World neurosurgery最新文献

{"title":"Dementia Risk After Vertebral Augmentation for Osteoporotic Vertebral Compression Fracture: A Propensity Score-Matched Cohort Study.","authors":"Chien-Min Chen, Yu Chang, Hong-Min Lin","doi":"10.1016/j.wneu.2026.125490","DOIUrl":"https://doi.org/10.1016/j.wneu.2026.125490","url":null,"abstract":"<p><strong>Background: </strong>Osteoporotic vertebral compression fractures (VCFs) cause chronic pain and prolonged immobility, both potentially modifiable risk factors for dementia. Vertebral augmentation (VA), performed as percutaneous vertebroplasty or balloon kyphoplasty, relieves pain and enables earlier mobilization. We examined whether VA is associated with a lower long-term risk of dementia than conservative management.</p><p><strong>Methods: </strong>Using the TriNetX Global Collaborative Network, we conducted a retrospective, propensity score-matched cohort study of patients older than 60 years with a newly diagnosed VCF. Patients were grouped by receipt of VA within six months of diagnosis. After 1:1 propensity score matching on demographic, comorbidity, and osteoporosis-medication variables, we assessed incident dementia over five years using odds ratios (ORs) with 95% confidence intervals (CIs) and Kaplan-Meier curves with the log-rank test. A six-month landmark analysis was performed to limit immortal-time bias.</p><p><strong>Results: </strong>Matching produced 3,830 patients per group, with every standardized mean difference below 0.1. Dementia occurred in 8.1% of the VA group and 9.9% of the non-VA group over five years (OR 0.80, 95% CI 0.68-0.94; absolute risk difference 1.8 percentage points). The association persisted in the six-month landmark analysis (3,497 patients per group; 6.2% vs 7.5%; OR 0.81, 95% CI 0.67-0.98).</p><p><strong>Conclusions: </strong>In older adults with osteoporotic VCF, vertebral augmentation was associated with a lower medium-term incidence of dementia than conservative management. Given the observational design, unmeasured confounding, and competing mortality, this association is preliminary and hypothesis-generating, and requires confirmation in prospective studies before any causal inference or change in practice.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"125490"},"PeriodicalIF":2.0,"publicationDate":"2026-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149335360","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 Synchronized Two-Surgeon Workflow for Two-Level Unilateral Biportal Endoscopic Transforaminal Lumbar Interbody Fusion: Technical Note and Preliminary Case Series.","authors":"Jixiang Zhang, Zongjiang Wang, Huiquan Li, Hongfei Li, Leming Mou, Hongyu Wang, Wanping Zhu, Hao Luo, Huanning Yang, Dengxing Lun","doi":"10.1016/j.wneu.2026.125483","DOIUrl":"https://doi.org/10.1016/j.wneu.2026.125483","url":null,"abstract":"<p><strong>Objective: </strong>To describe a standardized four-phase synchronized two-surgeon workflow for selected two-level unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and report its preliminary outcomes.</p><p><strong>Methods: </strong>This single-center retrospective Technical Note included 33 consecutive patients (66 operated levels) treated in 2025 by a fixed pair of experienced surgeons. Each surgeon performed endoscopic decompression and interbody fusion at an assigned level, with coordinated fluoroscopy, guidewire staging, shared-device use, and percutaneous instrumentation. Perioperative outcomes, pain and disability scores, 90-day adverse events, and CT-based fusion assessments obtained at least 12 months postoperatively were reviewed.</p><p><strong>Results: </strong>All 33 procedures were completed. Mean operative time was 294 ± 59 minutes, estimated blood loss was 299 ± 78 mL, and median spine-surgery ward stay was 7 days (interquartile range, 6-9). Three patients (9.1%) had recorded adverse events: incidental durotomy, wound infection requiring surgical debridement, and anemia requiring transfusion (one each). At a median final clinical follow-up of 427 days, median back- and leg-pain visual analog scale scores decreased from 6 to 1 and from 7 to 0, respectively; median Oswestry Disability Index decreased from 70 to 18 (all Holm-adjusted P < 0.001 versus baseline). CT at ≥12 months was available for 22/25 eligible patients; fusion (Bridwell I/II) was observed in 40/44 evaluable levels (91%) and at both operated levels in 20/22 patients (91%).</p><p><strong>Conclusions: </strong>The coordinated workflow was feasible in an experienced fixed surgical pair. Prospective comparative studies are needed to assess efficiency, safety, resource use, and generalizability.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"125483"},"PeriodicalIF":2.0,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149325140","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":"Seizure and motor outcomes following subtotal hemispherotomy: A retrospective case series and systematic review.","authors":"Manel Krouma, Takahiro Hayashi, Keiya Iijima, Yuiko Kimura, Shimpei Baba, Noriko Sumitomo, Takashi Saito, Didier Scavarda, Masaki Iwasaki","doi":"10.1016/j.wneu.2026.125481","DOIUrl":"https://doi.org/10.1016/j.wneu.2026.125481","url":null,"abstract":"<p><strong>Purpose: </strong>Subtotal hemispherotomy (SH) is a motor-sparing approach for multifocal or hemispheric epilepsy, but its efficacy and optimal indications remain unclear. We evaluated seizure and motor outcomes after SH and the factors associated with seizure freedom.</p><p><strong>Methods: </strong>We retrospectively analyzed patients who underwent SH at our institution between 2015 and 2024 and conducted a systematic review of studies reporting seizure and motor outcomes after SH. The primary outcome was seizure freedom (International League Against Epilepsy [ILAE] class 1) at last follow-up; seizure-free and non-seizure-free patients were compared.</p><p><strong>Results: </strong>Six institutional patients and 30 patients from the literature were included. In our cohort, seizure freedom (ILAE class 1) was achieved in 3 of 6 patients (50%) at 1 year and in 2 of 6 (33%) at last follow-up (median, 20 months), with no permanent new motor deficits. In the pooled literature cohort, 23 of 30 patients (77%; 95% CI, 58-90) were seizure-free at a median follow-up of 63.5 months; 19 of these patients came from a single, predominantly resective series, and the seizure-freedom rate after disconnective SH was 73% (8/11). No permanent motor deficits were reported. No factor was significantly associated with seizure freedom.</p><p><strong>Conclusion: </strong>SH preserved motor function in all patients. However, fewer than half of our patients remained seizure-free at long-term follow-up, a lower rate than reported in the literature. SH may be considered when preservation of motor function is a priority, provided that families are counseled that seizure outcomes may be inferior to those of complete hemispherotomy.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"125481"},"PeriodicalIF":2.0,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149325152","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 Mixed-Reality Virtual-Monitor Workspace for Endoscopic Pituitary Surgery: Proof of Concept from Bench to Bedside.","authors":"Carlotta Fontana, Michele Guacci, Francesco Corrivetti, Anna Tortora, Luigi Falchetta, Vincenzo Meglio, Giuliana Panico, Giuseppe Carpenzano, Giorgio Iaconetta, Nicola Cappetti, Matteo De Notaris","doi":"10.1016/j.wneu.2026.125474","DOIUrl":"https://doi.org/10.1016/j.wneu.2026.125474","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopic transsphenoidal pituitary surgery requires the management of an increasing amount of information: the surgeon must reconcile spatially separated operative screens - endoscopy, neuronavigation and preoperative imaging - each on its own monitor, away from the operative axis. To our knowledge, no three-source virtual-monitor workspace has been reported during live endoscopic pituitary surgery. This proof-of-concept study tested the workspace in the anatomy laboratory and in a first clinical case.</p><p><strong>Methods: </strong>A custom mixed-reality platform was developed to integrate the endoscopic feed, neuronavigation data, and radiological imaging into the HoloLens 2 headset, where information was displayed through voice-controlled virtual monitors within the surgeon's field of view. Ten operators (five consultants, five second-year residents) performed standardised endoscopic endonasal procedures on a cadaveric specimen while wearing the headset. Perceived usability (SUS) and workload (SURG-TLX) were assessed. The platform was used by the lead surgeon during resection of a pituitary microadenoma.</p><p><strong>Results: </strong>Laboratory SUS was 88 ± 6 and SURG-TLX weighted composite 38 ± 17 (0-100). In the clinical case the workspace was used through the nasal, sphenoidal and sellar stages without modifying the operative workflow or requiring removal of the headset (SUS 88; SURG-TLX 52). Situational stress, temporal demand and task complexity were rated highest; mental demand, physical demand and distractions lowest.</p><p><strong>Conclusions: </strong>A surgeon-centred mixed-reality workspace was feasible and well tolerated in both anatomical and live pituitary surgery. The findings support feasibility; whether workload was reduced was not assessed. Larger controlled studies incorporating objective measures of gaze, posture and workload are needed.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"125474"},"PeriodicalIF":2.0,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149325139","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":"Beyond Weight Loss: A Scoping Review and Thematic Analysis of GLP-1 Receptor Agonists Across the Neurosurgical Landscape.","authors":"Julia Diamandi, Serhat Aydin, Taha F Chomelawala, Ella O'Rourke, Benoy Sen, Qazi Zeeshan, Joseph C Maroon","doi":"10.1016/j.wneu.2026.125484","DOIUrl":"https://doi.org/10.1016/j.wneu.2026.125484","url":null,"abstract":"<p><strong>Background: </strong>GLP-1 receptor agonists (GLP-1RAs) are increasingly used for diabetes and obesity. Literature spans spinal fusion, idiopathic intracranial hypertension (IIH), and cerebrovascular disease, but has not been systematically mapped. We aimed to map literature on GLP-1RA exposure in neurosurgical landscapes by characterizing study design, drug class, disease-specific outcomes, and safety considerations.</p><p><strong>Methods: </strong>This scoping review was conducted per the PRISMA-ScR guideline. Eligible studies reported GLP-1RA exposure in adults with spinal, intracranial, or cerebrovascular disease, recording clinical, perioperative, or imaging outcomes. Two reviewers screened independently with third-reviewer adjudication. Extracted variables included country, design, agent, timing, indication, neurosurgical and metabolic outcomes, and adverse events.</p><p><strong>Results: </strong>Of 1342, 48 were included, predominantly from the United States (US) (34/48, 71%). Most were retrospective (43/48, 90%); 31/48 (65%) used propensity score matching; 5/48 (10%) were randomized. Three themes dominated: spinal fusion (24/48, 50%), IIH and cerebrospinal fluid (CSF) dynamics (14/48, 29%), and cerebrovascular and neurointerventional disease (10/48, 21%). In spinal fusion, perioperative GLP-1RA exposure was repeatedly associated with lower pseudarthrosis, although some studies reported increased postoperative complications. In IIH, GLP-1RAs were associated with lower papilledema, fewer CSF leaks, reduced acetazolamide requirement, and lower shunt placement. Cerebrovascular reports described lower intracerebral hemorrhage, subarachnoid hemorrhage, and post-stroke mortality, mostly in observational studies.</p><p><strong>Conclusions: </strong>GLP-1RA neurosurgical literature is dominated by US-based retrospective, propensity-matched analyses. Benefit signals are most consistent in spinal fusion and IIH, but perioperative adverse effects and overlap among database cohorts limit causal interpretation. Adequately powered prospective trials with standardized endpoints are needed to confirm results.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"125484"},"PeriodicalIF":2.0,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149325142","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":"Long-Term External Ventricular Drainage for Hydrocephalus Associated With Central Neurocytoma: A Single-Institution Experience from China.","authors":"Xuanwei Dong, Shuiqiang Zhao, Liangliang Li, Wenhao Li, Shuo Liu, Jianxing Niu","doi":"10.1016/j.wneu.2026.125488","DOIUrl":"https://doi.org/10.1016/j.wneu.2026.125488","url":null,"abstract":"<p><strong>Objective: </strong>To describe the feasibility and observed safety of long-term external ventricular drainage (ltEVD) as a bridge to tumor resection in patients with central neurocytoma and symptomatic hydrocephalus.</p><p><strong>Methods: </strong>This retrospective single-center observational study examined 14 patients treated at the Department of Neurosurgery, Aviation General Hospital between November 2019 and June 2024.Six other patients without ventricular enlargement or hydrocephalus were excluded. The institutional protocol combined ltEVD with staged tumor resection, maintaining drainage for at least 21 days overall and 14 days after resection. Outcomes included shunting, ventriculitis, and ventricular size.</p><p><strong>Results: </strong>Nine patients (64%; 95% confidence interval [CI], 35%-87%) were weaned without permanent shunting. Five (36%) required ventriculoperitoneal shunts; all had third ventricular tumors. One patient developed ventriculitis (7.1%; 95% CI, 0.2%-33.9%). Median Evans index decreased from 0.39 before treatment to 0.28 at 6 months and 0.26 at 12 months (both P<0.001 versus baseline; P=0.004 between follow-up assessments). Median follow-up was 25.5 months (range, 18-32). Eleven patients received radiotherapy.</p><p><strong>Conclusions: </strong>The bridging strategy was technically feasible in these selected patients who completed the minimum drainage duration. The uncontrolled design and subsequent shunting and radiotherapy preclude attributing ventricular reduction to ltEVD alone or establishing superiority over other diversion strategies.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"125488"},"PeriodicalIF":2.0,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149325146","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":"Pressure-Controlled Fibrinolytic Irrigation via Twist-Drill Craniostomy for Selected Traumatic Acute Subdural Hematomas: A Single-Center Implementation and Safety Experience.","authors":"Roberto Doria-Medina, Marco Bissolo, István Csók, Mukesch Johannes Shah, Jürgen Beck, Roland Roelz","doi":"10.1016/j.wneu.2026.125485","DOIUrl":"https://doi.org/10.1016/j.wneu.2026.125485","url":null,"abstract":"<p><strong>Objective: </strong>To describe technical implementation and major safety outcomes of investigational twist-drill craniostomy with pressure-controlled fibrinolytic irrigation therapy (TDC-FIT) for selected traumatic acute subdural hematoma (aSDH).</p><p><strong>Methods: </strong>We retrospectively analyzed 27 patients selected for TDC-FIT between June 2023 and August 2025. Selection considered symptomatic hematoma, clinical and radiological stability, comorbidity, procedural burden, and treatment preferences. Eleven patients had been published previously. Events were classified by irrigation initiation and technical mechanism. Proportions and Wilson 95% confidence intervals (CIs) were reported. A historical craniotomy cohort (n = 37) provided descriptive context only.</p><p><strong>Results: </strong>Irrigation began in 24/27 patients (89%). Three conversions preceded irrigation: one for clinical deterioration without new bleeding and two for catheter malposition. Two rebleeds followed irrigation initiation (2/24; 8.3%; 95% CI, 2.3-25.8). Overall, three hemorrhagic events (11%), four conversions to craniotomy (15%), two delayed interventions for chronic SDH (7.4%), and five deaths during available follow-up (19%; 95% CI, 8.2-36.7) were recorded. One death was recorded after discharge, and to deaths were medical related. Adequate hematoma evacuation without open rescue was achieved in 21/27 (78%) selected patients and 21/24 in whom irrigation was initiated (88%). Technical and pre-irrigation complications remain part of the safety assessment.</p><p><strong>Conclusion: </strong>TDC-FIT was implemented and hematoma evacuation was often possible, but clinically important events, rescue surgery, and mortality occurred. These data do not establish clinical safety, efficacy, or benefit over observation or conventional evacuation. TDC-FIT remains investigational in highly selected cases.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"125485"},"PeriodicalIF":2.0,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149325149","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":"Quantitative Morphological Analysis of the Trigeminal Nerve in Trigeminal Neuralgia Caused Solely by Venous Compression.","authors":"Takamaro Takei, Yoji Tanaka, Shinya Onogi, Yoshikazu Nakajima, Azumi Kaneoka, Yukika Arai, Akihito Sato, Tadahiro Ishiwada, Taketoshi Maehara","doi":"10.1016/j.wneu.2026.125477","DOIUrl":"https://doi.org/10.1016/j.wneu.2026.125477","url":null,"abstract":"<p><strong>Objective: </strong>To clarify morphological characteristics of trigeminal neuralgia (TN) caused by venous compression using quantitative analysis of high-resolution MRI.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent microvascular decompression for TN caused solely by venous compression and achieved favorable outcomes. Three-dimensional trigeminal nerve models were constructed from pre- and postoperative MRI. Centerline length, curvature, torsion, cross-sectional area, flattening ratio, and long-axis angle were measured and compared between affected and unaffected sides and between pre- and postoperative images.</p><p><strong>Results: </strong>Sixteen patients' cases were analyzed. No significant preoperative differences were observed between affected and unaffected sides. On the affected side, postoperative centerline length was significantly shorter than preoperative values (6 [4-7] vs. 4 [3-4] mm, p<0.01), while postoperative cross-sectional area was significantly larger (78 [54-104] vs. 136 [94-186] pixels, p<0.01). Curvature, torsion, flattening ratio, and long-axis angle showed no significant changes. No significant pre- to postoperative differences were observed on the unaffected side. All analyzed patients achieved favorable postoperative outcomes without recurrence during follow-up.</p><p><strong>Conclusions: </strong>Quantitative three-dimensional morphometric analysis demonstrated significant postoperative morphological changes of the trigeminal nerve after MVD for TN caused solely by venous compression. Postoperative shortening of the centerline and enlargement of the cross-sectional area suggest release of chronic mechanical stress following decompression. These findings provide additional insight into the pathophysiology of venous neurovascular conflict and demonstrate the feasibility of quantitative assessment of postoperative nerve changes. Further studies including recurrent and unfavorable outcome cases are warranted to clarify the clinical significance of these morphometric findings.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"125477"},"PeriodicalIF":2.0,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149325151","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":"Are Admission Hemoglobin and Platelet Count Independent Prognostic Markers in Spontaneous Intracerebral Hemorrhage? A Retrospective Cohort Study.","authors":"Mehmetzeki Yıldız, Evren Sönmez, Berkay Paker, Sümeyye Özay Sönmez","doi":"10.1016/j.wneu.2026.125486","DOIUrl":"https://doi.org/10.1016/j.wneu.2026.125486","url":null,"abstract":"<p><strong>Aim: </strong>To examine whether admission hemoglobin (HB) and platelet (PLT) levels are associated with 90-day mortality independently of established severity markers in spontaneous intracerebral hemorrhage (ICH), and whether these associations relate to hematoma burden.</p><p><strong>Material and methods: </strong>We retrospectively analyzed 100 consecutive adults with predominantly hypertensive spontaneous ICH admitted to a single tertiary center between 2021 and 2025. Mortality associations were assessed using univariate and parsimonious multivariable logistic regression. Incremental prognostic value was evaluated using nested likelihood-ratio (LR) tests, pseudo-R² changes, and supplementary receiver operating characteristic analysis. Spearman correlations assessed relationships with hematoma volume. Sensitivity analysis excluded patients receiving comfort care and additionally adjusted for surgical status.</p><p><strong>Results: </strong>Ninety-day case-fatality was 38%. Non-survivors had lower HB (11.4 vs 12.4 g/dL; p=0.002) and PLT (171 vs 195 ×10³/μL; p=0.013). Both were associated with mortality in univariate analyses, but neither showed a statistically significant independent association after adjustment for Glasgow Coma Scale (GCS) plus hematoma volume or ICH score, while GCS and ICH score remained associated. Adding HB and PLT did not significantly improve model fit (LR p=0.93 for ICH score; p=0.71 for GCS plus volume), with essentially unchanged pseudo-R² and minimal discrimination improvement (AUC 0.870 versus 0.865). HB and PLT correlated inversely with hematoma volume (ρ=-0.38, p<0.001; ρ=-0.28, p=0.004). Sensitivity analysis yielded similar findings.</p><p><strong>Conclusion: </strong>Admission HB and PLT were associated with mortality in unadjusted analyses but provided limited additional prognostic information beyond hematoma burden and clinical severity. Larger studies are needed to confirm these findings.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"125486"},"PeriodicalIF":2.0,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149325141","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":"Long-Term Follow-up Study of Dynesys Dynamic Stabilization: A Single Institution Experience from China.","authors":"Tianhong Chen, Zhuowen Hao, Hongliang Zhang, Zhenhua Xu, Jingfeng Li","doi":"10.1016/j.wneu.2026.125487","DOIUrl":"https://doi.org/10.1016/j.wneu.2026.125487","url":null,"abstract":"<p><strong>Objective: </strong>To describe the long-term outcomes of Dynesys dynamic stabilization combined with decompression.</p><p><strong>Methods: </strong>This study included patients who underwent Dynesys dynamic stabilization plus decompression surgery at Zhongnan Hospital of Wuhan University (Wuhan, China) from January 2008 through December 2014. Clinical efficacy was evaluated using the Visual Analog Scale (VAS), Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index (ODI), and SF-36 quality of life scale. Preoperative and final follow-up imaging was collected to measure the intervertebral disc height and range of motion of the surgical and adjacent segments. The incidence of complications, including adjacent segment disease (ASD) and internal fixation loosening, was recorded.</p><p><strong>Results: </strong>A total of 35 patients were included (mean follow-up: 122 ± 23 months). Follow-up results showed significant improvements in VAS, JOA score, ODI, and SF-36 scores at the final follow-up compared with preoperative values (all P < 0.05). Imaging results showed that at the final follow-up, no significant difference in operative-segment disc height was detected between preoperative and final follow-up measurements (P = 0.518), whereas the disc heights of the cranial and caudal adjacent segments significantly decreased (both P < 0.05). The range of motion of the surgical segment decreased compared with preoperative values , while the range of motion of the cranial and caudal adjacent segments increased compared with preoperative values (P < 0.05). The incidence of symptomatic ASD at the final follow-up was 8.6%.</p><p><strong>Conclusions: </strong>Dynesys dynamic stabilization combined with decompression was associated with clinical improvement and partial preservation of operative-segment mobility during long-term follow-up.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"125487"},"PeriodicalIF":2.0,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149325147","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}