Neurosurgical Review最新文献

{"title":"Clinical and radiological outcomes of titanium cage versus polyetheretherketone cage in lumbar interbody fusion: a systematic review and meta-analysis.","authors":"Haozhong Wang, Hao Zhang, Changming Xiao, Kaiquan Zhang, Lisheng Qi","doi":"10.1007/s10143-025-03453-w","DOIUrl":"https://doi.org/10.1007/s10143-025-03453-w","url":null,"abstract":"<p><p>Interbody cages are widely used in lumbar interbody fusion (LIF). The aim of this meta-analysis is to compare the clinical and radiological outcomes between titanium (Ti) and polyetheretherketone (PEEK) cages in patients underwent LIF. A literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane library databases until October 2023. Studies comparing the clinical and radiological outcomes of Ti and PEEK cages in LIF were included. Subgroup analyses was performed to differentiate between patients who had three-dimensional printed titanium (3D-Ti) cage and non-3D Ti cage. A total of 19 studies with 820 Ti cages patients (including 476 patients with 3D-Ti cages) and 1237 PEEK cages patients were reviewed. Ti cages demonstrated advantages of better fusion rate, and lower cage subsidence and reoperation rate than PEEK cages. Patients with 3D-Ti cages showed significantly superior fusion rate, less cage subsidence rate and reduced reoperation rate by conducting subgroup analysis. No significant difference was found between non-3D Ti cages and PEEK cages in fusion, cage subsidence and reoperation rate. Both Ti and PEEK cages patients had similar postoperative visual analogue score, Oswestry disability index score, anterior disc height, intervertebral foraminal height, global lumbar lordosis and segmental lordosis. 3D-Ti cages have advantages over PEEK cages in promoting fusion rate, reducing risk of cage subsidence and lowering reoperation rate. 3D-Ti cage may be a superior implant compared with PEEK cage in LIF.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"295"},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616491","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":"Effects of the Japanese traditional medicine Goreisan on adverse events affecting mucosal edema in patients with subarachnoid hemorrhage treated with clazosentan.","authors":"Yosuke Akamatsu, Kohei Chida, Kenya Miyoshi, Daigo Kojima, Koji Yoshida, Toshinari Misaki, Takahiro Koji, Shunrou Fujiwara, Yoshitaka Kubo, Hiroshi Kashimura, Kuniaki Ogasawara","doi":"10.1007/s10143-025-03394-4","DOIUrl":"https://doi.org/10.1007/s10143-025-03394-4","url":null,"abstract":"<p><p>Despite successful management of pulmonary complication with fluid restriction protocol in aneurysmal subarachnoid hemorrhage (aSAH) patients treated with clazosentan, management of symptoms related to mucosal edema, such as diarrhea, stuffy nose, and difficulty in breathing, remains challenging. Hence, we investigated the effect of Goreisan shown to be effective in the treatment of symptoms related with mucosal edema in aSAH patients treated with clazosentan. Patients with aSAH who received clazosentan for vasospasm after aneurysm obliteration were prospectively enrolled in the study. Fluid balance parameters and the incidence of vasospasm, pulmonary edema, mucosal edema-related symptom (such as diarrhea and swelling of the nasal mucosa) were compared between these patients treated with Goreisan (Group G) and without Goreisan (Group NG). As results, Groups NG and G comprised 29 and 40 consecutive patients, respectively. No significant differences in fluid intake, urine volume, frequency of furosemide injection, incidence of vasospasm, pulmonary edema, or discontinuation of clazosentan treatment between the two groups were found over the treatment course, although refractory hyponatremia occurred less frequently in Group G than in Group NG (0% and 10.3%, p = 0.039, respectively). The incidence of diarrhea and the relative mucosal thickness was also significantly lower in Group G than in Group NG (7.3% and 21.9%; p = 0.0004, 113.8% vs. 175.4%; p = 0.001). Clazosentan combined with diuretics and Goreisan effectively reduced diarrhea and nasal mucosal swelling in patients with aSAH. This protocol may offer a viable approach for managing clazosentan-associated adverse events in aSAH patients.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"293"},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605407","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":"Pre-residency neurosurgical fellowship programs impact on a successful re-application: a departmental experience.","authors":"Mareshah N Sowah, Benjamin R Klein, Victor M Lu, Ricardo J Komotar, Allan D Levi","doi":"10.1007/s10143-025-03444-x","DOIUrl":"10.1007/s10143-025-03444-x","url":null,"abstract":"<p><p>Matching into neurosurgery residency within the United States is one of the most competitive endeavors for medical students. Pursuing a neurosurgery pre-residency fellowship program is becoming a popular option among domestic applicants, as well as international medical graduates (IMGs), who are unsuccessful in their neurosurgery match or wish to create a more competitive application prior to applying. The aim of this study was to review the University of Miami's pre-residency fellowship program experience to date. Records were retrospectively reviewed for all pre-residency fellows that rotated within the Department of Neurosurgery at the University of Miami between 2000 (inception) to 2024 with match success rate as the primary outcome of interest. A total of 23 pre-residency fellows who trained within the University of Miami's Department of Neurosurgery since the inception of the program were identified during the study period of 2000 to 2024. There were 15 (65%) IMGs and 8 (35%) United States medical graduates based on previous medical education. All of the fellows successfully completed their pre-residency training, and 12 (53%) successfully matched into neurosurgery. Another significant trend noted was that IMGs had more research and post-graduate neurosurgical experiences compared to US medical graduates at the time their fellowship began. Pre-residency fellowship programs are a feasible and tangible alternative route for neurosurgery match applicants who wish to augment their application. The outcomes of our pre-residency fellowship are promising, particularly for IMGs, however more prospective data and experiences across multiple departments are required to truly understand parameters of success for pre-residency fellowship programs in neurosurgery.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"294"},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605410","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":"A systematic review of reviews on ventriculostomy related infection definitions: A fundamental problem.","authors":"Mikael Håndstad, Adam Alaoui-Ismaili, Marianne Juhler, Tiit Illimar Mathiesen","doi":"10.1007/s10143-025-03447-8","DOIUrl":"https://doi.org/10.1007/s10143-025-03447-8","url":null,"abstract":"<p><p>Despite being a common, well-recognized and important complication to External Ventricular Drainage (EVD), a consensus definition for Ventriculostomy Related Infections (VRI) has not yet been established. We conducted a review to qualitatively assess definition heterogeneity and objectivity among Randomized Controlled Trials (RCTs); and investigated systematic reviews, meta-analyses, and reviews of the literature for definition citation accuracy and common methodological approaches and points of discussion related to VRI definitions. RCTs were grouped into arbitrarily chosen infection rate brackets to examine the hypothesized correlation between broader definitions and higher infection rates in RCTs. A literature search was conducted via Ovid in the Embase, MedLine and Cochrane databases from all years until the 8th of January 2025. Using Covidence, two authors (MH, AA) independently evaluated records, including studies that had ≥ 1 VRI definitions and numerical VRI rates. We identified 12 definitions in 13 RCTs, documenting pronounced disagreement. Cumulative rates for \"definitive\" VRI (8.4%) were lower than \"suspected\" VRI (13.5%). Qualitatively assessed, studies with narrow definitions presented lower VRI rates. All 17/17 meta-analyses and systematic reviews, and 15/19 literature reviews cited ≥ 1 definition inaccurately. Trial results may change based on definition choice. Definition heterogeneity was not sufficiently accounted for in meta-analyses. All literature-based studies were confounded by definition heterogeneity. Previously reported findings based on meta-analytical methodologies may be invalid, and inaccurately presented definitions could give a false impression of trial comparability. A consensus set of definitions are necessary to allow comparison between studies, and should be constructed to account for the intended use since sensitivity and specificity may have different weight depending on the context.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"292"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605400","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":"Effect of the enhanced recovery after surgery protocol in patients undergoing elective craniotomies: a systematic review and meta-analysis.","authors":"Suresh Kumar Choudhary, Dinesh Bijarniya, Shravan Kumar Jat, Manish Agrawal, Shubham Vasudeva","doi":"10.1007/s10143-025-03446-9","DOIUrl":"https://doi.org/10.1007/s10143-025-03446-9","url":null,"abstract":"<p><p>Enhanced recovery after surgery protocol (ERASP) improves postoperative outcomes. However, its implementation in neurosurgery remains under explored, resulting in the absence of standard evidence-based guidelines. Thus, we compared the outcomes of ERASP and conventional perioperative care (CPC) in patients undergoing elective craniotomy for various intracranial pathologies. This systematic review and meta-analysis involved the search of PubMed, Cochrane Library, and Google Scholar until December 4, 2024. The primary outcomes were total and postoperative length of stay (LOS). Secondary outcomes included hospitalization cost, pain, analgesic use, Karnofsky performance status (KPS) score, postoperative nausea and vomiting (PONV), postoperative complications, 30-days readmission and reoperation, and mortality. A total of 15 studies, including randomized controlled trials (n = 9) as well as prospective and retrospective studies (each n = 3) were included. Compared to CPC, ERASP significantly reduced total LOS (MD -3.32, 95%CI -3.66 to -2.98; P < 0.0001, I² = 34%), postoperative LOS (MD -2.80, 95%CI -3.82 to -1.79; P < 0.0001, I² = 90%), hospitalization cost (MD -$1044, 95%CI -$1289 to -$800; P < 0.0001, I² = 47%), postoperative pain (MD -1.55, 95%CI -1.92 to -1.19; P < 0.0001, I² = 83%), analgesic use (OR 0.56, 95%CI 0.40 to 0.80; P = 0.001, I² = 0%), KPS score (MD 6.68, 95%CI 0.15 to 13.21; P = 0.045, I² = 93%), respiratory complications (OR 0.28, 95%CI 0.13 to 0.58; P = 0.001, I² = 0%), and PONV (OR 0.39, 95%CI 0.27 to 0.57; P < 0.0001, I² = 0%). While ERASP and CPC were comparable regarding other outcome measures. Thus, in elective craniotomy, ERASP shortens total and postoperative LOS, decreases hospitalization costs, improves functional recovery, decreases pain and analgesic use, with reduced incidence of PONV and respiratory complications.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"291"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597424","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":"A systematic review of high-grade glioma associated with Li-Fraumeni syndrome.","authors":"Trent Kite, Vineetha Yadlapalli, Rhea Verma, Mokshal Porwal, John Herbst, Stephen Karlovits, Rodney E Wegner, Matthew J Shepard","doi":"10.1007/s10143-025-03437-w","DOIUrl":"https://doi.org/10.1007/s10143-025-03437-w","url":null,"abstract":"<p><p>Li-Fraumeni Syndrome (LFS) is a rare hereditary cancer syndrome characterized by an increased risk of early-onset and multiple tumors across various organ systems, predominantly linked to germline TP53 mutations. While commonly associated neoplasms include sarcomas, breast cancer, and adrenocortical carcinoma, the occurrence of high-grade gliomas (HGG), including glioblastoma multiforme (GBM), in LFS patients is less documented and typically presents at a younger age relative to sporadic cases. A systematic review following PRISMA guidelines was conducted, focusing on clinical studies and case reports that explore the association between HGG and LFS. A comprehensive PubMed search was used to capture relevant studies. The inclusion criteria focused on patients with a confirmed diagnosis of LFS and histopathologically verified HGG. A total of 248 articles were initially identified, with 8 studies meeting the final inclusion criteria after independent review and consensus. Overall, 8 studied reported on patients with either WHO grade 3 or 4 gliomas in the setting of LFS. In total these studies represent 12 patients, with 8 (66%) WHO grade 4, and 4 (33%) WHO grade 3. 9 (75%) patients underwent maximal safe resection, 5 (42%) underwent concurrent TMZ and EBRT. 9 (75%) patients underwent external beam radiation therapy (EBRT), 1 (8%) underwent intensity modulated radiation therapy (IMRT), and 1 (8%) underwent adjuvant treatment with tumor treating fields (TTF) therapy. Overall chemotherapy utilization was 75% with 9 patients receiving some form of chemotherapy. The median time to recurrence following initial treatment was 7 months (IQR: 2.00-7.00). Time to progression was variable, ranging from 5.1 months to 7 years. 64% of patients succumbed to their disease with a median OS of 17 months across studies. LFS associated HGGs are a genetically heterogenous entity. Detailed study of outcomes reported in the literature with respect to these genetics will develop further insight into therapeutic response and prognostication.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"290"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597423","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":"Individual surgical management of trigeminal schwannomas guided by an extended classification: a consecutive series of 96 clinical cases at a single institution.","authors":"Qun Xiao, Hao Peng, Guodong Tang, Jian Yuan, Gang Peng, Chi Zhang, Xiangyu Wang, Weicheng Huang, Chaoying Qin, Qing Liu","doi":"10.1007/s10143-025-03404-5","DOIUrl":"10.1007/s10143-025-03404-5","url":null,"abstract":"<p><p>Trigeminal schwannoma (TS) is a rare intracranial neurinoma that affects the multicompartmental skull base. In recent decades, advancements in skull-base neurosurgical techniques and endoscopic surgery have significantly improved outcomes for TS patients. In this study, we present our experience with surgical resection of TS using a further classification system. We conducted a retrospective analysis of the clinical, surgical, and follow-up data of 96 patients diagnosed with TS at our institution between March 2012 and June 2022. The tumors were classified based on the MPE classification, with Type M further divided into M1 and M2 subtypes according to the origin of the tumor and the patterns of cavernous sinus (CS) invasion. Type MP tumors were divided into M1P and M2P subtypes based on whether the tumors in the middle cranial fossa extended into the anterior CS. Optimal surgical approaches were proposed for each subtype. The outcomes of the case series were collected and analyzed. Based on the further MPE classification, 32 tumors were classified as Type M2P, 21 as Type M1P, 12 as Type ME, 8 as Type P, 8 as Type M1, 8 as Type MPE, and 7 as Type M2. Gross total resection (GTR) was achieved in 88 patients, while five patients underwent subtotal resection (STR), and three patients received partial resection (PR). No deaths occurred during the perioperative period. The extended MPE classification provides specific insights into the features of TS involving the middle fossa, enabling more individualized and tailored treatment strategies, as well as appropriate approach selection. The combination of microsurgery, endoscopic surgery, and stereotactic radiotherapy can lead to satisfactory outcomes in managing complex TS, achieving high rates of GTR while minimizing complications.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"289"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586423","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":"Clipping of anterior circulation aneurysms using fully endoscopic-assisted minimally invasive keyhole craniotomy: a clinical study and analysis.","authors":"Huadong Tang, Pengyuan Niu, Dongqi Shao, Shan Xie, Yu Li, Xialin Zheng, Jie Feng, Lei Li, Yuchun Shang, Lulu Chen, Zhiquan Jiang","doi":"10.1007/s10143-025-03226-5","DOIUrl":"10.1007/s10143-025-03226-5","url":null,"abstract":"<p><p>Endoscopy's ability to provide close observation, deep magnification, and multi-angle views has proven to be an effective tool for minimally invasive craniotomy in neurosurgery. However, no large case series have been published on the use of fully endoscopic-assisted minimally invasive keyhole craniotomy for clipping intracranial aneurysms (IAs). To evaluate the value of fully endoscopic-assisted minimally invasive keyhole craniotomy in the treatment of anterior circulation aneurysms. A retrospective analysis was conducted on 20 patients who underwent fully endoscopic-assisted minimally keyhole invasive craniotomy for clipping of IAs. A total of 9 anterior communicating artery (ACoA) aneurysms were clipped using the supraorbital keyhole approach (SKA). Additionally, 10 middle cerebral artery aneurysms (MCA) and 2 posterior communicating artery (PCoA) aneurysms were clipped using the pterional keyhole approach (PKA). The clipping success rate was 100% in all patients. Apart from one patient who experienced transient third cranial nerve palsy, one who developed an intracranial infection, and one who had a brief seizure, no other patients experienced serious complications. Except for one patient who had residual muscle weakness due to a preoperative basal ganglia hemorrhage, all other patients had a modified Rankin Scale (mRS) score of ≤ 1. Fully endoscopic-assisted minimally invasive keyhole craniotomy has promising applications in the treatment of anterior circulation aneurysms in Hunt-Hess grade 0-II, especially for unruptured aneurysms. Future multi-center studies are needed to confirm its broader applicability.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"288"},"PeriodicalIF":2.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582334","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":"Readmission patterns and 6-month outcomes in patients with spontaneous intracerebral hematoma: a single centre retrospective analysis in Ghana.","authors":"Pearl Ohenewaa Tenkorang, Olivia Asiedu, Adjoa Sam Annan, Kwadwo Darko, Emmanuel Kwadwo Adjei Osei, Teddy Totimeh","doi":"10.1007/s10143-025-03438-9","DOIUrl":"https://doi.org/10.1007/s10143-025-03438-9","url":null,"abstract":"<p><p>Hospital readmissions following spontaneous intracerebral hemorrhage (sICH) are a significant concern in Ghana. The paper explores readmission rates and influencing factors. Adult patients with sICH between 2021 and 2023 were reviewed to evaluate readmission rates and associated factors. Statistical analyses were performed using Wilcoxon rank sum and chi-square tests comparing non-readmitted and readmitted groups. The study included 102 patients, of which 82.4% (84) were not readmitted and 17.6% (18) were re-admitted. The median age of patients in the non-readmitted group was 50 years (Interquartile range [IQR]: 44-60) vs. 60.5 years (IQR: 50-71.5). Regarding gender, 61 patients (72.6%) in the non-readmitted group were male, while the readmitted group had an equal number of males and females (9 each, 50.0%). Hypertension was the most prevalent comorbidity in both groups, observed in 71 patients (85.5%) vs. 15 patients (83.3%). Most patients were managed conservatively, with 88.1% of non-readmitted patients and 77.8% of readmitted patients receiving conservative treatment (p = 0.265). The median hospital length of stay was 8.5 days (IQR: 4-14.8) vs. 5 days (IQR: 3-11, p = 0.094). The median modified rankin scale (mRS) score at 1-month post-discharge was 2.0 (IQR: 0.5-4) for the non-readmitted group and 3.5 (IQR: 3-4) for the readmitted group (p = 0.225). At 6 months post-discharge, the median mRS score was 1 (IQR: 0-3) in the non-readmitted group and 3.5 (IQR: 3-4) in the readmitted group (p = 0.072). Readmitted patients had a higher median age, greater prevalence of diabetes, and worse functional outcomes at 1- and 6-month follow-ups. These findings highlight the need for comprehensive discharge planning and post-discharge support for sICH patients, particularly those with diabetes and higher mRS scores. Tailored interventions and follow-up protocols can potentially reduce readmission rates and improve outcomes, warranting further research in this area.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"287"},"PeriodicalIF":2.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573564","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":"Fully endoscopic microvascular decompression for hemifacial spasm: a systematic review.","authors":"Ali Ansari, Roozbeh Tavanaei, Alireza Alikhani, Bardia Hajikarimloo, Sina Zoghi, Ahmed M Alnemari, MirHojjat Khorasanizadeh, Nathan T Zwagerman","doi":"10.1007/s10143-025-03181-1","DOIUrl":"https://doi.org/10.1007/s10143-025-03181-1","url":null,"abstract":"<p><p>Hemifacial spasm (HFS) is a distressing condition caused by facial nerve compression and characterized by involuntary facial muscle twitching, adversely impacting quality of life. Microvascular decompression (MVD) is effective but poses risks. Fully endoscopic MVD (E-MVD) as an emerging technique offers enhanced safety and efficacy. Therefore, this systematic review aimed to evaluate the use of fully E-MVD in treating HFS. In accordance with PRISMA guidelines, the systematic review included a thorough literature search in PubMed/MEDLINE, Embase, and Cochrane Library. Eligible studies were evaluated based on predefined criteria, with duplicates eliminated and conflicts resolved by a senior author. Data extraction was performed independently by two authors, with disagreements resolved by the senior author. Details on study characteristics, demographics, intraoperative observations, postoperative complications, and efficacy of fully E-MVD for HFS were gathered. Quality assessment was conducted using the NIH tool. A total of 408 patients were included in the study, with females comprising 68% and males 32% of the cohort. The mean age of patients was 52.4 years, with an average symptom duration of 4.5 years. Right-sided and left-sided symptoms were reported in 54.4% and 46.6% of patients, respectively. Intraoperatively, the most common offending blood vessel was a single AICA (48.1%). Early postoperative complications were reported in 13.6% of patients, which primarily consisted of transient facial palsy (6.8%) and hearing impairment (4%). All cases of facial palsy resolved during the follow-up period, yet 1.3% of hearing impairments persisted. The efficacy of Fully E-MVD for HFS was promising, with 93.3% of patients experiencing effective resolution at follow-up. With advancements in surgical techniques and technology, fully E-MVD continues to show promising results in improving the quality of life for patients suffering from HFS. Favorable outcomes and symptom resolution support fully E-MVD's advantages. Surgeons must consider limitations and proper techniques for optimal patient outcomes.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"285"},"PeriodicalIF":2.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573562","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}