World neurosurgery最新文献

{"title":"Editor's Choices","authors":"","doi":"10.1016/S1878-8750(25)00803-4","DOIUrl":"10.1016/S1878-8750(25)00803-4","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"201 ","pages":"Article 124447"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply to the Letter to the Editor Regarding \"Pathogenic Variants and Prognosis in Meningiomas: A Systematic Review and Meta-Analysis\".","authors":"Rubén David Dos Reis Zuniga, Gabriel Sant'Ana Carrijo, Matheus Rocha do Vale, Beatriz da Costa Aguiar Alves Reis, Glaucia Raquel Luciano da Veiga, Paulo Henrique Pires de Aguiar, Fernando Luiz Affonso Fonseca","doi":"10.1016/j.wneu.2025.124296","DOIUrl":"10.1016/j.wneu.2025.124296","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124296"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous versus Traditional Fixation for Fracture Patients with Ankylosing Spinal Disorders: A Meta-Analysis.","authors":"Jiaxiao Shi, Jiaxin Shen, Wei Guo, Chaochao Zhang, Fangfang Wang","doi":"10.1016/j.wneu.2025.124290","DOIUrl":"10.1016/j.wneu.2025.124290","url":null,"abstract":"<p><strong>Objective: </strong>With the advancement of surgical technology and the refinement of minimally invasive techniques, the emergence of novel technologies has exerted a discernible impact on conventional approaches. Currently, percutaneous internal fixation guided by X-ray fluoroscopy has been employed in patients with ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis, presenting a challenge to traditional open surgery. Our objective was to conduct a comprehensive literature review aiming to evaluate the potential surgical advantages associated with percutaneous internal fixation.</p><p><strong>Methods: </strong>The databases PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure were systematically searched to identify both randomized and nonrandomized studies focusing on fracture patients with ankylosing spinal disorders.</p><p><strong>Results: </strong>The analysis included 10 studies comparing clinical indexes. Percutaneous internal fixation technology demonstrated overall feasibility in terms of operative time, intraoperative blood loss, postoperative bed rest duration, hospitalization duration, and complications (P < 0.05). However, there were no significant differences between the 2 groups in visual analog scale score, MacNab score, Cobb angle of injured segment, and vertebral height at 6 months and 1 year after operation (P > 0.05).</p><p><strong>Conclusions: </strong>Based on the current evidence, percutaneous internal fixation demonstrates clear advantages over open internal fixation. However, considering the limited quality of some studies, it is imperative to conduct additional high-quality randomized controlled trials to further validate these findings.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124290"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Efficacy of Venous Sinus Stenting for Idiopathic Intracranial Hypertension in a Non-Western Country.","authors":"Hazem Abdelkhalek, Islam El Malky, Alaa Elkordy, Raed Ahmed, Essam Abdelhameed, Ashraf Elaggan, Ahmed Elhfnawy","doi":"10.1016/j.wneu.2025.124226","DOIUrl":"10.1016/j.wneu.2025.124226","url":null,"abstract":"<p><strong>Objective: </strong>Most patients with idiopathic intracranial hypertension (IIH) have venous sinus stenosis. In the previous decade, venous sinus stenting has emerged as an ultimate treatment for resistant or refractory cases with IIH. However, studies in this regard are relatively few, especially from lower income countries. We aimed to evaluate the feasibility and efficacy of venous sinus stenting in our tertiary center.</p><p><strong>Methods: </strong>We retrospectively reviewed our prospectively collected database from January 2021 to January 2023 and recruited eligible patients with IIH and venous sinus stenosis who underwent stenting.</p><p><strong>Results: </strong>We recruited 113 patients, all of them were females with a mean age of 30±8 years and mean body mass index of 30±3.1. Stenting was technically successful in all our patients. Post stenting angioplasty was warranted in 3 cases (2.6%). Complications occurred in 1 case (0.9%) in the form of a rim of subdural hematoma without any clinical sequelae. At 3 months follow-up, 93 patients (82.3%) experienced complete relief of their symptoms, whereas 11 patients (9.7%) still had headache without papilledema and 9 patients (8%) had papilledema. Seven patients (6.2%) received ventriculoperitoneal shunting and 2 patients (1.8%) experienced restenosis and received another stenting procedure.</p><p><strong>Conclusions: </strong>Stenting of the venous sinus stenosis in IIH patients is effective and safe treatment and can be accomplished with a very low complication rate and relatively high success rate.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124226"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Computed Tomography-Based Classification of Spondylolisthesis due to Pars Defect and Comparison with Meyerding Classification","authors":"Burhan Oral Güdü ,&nbsp;Belgin Karan","doi":"10.1016/j.wneu.2025.124335","DOIUrl":"10.1016/j.wneu.2025.124335","url":null,"abstract":"<div><h3>Objective</h3><div>We propose a new classification of spondylolisthesis based on the anterior displacement of the defective pars neck relative to the inferior articular process line on parasagittal computed tomography images. We aimed to compare this classification with Meyerding grades (MGs), assess its reliability and applicability, and evaluate its clinical implications.</div></div><div><h3>Methods</h3><div>A total of 205 lumbar computed tomography images of patients with pars defects and degenerative disc disease were included in the study. According to the algorithm, the pars listhesis grade (PLG) was determined as PLG 0 if the defective pars neck was behind the inferior articular process line, PLG 1 (mild) if it was within the line, PLG 2 (moderate) if it was entirely in front of the line, and PLG 3 (severe) if it was displaced in front of the line with the superior articular process. The rates of bilateral PLG and MG and demographic data were analyzed. Clinical data from 40 patients (10 per PLG grade) were analyzed.</div></div><div><h3>Results</h3><div>There was a moderate positive correlation between the PLG and MG (r = 0.46) and a strong positive correlation between right and left PLG grades (r = 0.82). Intra- and interobserver reliability showed almost perfect agreement (0.84–0.97). Clinical scores, the visual analog scale, the Oswestry Disability Index, and the SF-36 showed significant differences among PLG levels, with increased disability and decreased physical health observed with higher PLG levels.</div></div><div><h3>Conclusions</h3><div>PLG classification can be used as a new grading system for spondylolisthesis, especially with low Meyerding grades.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"201 ","pages":"Article 124335"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optic Nerve Sheath Diameter in the Prognosis of Patients with Traumatic Optic Neuropathy: Evaluation and Predictive Efficacy.","authors":"Yuxin Luo, Yuxing Jie, Keying Wu, Yiyang Tian, Zehong Cai, Ziping Huang, Weidong Du, Weipiao Kang, Yu Lin","doi":"10.1016/j.wneu.2025.124213","DOIUrl":"10.1016/j.wneu.2025.124213","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate and predict visual prognosis in patients with traumatic optic neuropathy by measuring the optic nerve sheath diameter (ONSD).</p><p><strong>Methods: </strong>This study included patients diagnosed with traumatic optic neuropathy at a single center between September 1, 2023, and October 1, 2024. Data collection and ONSD measurements were performed before starting treatment. ONSD was measured at 3, 5, 10, and 15 mm (ONSD3, 5, 10, and 15, respectively) behind the globe using computed tomography scanning. The t-test, Mann-Whitney U test, and chi-squared test were used to compare the significance of each variable. Receiver operating characteristic curves and decision curve analysis were used to evaluate predictive efficacy.</p><p><strong>Results: </strong>Of the 22 patients included, treatment was effective for 14 and ineffective for 8. ONSD3 (but not the other ONSD distances) was significantly lower in the effective-treatment group than in the ineffective-treatment group (P < 0.05). ONSD3 achieved the highest area under the curve (0.893; 95% confidence interval, 0.739-1.000) for predicting prognosis. Good visual recovery was more likely in patients with ONSD3 ≤ 5.07 mm (sensitivity, 100%; specificity, 85.7%). Initial visual acuity differed significantly between the 2 groups (P < 0.05). ONSD3 and initial visual acuity in combination improved predictive efficacy (area under the curve, 0.929; 95% confidence interval: 0.818-1.000). Based on our decision curve analysis results, considering both these variables could provide benefits to patients with traumatic optic neuropathy.</p><p><strong>Conclusions: </strong>ONSD3 thus represents a potentially important and novel index for evaluating and predicting visual prognosis in traumatic optic neuropathy.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124213"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pioneering a Civilian-Military Neurosurgery Partnership Through the Department of Defense SkillBridge Program","authors":"Maria Cielito L. Robles ,&nbsp;Ryan P. Brennan ,&nbsp;Gavin P. Dunn","doi":"10.1016/j.wneu.2025.124313","DOIUrl":"10.1016/j.wneu.2025.124313","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"201 ","pages":"Article 124313"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Clinical Prediction Model for Complications After Cranioplasty Based on Modified-Brain Collapse Ratio and Comorbidity Burden.","authors":"Yizhou Lu, Hongyue Huo, Jianxin Jiang","doi":"10.1016/j.wneu.2025.124235","DOIUrl":"10.1016/j.wneu.2025.124235","url":null,"abstract":"<p><strong>Background: </strong>Cranioplasty (CP) after decompressive craniectomy is linked to a high complication rate. Although neuroimaging parameters and comorbidity burden are considered potential predictors, no predictive model has been established. This study aimed to develop a clinical prediction model to visualize and ameliorate the occurrence of post-CP complications.</p><p><strong>Methods: </strong>Our study retrospectively encompassed 368 adults undergoing unilateral CP after decompressive craniectomy and divided them into 2 groups based on the occurrence of complications. Modified-brain collapse ratio (m-BCR) was calculated by a 3-dimensional way and age-adjusted Charlson Comorbidity Index (aCCI) scores were collected from electronic records.</p><p><strong>Results: </strong>Postoperative complications occurred in 18.48% (68/368) of patients. Multivariable analysis identified 5 independent predictors: m-BCR (odds ratio [OR = 1.670, 95% confidence interval [CI]: 1.150-2.426, P = 0.007), aCCI score (OR= 1.450, 95% CI: 1.233-1.706, P < 0.001), operative duration (OR = 1.005, 95% CI: 1.000-1.010, P = 0.044), intraoperative blood loss (OR = 1.006, 95% CI: 1.001-1.010, P = 0.010), and total serum protein (OR = 0.963, 95% CI: 0.928-0.998, P = 0.040). Receiver operating characteristic analysis showed optimal cutoffs: m-BCR = 1.265 (sensitivity 60.3%, specificity 79.7%) and aCCI = 1.5 (61.8%, 70.3%). The integrated prediction model demonstrated superior discrimination (area under the curve = 0.776, 95% CI: 0.712-0.840, P < 0.001) compared to individual parameters.</p><p><strong>Conclusions: </strong>Based on m-BCR and aCCI as satisfactory risk predictors with significant weights, an effective clinical model was developed to predict complications after CP.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124235"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and External Validation of a Predictive Tool for Early Neurological Deterioration in Acute Minor Vertebrobasilar Occlusive Stroke Managed Medically.","authors":"Baolin Du, Wei Li, Jingwen Sun, Yeteng Zhang, Jun Hong","doi":"10.1016/j.wneu.2025.124304","DOIUrl":"10.1016/j.wneu.2025.124304","url":null,"abstract":"<p><strong>Objective: </strong>We sought to construct a scoring model to predict early neurological worsening (END) among minor vertebrobasilar occlusive strokes (National Institutes of Health Stroke Scale score <6) following best medical management.</p><p><strong>Methods: </strong>Between January 2019 and June 2024, 137 patients were recruited from a single center. END was characterized by a ≥ 4-point rise in the National Institutes of Health Stroke Scale within 72 hours, without intracranial hemorrhage. Logistic regression analysis identified predictors for END, which were used to construct a scale. External validation was performed using a separate cohort from another hospital during the same study period (n = 81). Model performance was assessed using receiver operating characteristic curve analysis, area under the curve (AUC), calibration plots, and Brier score.</p><p><strong>Results: </strong>END occurred in 41 patients (29.9%). Independent predictors for END were fluctuating symptoms (adjusted odds ratio [aOR] = 1.64, assigned 1 point), proximal vertebrobasilar occlusion (aOR = 2.59, assigned 2 points), and Tmax >6-second volumes (aOR = 1.87, assigned 1 point) (all P < 0.001). The predictive scale showed excellent discrimination in the derivation cohort (AUC = 0.921, 95% confidence interval: 0.882-0.965) and good calibration (Brier score = 0.103). The derivation and validation cohorts were similar in most baseline characteristics. Significant differences were observed in symptom evolution, intravenous thrombolysis usage, and occlusion sites. External validation in an independent cohort yielded an AUC of 0.857 (0.825-0.934) and a Brier score of 0.130.</p><p><strong>Conclusions: </strong>This externally validated scale provided a practical tool to identify high-risk END patients for targeted interventions.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124304"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Treatment of Cryptogenic Brain Abscesses: Metagenomic Next-generation Sequencing and Imaging for Recurrence Control.","authors":"Xiao-Yu Zheng, Dong-Yue Li, Meng-Hui Li, Mao-Ying Zhang, Jian-Cheng Liao","doi":"10.1016/j.wneu.2025.124288","DOIUrl":"10.1016/j.wneu.2025.124288","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the precision diagnosis and treatment strategies for cryptogenic brain abscesses, integrating multimodal imaging (320-slice computed tomography + 3.0 T magnetic resonance imaging) and metagenomic next-generation sequencing (mNGS) technology to optimize treatment regimens and control recurrence risk.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 88 patients with cryptogenic brain abscesses admitted to the Department of Neurosurgery, the First Affiliated Hospital of Jinan University from January 2014 to August 2023. The patients were defined as having no clear infection source, acute onset, and negative or delayed-positive bacterial cultures. They were divided into a medication group (16 cases), a surgical puncture group (15 cases), and a surgical resection group (57 cases) according to treatment modalities. Fisher's exact test, Kruskal-Wallis test, and multivariate logistic regression were used to analyze the factors related to efficacy and recurrence.</p><p><strong>Results: </strong>The cure rate in the surgical resection group (98.2%, 56/57) was significantly higher than that in the surgical puncture group (86.7%, 13/15) and the medication group (68.8%, 11/16) (P < 0.001). The recurrence rates were 0% in the surgical resection group, 13.3% (2/15) in the puncture group, and 43.8% (7/16) in the medication group (P < 0.001). Multivariate regression analysis showed that an abscess diameter ≤2.5 cm (95%CI: 1.12-9.43, P < 0.05) and mixed infections was an independent risk factor for recurrence. The pathogen detection rate was increased to 84.1% (74/88) by mNGS, which was significantly higher than that of traditional culture (44.3%, 39/88, P < 0.001).</p><p><strong>Conclusions: </strong>Combined multimodal imaging and mNGS serve as the core modalities for early diagnosis of cryptogenic brain abscesses. Surgical resection significantly improves cure rates and reduces recurrence risk, particularly suitable for patients with abscesses larger than 2.5 cm in diameter or mixed infections.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124288"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}