Neurosurgical Review最新文献

{"title":"Correction to: Magnesium sulfate in combination with nimodipine in non-traumatic subarachnoid hemorrhage: a retrospective analysis of short- and longterm mortality.","authors":"Hui Shen, Yibo Yang, Qing Mei, Zhenkun Xiao, Bing Wang, Aihua Liu","doi":"10.1007/s10143-025-03778-6","DOIUrl":"https://doi.org/10.1007/s10143-025-03778-6","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"624"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962862","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":"Delayed cerebral infarction in poor grade subarachnoid hemorrhage. Features, predictors, and clinical impact.","authors":"Andrea M Alexandre, Anselmo Caricato, Alessandro Pedicelli, Enrico Marchese, Luca Scarcia, Alberto Feletti, Mattia Testa, Paolo Zanatta, Nicola Gitti, Simone Piva, Dikran Mardighian, Vittorio Semeraro, Giordano Nardin, Emilio Lozupone, Giafranco Paiano, Edoardo Picetti, Vito Montanaro, Massimo Petranca, Carlo Bortolotti, Antonino Scibilia, Luigi Cirillo, Raffaele Aspide, Andrea Luigi Lanterna, Rosanna Vaschetto, Francesca Grossi, Fabio Picciafuochi, Francesco Magiotti, Alessandro Ambrosi, Pietro Mortini, Maria Luisa Azzolini, Roberta Cao, Luca Ruffino, Francesco Scomazzoni, Andrea Falini, Pietro Panni","doi":"10.1007/s10143-025-03762-0","DOIUrl":"10.1007/s10143-025-03762-0","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate predictors and clinical impact of delayed cerebral infarction (CI) in a national multicentric poor grade aneurysmal subarachnoid hemorrhage (aSAH) population.</p><p><strong>Methods: </strong>Retrospective analysis of prospectively collected data from the multi-centric POGASH (Poor Grade aSAH) registry of consecutive patients treated from January 1st, 2015, to June 30th, 2023. Poor grade was defined according to the worst-pretreatment WFNS scale. CI was defined as a new ischemic lesion/s within 6 weeks of aSAH onset, not present on CT acquired within 48hrs and not related to treatment or hematoma. Clinical outcome was assessed by the modified Rankin Scale.</p><p><strong>Results: </strong>Among 532 consecutive WFNS grades IV-V aSAH patients, CI occurred in 106 (19.9%). CI (adjusted OR 0.59 0.35-0.98; p 0.045) independently predicted increased disability. Volume of SAH (aOR 1.02, 95% C.I. 1.00-1.04; p 0.015), anterior communicating aneurysm, ACoA, (aOR 6.2, 95% C.I. 1.4-27.3; p 0.015) and need of angiographic treatment (aOR 2.2, 95% C.I. 1.3-3.8; p 0.002) resulted independently predictive of CI occurrence. CI volume emerged as the strongest predictor of increased disability (aOR 1.03 95% C.I. 1.01-1.05; p < .001) and mortality (aOR 1.009 95% CI 1.002-1.02; P 0.018) in the CI affected population.</p><p><strong>Conclusions: </strong>ACoA, SAH volume and need for DSA treatment predicted CI, whose detrimental role on outcome is mainly driven by its volumetric extension. CI volume resulted independently predictive of mortality and increased disability in early brain injury survivors.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"620"},"PeriodicalIF":2.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962889","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 causal association between 91 inflammatory Circulating proteins and intracerebral hemorrhage: A bidirectional two-sample Mendelian randomization study.","authors":"Chaoyi Liu, Dan Lei, Qiang Min","doi":"10.1007/s10143-025-03764-y","DOIUrl":"https://doi.org/10.1007/s10143-025-03764-y","url":null,"abstract":"<p><strong>Background: </strong>Intracerebral hemorrhage (ICH), a subtype of stroke, is associated with high incidence and disability rates. The link between inflammatory circulating proteins and ICH is still not definitively established. Our research sets out to delve into this mystery by examining the potential causal connection between 91 such proteins and ICH, employing a sophisticated two-sample Mendelian randomization approach to get to the bottom of it.</p><p><strong>Methods: </strong>We obtained 91 SNPs associated with inflammatory circulating proteins from a genome-wide association study (GWAS). Two-sample and multivariable Mendelian randomization analyses were conducted, with inverse variance weighted (IVW) serving as the primary method to assess the relationship between exposure and outcome. To enhance the reliability of the findings, additional methods such as MR-Egger, weighted median, simple mode, and weighted mode were employed. Cochran's Q test was used to assess the heterogeneity of the SNPs, while MR-Egger regression and MR-PRESSO were applied to evaluate the directional pleiotropy of the instrumental variables.</p><p><strong>Results: </strong>Univariate Mendelian randomization analysis identified a significant causal relationship between four inflammatory circulating proteins, Axin1 (odds ratio (OR): 0.77, 95% confidence intervals (CI): 0.61-0.96, P-value = 0.0239), CXCL1 (OR: 0.81, 95% CI: 0.68-0.96, P-value = 0.0190), CXCL9 (OR: 0.85, 95% CI: 0.74-0.98, P-value = 0.0256), and MCP4 (OR: 0.79, 95% CI: 0.69-0.90, P = 0.0007), and the risk of ICH. After adjusting for confounding factors such as body weight and alcohol consumption, multivariable Mendelian randomization analysis still demonstrated a significant causal relationship between these four proteins and ICH. Furthermore, after excluding hypertension as a confounder, MCP4 expression remained significantly associated with ICH. When adjusting for type 2 diabetes, both CXCL9 and MCP4 exhibited a significant causal relationship with ICH. Reverse Mendelian randomization analysis revealed a negative correlation between ICH (as the exposure) and the expression of seven inflammatory circulating proteins.</p><p><strong>Conclusion: </strong>In summary, our two-sample Mendelian randomization analysis, which operates in both directions, has revealed a likely causal link between four inflammatory proteins present in circulation and the risk of ICH. Keeping track of the expression levels of these inflammatory proteins may prove beneficial for both the prevention and management of ICH.</p><p><strong>Highlight: </strong>There is a significant bidirectional causal relationship between inflammatory circulating proteins and the risk of intracerebral hemorrhage (ICH) onset. The expression levels of Axin1, CXCL1, CXCL9, and MCP4 are negatively correlated with the risk of ICH onset, suggesting that they may serve as potential important molecular targets for ICH.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"619"},"PeriodicalIF":2.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962899","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":"Optimizing dural opening and closure in endonasal transsphenoidal surgery: Technical considerations for incision design and clinical utility.","authors":"Kosaku Amano, Yuichi Oda, Takakazu Kawamata","doi":"10.1007/s10143-025-03767-9","DOIUrl":"https://doi.org/10.1007/s10143-025-03767-9","url":null,"abstract":"<p><p>Dural opening and closure represent a crucial yet under-discussed aspect of transsphenoidal surgery (TSS), where the operative field is narrow and cerebrospinal fluid (CSF) leakage remains a significant complication. In 2010, we abandoned the conventional cruciate dural incision and began developing optimized designs that provide wide exposure, minimal interference, and facilitate watertight closure. After investigating various incision types, we empirically established a modified H-shaped dural incision in 2011. This design minimizes the interdural gap, enabling effective dural flap tenting and suturing, and has since become our standard dural incision in TSS. Planar geometrical analysis further supported this design as optimal, demonstrating that it requires the shortest total incision length among the evaluated techniques. Additionally, a combined Y and upside-down T-shaped incision proved effective for extended TSS, while sideways Y-shaped and straight incisions were advantageous in cases where a large dural window was unnecessary. Between 2011 and 2022, we applied tailored dural incisions in 628 endonasal TSS, with selection based on tumor type, location, and extent. The modified H-shaped incision was the most commonly used (61.0%), particularly in midline non-functioning pituitary neuroendocrine tumors. Compared with the cruciate incision, it reduced the total incision length and did not increase the postoperative CSF leakage rate (1.91%, vs. 0.48%, p = 0.019). Our findings suggest that strategic selection of dural incision designs, combined with primary dural suturing, improves intraoperative handling and reduces postoperative complications. These results highlight the need to re-evaluate traditional dural opening techniques in the era of high-definition endoscopic and extended TSS.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"616"},"PeriodicalIF":2.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962921","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":"Adenoid cystic carcinoma brain metastases treated with stereotactic radiosurgery: A single institution retrospective cohort study and comprehensive literature review.","authors":"Ahed H Kattaa, Yusuke S Hori, Paul M Harary, Amirhossein Akhavan-Sigari, Aroosa Zamarud, Amit R Persad, Armine Tayag, Louisa Ustrzynski, Sara C Emrich, David J Park, Steven D Chang","doi":"10.1007/s10143-025-03761-1","DOIUrl":"https://doi.org/10.1007/s10143-025-03761-1","url":null,"abstract":"<p><p>Adenoid cystic carcinoma (ACC) is a malignant neoplasm arising from the minor and major salivary glands that tend to spread by perivascular and perineural routes. Brain metastases (BM) secondary to ACC are extremely rare, and the standard management strategy has not been well reported due to the rarity. Notably, no previous study has specifically examined the efficacy of stereotactic radiosurgery (SRS) for BM from ACC. We retrospectively reviewed cases of BM from ACC treated with CyberKnife (CK) SRS at our institution between 1998 and 2024. A total of 40 lesions from 5 patients were included. Tumor control was defined based on radiological response to CK SRS as a complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) per response evaluation criteria in solid tumors (RECIST) guidelines. The median Follow-up duration was 11 months (Range: 3-51 months). The median age at treatment was 52 years with a male-to-female ration of 3:2. The median maximum diameter of the lesions was 7.mm. The median prescription dose delivered was 24 Gy. The treatment responses at the first follow-up were CR/PR/SD/PD: 9/19/12/0. At the last follow-up, 5 lesions had local progression, with one lesion at 39 months, and 4 lesions at 11 months after CK SRS, while 16 lesions remained CR. The cumulative 3-months, 6-months, and 12-months local control rates were 100%, 100%, and 89%, respectively. To date, this is the largest study examining the efficacy of SRS for ACC BM. Our results showed sufficient local control following the treatment.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"618"},"PeriodicalIF":2.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962541","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 retrosigmoid keyhole approach to the cerebellopontine angle: a modified surgical technique and the evaluation of cerebrospinal fluid fistulas.","authors":"Daniel Staribacher, Dzmitry Kuzmin, Iván N Camal Ruggieri, Gavin Britz, Guenther C Feigl","doi":"10.1007/s10143-025-03756-y","DOIUrl":"https://doi.org/10.1007/s10143-025-03756-y","url":null,"abstract":"<p><p>Cerebrospinal fluid (CSF) leakage is a common postoperative complication after suboccipital craniotomies and can develop into a potentially life-threatening situation. Advances in dural replacement materials have revolutionized the treatment of CSF leaks and provide innovative alternatives to traditional repair methods. Synthetic and biological dural replacement materials, as well as fibrin sealants and tissue engineering approaches, offer improved durabilit, biocompatibility, and regenerative properties. However, to avoid complications associated with biomaterials and to minimize the use of dural substitutes whenever possible, careful surgical technique is essential for dural closure. Therefore, the aim of this study was to analyze the utility of a modified surgical technique for the retrosigmoid keyhole approach in reducing postoperative CSF leaks. A total of 168 consecutive patients were included in this retrospective study. All of them underwent surgery between 2015 and 2024 at our clinic for lesions in the cerebellopontine angle. A retrosigmoid keyhole approach was used in all cases. Two patients (1.2%) of the 168 developed a postoperative CSF leak: 1 (0.6%) incisional and 1 (0.6%) non-incisional. None of them developed CSF leak-related meningitis. The small retrosigmoid approach combined with the sandwich dural closure technique proved effective in reducing postoperative CSF leakage. While biomaterials contribute to improved dural sealing, careful surgical handling of posterior fossa structures remains essential for optimal outcomes. CLINICAL TRIAL NUMBER: Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"617"},"PeriodicalIF":2.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962935","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":"Dynamic sodium dysregulation predicts mortality in intracerebral hemorrhage: A retrospective cohort study of temporal variability and absolute thresholds.","authors":"Shuwen Sun, Xiaobin Fei, Kai Gong, Xin Huang","doi":"10.1007/s10143-025-03781-x","DOIUrl":"https://doi.org/10.1007/s10143-025-03781-x","url":null,"abstract":"<p><p>Dysnatremia and sodium variability are emerging prognostic markers in neurocritical care, yet their role in intracerebral hemorrhage (ICH) remains underexplored. This study investigates the independent and synergistic effects of serum sodium variability (coefficient of variation, CV) and absolute sodium levels on mortality in ICH patients. We conducted a retrospective cohort study using data from the Medical Information Mart for Intensive Care (MIMIC-IV) database. Sodium variability was quantified as CV, while mean sodium levels were categorized into normonatremia (135-145 mmol/L), hyponatremia (< 135 mmol/L), and hypernatremia (> 145 mmol/L). Outcomes included 30-day, in-hospital, and ICU mortality. Multivariable Cox models adjusted for demographics, disease severity, and interventions. A total of 2044 ICH patients were included in the study. Increased sodium variability exhibited a robust linear association with mortality, with each 1% rise in CV independently predicting a 38% higher 30-day mortality risk (adjusted HR 1.38, 95% CI 1.31-1.46; P < 0.001). Patients in the highest CV quartile (Q4) faced a 2.48-fold mortality risk compared to the lowest quartile (Q1). Hypernatremia (> 145 mmol/L) emerged as a potent independent predictor of mortality (HR 2.93, 95% CI 2.43-3.52; P < 0.001), whereas hyponatremia showed non-significant trends (HR 1.17, 0.85-1.61). Restricted cubic spline analyses revealed a U-shaped relationship between mean sodium levels and mortality, with 140.7 mmol/L as the optimal threshold, while sodium variability demonstrated a linear dose-response effect. Both sodium variability and hypernatremia independently predict mortality in ICH, with CV demonstrating a linear dose-response relationship and absolute levels showing a U-shaped risk curve. These findings advocate for dual monitoring of sodium homeostasis to guide precision fluid management in ICH.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"615"},"PeriodicalIF":2.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962882","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 microvascular decompression in the treatment of trigeminal neuralgia: a retrospective Single-Center study of 28 cases.","authors":"Anastasija Krzemińska, Marta Koźba-Gosztyła, Joanna Bladowska, Bogdan Czapiga","doi":"10.1007/s10143-025-03772-y","DOIUrl":"https://doi.org/10.1007/s10143-025-03772-y","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness, safety, and patient satisfaction associated with microvascular decompression (MVD) in the treatment of trigeminal neuralgia (TN), and to identify clinical and surgical factors associated with postoperative outcomes and TN recurrence.</p><p><strong>Methods: </strong>This retrospective single-center study included 28 patients with TN who underwent MVD between 2018 and 2025. Data on demographics, TN subtype, preoperative imaging, prior treatments, surgical findings, use of Teflon suture, and complications were analyzed. Outcomes were assessed using the Barrow Neurological Institute (BNI) Pain Intensity Scale at early postoperative and follow-up stages. Kaplan-Meier survival analysis was used to assess pain-free intervals. Patient satisfaction was evaluated based on willingness to undergo the surgery again.</p><p><strong>Results: </strong>Classical TN was diagnosed in 75% of patients. Preoperative MRI correctly predicted the presence of a conflict in 20 of 26 patients who actually had one (76.9%). Immediate postoperative pain relief (BNI I-II) was achieved in 85.7% of patients, and recurrence occurred in 16.7% of initially pain-free individuals. The average pain-free period was 28.5 ± 29.4 months. The use of a Teflon suture did not significantly affect recurrence or outcome. Major complications occurred in 10.7% of cases and included CSF leak from the surgical wound, neuroinfection and hematoma. Patient satisfaction was high, with 82% stating they would choose to undergo MVD again. Better outcomes were significantly associated with classical TN subtype. No significant associations were found with age, sex, prior gamma knife therapy, or Teflon fixation technique.</p><p><strong>Conclusions: </strong>in our cohort MVD was a highly effective and well-tolerated treatment for TN, particularly in classical cases, offering high rates of long-term pain relief and patient satisfaction. Complications were rare in our cohort. Outcomes were not influenced by Teflon suture use or demographic factors, supporting the role of MVD as a first-line surgical option in appropriate candidates.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"614"},"PeriodicalIF":2.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962877","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 middle meningeal artery embolization alone, in combination with surgery, and surgery alone for chronic subdural hematoma: a network meta-analysis of 143,590 patients.","authors":"Alireza Soltani Khaboushan, Pavel S Pichardo-Rojas, Amirhossein Zare, Amirhossein Kamroo, Aysan Moeinafshar, Camila Teran Hooper, Yoshua Esquenazi, Adnan H Siddiqui, Leonardo Rangel-Castilla","doi":"10.1007/s10143-025-03751-3","DOIUrl":"10.1007/s10143-025-03751-3","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"612"},"PeriodicalIF":2.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883315","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 stereotactic radiosurgery and rhizotomy for trigeminal neuralgia: A systematic review and Meta-Analysis.","authors":"Alireza Soltani Khaboushan, Seyed Farzad Maroufi, Negin Jarrah, Maral Moafi, Mohammadmahdi Sabahi, Hamid Borghei-Razavi, Jason P Sheehan","doi":"10.1007/s10143-025-03763-z","DOIUrl":"https://doi.org/10.1007/s10143-025-03763-z","url":null,"abstract":"<p><strong>Objective: </strong>Trigeminal neuralgia (TN) is a chronic, debilitating neuropathy characterized by sudden, severe facial pain, often refractory to medical therapy. When medications fail, surgical options such as microvascular decompression (MVD) are preferred, but for patients unsuitable for open surgery, stereotactic radiosurgery (SRS) and percutaneous rhizotomy are viable alternatives. This systematic review and meta-analysis aimed to compare the efficacy and safety of SRS and rhizotomy in the management of TN.</p><p><strong>Methods: </strong>Following PRISMA guidelines, PubMed, Embase, Scopus, and Web of Science were searched up to September 2024 for studies comparing SRS and rhizotomy in TN patients. Eligible studies reported pain relief, recurrence, retreatment rates, or complications. Data were extracted and analyzed using a random-effects model, with subgroup analyses for multiple sclerosis (MS) status.</p><p><strong>Results: </strong>Fifteen studies involving 1,251 patients (577 SRS, 674 rhizotomy) were included. Rhizotomy provided superior initial pain-free outcomes (RR = 0.66, 95%CI = 0.49 ;0.91, p < 0.01), while SRS showed no significant difference in pain-free rates at the last follow-up (RR = 0.99, 95%CI = 0.80 ;1.22, p = 0.89) or overall pain relief (RR = 1.14, 95%CI = 0.90 ;1.44, p = 0.29). SRS significantly reduced recurrence (RR = 0.70, 95%CI = 0.51 ;0.96, p < 0.05), retreatment need (RR = 0.67, 95%CI = 0.46 ;0.96, p < 0.05), and facial numbness (RR = 0.61, 95%CI = 0.37 ;0.99, p < 0.05). Overall complications were comparable (RR = 0.70, 95%CI = 0.34 ;1.43, p = 0.33), though SRS trended toward fewer complications in MS patients.</p><p><strong>Conclusion: </strong>Rhizotomy provides immediate pain relief, making it suitable for patients requiring rapid results, while SRS offers greater durability and lower morbidity. Treatment choices should be tailored to patient-specific factors, including the urgency of relief and MS status. Future prospective studies with standardized outcomes and extended follow-up are needed to address the limitations of retrospective data and study heterogeneity.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"613"},"PeriodicalIF":2.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962913","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}