Neurosurgery最新文献

{"title":"The Fast and the Fragile: Neurosurgical Trauma in the Age of Micromobility.","authors":"Hannah Weiss, Roee Ber, Mason Blacker, Nora Kim, Cordelia Orillac, Clotilde Balucani, Paul P Huang","doi":"10.1227/neu.0000000000003995","DOIUrl":"10.1227/neu.0000000000003995","url":null,"abstract":"<p><strong>Background and objectives: </strong>The rapid rise of electric and mechanical bikes and scooters has transformed urban transportation, but their neurosurgical consequences remain underexplored. This study aimed to evaluate micromobility-related injuries over time, examining mechanisms of injury, patient risk factors, injury patterns, and associated clinical outcomes at a Level-1 trauma center over a 5-year period.</p><p><strong>Methods: </strong>We performed a retrospective review of patients who sustained micromobility-related injuries and presented to the Bellevue Hospital Center between 2018 and 2023. The cohort included riders of electric or mechanical bikes and scooters, as well as pedestrians struck by these devices. Key clinical variables and outcomes were compared across device types, both before and after propensity score matching. Unlike national database studies, this hospital-based analysis provides detailed clinical and neurosurgical outcome data.</p><p><strong>Results: </strong>A total of 914 patients presented with micromobility-related injuries, accounting for 6.9% of all trauma admissions. Annual case volume and electric device involvement increased over time. The most common mechanism was collision with a motor vehicle (49.9%). Most patients (68.7%) required admission; 30.2% required intensive care. The median length of hospital stay was 3 days [IQR 1-5]. Half underwent a surgical intervention or procedure, and the overall mortality was 1.2%. Helmet use was low (31.7%). Pedestrians experienced the most severe outcomes, particularly when struck by electric devices. Injuries clustered during evening hours, suggesting modifiable environmental and behavioral risk factors.</p><p><strong>Conclusion: </strong>Micromobility-related trauma imposes a substantial neurosurgical burden, with frequent traumatic brain injury, intensive care unit utilization, and operative intervention. Unlike previous database studies, this hospital-based analysis provides detailed neurosurgical outcome data and identifies prevention targets-including helmet use, intoxication, and urban infrastructure-to reduce morbidity and resource utilization.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":"98 5","pages":"974-983"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691181","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":"Letter: Using Artificial Intelligence to Identify Three Presenting Phenotypes of Chiari Type 1 Malformation and Syringomyelia.","authors":"Vivek P Gupta, Ziqi Xu, Jacob K Greenberg, Jennifer M Strahle, Gabe Haller, Thanda Meehan, Ashley Roberts, David D Limbrick, Chenyang Lu","doi":"10.1227/neu.0000000000003985","DOIUrl":"10.1227/neu.0000000000003985","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":"98 5","pages":"e62-e64"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Clinical Benefits of Age-Adjusted Sagittal Correction in Adult Spinal Deformity Surgery: Results From Patient Grouping Using a Hierarchical Cluster Analysis.","authors":"Se-Jun Park, Hyun-Jun Kim, Jin-Sung Park, Dong-Ho Kang, Minwook Kang, Kyunghun Jung, Chong-Suh Lee","doi":"10.1227/neu.0000000000003726","DOIUrl":"10.1227/neu.0000000000003726","url":null,"abstract":"<p><strong>Background and objectives: </strong>Age-adjusted sagittal alignment correction has emerged as a critical consideration for adult spinal deformity (ASD) surgery. This study aimed to explore the long-term clinical benefits of age-adjusted sagittal alignment by integrating multiple sagittal parameters (pelvic incidence minus lumbar lordosis, pelvic tilt, T1 pelvic angle, and sagittal vertical axis) using hierarchical cluster analysis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 386 patients with ASD who underwent surgical correction with at least 5-level fusion, including sacrum/pelvis, with a minimum follow-up of 2 years. Hierarchical cluster analysis was used to stratify patients based on postoperative offsets between age-adjusted alignment targets and actual pelvic incidence minus lumbar lordosis, pelvic tilt, T1 pelvic angle, and sagittal vertical axis values. Radiographic outcomes, proximal junctional kyphosis/failure, and clinical outcomes (Oswestry Disability Index, Scoliosis Research Society-22 revised) were compared across clusters.</p><p><strong>Results: </strong>Hierarchical cluster analysis grouped patients into 3 clusters: 72 in cluster A, 211 in cluster B, and 103 in cluster C. The mean offset values were significantly greater in cluster C, followed by clusters B and A, for all sagittal parameters with an overcorrected tendency in cluster C and an undercorrected tendency for cluster A. The mean follow-up duration was 36.6 months. Proximal junctional kyphosis/failure rates were significantly higher in cluster C (37.9%) compared with cluster B (27.5%) and cluster A (20.9%) ( P = .046). At final follow-up, clinical outcomes were significantly better in cluster B than in clusters A and C regarding Oswestry Disability Index ( P = .034) and Scoliosis Research Society-22 revised scores ( P < .001).</p><p><strong>Conclusion: </strong>Hierarchical cluster analysis effectively stratified ASD patients based on postoperative sagittal parameter offsets and identified a balanced alignment (cluster B) that optimizes clinical outcomes and minimizes mechanical complications. These results suggest a practical and nuanced approach to sagittal alignment correction in ASD surgery, emphasizing the integration of multiple parameters for improved outcomes.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"1040-1050"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality-of-Life Outcomes in Adults and Children With Chiari 1 Malformation and in Those Managed Without Surgery: A Prospective, Multicenter, Observational Study.","authors":"Rory J Piper, Fardad T Afshari, Wai C Soon, Edward W Dyson, Justyna Ekert, Michael D Cearns, Menaka Fry, Saeed Kayhanian, Matthew Boissaud-Cooke, Linda D'Antona, Daniel Thompson, Milo Hollingworth, Julie Woodfield, Hazel Sanghvi, Shivani Rajkumar, Susan I Honeyman, Aswin Chari, M Zubair Tahir, Shailendra Magdum, Graham Flint, Nicholas Haden, Angelos Kolias, Laurence Watkins, Rodney Laing, William B Lo, Jayaratnam Jayamohan","doi":"10.1227/neu.0000000000003718","DOIUrl":"10.1227/neu.0000000000003718","url":null,"abstract":"<p><strong>Background and objectives: </strong>Chiari 1 malformation (CM1) is a common MRI finding and a frequent reason for neurosurgical consultation. Although many studies have investigated surgical outcomes for patients with CM1, outcomes for those treated without surgery have been less frequently reported. The UK Chiari 1 Study reports the quality of life of adults and children with CM1 treated without surgery, 12 months after the first neurosurgical clinic visit.</p><p><strong>Methods: </strong>The UK Chiari 1 Study was a prospective, multicenter cohort study of adults (≥16 years) and children (<16 years) with CM1. This was an observational study that did not alter the course of clinical care. Symptoms and quality-of-life data (using Short-Form 36 in adults and the Pediatric Quality of Life Inventory™ in children) were collected at baseline and 12 months after the first clinical review for all participants.</p><p><strong>Results: </strong>One hundred ninety-two patients with CM1 (146 females; 148 adults) were studied at baseline, and 113 patients with CM1 treated without surgery were studied at a 12-month follow-up. Baseline quality-of-life scores in the study cohort were significantly lower in every domain compared with normative control data, in both adults and children. There were no decreases in quality-of-life subscores after 12 months in this cohort of adults and children with CM1 treated without surgery. Social functioning ( t = -40, P < .001) and bodily pain (t = -2.9; P = .03) Short-Form 36 scores showed improvements at 12 months in adult patients treated without surgery.</p><p><strong>Conclusion: </strong>This study demonstrates the stability of quality-of-life domains in adults and children with CM1 after 12 months who have been managed without surgery. Further studies are required to understand the determinants of poor quality of life in patients with CM1 and to investigate interventions for improving quality of life. There is a further need for robust comparison of surgical and nonsurgical management for patients with CM1.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"1113-1128"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023865","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":"Endovascular Treatment of Brain Arteriovenous Malformations After New Liquid Embolic Agents: A Single-Center 7-Year Experience With Safety Outcomes.","authors":"Natália Vasconcellos de Oliveira Souza, Jonathan Cortese, Sébastien Soize, Vanessa Chalumeau, Cristian Mihalea, Fernanda Rodriguez-Erazú, Jildaz Caroff, Mathieu Vieira, Léon Ikka, Laurent Spelle","doi":"10.1227/neu.0000000000003691","DOIUrl":"10.1227/neu.0000000000003691","url":null,"abstract":"<p><strong>Background and objectives: </strong>Embolization is part of multidisciplinary brain arteriovenous malformations (AVMs) treatment, yet safety data for novel liquid embolization agents (LEAs) such as Squid and PHIL remain limited. This study reports complications and outcomes from curative embolization using Onyx, Squid, PHIL, and Glue.</p><p><strong>Methods: </strong>Adult patients with brain AVMs treated with LEAs from July 2015 to December 2022 were reviewed for intraprocedural technical issues, postoperative hemorrhagic, and ischemic complications. Minor (modified Rankin Scale ≤2) and major complication rate (morbidity/modified Rankin Scale >2), mortality, and 6-month angiographic cure rate were evaluated.</p><p><strong>Results: </strong>In total, 135 patients (62.2% male, mean age 41.7 ± 15.1 years) with 206 embolizations (34% Onyx, 18.9% Squid, 17.5% PHIL, 28.2% Glue) were included. Overall, 87.4% procedures were in ruptured AVMs and 84% treated by the transarterial technique (84%). The 6-month angiographic cure rate was 53.3%, higher when nonadhesive LEAs were used than Glue (65.3% vs 17.6%, P < .001). In adjusted analysis, only eloquent location (odds ratio [OR] = 4.4; P = .007) and Glue (OR = 9.1; 95% CI 2.9-28.9, P < .001) were predictors of lower angiographic occlusion rate, whereas size had an inverse correlation (OR = 0.67; P = .019). Technical procedural complications, hemorrhagic, and ischemic rates were 10.2% (2.2% morbidity), 13.1% (3.7% morbidity and 2.2% mortality), and 9.2% (2.2% morbidity, 0% mortality), respectively, regardless of the preferred LEA. Minor, major complications, and mortality rates were 3.7%, 4.4%, and 2.2%, respectively. Hemorrhage was the major contributor to morbidity and mortality, whereas deep venous drainage was an independent predictor of hemorrhage and mortality.</p><p><strong>Conclusion: </strong>PHIL and Squid demonstrated complication and angiographic cure rates comparable with Onyx. However, curative embolization of brain AVMs resulted in only moderate angiographic occlusion. Larger multicenter studies with standardized operator protocols, cost-effectiveness assessments, and extended follow-up are warranted to validate these findings.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"1063-1075"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Neurological Surgery Manpower Training and Density in Islamic Republic of Iran: A Population Study.","authors":"Zahra Ramezani, Vafa Rahimi-Movaghar","doi":"10.1227/neu.0000000000003402","DOIUrl":"10.1227/neu.0000000000003402","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"e56-e57"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential of Magnetic Targeted Natural Killer Cell Therapy for Glioblastoma: An in Vivo Study of Natural Killer Cells Loaded With Low-Temperature Synthesized Folic Acid-Modified Superparamagnetic Iron Oxide Nanoparticles.","authors":"Pao-Chun Lin, Ya-Jyun Liang, Wei-Ting Kuo, Feng-Huei Lin, Fon-Yih Tsuang","doi":"10.1227/neu.0000000000003731","DOIUrl":"10.1227/neu.0000000000003731","url":null,"abstract":"<p><strong>Background and objectives: </strong>Glioblastoma (GBM) is a highly malignant brain tumor with limited treatment options. While natural killer (NK) cell-based immunotherapy shows promise in cancer treatment, effective tumor targeting remains a challenge. This study investigates the use of folic acid-modified superparamagnetic iron oxide nanoparticles (SPIONs-PEG-FA) to magnetize NK cells, enabling them to accumulate at the tumor site under an external magnetic field while retaining their cytotoxic activity against GBM cells.</p><p><strong>Methods: </strong>SPIONs-PEG-FA were synthesized using PEGylation and coprecipitation to ensure efficient NK cell uptake. Their successful synthesis was confirmed through material characterization, including X-ray diffraction, Fourier transform infrared spectroscopy, transmission electron microscopy, and dynamic light scattering. In vitro studies evaluated their safety, cellular uptake, and cytolytic activity, whereas in vivo experiments assessed tumor targeting and therapeutic efficacy in GBM-bearing mice.</p><p><strong>Results: </strong>SPIONs-PEG-FA-loaded NK cells were successfully developed for targeted GBM therapy. In vitro studies confirmed their safety and effectiveness against GBM tumor cells, whereas transmission electron microscopy analysis verified the cellular uptake of SPIONs-PEG-FA by NK cells. In vivo experiments in GBM-bearing mice demonstrated improved tumor targeting, enhanced cytolytic efficiency, and overall safety of SPIONs-PEG-FA-loaded NK cells.</p><p><strong>Conclusion: </strong>SPIONs-PEG-FA-loaded NK cells represent a promising approach for targeted GBM therapy. Their successful synthesis and characterization, coupled with in vitro and in vivo validation, highlight their potential for improved therapeutic outcomes. This magnetic field-guided NK cell therapy offers a promising strategy for overcoming challenges in GBM treatment.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"1195-1203"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Retreatment of Previously Clipped Intracranial Aneurysms: An Individual Patient Data Meta-analysis.","authors":"Keng Siang Lee, Julian Han, Sherif R W Kirollos, Ramez Kirollos, Michael T Lawton, Adam S Arthur, Pascal Jabbour","doi":"10.1227/neu.0000000000003693","DOIUrl":"10.1227/neu.0000000000003693","url":null,"abstract":"<p><strong>Background and objectives: </strong>To evaluate the effectiveness and safety of endovascular retreatment of previously clipped intracranial aneurysms (IAs).</p><p><strong>Methods: </strong>Systematic searches of Medline, Embase and Cochrane Central were performed. The primary outcome was good functional outcome (modified Rankin Scale 0-2) at the last follow-up. Secondary outcomes included complete occlusion, and perioperative complications. One-stage individual patient data meta-analysis was performed, adjusted using generalized linear mixed models with prespecified covariables and study as a random effect.</p><p><strong>Results: </strong>Twenty-six studies reporting 413 patients with 414 previously clipped IAs retreated endovascularly were included. Totally, 249 (60.1%), 39 (9.4%), 39 (9.4%), 81 (19.6%) and 6 (1.4%), underwent simple coiling, balloon-assisted coiling, stent-assisted coiling, flow diversion, and disruption, respectively. Of these, 88.6% and 11.4% IAs were located anteriorly and posteriorly. Mean size of the IAs at retreatment was 6.8 mm. Most (70.4%) of previously clipped IAs were unruptured at retreatment, mainly due to regrowth (n = 48), remnants (n = 49) or recurrences (n = 41), when reported. With clinical follow-up of 26.8 months, proportions of good functional outcomes, improved/unchanged neurological outcomes, and deaths were 77.3% (95%CI: 72.15; 81.74), 88.2% (95%CI: 64.57; 96.85), and 6.9% (95%CI: 4.19; 11.18), respectively. With angiographical follow-up of 19.4 months, the proportion of complete occlusion was 74.4% (95%CI: 64.38; 82.29). Multivariate analyses showed that a prolonged interval (>1 month) between clipping and endovascular retreatment was associated with good functional outcome (odds ratio 7.37, 95%CI: 2.16; 29.94) whereas posteriorly located IAs were associated with perioperative complications (odds ratio 8.05, 95%CI: 1.45; 50.48).</p><p><strong>Conclusion: </strong>Endovascular retreatment of previously clipped IAs can be accomplished safely and effectively in well-selected patients. The indications for retreatment need to be carefully weighed against the natural history of a previously clipped IA.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"1002-1012"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Long-Term Clinical Benefits of Age-Adjusted Sagittal Correction in Adult Spinal Deformity Surgery: Results From Patient Grouping Using a Hierarchical Cluster Analysis.","authors":"Wiley B Gillam, Connor E Rupp, Zachary A Sorrentino, Steven G Roth, Julie L Chan","doi":"10.1227/neu.0000000000003808","DOIUrl":"10.1227/neu.0000000000003808","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"e49-e50"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Lattice Flow Diverter and Pipeline Embolization Device in Unruptured Intracranial Aneurysms: A Real-World, Propensity Score Matching Study.","authors":"Li Bao, Yiran Lu, Shuang He, Yunfeng Zhang","doi":"10.1227/neu.0000000000003788","DOIUrl":"10.1227/neu.0000000000003788","url":null,"abstract":"<p><strong>Background and objectives: </strong>Flow diverters (FDs) have been increasingly used in treating unruptured intracranial aneurysms (UIAs). However, comparative studies between the novel lattice flow diverter (LFD) and other FDs are limited. Our study aimed to compare outcomes of LFD and the pipeline embolization device (PED) for UIAs using propensity score matching (PSM).</p><p><strong>Methods: </strong>Patients with UIAs treated with LFD or PED between August 2023 and November 2024 were included. PSM was performed to adjust for age, sex, comorbidities, ischemic stroke history, smoking status, alcohol abuse, preoperative modified Rankin Scale scores, history of multiple aneurysms, aneurysm characteristics, adjunctive coiling, and angiographic follow-up duration. Perioperative complications and clinical and angiographic outcomes were compared after matching.</p><p><strong>Results: </strong>A total of 99 patients treated by LFD and 187 patients treated by PED were included. Compared with the PED group, the LFD group had fewer females and more patients with a history of multiple aneurysms, wider aneurysm necks, shorter stent lengths, and lower rates of in-stent stenosis (ISS) (stenosis > 50%). After PSM, 55 matched pairs were analyzed. The LFD group demonstrated significantly lower ISS rates (1.8% vs 14.5%, P = .037), with no significant differences in perioperative complications, the complete occlusion rate at the median 216-day angiographic follow-up (87.3% vs 85.5%, P > .999), or favorable outcomes (96.4% vs 94.5%, P > .999) compared with the PED group.</p><p><strong>Conclusion: </strong>The mechanical balloon-based LFD with surface modification showed a lower ISS rate and comparable perioperative outcomes, short-term occlusion rates, and clinical prognosis compared with PED. The advantages brought by the Innovation of LFD warrant further validation through long-term randomized controlled trials.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"1176-1185"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239465","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}