Neurosurgical Review最新文献

{"title":"Socioeconomic status as a determinant of survival in glioblastoma: a systematic review and meta-analysis.","authors":"Jeremiah Hilkiah Wijaya, Saad Hulou, Brandon Lucke-Wold, Wiley Braxton Gillam V, Chris B Lamprecht, Fnu Ruchika, Bryce Schneider, Devon Foster, Pouria Abolfazli, Miguel David Quintero-Consuegra, Zahraa F Al-Sharshahi, Julius July","doi":"10.1007/s10143-025-03647-2","DOIUrl":"10.1007/s10143-025-03647-2","url":null,"abstract":"<p><p>Studies highlight the importance of social factors, such as race and socioeconomic status (SES), in disease management. Integrating these factors helps improve understanding of disease outcomes and the development of effective treatments. Thus, we aimed to systematically identify and review relevant studies exploring the relationship between SES and survival outcomes in GBM patients. An extensive exploration of academic databases, including Scopus, EMBASE, and PubMed, was undertaken, covering records from their inception until December 14, 2024. This search targeted specific keywords and their synonymous terms: glioblastoma, survival, and socioeconomic. We included 230,601 patients, with many individuals being diagnosed between the ages of 46 and 65. Notably, Female exhibited a higher risk (HR = 1.07, 95% CI: 1.05-1.09) of death compared to male, while African Americans demonstrated a higher risk than Caucasians (HR = 0.92, 95% CI: 0.88-0.97), alongside Hispanics (HR = 0.85, 95% CI: 0.72-0.99) and other races (HR = 0.78, 95% CI: 0.73-0.85). Similarly, unmarried individuals faced a higher risk (HR = 1.14, 95% CI: 1.09-1.20) compared to married counterparts. Noteworthy trends were observed in insurance, where private payers (HR = 1.11, 95% CI: 1.06-1.15) and government-based insurance (HR = 1.09, 95% CI: 1.00-1.19) showed increased risks compared to private insurance. However, associations in widowhood (HR = 2.45, 95% CI: 0.34-17.40), comorbidities (HR = 1.05, 95% CI: 0.93-1.18), median household income (MHI) (HR = 0.94, 95% CI: 0.85-1.05), and rural living (HR = 1.06, 95% CI: 0.98-1.16) were non-significant or inconclusive. These findings emphasize the complex interplay between socioeconomic factors and health risks, highlighting the necessity for tailored interventions to address health disparities across diverse demographic groups.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"500"},"PeriodicalIF":2.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266882","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":"Reoperations for cage removal or replacement in patients undergoing ALIF: operative morbidity and surgical strategy.","authors":"Aécio Rubens Dias Pereira Filho, Vinicius Santos Baptista, Matheus Galvão Valadares Bertolini Mussalem, Vinicius de Meldau Benites, Milton Kiyonory Uehara, Nuno Rodolfo Colaço Aguiar, Alexandre Vinhal Desideri, Allison Roxo Fernandes, Francisco Cialdine Frota Carneiro Júnior","doi":"10.1007/s10143-025-03670-3","DOIUrl":"10.1007/s10143-025-03670-3","url":null,"abstract":"<p><strong>Context: </strong>Anterior Lumbar Interbody Fusion (ALIF) is used for degenerative spinal conditions, but reoperations are sometimes needed. Same-approach reoperation is challenging due to scarring and vascular proximity; literature on this is scarce.</p><p><strong>Objective: </strong>To evaluate morbidity and clinical outcomes of same-approach ALIF reoperations by a specialized team.</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>Data from a prospectively maintained database (Instituto de Acesso à Coluna Aécio Dias) were analyzed for patients undergoing same-approach ALIF reoperation (cage exchange/removal) between April 2019 and June 2024 (n = 16).</p><p><strong>Inclusion criteria: </strong>age > 18, prior ALIF, reoperation due to complications.</p><p><strong>Exclusion criteria: </strong>different approach, outside study period.</p><p><strong>Outcomes: </strong>intraoperative morbidity (vascular, organ, nerve injuries), postoperative morbidity (infections, VAS Scale, etc.), surgical strategies. Descriptive and inferential statistics (paired t-test, p < 0.05) were used (Python).</p><p><strong>Results: </strong>Mean age: 54.37 years (SD = 9.52); 62.5% male. Main reoperation indication: cage migration (43.75%). Mean interval between surgeries: 17.06 weeks (SD = 15.97). Three vascular injuries (1 arterial, 2 venous) occurred (18.75%). Two postoperative complications (retroperitoneal infection, lymphocele) were noted (12.5%). Mean operative time: 142.50 min (SD = 56.50); mean blood loss: 114.06 ml (SD = 64.52). Most reoperations were at L5-S1 (75%).</p><p><strong>Conclusions: </strong>Same-approach ALIF reoperation appears safe with an experienced team. Higher lumbar level reoperations carry greater morbidity, warranting consideration of conservative management. Reoperation may be linked to initial procedural failures or patient selection. Risks are amplified compared to primary ALIF due to scar tissue.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"499"},"PeriodicalIF":2.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258542","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":"The effects of reverse trendelemburg position during intracranial neurosurgery on brain hydrodynamics and hemodynamics: a systematic review and meta-analysis.","authors":"Miguel Bertelli Ramos, João Pedro Einsfeld Britz, Matheus Machado Rech, Vitoria Pinheiro Alves do Nascimento, Pedro Borges, Savio Batista, Eberval Gadelha Figueiredo","doi":"10.1007/s10143-025-03655-2","DOIUrl":"10.1007/s10143-025-03655-2","url":null,"abstract":"<p><strong>Background and objectives: </strong>The reverse Trendelenburg position (rTP) tends to reduce jugular bulb pressure (JBP) and intracranial pressure (ICP), and thus improves the operative conditions by increasing brain relaxation. However, through simultaneous decreases in MAP, the cerebral perfusion pressure (CPP) can theoretically decrease, remain unchanged, or increase. We aim to evaluate the effects of rTP on ICP, MAP, JBP, and CPP in intracranial neurosurgery in order to determine the optimal degree of rTP to provide best operating conditions. We also aim to assess the subjective tactile estimation of the dura by neurosurgeons.</p><p><strong>Methods: </strong>Systematic review and meta-analysis on PubMed, Scopus, and Cochrane Library of studies comparing the effect of rTP with neutral position on ICP, MAP, JBP, and CPP during intracranial neurosurgical procedures.</p><p><strong>Results: </strong>Five studies were included. For all outcomes, a meta-analysis was only possible for the 10º rTP. The effect of other degrees was not evaluated by more than one study. The mean ICP of patients in the 10º rTP group was lower than in the neutral position group (MD = -4.11mmHg; 95% CI = -5.20mmH to -3.01mmHg; p < 0.00001). The mean MAP (MD = -5.01mmHg; 95% CI = -8.74mmHg to -1.28mmHg; p < 0.008) and mean JBP (MD = -3.92mmHg; 95% CI = -5.38mmHg to -2.47mmHg; p < 0.00001) were also lower in the 10ºrTP group. The CPP remained unchanged between groups (MD = -0.52mmHg; 95% CI = -4.30mmHg to 3.27mmHg; p = 0.79). Estimated dural tension was lower in the 10º rTP group.</p><p><strong>Conclusion: </strong>When compared to the neutral position, the 10º rTP is effective at lowering ICP and JBP while maintaining CPP unchanged during intracranial neurosurgical procedures, despite a decrease in MAP. It was also associated with lower dural tension. There were no sufficient studies allowing a meta-analysis of other degrees of rTP.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"498"},"PeriodicalIF":2.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248901","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":"Application of systematic early rehabilitation training in patients undergoing primary neuroanastomosis and thumb opposition reconstruction due to complete median nerve laceration due to carpal injuries.","authors":"Zhigang Chen, Xin Chen, Chengliang Liang, Jinbo Lin, Shi Li, Shengchan Yi, Hairu Qi","doi":"10.1007/s10143-025-03643-6","DOIUrl":"10.1007/s10143-025-03643-6","url":null,"abstract":"<p><strong>Objective: </strong>This study is intended to investigate the effect of systematic early rehabilitation training in patients undergoing primary neuroanastomosis and thumb opposition reconstruction due to complete median nerve laceration due to carpal injuries.</p><p><strong>Method: </strong>Sixty patients with complete median nerve laceration due to carpal injuries, who underwent primary neuroanastomosis and thumb opposition reconstruction were randomly divided into a control group (started conventional rehabilitation training 4 weeks after surgery) and an observation group (started systematic early rehabilitation training 48 h postoperatively), with 30 cases in each group. The functional status of the median nerve (sensory/motor nerve conduction velocity, amplitude and latency) was determined 3 months after training in both groups. Hand function [tendon total active mobility (TAM), Minnesota Manual Dexterity Text (MMDT), and Purdue Pegboard Test (PPT)] was assessed in both groups after 2 and 3 months of training. The incidence of clinical symptoms (limb numbness, joint stiffness, chronic pain, and limb atrophy) at 1 year after training was compared.</p><p><strong>Results: </strong>After 3 months of training, compared to the control group, the conduction velocity and amplitude of sensory and motor nerves of the median nerve were higher and the latency was shorter in the patients of the observation group (P < 0.05). After 2 and 3 months of training, the recovery effects of tendon TAM, MMDT and PPT of patients in the observation group were better versus the control group (P < 0.05). One year after training, the incidence of limb numbness, joint stiffness, chronic pain and limb atrophy of patients in the observation group was lower relative to the control group (P < 0.05).</p><p><strong>Conclusion: </strong>The implementation of systematic early rehabilitation training in patients undergoing primary neuroanastomosis and thumb opposition reconstruction for complete median nerve laceration resulting from wrist injury significantly promotes the early recovery of median nerve and hand function while reducing the incidence of complications.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"497"},"PeriodicalIF":2.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248832","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":"Glue-transposition technique for hemifacial spasm involving vertebrobasilar dolichoectasia: a comparative study and literature review.","authors":"Wen-Jian Zheng, Rui He, Xiejun Zhang, Fanfan Chen, Lei Chen, Yufei Liu, Jihu Yang, Zhong Deng, Taipeng Jiang, Guodong Huang","doi":"10.1007/s10143-025-03612-z","DOIUrl":"10.1007/s10143-025-03612-z","url":null,"abstract":"<p><p>Vertebrobasilar dolichoectasia (VBD) is relatively common among patients with hemifacial spasm (HFS). Vertebral artery (VA)-associated HFS accounts for 10-30% of cases. In microvascular decompression (MVD) for these patients, mobilization of the VA and other offending vessels is challenging, often limiting exposure of the root exit zone (REZ). Glue-transposition has emerged as the primary technique to address this issue. This study aims to evaluate the outcomes and complications associated with glue-transposition through a cohort study and a comprehensive literature review. A retrospective analysis of 164 patients who underwent MVD at Shenzhen Second People's Hospital was conducted, categorizing them into VBD (14 patients) and non-VBD (150 patients) groups. Additionally, a systematic literature search was performed in PubMed up to June 2024, including clinical studies that applied the glue-transposition technique in MVD. The remission rate, complications, and surgical techniques were analyzed in detail. In our cohort, patients in the VBD group had a higher mean age and a higher prevalence of hypertension. Glue-transposition was required in 64.3% of VBD cases. Logistic regression analysis identified hypertension as significantly associated with VBD. The spasm remission rates and complication rates were comparable between VBD and non-VBD groups. The systematic review included 14 studies, of which 10 employed the one-step transposition technique, while four utilized the two-step approach. The included studies reported favorable outcomes (Cohen grade I or II) with the glue-transposition technique, ranging from 84.9 to 100%. The complication rates varied from 0 to 9.5%. Hypertension is an independent risk factor for VBD, which significantly increases the surgical complexity in MVD. Glue-transposition remains the most widely used technique for VA-associated HFS, with fibrin being the most common adhesive. We present the first experience of using cyanoacrylate as an adhesive in our cohort. Both our cohort study and literature review demonstrate that the glue-transposition technique is safe and effective.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"495"},"PeriodicalIF":2.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248876","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":"Patient perspectives in neurosurgery: the role of patient-reported experience measures (PREM) in enhancing care quality.","authors":"Marie Bertl, Jana Schleitzer, Marcel Alexander Kamp, Christiane von Sass, Falko Schwarz, Oliver Schöffski, Christian Alexander Senft, Nazife Dinc","doi":"10.1007/s10143-025-03654-3","DOIUrl":"10.1007/s10143-025-03654-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of Patient-Reported Experience Measures (PREMs) on satisfaction and care quality and identify factors influencing patient evaluations. A modified patient survey was conducted at the Department of Neurosurgery at the University Hospital Jena. Additionally, a comprehensive literature review was performed to contextualize the findings and assessed the significance and preferred applications of PREMs in current research.</p><p><strong>Methods: </strong>This monocentric study employed a modified questionnaire developed in accordance with internal quality standards. The questionnaire was distributed anonymously to neurosurgical inpatients treated at the University Hospital Jena between May 1, 2023 and July 31, 2023. Data collection took place through postal surveys and during discharge management.</p><p><strong>Results: </strong>Of the 159 patients included, 69 completed the questionnaire, with 46 responding by post and 23 in person. The response rate was 66.7% for postal surveys and 33.3% for on-site collection (p < 0.001). Overall satisfaction was high, with 96.8% of respondents indicating that they would recommend the hospital. More than half of patients rated care quality and physician communication as \"very good\". Patients who provided positive evaluations of physician communication were significantly more likely to rate overall care quality as \"good\" to \"very good\" (p = 0.002). Additionally, surgical treatment and hospital recommendation were identified as significant predictors of care quality.</p><p><strong>Conclusion: </strong>Physician communication strongly correlates with patient satisfaction, symptom improvement, and treatment adherence. Expanding the use of PREMs and providing clinician training in relationship-centered communication can enhance patient-centered care, leading to measurable improvements in healthcare outcomes.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"494"},"PeriodicalIF":2.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248900","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":"Development and validation of a clinical-radiomics nomogram for predicting 180-day functional outcomes in patients with spontaneous thalamic hemorrhage.","authors":"Xi Zhang, Yiwei Zhang, Jie Zhang, Yansong Liu, Shang Gao, Haopeng Zhang, Zhaoxin Fan, Yuyang Feng, Aili Gao, Hongsheng Liang","doi":"10.1007/s10143-025-03653-4","DOIUrl":"https://doi.org/10.1007/s10143-025-03653-4","url":null,"abstract":"<p><p>Spontaneous thalamic hemorrhage (STH) is a severe type of hemorrhagic stroke with high mortality and disability rates. Identifying key risk factors for poor outcomes is crucial. This study developed and validated a clinical-radiomics nomogram to predict 180-day outcomes in STH patients. A total of 410 STH patients from the First Affiliated Hospital of Harbin Medical University were retrospectively included, with 287 in the training cohort and 123 in the internal validation cohort. The least absolute shrinkage and selection operator (LASSO) algorithm was used to select 6 of 107 extracted CT radiomics features, which were then analyzed for multicollinearity, and a Rad-score was calculated. LASSO-Logistic regression identified four clinical risk factors for poor prognosis, which were subsequently included in multicollinearity analyses. Three models: clinical, radiomics, and clinical-radiomics nomogram were constructed and validated. Model performance was evaluated using area under the curve (AUC), decision, and calibration curves, with DeLong tests for comparisons. Univariate and multivariate logistic regression analyses were conducted separately for the conservative and surgical treatment groups to identify independent prognostic factors in each group. The clinical-radiomics nomogram, incorporating age, GCS score, mGS score, rehabilitation therapy, and Rad-score, achieved high predictive performance (training cohort AUC: 0.899; internal validation: 0.889). Decision and calibration curves confirmed its clinical utility. The combined model outperformed standalone clinical or radiomics models. Subgroup analyses revealed that the Rad-score remained an independent risk factor for poor prognosis in both the conservative and surgical treatment groups. The AUC of the combined model was 0.898 and 0.828 in the conservative and surgical treatment groups, respectively. The clinical-radiomics nomogram we developed effectively predicts 180-day poor outcomes in STH patients and demonstrates superior predictive performance compared to the clinical and radiomics models. It offers a practical tool for clinicians to assess the prognosis and guide treatment decisions for high-risk patients. Clinical trial number Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"496"},"PeriodicalIF":2.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248875","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":"Clinical implications of pineal cyst resection in the absence of hydrocephalus or clear neurological signs: a case series.","authors":"Beste Gülsuna, Amanda Kate McDaniel, Rachel Lopez, Kishore Balasubramanian, Jeffrey Zuccato, Ian F Dunn","doi":"10.1007/s10143-025-03622-x","DOIUrl":"10.1007/s10143-025-03622-x","url":null,"abstract":"<p><strong>Background: </strong>Pineal cysts are benign lesions found in 1-4% of the population. While surgery is indicated for patients with symptoms related to hydrocephalus or signs of tectal compression, most patients present with non-specific symptoms such as headaches, psychiatric disturbances, sleep dysregulation, dizziness, and fatigue, among others, where the role for surgery remains unclear. Although the etiology of these symptoms is not fully understood, the habenula, which is anatomically and functionally linked to the pineal gland, may contribute to these symptoms through its role in circadian rhythms, pain modulation, and neurotransmitter regulation.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent pineal cyst resection at our center between January 2020 and December 2024. Patients presenting with hydrocephalus or concomitant conditions were excluded.</p><p><strong>Results: </strong>Seven female patients (median age 27, range 19-42) were analyzed. The most common preoperative symptom was headaches, present in all patients, followed by fatigue, dizziness, memory problems, and psychiatric symptoms. Postoperatively, 85.7% (6/7) had complete headache resolution, while one (14.3%) had partial relief. Cognitive symptoms, including memory and concentration problems, improved in 66.6% (2/3) of cases, and psychiatric symptoms improved in 66% (4/6). The median follow-up was 24 months, with no new neurological deficits at the final follow-up.</p><p><strong>Conclusions: </strong>Surgical resection can lead to significant improvements in non-specific symptoms including headaches, psychiatric disturbances, and cognitive issues in a subset of pineal cyst patients with severe refractory symptoms. These findings support the role of surgical intervention for such carefully selected patients and highlight the need for further investigation into the pathophysiology of these symptoms.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"492"},"PeriodicalIF":2.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248874","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":"Lumbar spine deformation between prone and supine CTs.","authors":"Ikaasa Suri, Daniel Kwon, Sayahi Suthakaran, Julian Javier, Maria Syed, James Hu, Matthew Carr, Jeremy Steinberger","doi":"10.1007/s10143-025-03648-1","DOIUrl":"https://doi.org/10.1007/s10143-025-03648-1","url":null,"abstract":"<p><p>Spinal navigation systems improve pedicle screw placement accuracy, but their reliance on supine preoperative imaging can introduce errors due to positional differences between preoperative and intraoperative spinal alignment. These misalignments may compromise surgical outcomes, particularly in lumbar spine procedures. This study investigates how key lumbar and lumbopelvic parameters differ between prone and supine positions, aiming to refine imaging workflows and surgical navigation practices. A retrospective cohort study analyzed paired prone and supine CT images from 85 adult patients in the ACRIN database. Key parameters-pelvic tilt, lumbar lordosis, L1 slope, pelvic incidence, and L1-L5 Cobb angle-were measured. Statistical significance was assessed using two-tailed t-tests, with pairwise comparisons conducted to evaluate positional differences. Significant differences were observed in pelvic tilt (mean prone-supine difference: 4.27°, p = 0.0002) and L1 slope (mean prone-supine difference: 3.16°, p = 0.001). Other parameters, including lumbar lordosis, pelvic incidence, and L1-L5 Cobb angle, showed no significant differences. Our study provides the first comprehensive analysis of prone versus supine alignment in the lumbar spine, addressing a critical gap in spinal navigation research. The findings underscore the limitations of supine preoperative imaging in reflecting intraoperative conditions. Incorporating these insights into navigation workflows can improve registration accuracy and surgical outcomes. Future innovations, such as AI-based predictive modeling, may further address positional discrepancies and optimize lumbar spine surgeries. This work highlights the importance of advancing imaging protocols to align with intraoperative realities.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"493"},"PeriodicalIF":2.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248899","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":"Establishment and validation of a nomogram model for surgical site infections after posterior lumbar interbody fusion: a retrospective observational study.","authors":"Zongke Long, Xiaole Hu, Jian Liu, Peiyun Zhou, Bingyan Zhang, Simeng Zhang, Huimin Wei, Wenran Qu, Xiaorong Luan","doi":"10.1007/s10143-025-03645-4","DOIUrl":"10.1007/s10143-025-03645-4","url":null,"abstract":"<p><p>Surgical site infection is a serious complication of posterior lumbar interbody fusion surgery and is influenced by various factors. To construct a predictive nomogram of the risk of surgical site infection among patients after posterior luminal interbody fusion surgery. A total of 496 patients who underwent posterior lumbar interbody fusion surgery between January 2019 and December 2023 were included, and randomly assigned to a training or a validation queue following a 7:3 ratio. A nomogram prediction model was established based on the training queue, and evaluation of its accuracy and discriminative ability was done using calibration curves and receiver operating characteristic analysis. Decision curve analysis was used to estimate the clinical value of the nomograms. Seventeen cases (3.43%) of SSI were observed. The predictive factors included preoperative hypoalbuminemia (P = 0.048), drainage tube retention time (P = 0.002), number of fusion segments(P < 0.001), and postoperative white blood cell count (P = 0.003). The receiver operating characteristic analysis indicated that the model had good predictive performance (training cohort: 0.95; validation cohort: 0.903). The calibration curves showed good consistency between the predicted and actual values, and the decision curve indicated good clinical benefits. Preoperative hypoalbuminemia, drainage tube retention time, number of fusion stages, and postoperative white blood cell count were independent risk factors of surgical site infection in patients undergoing posterior lumbar interbody fusion surgery. The nomogram model had a good predictive performance and can provide an effective evaluation method to improve prediction accuracy.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"488"},"PeriodicalIF":2.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234614","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}