World neurosurgery最新文献

{"title":"Clinical Efficacy of Biportal versus Uniportal Endoscopic Discectomy for Far Lateral Lumbar Disc Herniation: A Retrospective Study Analysis","authors":"Zhang Zhiqiang ,&nbsp;Yang Jiandong ,&nbsp;Huang Zhi ,&nbsp;Abdiaziz Ahmed Mohamed ,&nbsp;Zhang Liang ,&nbsp;Feng Xinmin","doi":"10.1016/j.wneu.2025.123788","DOIUrl":"10.1016/j.wneu.2025.123788","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to compare the clinical efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) and unilateral biportal endoscopy (UBE) in treating far lateral lumbar disc herniation (FLLDH).</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on 42 patients treated for FLLDH at our hospital between January 2020 and October 2023, comprising 17 UBE cases and 25 PTED cases. Patients were followed up for six months. The study compared operation time, hospital stay, cross-sectional area of the intervertebral foramen, and clinical efficacy using a visual analog scale (VAS), the Oswestry Disability Index, and modified Macnab criteria.</div></div><div><h3>Results</h3><div>Both surgical procedures were successful. The UBE group had a significantly shorter operation time than the PTED group (108.0 ± 35.3 vs. 84.3 ± 25.4 minutes; <em>P</em> = 0.023). There were no significant differences in hospitalization periods or cross-sectional area of the intervertebral foramen between the groups. The UBE group had better VAS scores for back pain at 1-day (2.72 ± 0.84 vs. 2.12 ± 0.70, <em>P</em> = 0.015) and 1-month (1.76 ± 0.66 vs. 1.29 ± 0.77, <em>P</em> = 0.047) postoperation compared to the PTED group. However, both groups showed significant improvements in VAS and Oswestry Disability Index scores after surgery, with no statistically significant difference at the final follow-up. The modified Macnab criteria at the final follow-up demonstrated similar good-to-excellent satisfactory outcomes in both the PTED and UBE groups, at 92% and 94.1%, respectively.</div></div><div><h3>Conclusions</h3><div>Both UBE and PTED techniques are clinically effective for treating FLLDH, with UBE having a shorter operation time than PTED.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123788"},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The possible role of Wnt/ β-catenin pathway in central neurocytoma.","authors":"Evrim Önder, Kutsal Doğan, Gökhan Veli Alkan","doi":"10.1016/j.wneu.2025.123944","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123944","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123944"},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744081","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":"Cerebral Contrast Staining on Dual-Energy CT after Coil Embolization of Unruptured Intracranial Aneurysms: Frequency, Risk Factors, and Clinical Implications.","authors":"Byeong-Su Park, Jung Hoon Han, Won Ki Yoon, Sang-Il Suh","doi":"10.1016/j.wneu.2025.123930","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123930","url":null,"abstract":"<p><strong>Objective: </strong>Cerebral contrast staining (CCS) post-endovascular procedures may mimic subarachnoid hemorrhage. This study investigates CCS frequency and risk factors using dual-energy computed tomography (DECT) following coil embolization of unruptured intracranial aneurysms.</p><p><strong>Methods: </strong>A retrospective analysis included 232 patients undergoing coil embolization and immediate DECT imaging between October 2018 and March 2023. CCS was defined as hyperattenuation on iodine overlay images absent on virtual non-contrast images. Logistic regression identified predictors of CCS.</p><p><strong>Results: </strong>CCS occurred in 95 patients (40.9%), predominantly in anterior circulation aneurysms (48.1%) compared to posterior circulation (14.3%, p = 0.001). High CCS rates occurred particularly in posterior communicating (59.1%) and anterior communicating/anterior cerebral artery aneurysms (59.0%). Low-osmolar contrast media had higher CCS incidence (56.4%) compared to iso-osmolar media (30.4%, p < 0.001). CCS-positive patients had higher contrast volume (186.35 ± 46.62 mL vs. 171.62 ± 34.89 mL; p = 0.009) and longer procedures (158.41 ± 41.25 vs. 135.28 ± 35.07 min, p < 0.001). Multivariate analysis identified posterior communicating artery aneurysms, low-osmolar contrast media, procedure duration, and contrast volume as independent CCS predictors. Demographic factors and blood pressure variability were unrelated. One transient contrast-induced encephalopathy case occurred; no hemorrhages were identified.</p><p><strong>Conclusions: </strong>CCS is common after coil embolization, especially with longer procedures, anterior aneurysms, and low-osmolar contrast media. DECT effectively differentiates CCS from hemorrhage, potentially reducing unnecessary follow-up imaging.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123930"},"PeriodicalIF":1.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731841","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":"Progress on Direct Regulation of Systemic Immunity by the Central Nervous System","authors":"Xiaotian Tan,&nbsp;Junming Zhang,&nbsp;Weiming Chen,&nbsp;Tunan Chen,&nbsp;Gaoyu Cui,&nbsp;Zhi Liu,&nbsp;Rong Hu","doi":"10.1016/j.wneu.2025.123814","DOIUrl":"10.1016/j.wneu.2025.123814","url":null,"abstract":"<div><div>This article reviews the research progress on the direct regulation of the immune system by the central nervous system (CNS). The traditional “neuro-endocrine-immune” network model has confirmed the close connection between the CNS and the immune system. However, due to the complex mediating role of the endocrine system, its application in clinical treatment is limited. In recent years, the direct regulation of the peripheral immune system through the CNS has provided new methods for the clinical treatment of neuroimmune-related diseases. This article analyzes the changes in the peripheral immune system after CNS injury and summarizes the effects of various stimulation methods, including transcranial magnetic stimulation, transcranial electrical stimulation, deep brain stimulation, spinal cord stimulation, and vagus nerve stimulation, on the peripheral immune system. Additionally, it explores the clinical research progress and future development directions of these stimulation methods. It is proposed that these neural regulation techniques exhibit positive effects in reducing peripheral inflammation, protecting immune cells and organ functions, and improving immunosuppressive states, providing new perspectives and therapeutic potential for the treatment of immune-related diseases.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123814"},"PeriodicalIF":1.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Force Control a Safe and Efficient Surgical Technology for Thoracolumbar Fusion Surgery? A Post Market Clinical Follow-Up Study","authors":"David C. Noriega ,&nbsp;Francisco Ardura ,&nbsp;Kirollos Awad ,&nbsp;Shefqet Hajdari ,&nbsp;Israel Sánchez Lite ,&nbsp;Yasser Abdalla","doi":"10.1016/j.wneu.2025.123812","DOIUrl":"10.1016/j.wneu.2025.123812","url":null,"abstract":"<div><h3>Background</h3><div>Early screw loosening, a relevant complication after posterior thoracolumbar fusion, indicates high mechanical stress during rod connection. Force Control is a surgical technology that goes beyond the usual to identify, control, and minimize intended and unintended, usually unnoticed forces to achieve the most stressless fixation. Optimized, extremely lightweight instruments support this principle on part of the pedicle screw system (PSS). The study objective is to evaluate the safety and efficacy of a novel PSS for Force Control fusion surgery.</div></div><div><h3>Methods</h3><div>In this literature-controlled observational study, patients underwent surgery with a PSS that supports Force Control. Safety is demonstrated 1 year postoperatively by noninferiority in screw loosening rate and efficacy by noninferiority in Oswestry Disability Index (ODI) improvement. Secondary endpoints: 2-year ODI, spine-related adverse events, and outcomes. Statistical significance: <em>P</em> &lt; 0.025 (Bonferroni correction 0.05/2).</div></div><div><h3>Results</h3><div>75 patients enrolled, main diagnoses were trauma (73.3%), spinal stenosis (17.3%), and degenerative disc disease (6.7%). Screw loosening rate at 1 year was 2.7%, being not inferior (<em>P</em> = 0.005) to the control group at 9.2%. Mean ODI improvement of 49.3 showed noninferiority (<em>P</em> &lt; 0.001) versus 35.2 in the control group. Mean 2-year ODI was 19, mean visual analog scale back pain improved from 80.3 to 24.1 (3 months) and 21.6 (1 year). The implant-related revision rate was 4.1%.</div></div><div><h3>Conclusions</h3><div>Force Control, aiming to go beyond the familiar by controlling intended and unintended forces to achieve the most stressless fixation, is a safe and efficient method. Lightweight instruments are designed to allow identifying, controlling, and reducing mechanical stress. Patients benefit from Force Control regarding screw loosening and clinical outcome.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123812"},"PeriodicalIF":1.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral Biportal Endoscopic Discectomy via the Contralateral Sublaminar Approach for Lumbar Disc Herniation with Very High-Grade Migration: A Technical Note and Case Series.","authors":"Yong Jin Park, Man Kyu Park, Sang Kyu Son, Young San Ko","doi":"10.1016/j.wneu.2025.123939","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123939","url":null,"abstract":"<p><strong>Background: </strong>Lumbar disc herniation (LDH) with very high-grade migration is difficult to manage surgically because of its anatomical complexity and the risk of incomplete decompression. The unilateral biportal endoscopic (UBE) contralateral sublaminar approach is a minimally invasive technique that may be an alternative option for managing these cases.</p><p><strong>Methods: </strong>In this multicenter retrospective study, we analyzed the clinical data of 15 patients with LDH with very high-grade upward or downward migration of ruptured disc fragments removed via the UBE contralateral sublaminar approach between June 2022 and June 2024. Clinical outcomes were assessed using the visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and modified MacNab criteria. Radiological outcomes were evaluated on postoperative MR images and serial plain radiographs.</p><p><strong>Results: </strong>The mean operation time was 45.3 minutes, and the average length of hospital stay was 4.1 days. The VAS scores for back and leg pain improved significantly, and the ODI scores were notably lower at the final follow-up. Postoperative MRI confirmed the complete removal of migrated disc fragments in all patients, with no segmental instability observed during the follow-up. The technique allows for effective decompression with minimal bone removal, thereby preserving adjacent structures.</p><p><strong>Conclusions: </strong>This study revealed the feasibility and potential benefits of the UBE contralateral sublaminar approach for LDH with very high-grade migration of ruptured disc fragments. While initial outcomes are promising, further comparative studies with more patients are needed to validate its efficacy and safety.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123939"},"PeriodicalIF":1.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732002","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":"Efficacy and safety of adjunctive coiling in pipeline embolization device implantation for small and medium-sized unruptured cerebral aneurysms: a retrospective cohort study and literature review.","authors":"Michiyasu Fuga, Toshihiro Ishibashi, Issei Kan, Rintaro Tachi, Ken Aoki, Naoki Kato, Shunsuke Hataoka, Gota Nagayama, Tohru Sano, Kazufumi Horiuchi, Hiroyuki Enomoto, Kazutaka Shirokane, Yuichi Murayama","doi":"10.1016/j.wneu.2025.123933","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123933","url":null,"abstract":"<p><strong>Background: </strong>The pipeline embolization device (PED) with adjunctive coiling (PAC) for small and medium-sized unruptured cerebral aneurysms (UCAs) has not yet been fully evaluated for promoting aneurysm occlusion and preventing delayed rupture. The present study investigated the efficacy and safety of the PAC for UCAs ≤10 mm in diameter.</p><p><strong>Methods: </strong>Fifty consecutive UCAs (50 patients) ≤10 mm in diameter that underwent flow diversion with a single PED at three institutions between January 2019 to January 2024 were retrospectively reviewed. Patients were divided into PAC (n=23) and PED-alone (n=27) groups. Data were compared regarding embolization results and complications.</p><p><strong>Results: </strong>Aneurysms with bleb formation, medium-sized aneurysms (7-10 mm), and those treated via transfemoral access were significantly more frequently managed with PAC than PED-alone. In the PAC group, Raymond-Roy Occlusion Classification scores immediately after treatment were Class 1 in one case (4.3%) and Class 3 in 22 cases (96%), with a mean volume embolization ratio of 20.6%. The PAC group had a significantly longer procedure time (184 vs. 117 minutes, P < .001) but showed no differences in ischemic or hemorrhagic complications, access site complications, or in-stent stenosis. Complete occlusion was significantly higher in the PAC group at 6 months (100% vs. 67%, P = .002) and 1 year (100% vs. 74%, P = .011). No delayed complications, including ischemic events, aneurysm rupture, or death, were observed in either group.</p><p><strong>Conclusions: </strong>PAC for UCAs ≤10 mm in diameter may enhance the rate of complete occlusion without increasing the risk of complications.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123933"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731891","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":"Effects of multimodal interventions on patients with neck pain: a systematic review and meta-analysis.","authors":"Lei Chen, Xinyu Hu, Wenlu Zhou, Zhenyu Shi, Qinwe Ge, Yiqing Ling, Ju Li, Taotao Xu, Peijian Tong, Minwei Jin","doi":"10.1016/j.wneu.2025.123927","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123927","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of multimodal therapy on patients with neck pain.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, Cochrane Library, Web of Science, and Embase databases from their inception until April 2024. Randomized controlled trials (RCTs) involving multimodal therapy for neck pain were included. Two researchers independently screened the literature, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using RevMan 5.4 software.</p><p><strong>Results: </strong>A total of 10 studies were included. The meta-analysis results showed that multimodal therapy significantly reduced the Visual Analogue Scale (VAS) scores for neck pain [Standardized Mean Difference (SMD) = -2.96, 95% Confidence Interval (CI): -4.21 to -1.71, P < 0.001] and the Neck Disability Index (NDI) scores [Mean Difference (MD) = -6.15, 95% CI: -10.25 to -2.04, P < 0.01], decreased kinesiophobia [MD = -18.48, 95% CI: -29.22 to -2.74, P < 0.001], and increased the pressure pain threshold (PPT) [left trapezius: MD = 0.48, 95% CI: 0.20 to 0.77, P < 0.01; right trapezius: MD = 0.50, 95% CI: 0.22 to 0.79, P < 0.01]. Subgroup analysis revealed that when the intervention duration was greater than 4 weeks, multimodal therapy significantly improved neck function [MD = -5.97, 95% CI: -11.52 to -0.42, P = 0.04].</p><p><strong>Conclusion: </strong>Multimodal therapy can effectively reduce pain severity, improve kinesiophobia and pain thresholds in patients with neck pain, and significantly improve neck function when the intervention duration exceeds 4 weeks. Future studies with larger sample sizes and higher quality are needed for further exploration.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123927"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731880","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":"Letter to the Editor Regarding \"Instrumented Facet Fusion in the Lumbosacral Spine: Long-Term Clinical and Radiographic Results\".","authors":"Hongzhou Zhao, Yuhui Hu","doi":"10.1016/j.wneu.2025.123937","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123937","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123937"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731913","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":"Identification and Protective Strategies for \"Cortical Dangerous Veins\" in Neurosurgical Craniotomies.","authors":"Siqi Ou, Mingyang Jiang, Xinman Liu, Jia Yang, Erqiao Han, Tianyu Hu, Fanying Li, Yuanlin Chen, Yongfu Li, Kejun He","doi":"10.1016/j.wneu.2025.123935","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123935","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the identification and management techniques and strategies for cortical dangerous veins during neurosurgical craniotomies.</p><p><strong>Methods: </strong>We retrospectively analyzed 37 patients who underwent craniotomies involving the intraoperative protection of cortical dangerous veins between July 2022 and June 2024. Preoperatively, high-resolution MRI data were used for three-dimensional visualization to delineate the resection margins and plan the management of related cortical dangerous veins, including bridging veins, superficial Sylvian veins, anastomotic veins, and veins in the eloquent cortex. Intraoperatively, attention was paid to preserving the cortical dangerous veins. Postoperatively, venous flow disturbances were assessed on the basis of symptoms, imaging findings, physical examinations, and other clinical findings.</p><p><strong>Results: </strong>Preoperative three-dimensional visualization of the cerebral structures and veins corresponded to the intraoperative observations in all 37 patients. Forty-seven cortical dangerous veins were dissected and protected intraoperatively, including 14 bridging veins, five superficial Sylvian veins, eight anastomotic veins, and 20 veins involving the central lobe. Six patients experienced intraoperative venous injury, which was managed by suturing or pressure hemostasis. No patient exhibited definite postoperative symptoms or radiological changes attributable to venous infarction.</p><p><strong>Conclusion: </strong>This study highlights the importance of integrating cortical dangerous vein protection into surgical planning and lesion resection. Employing three-dimensional visualization to advance identification of cortical dangerous veins and preserve vein integrity during resection may mitigate postoperative venous infarction-related deficits without adversely affecting treatment efficacy.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123935"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731901","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}