null,"abstract":"<p><p>Assessment of the potential impact of epilepsy as primary tumor manifestation on survival in elderly glioblastoma multiforme (GBM) patients. Two academic neurosurgical centers retrospectively analyzed all GBM patients aged 65 years and older with de-novo tumors, who underwent surgery between 2006 and 2021. Epidemiological, histopathological, imaging and survival data were obtained from patients' electronic charts, and screened for the presence of epilepsy preoperatively and during follow-up. Patient status was assessed by the Karnofsky Performance Scale (KPS), epilepsy was evaluated using the Engel classification. Patients were categorized in an epilepsy cohort (i.e. patients with epilepsy as primary GBM manifestation, and a reference cohort (i.e. patients with no initial epilepsy). This study analyzed 451 GBM patients (55% males); median age at tumor diagnosis was 73 years. The epilepsy cohort was younger (71.0 vs. 74.0 year; p = 0.001), had better KPS (80 vs. 70; p = 0.039), and had smaller tumors (127 vs. 221 cm³; p = 0.001) compared to the reference cohort. There were no differences with regard to neurosurgical treatment (i.e. resection vs. biopsy), tumor biomarkers, surgery-associated complications, and performed adjuvant treatment (all p > 0.05). We did not detect a significant difference in median survival between the epilepsy and reference cohorts (8 vs. 6 months; p = 0.21). New epilepsy during follow-up often coincided with tumor recurrence/progression, but also did not significantly affect survival. The majority of patients (98%) achieved seizure freedom by a combination of tumor-specific treatments and antiseizure medication. Epilepsy as primary tumor manifestation does not correlate with survival in elderly GBM patients.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"264"},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizure presentation and incidence-associated factors in treated cerebral arteriovenous malformations: a secondary analysis of the MISTA consortium.","authors":"Daniel Sconzo, Felipe Ramirez-Velandia, Sandeep Muram, Alejandro Enriquez-Marulanda, Nimer Adeeb, Sandeep Kandregula, Hamza Adel Salim, Basel Musmar, Adam A Dmytriw, Douglas Kondziolka, Kareem El Naamani, Jason Sheehan, Natasha Ironside, Salem Tos, Ahmed Abdelsalam, Deepak Kumbhare, Cagdas Ataoglu, Muhammed Amir Essibayi, Abdullah Keles, Howard Riina, Arwin Rezai, Johannes Pöppe, Rajeev D Sen, Christoph J Griessenauer, Pascal Jabbour, Stavropoula I Tjoumakaris, Jan-Karl Burkhardt, Robert M Starke, Ufuk Erginoglu, Mustafa K Baskaya, Laligam N Sekhar, Michael R Levitt, David J Altschul, Malia McAvoy, Assala Aslan, Abdallah Abushehab, Christian Swaid, Adib Abla, Christopher Stapleton, Matthew Koch, Visish M Srinivasan, Peng R Chen, Spiros Blackburn, Mark J Dannenbaum, Omar Choudhri, Bryan Pukenas, Darren Orbach, Edward Smith, Markus Möhlenbruch, Ali Alaraj, Ali Aziz-Sultan, Aman B Patel, Hugo H Cuellar, Michael Lawton, Jacques Morcos, Bharat Guthikonda, Philipp Taussky, Christopher S Ogilvy","doi":"10.1007/s10143-025-03337-z","DOIUrl":"https://doi.org/10.1007/s10143-025-03337-z","url":null,"abstract":"<p><p>Seizures occur in 20-45% of patients with cerebral arteriovenous malformations (AVMs) and can potentially influence their quality of life. Some studies have suggested risk factors influencing their development, but the evidence is limited to small cohorts. To analyze seizure presentation and factors influencing seizure development in patients with cerebral AVMs using a multi-institutional consortium. Retrospective multicenter registry from multiple centers in North America and Europe of patients aged 1 to 89 years who had undergone any intervention for brain AVMs between January 2010 and December 2023. Demographics, functional assessment (modified Rankin Scale; mRS), and AVM characteristics, were evaluated to assess for relationship with seizures using a multivariate generalized linear mixed-effects model. 1,005 AVM patients were analyzed; the median age was 42, 73% had a baseline mRS ≤ 2. The median nidus size was 2.2 cm, and most AVMs were Spetzler-Martin grade II (37%). Seizure was the presenting symptom in 237 patients (24%). After adjusting for significant variables, patient-specific factors associated with seizures were younger age (OR 0.99, CI95% 0.98-1), male sex (OR 1.65, CI95% 1.18-2.30), and smoking history (OR 1.69, CI95% 1.17-2.44). AVM-specific factors associated with seizures included rupture status (OR 0.42, CI95% 0.30-0.61); eloquent cortex (OR 1.61, CI95% 1.13-2.29); frontal (OR 1.54, CI95% 1.01-2.35), temporal (OR 1.93, CI95% 1.26-2.96) and parietal (OR 1.71 CI95% 1.08-2.71) location; larger nidal size (OR = 1.23, CI95% 1.08-1.39), and superficial draining vein location (OR 1.86, CI95% 1.15-3.01). In this multicenter consortium, after controlling for significant variables, the incidence of AVM-related seizures was associated with younger age, male sex, smoking history, larger AVMs, eloquent locations, and AVMs in the frontal, temporal, and parietal cortices. Conversely, rupture status, deep venous drainage, and cerebellar locations were negatively associated with seizures.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"263"},"PeriodicalIF":2.5,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476842","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":"Endoscopic versus open treatment for sagittal craniosynostosis: a systematic review and meta-analysis.","authors":"Lucca B Palavani, Marcelo Costa, Isabela Banderali, Paulo Victor Zattar Ribeiro, Bernardo Vieira Nogueira, Mariano Belfort Santos, Marina Vilardo, Henrique L Lepine, Julia Sader, Raphael Bertani","doi":"10.1007/s10143-025-03423-2","DOIUrl":"https://doi.org/10.1007/s10143-025-03423-2","url":null,"abstract":"<p><p>Sagittal craniosynostosis is the most common form of craniosynostosis. Patients diagnosed with this condition can undergo surgical management using either the conventional open surgery method or the modern approach of minimally invasive endoscope-assisted craniectomy. The present study aimed to compare different outcomes of patients with sagittal craniosynostosis treated with endoscopic procedures versus open surgery. Multiple databases were systematically searched for studies comparing endoscopic and open repair of sagittal craniosynostosis. Outcomes analyzed included estimated blood loss, length of hospital stay, operative time, transfusion rates, complications, reoperations, and cranial indices. Random-effects meta-analyses were performed. Seventeen studies with 2,365 patients were included. Endoscope-assisted surgery showed significantly lower estimated blood loss (mean difference - 118.47 ml), shorter hospital stays (-2.08 days), and reduced operative times (-84.70 min) compared to open surgery. Intraoperative and postoperative transfusion rates were lower with endoscopic treatment (risk ratios 0.22 and 0.30, respectively). Postoperative complications were reduced with endoscopic repair (RR 0.39), without differences in intraoperative complications or reoperations. Preoperative and postoperative cranial indices slightly favored endoscopic approaches. Endoscope-assisted surgery for sagittal craniosynostosis offers perioperative advantages including reduced blood loss, shorter hospitalizations, briefer operative times, lower transfusion needs, and fewer postoperative complications compared to open calvaria remodeling, while achieving comparable cranial reshaping. These findings support an increasing use of minimally invasive endoscopic techniques for repair of sagittal craniosynostosis.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"262"},"PeriodicalIF":2.5,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472611","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":"Helsinki computed tomography score in predicting short- and long-term outcomes after primary decompressive craniectomy for traumatic brain injury.","authors":"Yu-Hua Huang, Tsung-Han Lee","doi":"10.1007/s10143-025-03410-7","DOIUrl":"https://doi.org/10.1007/s10143-025-03410-7","url":null,"abstract":"<p><p>Primary decompressive craniectomy (DC) is performed alongside the removal of mass lesions from traumatic brain injury (TBI). The Helsinki computed tomography (CT) score predicts post-TBI outcomes and is partly based on the size of the mass lesion. It remains unclear if this scoring system can be applied to this subgroup and exhibit discriminative ability. This study sought to validate the prognostic value of the Helsinki CT score in TBI patients undergoing primary DC. In this retrospective analysis, we evaluated 187 patients who underwent primary DC for TBI. Short-term outcomes, identified at discharge, included all participants (N = 187), while long-term outcomes were ascertained either through a minimum 12-month follow-up or up to the patient's death (N = 162). The Glasgow Outcome Scale (GOS) score of 1-3 denoted unfavorable outcomes. Higher Helsinki CT scores corresponded with an increase in unfavorable outcomes. The Helsinki CT score's predictive capability for these outcomes was evident in both the short term (OR: 1.36, 95% CI: 1.08-1.71, p = 0.009) and long term (OR: 1.30, 95% CI: 1.01-1.67, p = 0.041). The area under the Receiver Operating Characteristic curves was 0.743 (p < 0.001) for the short term and 0.686 (p < 0.001) for the long term. In conclusions, the Helsinki CT score holds considerable prognostic value following primary DC for TBI. Our findings suggest that the size of the mass lesion is not the predominant factor in prognostic judgments after primary DC, nor does it reduce the Helsinki score's utility.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"258"},"PeriodicalIF":2.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468730","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":"Artificial intelligence in neurovascular decision-making: a comparative analysis of ChatGPT-4 and multidisciplinary expert recommendations for unruptured intracranial aneurysms.","authors":"Alexis Hadjiathanasiou, Leonie Goelz, Florian Muhn, Rebecca Heinz, Lutz Kreißl, Paul Sparenberg, Johannes Lemcke, Ingo Schmehl, Sven Mutze, Patrick Schuss","doi":"10.1007/s10143-025-03341-3","DOIUrl":"https://doi.org/10.1007/s10143-025-03341-3","url":null,"abstract":"<p><p>In the multidisciplinary treatment of cerebrovascular diseases, specialists from different disciplines strive to develop patient-specific treatment recommendations. ChatGPT is a natural language processing chatbot with increasing applicability in medical practice. This study evaluates ChatGPT's ability to provide treatment recommendations for patients with unruptured intracranial aneurysms (UIA). Anonymized patient data and radiological reports of 20 patients with UIAs were provided to GPT-4 in a standardized format and used to generate a treatment recommendation for different clinical scenarios. GPT-4 responses were evaluated by a multidisciplinary panel of specialists by means of the Likert scale and subsequently benchmarked against the Unruptured Intracranial Aneurysm Treatment Score (UIATS) as well as the actual treatment decision made by the multidisciplinary institutional neurovascular board (INVB). Agreement between expert raters was measured using linear weighted Fleiss-Kappa coefficient. GPT-4 analyzed individual pathological features of the radiological reports and formulated a corresponding assessment for each aspect. None of the recommendations generated reflected evidence of factual hallucination, although in 25% of the case studies no specific recommendation could be derived from the GPT-4 responses. The expert panel rated the overall quality of the GPT-4 recommendations with a median of 3.4 out of 5 points. The GPT-4 recommendations were congruent with those of the INBI in 65% of cases. Interrater reliability among experts showed moderate to low agreement in the assessment of AI-assisted decision making. GPT-4 appears to be able to process clinical information about UIAs and generate treatment recommendations. However, the level of ambiguity and the utilization of scientific evidence in the recommendations are not yet patient/case specific enough to substitute the decision-making of a multidisciplinary neurovascular board. A prospective evaluation of GPT-4 competence as a companion in decision-making panels is deemed necessary.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"261"},"PeriodicalIF":2.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468695","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":"Correction to: Outcomes for standalone anterolateral corpectomy for thoracolumbar burst fractures.","authors":"Michael J Ortiz Torres, Kaushik Ravipati, Caitlyn J Smith, Kiersten Norby, Jamir Pleitez, Walter Galicich, Thomas Bergman, Christopher Roark, Farhan Siddiq","doi":"10.1007/s10143-025-03417-0","DOIUrl":"https://doi.org/10.1007/s10143-025-03417-0","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"259"},"PeriodicalIF":2.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468726","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":"Mapping neuroendoscopy practices: an assessment of endoscopic practices and training needs across Latin American and African countries.","authors":"Guilherme Mansur, Leopoldo Mandic Ferreira Furtado, Jose Aloysio da Costa Val Filho, Rodrigo Moreira Faleiro, Jose Mauricio Siqueira, Jair Raso, Roberto Alexandre Dezena, Samuel Tau Zymberg, Artur Cunha, Luis Alencar Borba, Mikail Sallé, Daniel M Prevedello, Diego Armando Servian Duarte, Ellianne J Dos Santos Rubio, Adilson de Oliveira, Álvaro Córdoba, Adrian Caceres Chacon, Lucas Ramos Lima","doi":"10.1007/s10143-025-03421-4","DOIUrl":"https://doi.org/10.1007/s10143-025-03421-4","url":null,"abstract":"<p><p>Neurosurgical capabilities vary significantly across Latin American and African countries, with advanced centers having state-of-the-art technology while others struggle with basic procedures. This study aims to assess the current state of endoscopic neurosurgery in Latin American and Portuguese or Spanish-speaking African countries (LAPSSAC), focusing on infrastructure and training needs. A 50-question survey was distributed to neurosurgeons across 19 Latin American countries and six Portuguese- or Spanish-speaking African countries between May 19th and June 20th, 2023. The survey covered institutional types, residency programs, availability of endoscopic equipment, types of procedures performed, and interest in additional training. Data from 202 responses representing 216 hospitals were analyzed using descriptive statistics. Most respondents worked in public institutions (69.42%), with 58.42% having residency programs. Essential equipment for endoscopic procedures was available in 83.17% of hospitals, while 71.29% had the necessary tools for ventricular and 61.39% for skull base endoscopy. Ventricular endoscopy was performed in 89.11% of hospitals, compared to 71.78% for skull base procedures. Significant gaps in equipment and training were identified, especially in African countries. Interest in additional training was high, with 83.33% and 92.41% of respondents expressing a need for training in ventricular and skull base endoscopy, respectively. The findings highlight disparities in neurosurgical capabilities, with many centers lacking essential resources for endoscopic procedures. While most hospitals have some basic tools, there remains a need for investment in education and equipment. The study suggests that enhancing international collaborations and targeted investments could address these gaps and improve neurosurgical care in low-resource settings. Significant disparities in neuroendoscopic training and equipment exist across LAPSSAC. Addressing these disparities through strategic investments and international partnerships is essential to improving neurosurgical outcomes in these regions.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"260"},"PeriodicalIF":2.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468734","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 accuracy of pedicle screw placement for adolescent idiopathic scoliosis using freehand fluoroscopic, navigation, and robotic-assisted techniques - a systematic review and bayesian network meta-analysis.","authors":"Paweł Łajczak, Ayesha Ayesha, Rabbia Jabbar, Yasmin Picanço Silva, Eshita Sharma, Oguz Kagan Sahin, Kaike Eduardo da Silva Lobo, Iago Nathan Simon Petry, Aisha Rizwan Ahmed, Fabio Victor Vieira Rocha, Walter Fagundes, Yan G M D Silva","doi":"10.1007/s10143-025-03333-3","DOIUrl":"https://doi.org/10.1007/s10143-025-03333-3","url":null,"abstract":"<p><p>Adolescent idiopathic scoliosis (AIS) is a prevalent spinal deformity, often requiring surgical intervention. Posterior pedicle spine instrumentation, a common procedure for correcting AIS, can be performed using freehand fluoroscopic (FHF), navigation-assisted (NVA), or robotic-assisted (RBA) techniques for pedicle screw insertion. This study aimed to evaluate the accuracy and clinical outcomes of these techniques through a Bayesian network meta-analysis (BNMA) of 764 patients and 8,144 screws from twelve studies. Our findings suggest that RBA offers superior accuracy in pedicle screw placement compared to both FHF and NVA. However, RBA is associated with longer operative times. NVA, in contrast, provides a balanced approach by offering good accuracy with relatively shorter surgery times. No significant differences were observed in blood loss, Cobb angle correction, or hospital stay between the techniques. Additionally, no statistically significant differences were found between RBA and NVA in terms of operative duration or blood loss. These results have important clinical implications, indicating that RBA may be the preferred option for achieving high precision, particularly in complex cases, while NVA remains a viable alternative for quicker procedures. Further research is needed to assess the long-term outcomes, radiation exposure, and cost-effectiveness of these techniques in clinical practice.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"257"},"PeriodicalIF":2.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468699","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":"Sarcopenia as a predictor of poor functional outcome of cervical spine surgery: a systematic review and meta-analysis.","authors":"Anish Tayal, Satyam Wahi, Aiman Perween Afsar, Bhavya Pahwa, Kanwaljeet Garg","doi":"10.1007/s10143-025-03398-0","DOIUrl":"https://doi.org/10.1007/s10143-025-03398-0","url":null,"abstract":"<p><p>Sarcopenia is a progressive loss of muscle mass. This study aims to determine the association of pre-operative sarcopenia with the outcome of cervical spine surgery. Pubmed, Ovid, Embase, and Web of Sciences databases were searched until September 2023 to include articles regarding the prognostic role of preoperative sarcopenia in cervical spine surgery patients. The Quality In Prognosis Studies (QUIPS) tool was used to assess the risk of bias. Meta-analyses Of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. The vote-counting model was used for the qualitative appraisal of the studies. Statistical analysis was performed with a significant p < 0.05 using SPSS software (version 23). Of the 1,134 articles revealed from the search, 15 studies with 1463 patients were included. A significant difference between patients with and without sarcopenia was not found for the occurrence of loss of lordosis (OR = 1.28, 95%CI = 0.21 to 7.62, p = 0.6137), and deterioration of the Neck disability index postoperatively (OR = 1.53, 95%CI = 0.0 to 632.04, p = 0.7914). In the vote-counting model, there was strong evidence that sarcopenia worsens postoperative patient-reported outcomes and spine stability, while evidence was conflicting on whether sarcopenia can affect the occurrence of surgical complications. Sarcopenia may predispose cervical spine surgery patients to a worse surgical outcome as compared to non-sarcopenic patients, and it can be used to prognosticate the patients.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"256"},"PeriodicalIF":2.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458607","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}