Neurospine最新文献

{"title":"Long-term Outcomes of Multilevel Anterior Cervical Osteotomy and Posterior Instrumentation for OPLL-Induced Myelopathy With Cervical Kyphosis.","authors":"Shin-Jae Kim, Pratyush Shahi, Sang-Ho Lee, Junseok Bae","doi":"10.14245/ns.2550256.128","DOIUrl":"10.14245/ns.2550256.128","url":null,"abstract":"<p><strong>Objective: </strong>To analyze long-term clinical and radiological outcomes after multilevel anterior osteotomy with posterior instrumentation in patients with ossification of posterior longitudinal ligament (OPLL)-induced myelopathy and cervical kyphosis.</p><p><strong>Methods: </strong>Patients who underwent multilevel anterior osteotomy with posterior instrumentation for OPLL-induced myelopathy and cervical kyphosis and had a minimum of 5-year follow-up were included. Clinical outcomes (Japanese Orthopaedic Association score system for cervical myelopathy [C-JOA], 12-item Short Form health survey [SF-12], Neck Disability Index [NDI]) and radiological parameters (C2-7 lordosis, center of gravity of the head [CGH]-C7 sagittal vertical axis [SVA], T1 slope) were analyzed at the preoperative, immediate postoperative, and latest follow-up timepoints.</p><p><strong>Results: </strong>Twenty-eight patients were included. The average follow-up period was 66.4 months. All clinical outcome parameters showed significant improvement. C-JOA, SF-12, and NDI showed significant improvement at latest follow-up (p<0.001). C2-7 lordosis increased significantly immediately postoperatively (-6.0°±10.4°) compared to preoperatively (+9.2°±9.6°), and was largely maintained at latest follow-up (-5.7°±9.4°). T1 slope significantly increased between the immediate postoperative timepoint (21.9°±7.7°) and latest follow-up (24.2°±9.5°) (p=0.046). CGH-C7 SVA significantly increased between the immediate postoperative timepoint (22.7±14.8 mm) and latest follow-up (32.2±22.6 mm) (p=0.046).</p><p><strong>Conclusion: </strong>Multilevel anterior osteotomy with posterior instrumentation is a safe and effective surgical option for OPLL-induced myelopathy with kyphotic cervical alignment. Future studies are required to investigate the forward tilting of cervical spine over time after surgery.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 3","pages":"623-630"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chiari Malformation and Hindbrain Descent: Characterization and New Classification Based on Mechanism and Pathogenesis, and Surgical Management.","authors":"Misao Nishikawa, Paolo A Bolognese, Masaki Yoshimura, Kentarou Naito, Noritsugu Kunihiro, Hiromichi Ikuno, Mitsuhiro Hara, Hiroaki Sakamoto, Kenji Ohata, Takeo Goto","doi":"10.14245/ns.2551050.525","DOIUrl":"10.14245/ns.2551050.525","url":null,"abstract":"<p><p>H. Chiari described 4 types of abnormal development of the posterior fossa, which were subsequently classified as Chiari malformation types I, II, III, and IV. Many issues in neurosurgery concerning classification and surgical management are without evolving concepts. This review aims to clarify the mechanisms and pathogenesis underlying hindbrain (the brain stem and cerebellum) descent, classify them accordingly, and discuss appropriate surgical management. We propose a classification of 4 independent pathogenic mechanisms: (1) constriction in the posterior cranial fossa (PCF) due to underdevelopment of the occipital bone; (2) enlargement of hindbrain; and (3) traction caused by tethering lesions. We examine the pathogenesis of hindbrain descent from embryological perspectives and neuroradiological findings, with a particular focus on lesser-known mechanisms. Additionally, another fourth mechanism is proposed: (4) instability at the craniocervical junction. We suggest a novel classification for Chiari malformation type I based on the underlying pathogenesis, guided by morphometric (occipital bone size) and volumetric (PCF volume) analyses. Furthermore, it delves deeper into their pathogenesis by drawing on insights from developmental biology, genetic studies, and experimental research. Surgical management is tailored to the underlying mechanism, and we proposed the algorithm for decision of surgical intervention. For crowding of the PCF due to underdevelopment of the occipital bone, posterior fossa decompression is the appropriate surgical intervention. For craniocervical instability, occipitocervical fixation is recommended. We also review the recent literature on surgical outcomes associated with each treatment approach. Finally, we highlight current genetic research related to the pathogenesis of hindbrain descent.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 3","pages":"696-712"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Time Water Pressure Monitoring in Unilateral Biportal Endoscopic Spine Surgery.","authors":"Dongwoo Yu, Ikchan Jeon, Sang Woo Kim","doi":"10.14245/ns.2550648.324","DOIUrl":"10.14245/ns.2550648.324","url":null,"abstract":"<p><strong>Objective: </strong>Unilateral biportal endoscopic (UBE) spine surgery is a minimally invasive technique that uses continuous irrigation to improve visualization and control bleeding. Effective water pressure management is crucial for patient safety, particularly at the cervical and thoracic levels where spinal cord injury risk is higher. However, real-time pressure monitoring remains underexplored. This study evaluates the impact of real-time water pressure monitoring on safety during UBE surgery.</p><p><strong>Methods: </strong>A prospective study was conducted involving 20 patients undergoing UBE lumbar spine surgery. Patients were divided into 2 groups based on the irrigation system: gravity-based or infusion pump. Real-time water pressure was monitored using a digital sensor throughout surgery. Each procedure was categorized into 3 phases: phase I, working space preparation; phase II, laminectomy; phase III, flavectomy, dura exposure, and discectomy. Data was analyzed according to the type of irrigation system and surgical phase.</p><p><strong>Results: </strong>The mean water pressure in the surgical field during UBE spine surgery was 17.98± 8.07 mmHg, with no significant differences between surgical phases. However, the infusion pump system maintained significantly lower mean pressure (12.10±3.51 mmHg) compared to the gravity-based system (23.86±6.97 mmHg, p=0.001). The infusion pump system consistently maintained a significantly lower mean water pressure compared to the gravity-based system.</p><p><strong>Conclusion: </strong>Real-time water pressure monitoring during UBE surgery enhances safety by enabling improved control of pressure within the surgical field. Both the gravity-based and infusion pump systems safely maintained working space pressure, with the pump system showing significantly lower pressure levels.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 3","pages":"812-818"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating Proximal Junctional Kyphosis and Failure: The Role of Tethering in a Multifactorial Problem - A Commentary on \"Efficacy of Proximal Junctional Tethering in Spinal Fusion Surgery for Preventing Proximal Junctional Kyphosis and Proximal Junctional Failure: A Meta-analysis\".","authors":"Niall Buckley, Ashel C Dsouza, Lee A Tan","doi":"10.14245/ns.2551388.694","DOIUrl":"10.14245/ns.2551388.694","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 3","pages":"678-679"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging.","authors":"Ji Yeon Kim, Su Yong Choi, Dong Chan Lee, Hyeun Sung Kim, Dong Hwa Heo","doi":"10.14245/ns.2550338.169","DOIUrl":"10.14245/ns.2550338.169","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates surgical strategies based on preoperative computed tomography (CT) findings during unilateral biportal endoscopic (UBE) surgery for thoracic ossification of the ligamentum flavum (OLF) with dural ossification.</p><p><strong>Methods: </strong>This retrospective study included patients undergoing posterior thoracic laminectomy via UBE surgery to treat symptomatic thoracic stenosis due to OLF. Clinical outcomes were assessed using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) scores, alongside analyses of preoperative CT and intraoperative videos for dural ossification characteristics.</p><p><strong>Results: </strong>A total of 34 patients participated, showing significant improvements in VAS and JOA scores postoperatively. All focal dural ossifications exhibiting the tram-track sign were effectively excised without significant dural defects. The circumferential floating technique was employed for cases with the bridge sign, whereas wide excision was warranted for those with the comma sign.</p><p><strong>Conclusion: </strong>UBE surgery effectively manages progressive thoracic OLF associated with dural ossification. Preoperative CT imaging is essential for assessing dural involvement and guiding surgical techniques. Microscopic surgery is recommended for inexperienced surgeons requiring wide dural excision.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 3","pages":"819-828"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical Impact of Cement Augmentation on Pedicle Screw Fixation and Adjacent Segment Disease in Multilevel Lumbar Fusion: A Finite Element Analysis.","authors":"Min-Young Jo, Sung-Jae Lee, Je-Hoon An, Young-Hoon Kim, Jun-Seok Lee, Hyung-Youl Park","doi":"10.14245/ns.2550294.147","DOIUrl":"10.14245/ns.2550294.147","url":null,"abstract":"<p><strong>Objective: </strong>Cement augmentation is widely used to enhance pedicle screw fixation, particularly in osteoporotic patients. However, its effects on adjacent segment disease (ASD) and implant failure in multilevel lumbar interbody fusion remain unclear. This study aimed to assess the effectiveness of cement augmentation in preventing implant failure and its impact on ASD risk using finite element analysis (FEA).</p><p><strong>Methods: </strong>A FEA of L2-S1 multilevel lumbar interbody fusion was performed to evaluate the biomechanical effects of cement augmentation. Three models were analyzed under normal and osteoporotic conditions: type 1 (no augmentation), type 2 (upper instrumented vertebra [UIV] augmentation), and type 3 (UIV and UIV+1 augmentation). Range of motion (ROM), intradiscal pressure (IDP), screw pull-out risk, and implant failure were assessed.</p><p><strong>Results: </strong>Cement augmentation significantly reduced screw pull-out risk, particularly in osteoporotic conditions, where type 1 exhibited a failure rate of 91.5%, while type 2 and type 3 remained below 39%. Cement augmentation did not demonstrate a substantial impact on ASD development, as ROM and IDP changes remained within a minimal range in this FEA model. However, osteoporosis was associated with a substantial increase in IDP, with a result as high as 809%. Despite its benefits, augmentation at UIV+1 increased the risk of pedicle screw breakage and vertebral body fracture, with L1 (UIV+1) lower endplate fracture rate of 82.7% in type 3, compared to 56.6% in type 2 and 52.8% in type 1.</p><p><strong>Conclusion: </strong>Cement augmentation effectively improves screw fixation and does not appear to significantly increase ASD risk based on this FEA study. Limiting cement augmentation to the UIV level in lumbar multilevel fusion may help reduce the risk of implant failure, though further clinical validation is required to confirm these biomechanical findings.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 3","pages":"763-773"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterolateral Sulcus Approach for Intramedullary Hemorrhage Associated With Cavernous Malformation of High Cervical Spine: Operative Technique and Outcomes.","authors":"Yoshiki Fujikawa, Hideki Kashiwagi, Masao Fukumura, Ryokichi Yagi, Ryo Hiramatsu, Masahiro Kameda, Naosuke Nonoguchi, Motomasa Furuse, Shinji Kawabata, Toshihiro Takami, Masahiko Wanibuchi","doi":"10.14245/ns.2550996.498","DOIUrl":"10.14245/ns.2550996.498","url":null,"abstract":"<p><strong>Objective: </strong>Intramedullary hemorrhage (IH) associated with cavernous malformation (CM) of the high cervical spine remains a significant challenge for neurosurgeons. This study aimed to evaluate the efficacy and safety of the posterolateral sulcus (PLS) approach in managing these complex cases.</p><p><strong>Methods: </strong>This single-center retrospective study included 58 cases of spinal intramedullary tumors treated surgically over the past 4 years. The PLS approach on the side of the IH was applied for the removal of CM. Neurological function was assessed using the modified McCormick functional scale (MMCS) before surgery, one week after surgery, and at the most recent follow-up.</p><p><strong>Results: </strong>Six patients with IH associated with CM above the C3 level were identified from the database. The mean age was 31.2 years, and 4 of the 6 patients were female. Symptom duration prior to surgery ranged from 0 to 48 months. Total removal of the CM was achieved in all 6 cases without any serious adverse events including respiratory complications. The average follow-up duration was 21.7 months. The mean MMCS score was 3.0 before surgery, maintained at 2.5 in the early postoperative period, and improved further to 2.2 at the most recent follow-up. One patient of ventral-type CM experienced recurrent hemorrhage at the same level 30 months after the initial surgery. This patient subsequently underwent a second surgery using the anterolateral sulcus approach, which was well tolerated.</p><p><strong>Conclusion: </strong>The PLS approach enables safe removal of CM even in the high cervical spine. However, ventral-type CMs remain a major surgical concern.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 3","pages":"713-724"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Facet Joint Orientation and Degenerative Spondylolisthesis: A Radiological Study of Double-Level Versus Single-Level Degenerative Spondylolisthesis.","authors":"Zhentao Zhang, Qingshuang Zhou, Haicheng Zhou, Bin Wang, Yong Qiu, Zezhang Zhu, Xu Sun","doi":"10.14245/ns.2550654.327","DOIUrl":"10.14245/ns.2550654.327","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the correlation between lumbar degenerative spondylolisthesis (LDS) and facet joint orientation, and to examine the factors influencing facet joint orientation in patients with double-level LDS (dLDS).</p><p><strong>Methods: </strong>A total of 40 patients with L3-5 dLDS (mean age, 64.1 years) and 106 patients with L4-5 single-level LDS (sLDS; mean age, 63.5 years) were included. Besides, 100 age-matched healthy participants were recruited as the control group. Facet joint angles at each level from L2-3 to L5-S1 were measured on axial computed tomogrpahy images. Slippage and spinopelvic sagittal parameters were measured using lateral full-spine x-rays.</p><p><strong>Results: </strong>Both dLDS and sLDS groups had significantly larger facet joint angles from L2-3 to L5-S1 than those in the control group, except for left L5-S1. In patients with spondylolisthesis, the facet joint angles at the L2-3 and L3-4 levels in the dLDS group were significantly greater than those in the sLDS group, while the angles at the L4-5 and L5-S1 levels showed no significant differences. In contrast to the sLDS group, the dLDS group had significantly greater pelvic tilt, sagittal vertical axis, L3 slope, and L4 slope, as well as smaller sacral slope, lumbar lordosis, L3-4 disc height, L4-5 disc height, L4-5 slippage angle, and L3-S1 height. Age and dLDS were identified as independent factors influencing the changes in the L3-4 facet joint angles between the 2 LDS groups.</p><p><strong>Conclusion: </strong>Spondylolisthesis and aging are associated with facet joint sagittalization. The present study provides evidence that the combined effects of preexisting degeneration and spondylolisthesis alter the morphology of the facet joints.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 3","pages":"803-811"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Strategy for Cervical OPLL with Kyphosis: Balancing Anterior, Posterior, and Combined Approaches - A Commentary on \"Long-term Outcomes of Multilevel Anterior Cervical Osteotomy and Posterior Instrumentation for OPLL-Induced Myelopathy With Cervical Kyphosis\".","authors":"Jae Taek Hong","doi":"10.14245/ns.2551334.667","DOIUrl":"10.14245/ns.2551334.667","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 3","pages":"631-633"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Clinical Insight Into Idiopathic Syringomyelia With Occult Arachnoid Webs: Neuropathological Features, Differential Diagnosis, and Surgical Strategy.","authors":"Chunli Lu, Min Yin, Fan Yuan, Chenyuan Ding, Xingwen Wang, Fengzeng Jian","doi":"10.14245/ns.2550278.139","DOIUrl":"10.14245/ns.2550278.139","url":null,"abstract":"<p><strong>Objective: </strong>Idiopathic syringomyelia (IS) associated with occult arachnoid pathology is a relatively rare condition characterized by a subtle onset, atypical clinical manifestations, and significant diagnostic and therapeutic challenges. This study aims to evaluate the radiographic and clinicopathological features of IS to improve surgical management and patient outcomes.</p><p><strong>Methods: </strong>In this study, clinical and radiologic data were retrospectively extracted from a single-center syringomyelia database (N=1,039) spanning December 2020 to March 2025. Among these, 15 patients diagnosed with IS underwent preoperative magnetic resonance imaging and myelography to identify the responsible spinal segments precisely. Comprehensive perioperative assessments and clinical outcomes were collected. During surgery, the subarachnoid space (SAS) was thoroughly explored, with complete removal of thickened and adherent arachnoid tissue to restore normal cerebrospinal fluid (CSF) circulation. Additionally, clinical data, pathological features, and surgical outcomes of IS were compared to those of posttraumatic delayed syringomyelia (PTDS) to evaluate potential differences.</p><p><strong>Results: </strong>In this series, all patients underwent preoperative myelography, revealing varying degrees of SAS obstruction. For IS cases that received precise and comprehensive arachnoid lysis, overall postoperative outcomes were favorable. Intraoperative pathology confirmed that all IS cases were characterized by noninfectious, nonacute inflammation. The preoperative maximal syrinx/cord ratio averaged 0.70±0.07 (range, 0.54-0.88), while the syrinx resolution rate varied from 12.2% to 100%, with a mean improvement of 29.6%. Patients with PTDS exhibited a relatively higher incidence of hypesthesia and a greater syrinx tension index. However, no significant differences were observed between IS and PTDS in terms of syrinx length, deviation, or location. Notably, the IS group demonstrated significantly better postoperative syrinx resolution and improvement in syringomyelia-related symptoms compared to the PTDS group.</p><p><strong>Conclusion: </strong>While both IS and PTDS share a common underlying mechanism of arachnoid adhesions, they differ significantly in pathological features, treatment approaches, and clinical outcomes. In cases of IS, thorough spinal arachnoid lysis at the affected segment could restore normal spinal cord pulsation and CSF circulation, leading to effective syrinx resolution and a favorable long-term prognosis.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 3","pages":"846-858"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}