World neurosurgery最新文献

{"title":"Surgery of atlantoaxial osteoarthritis.","authors":"Heta Räisänen, Antti Ronkainen, Juhana Frösen, Tuomo Thesleff","doi":"10.1016/j.wneu.2025.124507","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124507","url":null,"abstract":"<p><strong>Background: </strong>Unilateral atlantoaxial osteoarthritis (AAOA) is an underdiagnosed condition characterised by severe occipitocervical pain and restricted head rotation. This study aimed to compare clinical outcomes and complications associated with different surgical methods used to treat AAOA in cases where conservative management fails.</p><p><strong>Methods: </strong>This was a retrospective cohort study conducted at Tampere University Hospital, Finland, with patients treated between 2004 and 2024. Patients were divided into two groups based on the surgical approach. Clinical outcomes were evaluated at a median follow-up of 60 days postoperatively, with a focus on pain reduction and complication rates. The study included 49 patients diagnosed with unilateral AAOA who underwent either C1-2 fixation with or without C2 nerve root decompression (group 1) or only C2 nerve root decompression (group 2).</p><p><strong>Results: </strong>Both groups showed substantial pain reduction with good or excellent outcomes in 82.3 % in group 1 and 73.3 % in group 2. Complications were more common in group 1 (29.4 %) than in group 2 (13.3 %), with sensory loss in the C2 dermatome being the most frequent complication.</p><p><strong>Conclusions: </strong>These findings suggest that both C1-2 fixation and C2 nerve root decompression are safe and effective methods for pain caused by AAOA, the later especially when symptoms are related to C2 radiculopathy.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124507"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179220","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":"Frailty in Spontaneous Intracerebral Haemorrhage and its Outcomes: A Systematic Review and Meta-Analysis.","authors":"Claire Yi Jia Lim, Lucas Tze Peng Tan, Jin Hean Koh, Mervyn Jun Rui Lim, Li Feng Tan","doi":"10.1016/j.wneu.2025.124503","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124503","url":null,"abstract":"<p><strong>Background: </strong>Frailty has been shown to be a better predictor of clinical outcomes than age alone across many diseases. Few studies have evaluated the association of frailty and SICH incidence and outcomes. The aim of this systematic review and meta-analysis was to investigate the odds of frailty in SICH and the prognosis of SICH patients who are frail.</p><p><strong>Methods: </strong>Following a PROSPERO-registered protocol, three authors conducted a systematic review of the PubMed/Medline, Embase, Cochrane Library and CINAHL databases up to 17 October 2024. The certainty of evidence was assessed using the GRADE framework. A standard pairwise meta-analysis using odds ratios and 95% confidence intervals was performed, with results presented in forest plots.</p><p><strong>Results: </strong>From 8 included studies (17, 524 participants), the odds of frailty are significantly higher in SICH patients than patients without SICH (OR: 1.47, 95% CI: 1.31 to 1.64, p < 0.01). Within the SICH cohort, frail patients have significantly higher rates of mortality (OR: 3.48, 95% CI: 2.51 to 4.82, p < 0.01) and unfavourable outcome (mRS 3-6) (OR: 1.75, 95% CI: 1.35 to 2.26, p < 0.01) CONCLUSION: SICH patients are more likely to be frail, and SICH patients who are frail have higher rates of mortality and adverse outcomes. Further research is required to compare the robustness of different frailty assessment tools in assessing frailty in SICH cohorts.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124503"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179165","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":"Intraventricular endoscopic surgery for pediatric hypothalamic hamartomas: surgical series and literature meta-analysis.","authors":"Giulia Cossu, Rinat Sufianov, Mahmoud Messerer, Philippe Ryvlin, Roy T Daniel, Albert Sufianov","doi":"10.1016/j.wneu.2025.124505","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124505","url":null,"abstract":"<p><strong>Objective: </strong>Intraventricular endoscopic procedures represent a valuable option for the treatment of hypothalamic hamartomas (HH). Thulium-laser disconnection has been proposed as an alternative to monopolar disconnection techniques. We aim to present our consecutive surgical series and we performed a meta-analysis to provide an overall summary of the relevant literature.</p><p><strong>Methods: </strong>We conducted a retrospective review of pediatric cases treated from 2016 to 2023. A description of the surgical procedures is provided, along with surgical outcomes and complications. We conducted a meta-analysis by selecting studies including pediatric patients with HH undergoing an endoscopic treatment and detailing epilepsy outcomes and postoperative complications.</p><p><strong>Results: </strong>Fifteen pediatric patients were operated in the aforementioned period: 13 had a thulium laser disconnection (87%). Six patients were seizure free (40%) and 9 had improved seizures' control (60%) at last follow-up. No permanent postoperative complications were reported. We included 8 articles and our series in the meta-analysis, encompassing 302 patients undergoing endoscopic surgeries. Endoscopic procedures were performed in 82% of cases and disconnection accounted for 75% of endoscopic procedures. Engel class I was reported in 52% of patients, while Engel Class I to II was obtained in 69% of cases at last follow-up (median 22.5 months). Complication rates were around 5%, mainly including memory deficits and thalamic infarcts.</p><p><strong>Conclusion: </strong>Endoscopic procedures for HH are a safe option for children, as they demonstrate a high level of success in controlling epilepsy and low rates of complications. Thulium-laser disconnection could represent an attractive tool for disconnection procedures. Larger studies could be valuable to validate this technique in the pediatric population.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124505"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179238","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":"3D Geometric Analysis of Anterior Circulation Anatomy in Patients with Intracranial Aneurysms.","authors":"Imadh Khan, Hannah E Johnson, Noah B Drewes, Blaine A Traylor, Andre F Catalano, Kristin Delfino, Hayan Dayoub","doi":"10.1016/j.wneu.2025.124504","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124504","url":null,"abstract":"<p><strong>Background: </strong>The formation and progression of intracranial aneurysms are influenced by multiple factors. Previous studies have shown the local geometry surrounding an aneurysm to influence its development. The geometry of the global cerebral vasculature, however, and its potential effects on aneurysms have not been well elucidated. We hypothesized that select geometries within the anterior cerebral circulation would differ among those with ruptured and unruptured aneurysms.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 38 patients who presented to our institution for catheter-based 3D rotational cerebral angiography for assessment of intracranial aneurysms. Geometric analysis was conducted using Materialise Mimics® and 3-Matic®.</p><p><strong>Results: </strong>Those with a ruptured aneurysm (n = 7) had a significantly larger bifurcation angle between the ACA and MCA compared to patients with unruptured aneurysms (97.96°, 91.60°, p = 0.01). Subgroup analysis demonstrated larger ACA diameters in the cohort of patients with ACA aneurysms (3.14 mm) compared to those with ICA and MCA aneurysms (2.45 mm, 2.61 mm, p=0.004). Patients over the age of 65 had larger MCA bifurcation angles (94.87°) compared to their younger counterparts (86.58°, p = 0.024). Males exhibited a significantly larger petrous ICA diameter (5.33 mm vs. 4.53 mm, p <0.001), ICA genu diameter (4.97 mm vs. 4.43 mm, p=0.017), and ACA diameter (2.96 mm vs. 2.55 mm, p=0.010), compared to female patients, but a smaller ACA-MCA bifurcation angle (91.11° vs. 94.31°, p = 0.039).</p><p><strong>Conclusion: </strong>We conclude that geometric differences may be the result of systemic vascular remodeling and a potential indicator of aneurysm integrity.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124504"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179164","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":"Lymphangioma in the Neurosurgical Axis: A Review and Illustrative Case Report.","authors":"Brian H Carlson, Coulson Rich, Parker Layton, Miles Hudson, Richard Zimmerman","doi":"10.1016/j.wneu.2025.124508","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124508","url":null,"abstract":"<p><p>Lymphangiomas are benign malformations of the lymphatic system that rarely present in adults. This report describes a rare case of cervical lymphangioma in an adult patient that mimicked a schwannoma, and reviews all published cases of histologically confirmed, non-complex adult lymphangiomas involving neurological structures. A comprehensive literature search of OVID/MEDLINE and Web of Science was conducted from inception to August 29, 2025, to identify all case reports and case series involving adult patients with histologically confirmed, non-complex lymphangiomas affecting cranial, spinal, or peripheral nerves, either by location or symptomatology. Eighteen articles comprising eighteen cases were included. Data collected included lesion location, presenting symptoms, size, imaging performed, histologic findings, treatment, and follow-up. The average patient age was 46.7 years (SD 19.6) with 8 males (44%), 9 females (50%), and one patient (6%) whose sex was not reported. The majority of patients experienced neurological symptoms (n = 14, 78%), most commonly pain (50%), paresthesia (44%), and weakness (17%); two patients (11%) presented with neck swelling and no other symptoms. All patients except one underwent surgical resection. Sixteen patients (89%) had no recurrence at last follow-up (mean follow-up time 15.2 months; SD 12.2), while two (11%) experienced recurrence. Although rare in adults, lymphangiomas can mimic other lesions and cause neurological symptoms due to involvement of adjacent nervous system structures. Clinicians should maintain awareness of this entity to avoid misdiagnosis and guide appropriate management. This review emphasizes the importance of recognizing lymphangiomas as a relevant consideration in neurosurgical differential diagnosis.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124508"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179184","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":"Single-Center Experience with AneuGuide™ Software-Assisted Flow Diverter Treatment for Complex Intracranial Aneurysms.","authors":"Yuexin Lu, Jiahao Tang, Rong Zou, Chaobo Zheng, Ming Wang, Jianping Xiang, Shu Wan","doi":"10.1016/j.wneu.2025.124501","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124501","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy and safety of flow diverters (FDs) guided by AneuGuide™ software in treating complex intracranial aneurysms.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 45 patients diagnosed with 48 complex intracranial aneurysms from August 2019 to December 2023. Among these, 21 aneurysms were treated with FDs implantation guided by AneuGuide™ software (ArteryFlow Technology, Hangzhou, China), and 27 aneurysms received FDs treatment without AneuGuide™ assistance. Immediate post-operative embolization rates, complication incidences, and clinical and imaging follow-up results were compared between the two groups.</p><p><strong>Results: </strong>A total of 49 FDs were implanted for the 48 aneurysms in the 45 patients, with 10 patients receiving additional coil embolization. No perioperative complications occurred. At 1-year follow-up, angiography showed: 9 aneurysms (18.8%) were grade B (partially visible), and 39 aneurysms (81.3%) were grade C or D (near-total occlusion), of which 37 (77.1%) were completely occluded (grade D). Multivariate cox regression analysis revealed that the AneuGuide™ group had a significantly higher complete occlusion rate at follow-up compared to the non-AneuGuide™ group (HR = 2.290, p = 0.044). One patient in the non-AneuGuide™ group developed in-stent stenosis without clinical symptoms. No new neurological deficits were observed in any of the patients during the follow-up period.</p><p><strong>Conclusion: </strong>FD placement for complex intracranial aneurysms assisted by AneuGuide™ software is a safe and effective treatment. Further prospective studies are needed to validate these findings.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124501"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179211","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":"Dynamic Bone Metabolism and Inflammatory-Immune Markers for Postoperative Outcome Assessment in Thoracolumbar Burst Fractures.","authors":"Guanyou Li","doi":"10.1016/j.wneu.2025.124510","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124510","url":null,"abstract":"<p><strong>Background: </strong>Postoperative failure after thoracolumbar burst-fracture fixation is difficult to anticipate using imaging alone. We tested whether early inflammatory biomarkers and bone-formation markers improve risk stratification.</p><p><strong>Methods: </strong>Prospective cohort of consecutive adults undergoing fixation for T10-L2 burst fractures with 24-month follow-up. The primary endpoint was treatment failure. Secondary endpoints were ≥10% vertebral height loss and ≥10° kyphosis progression. Biomarkers (C-reactive protein (CRP), interleukin-6 (IL-6), bone-specific alkaline phosphatase, osteocalcin, ESR) were measured serially. Primary analyses used the posterior-only cohort; full-cohort models adjusting for approach served as sensitivity checks. Forced-entry multivariable logistic regression quantified associations; performance was assessed with AUC and calibration. Prespecified sensitivities adjusted for infections ≤3 months and NSAID/steroid exposure near the two-week draw.</p><p><strong>Results: </strong>Of 196 screened, 174 were analyzed (posterior-only n=138); 50/174 (28.7%) met the primary endpoint. In posterior-only patients, two-week CRP (7.8 vs 4.1 mg/L; p=0.006) and IL-6 (16.8 vs 12.5 pg/mL; p=0.028) were higher in failures. Adjusted models showed TLICS ≥ 5 (OR 2.35, 95% CI 1.02-5.42), CRP ≥ 5 mg/L (OR 2.12, 1.22-3.70), and IL-6 ≥ 7 pg/mL (OR 1.63, 1.01-2.67) predicted failure; AUC = 0.75 (optimism-corrected 0.73) with good calibration. Two-week CRP/IL-6 provided peak discrimination (AUCs 0.73/0.70) and increased a baseline clinical AUC from 0.66 to 0.75. Associations persisted after infection and medication adjustments. Radiographic progression was more frequent in failures and associated with TLICS and, for height loss, CRP.</p><p><strong>Conclusions: </strong>Two-week CRP and IL-6, combined with TLICS, identify patients at risk of postoperative treatment failure after thoracolumbar burst-fracture fixation and support biomarker-guided surveillance.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124510"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179087","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":"Transverse Posterior Canal Stenosis as a Predictor of Redundant Nerve Roots in Lumbar Stenosis.","authors":"Dong Li, Dawei Wang, Bingcheng Liu, Tengfei Song, Wei Liu, Hao Tang, Shu Liu, Tianwen Ye","doi":"10.1016/j.wneu.2025.124497","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124497","url":null,"abstract":"<p><strong>Objectives: </strong>Redundant nerve roots (RNR) of the lumbar cauda equina is an important imaging presentation associated with lumbar spinal stenosis (LSS) and considered a potentially powerful prognostic indicator of poor functional recovery after surgery for symptomatic LSS. However, factors contributing to RNR remain undefined. This study aimed to investigate the effects of sagittal and transverse stenosis of the lumbar spinal canal on RNR formation.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted in 124 LSS patients over 18 years of age. They were divided into a RNR group and a non-RNR group. Correlations of LSS imaging parameters and pathogenic factors with RNR formation were analyzed.</p><p><strong>Results: </strong>Excluding 16 cases of non-degenerative LSS, 108 patients were finally included for analysis, including 33 patients (30.6%) in RNR group and 75 patients in non-RNR group. Age, included angle of the ligamentum flavum, maximum thickness of the ligamentum flavum, area of the dural sac, total area of the bilateral facet joints, and transverse diameter of the posterior spinal canal (PSC) showed statistically significant differences between the two groups (p≤0.001). The optimal cut-off point for the transverse diameter of PSC was 9.94mm. There was a significant positive correlation of transverse diameter of PSC and area of the dural sac with the presence of RNR (r=0.5897, p<0.001).</p><p><strong>Conclusions: </strong>Transverse stenosis of PSC is the key factor contributing to RNR formation in LSS patients and the value < 10mm can be used to predict the risk of RNR formation in LSS patients.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124497"},"PeriodicalIF":2.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150564","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":"5G remote robotic-assisted PKP is safe and effective for thoracolumbar vertebral compression fractures.","authors":"Xian-Liang Zhang, Lu-Ping Zhou, Xin-Yu Dong, Ao Liu, Chong-Yu Jia, Hua-Qing Zhang, Peng Ge, Yong Zhang, Ren-Jie Zhang, Cai-Liang Shen","doi":"10.1016/j.wneu.2025.124498","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124498","url":null,"abstract":"<p><strong>Objective: </strong>5G remote robotic-assisted (RRA) technology has been applied in percutaneous kyphoplasty (PKP) for the treatment of patients with thoracolumbar vertebral compression fractures. Although some cases of RRA have already been reported, the safety and effectiveness of this technology remain controversial. Meanwhile, the radiographic and clinical parameters of the RRA and conventional robotic-assisted (CRA) methods has not been compared for patients with thoracolumbar vertebral compression fractures.</p><p><strong>Method: </strong>This study aimed to compare the radiographic and clinical parameters of RRA versus the CRA technology for PKP in thoracolumbar vertebral compression fractures. A total of 95 patients with thoracolumbar vertebral compression fractures who received PKP using RRA (43 patients) and CRA (52 patients) techniques were retrospectively included. The radiographic parameters included vertebral height and local Cobb's angle. Meanwhile,the clinical parameters included bone cement leakage rate, pain indicators, surgical time, intraoperative blood loss and complications.</p><p><strong>Results: </strong>In radiographic parameters, the preoperative and postoperative vertebral height,including anterior vertebral height (AVH), middle vertebral height (MVH), posterior vertebral height (PVH) of both groups showed similar statistical results, with no statistically significant differences(P>0.05).In addition, the preoperative and postoperative vertebral compression ratio including anterior vertebral compression ratio (AVCR), middle vertebral compression ratio (MVCR), posterior vertebral compression ratio (PVCR) of both groups showed similar statistical results, with no statistically significant differences(P>0.05).Besides, the parameters of two groups' preoperative and postoperative local Cobb's angle were almost the same(P>0.05). Furthermore,in terms of clinical parameters,the RRA technique showed a lower rate of bone cement leakage than the CRA method , but there was no significant difference between the two groups (P = 0.809).The preoperative and postoperative pain scores calculated by visual analogue scale (VAS) and oswestry disability index (ODI) of both two groups shows approximate results.And the differences are not statistically significant.In addition,both the RRA and CRA group showed similar statistical results in terms of surgical time, intraoperative blood loss and complications with no statistically significant differences(P>0.05).</p><p><strong>Conclusions: </strong>RRA PKP for treating thoracolumbar compression fractures can effectively relieve patient pain, restore vertebral height, and improve local kyphosis while ensuring safety. The 5G remote robotic-assisted PKP is accurate and safe in clinical application.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124498"},"PeriodicalIF":2.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150626","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":"Ibero-Latin American Consensus on Oblique Lumbar Interbody Fusion (L2-L5): A Modified Delphi Study.","authors":"Federico Landriel, Alderico Girão Campos de Barros, Alejandro Morales Ciancio, Alfonso Vega, Alisson Teles, Álvaro Silva González, Carlos Arellanes-Chávez, David Suárez-Fernández, Gerd Bordon, Javier Gutierrez, José Augusto Malheiros, Juan Carlos Fernández, Nelson Morales Alba, Néstor Taboada, Pablo Vela, Ricardo Bermudez, Yamil Rivera, Boris Baranov, Santiago Hem","doi":"10.1016/j.wneu.2025.124490","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124490","url":null,"abstract":"<p><strong>Study design: </strong>Modified Delphi qualitative study.</p><p><strong>Objective: </strong>To establish expert consensus on the surgical application of oblique lumbar interbody fusion at the L2/5 spinal level (OLIF 25) using a modified Delphi process.</p><p><strong>Methods: </strong>Seventeen experienced spine surgeons from Iberia and Latin America participated in a four-round Delphi process (one face-to-face and three online surveys) conducted between July 2024 and April 2025. Consensus was defined as ≥70% agreement and graded as strong (≥90%), moderate (80-89.9%), or weak (70-79.9%).</p><p><strong>Results: </strong>A total of 56 statements across four domains (preoperative assessment, technology/instrumentation, intraoperative considerations, postoperative care) were evaluated. Consensus was achieved for 45 statements (80.4%), including 11 with strong agreement, 17 moderate, and 6 weak. Additional items were classified as optional recommendations (12.5%) or findings (7.1%). Key agreements included mandatory MRI for corridor assessment, indirect foraminal decompression, and Grade I degenerative spondylolisthesis as favorable indications. Major contraindications were severe canal stenosis with blocked facets and prior ipsilateral retroperitoneal surgery. High-risk steps identified were pin fixation, tubular retractor opening, and anterior longitudinal ligament (ALL) release.</p><p><strong>Conclusion: </strong>This study provides the first Delphi-based regional consensus specifically addressing OLIF 25. It delivers structured expert guidance on imaging, indications, contraindications, and intraoperative safety maneuvers, offering a framework to standardize OLIF 25 practice in Ibero-Latin America.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124490"},"PeriodicalIF":2.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138756","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}