World neurosurgery最新文献

{"title":"Evaluation of Hidden Blood Loss and Clinical Outcomes of Arthroscopy-Assisted Uni-Portal Spinal Surgery for Lumbar Disc Herniation with Lateral Recess Stenosis","authors":"Shihao Zhou ,&nbsp;Jiancuo A ,&nbsp;Xiaowan Xu ,&nbsp;Peiran Hu ,&nbsp;Tianluo Guo ,&nbsp;Hongshun Zhao ,&nbsp;Zhihua Xu ,&nbsp;Tengjun Gao ,&nbsp;Yan Hao ,&nbsp;Haoliang Tie","doi":"10.1016/j.wneu.2025.124026","DOIUrl":"10.1016/j.wneu.2025.124026","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate hidden blood loss (HBL) and its influencing factors in patients with lumbar disc herniation-related lateral recess stenosis who underwent arthroscopy-assisted uni-portal spinal surgery (AUSS). Additionally, the study assesses clinical outcomes at the 6-month postoperative follow-up.</div></div><div><h3>Methods</h3><div>This study included 129 patients with lumbar disc herniation-associated lateral recess stenosis who underwent AUSS during the year 2024. Demographic data and parameters related to blood loss were recorded. HBL was calculated using the Nadler and Gross formulas. Pearson or Spearman correlation analyses were performed to explore the relationships between patient characteristics and HBL. Multiple linear regression analysis was used to identify independent risk factors for HBL. Primary clinical outcomes (visual analog scale scores) and secondary outcomes (Oswestry Disability Index scores and the modified Macnab criteria) were assessed preoperatively and at 3 days, 3 months, and 6 months postoperatively. Longitudinal data were analyzed using generalized mixed linear models.</div></div><div><h3>Results</h3><div>A total of 129 consecutive patients (66 females and 63 males) were enrolled. The average HBL was 414.34 ± 179.15 ml. Correlation analyses (Pearson and Spearman) revealed significant associations between surgical duration, American Society of Anesthesiologists (ASA) score, muscle thickness, preoperative activated partial thromboplastin time, and preoperative D-dimer with HBL (<em>P</em> &lt; 0.05). Multiple linear regression analysis identified surgical duration and ASA score as independent risk factors for HBL. Postoperative visual analog scale and Oswestry Disability Index scores showed significant improvement compared to preoperative values.</div></div><div><h3>Conclusions</h3><div>The amount of HBL in patients undergoing AUSS should not be underestimated. ASA score and surgical duration are independent risk factors for HBL. AUSS, as an improved technique, significantly alleviates postoperative pain and enhances quality of life, demonstrating good short-term clinical efficacy. It is an effective treatment option for lateral recess stenosis caused by lumbar disc herniation.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"198 ","pages":"Article 124026"},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985500","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":"Evaluation of Thoracic Paraspinal Muscles Imbalance in Adolescent Idiopathic Scoliosis with Main Thoracic Curve Based on Magnetic Resonance Imaging","authors":"Yuan Gao,&nbsp;Jia Ying,&nbsp;Bowen Lai,&nbsp;Rui Gao,&nbsp;Heng Jiang,&nbsp;Xuhui Zhou","doi":"10.1016/j.wneu.2025.124025","DOIUrl":"10.1016/j.wneu.2025.124025","url":null,"abstract":"<div><h3>Objective</h3><div>While the etiology of adolescent idiopathic scoliosis remains unclear, it is assumed that paraspinal muscle imbalance contributes to curve progression. Previous studies have found the paraspinal muscles imbalance, but no study comprehensively analyzed the roles of different paraspinal muscle layers. Our study distinguished the thoracic paraspinal muscle into superficial, intermediate, and deep layers, and analyzed the imbalance of the 3 layers.</div></div><div><h3>Methods</h3><div>We retrospectively included adolescent idiopathic scoliosis patients with thoracic curve. The paraspinal muscle parameters including relative muscle cross-sectional area (rmCSA) and fatty infiltration in upper end vertebra, apical vertebra, and lower end vertebra regions and in superficial, intermediate, and deep layers were calculated. The parameters between convex and concave sides were compared by paired <em>t</em>-test. The correlation between paraspinal muscle parameters and radiographic parameters was tested by Spearman correlation analysis.</div></div><div><h3>Results</h3><div>A total of 46 patients were included. In apical vertebra region, the rmCSA in superficial (<em>P</em> = 0.038), intermediate (<em>P</em> = 0.001), and deep (<em>P</em> = 0.001) layers on convex side was greater than that on concave side, while the fatty infiltration in intermediate (<em>P</em> = 0.023) and deep layers (<em>P</em> = 0.000) on concave side was greater than that on convex side. Radiographic parameters were associated with both intermediate ΔrmCSA (<em>P</em> = 0.002) and deep ΔrmCSA (<em>P</em> = 0.000).</div></div><div><h3>Conclusions</h3><div>Our research indicates that the severity of paraspinal muscle imbalance is different in three layers, with the deep layer most severe, followed by the intermediate layer, and the superficial layer least severe. The imbalance of deep muscle correlates strongly with radiographic parameters, suggesting its role as a compensatory adaptation to curve magnitude.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"198 ","pages":"Article 124025"},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026707","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":"Assumptions","authors":"Ed Benzel","doi":"10.1016/j.wneu.2025.124006","DOIUrl":"10.1016/j.wneu.2025.124006","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"198 ","pages":"Article 124006"},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064752","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":"Extratemporal Cholesteatoma: A Review of 9 Cases","authors":"Yu Tarutani ,&nbsp;Noritaka Komune ,&nbsp;Daisuke Kuga ,&nbsp;Tomoharu Suzuki ,&nbsp;Yusuke Miyamoto ,&nbsp;Koji Yoshimoto ,&nbsp;Takashi Nakagawa","doi":"10.1016/j.wneu.2025.124022","DOIUrl":"10.1016/j.wneu.2025.124022","url":null,"abstract":"<div><h3>Background</h3><div>Complete removal of cholesteatoma is critical but challenging when the matrix adheres to or destroys surrounding vital structures, such as the facial nerve, inner ear, internal carotid artery, dura mater, jugular bulb, sigmoid sinus, cavernous sinus, etc. Damage to these structures can lead to severe complications such as cerebrospinal fluid leakage, life-threatening hemorrhage, and nerve deficits.</div></div><div><h3>Methods</h3><div>We reviewed 9 cases of extensive cholesteatoma extending beyond the temporal bone that were treated in our department between 2010 and 2022, focusing on surgical approaches and the role of endoscopic assistance.</div></div><div><h3>Results</h3><div>We used various strategies to manage cholesteatoma matrices adhering to critical structures, including blunt or sharp dissection, combined dural resection with reconstruction, and targeted tumor content removal while leaving the matrix intact. Endoscopic assistance enabled us to identify and remove residual matrix remnants that were difficult to visualize with microscopy alone. Incomplete removal and gross residual lesions were associated with high recurrence rates within one year, highlighting the necessity of maximal matrix removal. Where feasible, gross total removal is preferred to minimize recurrence risk.</div></div><div><h3>Conclusions</h3><div>Effective management of extensive cholesteatoma requires careful balancing of complete matrix removal with protection of critical structures. Endoscopic assistance offers enhanced visualization, improving surgical outcomes by reducing residual matrix and lowering the risk of early recurrence.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"198 ","pages":"Article 124022"},"PeriodicalIF":1.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047958","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":"Surgical Management of Unstable Atlas Fractures: A Single Institutional Retrospective Review with Comparison of Occipitocervical and Atlantoaxial Fusion Outcomes","authors":"Juan Vivanco-Suarez ,&nbsp;Clayton Rosinski ,&nbsp;Michael Kritikos ,&nbsp;Hashim Syed ,&nbsp;Nahom Teferi ,&nbsp;Satoshi Yamaguchi ,&nbsp;Girish Bathla ,&nbsp;Patrick Hitchon","doi":"10.1016/j.wneu.2025.124024","DOIUrl":"10.1016/j.wneu.2025.124024","url":null,"abstract":"<div><h3>Background</h3><div>Atlas fractures represent 25% of craniocervical injuries, most common in elders. Unstable first cervical vertebra fractures with lateral mass displacement require surgical fixation. Options include atlantoaxial fusion (AAF) or occiput-cervical fusion (OCF), each have their respective merits and detractors. Here, we compare the clinical and neurological outcomes of patients with unstable atlas fractures treated with AAF and OCF.</div></div><div><h3>Methods</h3><div>A retrospective review of patients with unstable atlas fractures that underwent either AAF or OCF between 2005 and 2023 was performed. Demographics, clinical characteristics, radiographic parameters, and outcomes were collected. Cervical sagittal balance was measured by O-second cervical vertebra (C2 or axis) angle, C2-7 lordosis, and C2-7 sagittal vertical axis (SVA).</div></div><div><h3>Results</h3><div>Forty-four patients with unstable atlas fractures were included (25 underwent AAF and 19 OCF). The median age was 73 years, and 52% were male. Demographics, mechanism of injury, and other clinical characteristics were similar. Landell's type 2 atlas fractures and lateral mass displacement were significantly in the OCF group. Median number of levels was significantly greater in the OCF group (3 vs. 2 in AAF, <em>P</em>=&lt;0.001). C2-7 lordosis was less in OCF versus AAF (<em>P</em> = 0.045). SVA was less in the AAF group versus OCF (<em>P</em> = 0.044). Cervical SVA was decreased 4.5 mm in average in the AAF group versus 5.2 mm increase in OCF (<em>P</em> = 0.040). There were no significant differences in the rates of postoperative complication, surgical revision, or neurologic function.</div></div><div><h3>Conclusions</h3><div>OCF results in significant loss of lordosis and increase in cervical SVA relative to AAF, which may impact long-term quality of life and disability not directly measured in this study.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124024"},"PeriodicalIF":1.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989186","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 Novel Concept for Making Decisions Regarding the Segments of Laminoplasty for Cervical Ossification of the Posterior Longitudinal Ligament: The Drifting Angle of Spinal Cord","authors":"Huajian Zhong,&nbsp;Leixin Wei,&nbsp;Chen Xu,&nbsp;Huiqiao Wu,&nbsp;Ruizhe Wang,&nbsp;Xinwei Wang,&nbsp;Yang Liu,&nbsp;Wen Yuan,&nbsp;Huajiang Chen,&nbsp;Xiaolong Shen","doi":"10.1016/j.wneu.2025.124019","DOIUrl":"10.1016/j.wneu.2025.124019","url":null,"abstract":"<div><h3>Background</h3><div>There is currently no established index for evaluating the adequacy of the surgical area during laminoplasty. This study aims to propose a novel concept of the drifting angle of the spinal cord (DA-SC) at the cephalic and caudal junction of surgical and nonsurgical laminae during laminoplasty, and to assess its clinical relevance.</div></div><div><h3>Methods</h3><div>A retrospective review of clinical and radiological data was conducted on 296 patients who underwent laminoplasty. Patients were classified into four groups based on preoperative DA-SC of cephalic and caudal junction of surgical and nonsurgical laminae: Group DA-SC SS (both cephalic and caudal DA-SC were small); DA-SC LL (both cephalic and caudal DA-SC were large); DA-SC LS (cephalic DA-SC was large whereas caudal DA-SC was small); and DA-SC SL (cephalic DA-SC was small whereas caudal DA-SC was large). Clinical outcomes were recorded and analyzed before surgery, 2 months postoperatively, and at the last follow-up.</div></div><div><h3>Results</h3><div>Both cephalic and caudal DA-SC increased significantly following laminoplasty, patients in group DA-SC SS demonstrated superior clinical recovery rate than that of other three groups, indicating that small DA-SC is positively related with great clinical outcomes.</div></div><div><h3>Conclusions</h3><div>The concept of DA-SC is valuable in assisting making decisions regarding the extent of laminoplasty in patients with cervical ossification of the posterior longitudinal ligament. Reducing the DA-SC by extending the surgical area is necessary when DA-SC is large.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"198 ","pages":"Article 124019"},"PeriodicalIF":1.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988509","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":"Simplified S1 Vertebral Bone Quality Score Predicts Screw Loosening in Patients with Lumbar Spondylolisthesis","authors":"Yongdi Wang ,&nbsp;Qian Chen ,&nbsp;Ce Zhu ,&nbsp;Youwei Ai ,&nbsp;Juehan Wang ,&nbsp;Hong Ding ,&nbsp;Dun Luo ,&nbsp;Lei Wang ,&nbsp;Chunguang Zhou ,&nbsp;Jing Tang ∗ ,&nbsp;Limin Liu","doi":"10.1016/j.wneu.2025.124012","DOIUrl":"10.1016/j.wneu.2025.124012","url":null,"abstract":"<div><h3>Objective</h3><div>Investigate whether S1 vertebral bone quality (VBQ) score serves as a viable substitute for the traditional VBQ score in predicting screw loosening in patients undergoing transforaminal lumbar interbody fusion (TLIF) for lumbar spondylolisthesis using quantitative computed tomography (QCT) as a standard reference.</div></div><div><h3>Methods</h3><div>We reviewed 165 patients undergoing single-segment TLIF for lumbar spondylolisthesis at our center from 2012 to 2021. Demographic and radiographic data were collected. To determine the independent factors affecting pedicle screw loosening, univariate analysis and multivariate logistic regression were conducted. Receiver operating characteristic analysis was carried out to assess the predictive ability.</div></div><div><h3>Results</h3><div>16.3% of patients experienced screw loosening at a minimum of 24 months of follow-up. Statistically significant differences in the 2 groups were observed in surgery level (L5–S1), traditional VBQ, S1 VBQ, and QCT values. QCT values, traditional VBQ score, and the S1 VBQ score were independent risk factors for screw loosening. The receiver operating characteristic analysis showed that area under the curve (AUC) of QCT was 0.839 (95% confidence interval [CI]: 0.771–0.907) and the cut-off value was 119 (sensitivity: 85.2% and specificity: 76.8%); AUC of VBQ scores was 0.787 (95% CI: 0.699–0.875) and the cut-off value was 3.585 (sensitivity: 88.9% and specificity: 69.6%), while AUC of S1 VBQ score was 0.823 (95% CI: 0.739–0.908) and the cut-off value was 3.72 (sensitivity: 81.5% and specificity: 76.8%).</div></div><div><h3>Conclusions</h3><div>The elevated S1 VBQ score was identified as an independent risk factor for screw loosening and exhibits greater predictive capability compared to the traditional VBQ score in forecasting screw loosening following TLIF for lumbar spondylolisthesis.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"198 ","pages":"Article 124012"},"PeriodicalIF":1.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002374","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":"Comparative Analysis of the Health-Related Quality of Life Between Patients with Familial and Sporadic Forms of Cerebral Cavernous Malformation","authors":"Alexandre Martins Cunha ,&nbsp;Gustavo da Fontoura Galvão ,&nbsp;Jorge Marcondes de Souza","doi":"10.1016/j.wneu.2025.124023","DOIUrl":"10.1016/j.wneu.2025.124023","url":null,"abstract":"<div><h3>Objective</h3><div>To compare health-related quality of life (HRQoL) in patients with familial form of cerebral cavernous malformation (fCCM) versus those with sporadic form of cerebral cavernous malformation (sCCM).</div></div><div><h3>Methods</h3><div>A cross-sectional observational study was conducted involving adult patients receiving outpatient care at a specialized referral center for cerebral cavernous malformation (CCM). In addition to clinic visits, demographic data and imaging were reviewed. Patients completed the Patient-Reported Outcome Measurements Information System, version 2.0 (PROMIS-29), and the EuroQol 5 dimensions 5 levels, version 3.1. Data were compared using a 2-tailed 2-sample <em>t</em>-test or Mann-Whitney test for continuous variables. Pearson χ² or Fisher's exact test assessed the association between 2 categorical variables.</div></div><div><h3>Results</h3><div>Eighty-three patients participated in the study over one year. The average age of the participants was 45.37 years (standard deviation = 14.75), with 53 (63.86%) being female. On average, patients had 12.48 years of education (standard deviation = 3.87), and 36 (43.37%) had the familial form of the disease. No significant differences in HRQoL were observed between patients with familial fCCM and sCCM. Among symptomatic patients, there were also no differences between the 2 groups in any domain of either assessment tool. However, within the fCCM group, symptomatic individuals reported worse HRQoL in the usual activities domain of the EuroQol 5 dimensions 5 levels (<em>P</em> = 0.014) and the physical function domain of the PROMIS-29 (<em>P</em> = 0.031) when compared to asymptomatic individuals.</div></div><div><h3>Conclusions</h3><div>This study found no significant differences in HRQoL between patients with fCCM and sCCM.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"198 ","pages":"Article 124023"},"PeriodicalIF":1.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018924","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":"Influence of Peripheral Blood Inflammatory Indices on the Distance of Growth and Prognosis of Peripheral Edema in Basal Ganglia Cerebral Hemorrhages","authors":"Ruiqing Cao ,&nbsp;Chaoyu Lv ,&nbsp;Zhihua Cheng ,&nbsp;Longfei You","doi":"10.1016/j.wneu.2025.124020","DOIUrl":"10.1016/j.wneu.2025.124020","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the effects of peripheral blood inflammatory markers, such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), perihematomal edema (PHE), edema extension distance (EED), EED growth, and functional prognosis in patients with basal ganglia hemorrhage.</div></div><div><h3>Methods</h3><div>The clinical data of patients with basal ganglia cerebral hemorrhage observed in the Department of Neurosurgery at Dangtu County People's Hospital between January 2017 and June 2023 were retrospectively collected. The primary outcomes were absolute PHE, relative PHE, EED, and EED growth. The secondary outcome was the clinical status 90 days postdischarge, assessed using the modified Rankin scale (mRS). Scores of 3–6 on the mRS indicate unfavorable functional outcomes.</div></div><div><h3>Results</h3><div>A total of 83 patients with basal ganglia cerebral hemorrhage were enrolled, with a median age of 67.0 years (interquartile range, 58.0–73.0) and 75.9% male predominance. Poor functional outcomes (mRS 3–6) were observed in 48 patients (57.8%) at the 90-day follow-up. Univariate linear regression analysis revealed no significant association between inflammatory ratios (NLR, LMR, and PLR) and PHE dynamics at both baseline and 24–72 hours measurements. Adjusted multivariate logistic regression analysis identified the baseline NLR and PLR as independent predictors of intracerebral hemorrhage in the basal ganglia. Receiver operating characteristic curve analysis revealed that baseline NLR had superior discriminative capacity (area under the curve [AUC] = 0.854; 95% confidence interval [CI], 0.767–0.927) compared to PLR (AUC = 0.787; 95% CI, 0.689–0.874) and hematoma volume (AUC = 0.788; 95% CI, 0.676–0.881). The optimal prognostic thresholds were NLR = 5.90, PLR = 141.53, and hematoma volume = 10.40 ml.</div></div><div><h3>Conclusions</h3><div>Although NLR, LMR, and PLR were not independent predictors of PHE progression in basal ganglia cerebral hemorrhage, they can be used as simple, noninvasive tools to predict the prognosis of patients with basal ganglia hematomas. Risk stratification can be enhanced by identifying patients requiring intensified monitoring or early neuroprotective interventions.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"198 ","pages":"Article 124020"},"PeriodicalIF":1.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039919","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":"Deep Learning-Based Models for Ventricular Segmentation in Hydrocephalus: A Systematic Review and Meta-Analysis","authors":"Bardia Hajikarimloo ,&nbsp;Ibrahim Mohammadzadeh ,&nbsp;Mohammad Amin Habibi ,&nbsp;Alireza Kooshki ,&nbsp;Saba Aghajani ,&nbsp;Mahboobeh Tajvidi ,&nbsp;Rana Hashemi ,&nbsp;Mahdi Hooshmand ,&nbsp;Sara Bana ,&nbsp;Dorsa Najari ,&nbsp;Roozbeh Tavanaei ,&nbsp;Mohammadhosein Akhlaghpasand","doi":"10.1016/j.wneu.2025.124001","DOIUrl":"10.1016/j.wneu.2025.124001","url":null,"abstract":"<div><h3>Background</h3><div>Ventricular segmentation is a critical step in neuroimaging data evaluation, particularly in hydrocephalus. Current methods are mainly based on 2-dimensional measurements and ratios. Traditional manual and semiautomatic ventricular segmentation are time-consuming, operator-based, and lack flexibility in handling numerous radiological features. Recently, deep learning (DL) models have been developed to perform ventricular segmentation and have shown promising outcomes. The objective of the current study was to evaluate the performance of DL-based models in ventricular segmentation in the hydrocephalus setting.</div></div><div><h3>Methods</h3><div>On December 5, 2024, a systematic search was conducted using an individualized search query in 4 electronic databases: PubMed, Embase, Scopus, and Web of Science. Studies that reported the mean dice similarity coefficient (DSC) of DL-based models in ventricular segmentation in patients with hydrocephalus were included. The mean DSC for the best-performance model was extracted.</div></div><div><h3>Results</h3><div>Twenty-four studies with 2911 patients were included. The mean DSC ranged from 0.671 to 0.99 across the best-performance models. The meta-analysis revealed a pooled mean DSC of 0.89 (95% CI: 0.84–92). The subgroup analysis yielded a pooled mean DSC of 0.88 (95% CI: 0.80–0.96) for magnetic resonance imaging-based models, 0.91 (95% CI: 0.86–0.95) for computed tomography-based models, and 0.84 (95% CI: 0.81–0.87) for ultrasound-based best-performance DL-based models.</div></div><div><h3>Conclusions</h3><div>DL-based models have demonstrated favorable outcomes in ventricular segmentation in patients with hydrocephalus. Application of these models in clinical practice can optimize the treatment protocol and enhance the clinical outcomes of hydrocephalus patients.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"198 ","pages":"Article 124001"},"PeriodicalIF":1.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052563","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}