World neurosurgery最新文献

{"title":"Idiopathic Normal Pressure Hydrocephalus and Shunt Complications per Valve Type: A Meta-Analysis of Proportions","authors":"James Kelbert ,&nbsp;Kristin Nosova ,&nbsp;Ashley Kern ,&nbsp;Rachel Russell ,&nbsp;Annie Pico ,&nbsp;James Mamaril-Davis ,&nbsp;Amna Hussein ,&nbsp;Ganesh Murthy ,&nbsp;Giovanni Barbagli ,&nbsp;Robert W. Bina","doi":"10.1016/j.wneu.2024.11.033","DOIUrl":"10.1016/j.wneu.2024.11.033","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic normal pressure hydrocephalus is classically recognized by the triad of gait disturbance, cognitive dysfunction, and urinary incontinence. Since ventricular shunting may be affected by valve type, we conducted a meta-analysis to assess the relationship between valve characteristics and outcomes.</div></div><div><h3>Methods</h3><div>English language studies that reported valve types, outcomes, and associated complications were included. Data were extracted and analyzed using R, version 4.3.2.</div></div><div><h3>Results</h3><div>Thirteen studies were included. With gravitational valves, meta-analysis yielded 0.04 [0.02, 0.07] for subdural effusions (SDEs), 0.00 [0.00, 0.00] for surgical SDEs, 0.06 [0.03, 0.09] for proximal revisions, and 0.06 [0.03, 0.09] for distal. With differential pressure valves (DPVs) with antisiphon control, meta-analysis showed an incidence of 0.10 [0.07, 0.13] for SDEs, 0.02 [0.01, 0.04] for surgical SDEs, 0.03 [0.01, 0.05] for proximal and 0.04 [0.02, 0.07] for distal revisions. With DPVs without antisiphon control, there was an incidence of 0.17 [0.11, 0.23] for SDEs, 0.11 [0.06, 0.19] for surgical SDEs, 0.00 [0.00, 0.02] for proximal shunt revisions, and 0.05 [0.02, 0.10] for distal shunt revisions. With flow regulated valves, there was an incidence of 0.05 [0.01, 0.12] for SDEs, 0.01 [0.00, 0.05] for surgical SDEs, 0.06 [0.02, 0.11] for proximal revisions, and 0.01 [0.00, 0.05] for distal.</div></div><div><h3>Conclusions</h3><div>Gravitational valves and NPVs are associated with fewer SDEs while DPVs with and without ASDs are associated with more while there were no differences in proximal or distal revisions.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123450"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693665","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":"Molecular Biomarkers Associated with Traumatic Brain Injury Outcome in Individuals of Black Racial Identity or African Ancestry: A Narrative Review","authors":"Tadeusz H. Wroblewski ,&nbsp;Erum Ajmal ,&nbsp;Favour Ononogbu-Uche ,&nbsp;David P. Lerner ,&nbsp;Tim B. Bigdeli ,&nbsp;Jasmin Divers ,&nbsp;Ernest J. Barthélemy","doi":"10.1016/j.wneu.2024.123620","DOIUrl":"10.1016/j.wneu.2024.123620","url":null,"abstract":"<div><div>Traumatic brain injury (TBI) is a leading cause of death and disability worldwide and a major global health concern. In the United States, individuals of Black or African American racial identity experience disproportionately higher rates of TBI and suffer from worse postinjury outcomes. Contemporary research agendas have largely overlooked or excluded Black populations, resulting in the continued marginalization of Black patient populations in TBI studies, thereby limiting the generalizability of ongoing research to patients in the United States and around the world. This review aims to highlight what is currently known, and identify knowledge gaps, in research on molecular biomarkers associated with TBI in Black populations. A PubMed literature search was conducted to identify studies that investigate molecular biomarkers associated with TBI outcomes that include participants of Black racial identity and those of African ancestry. Studies identified for this review investigate biomarkers associated with TBI outcomes through a lens that specifically examines race, ethnicity, or ancestry. Most studies focused on blood- or cerebrospinal fluid-derived protein biomarkers. Studies identified statistical variation in S100ß, ubiquitin C-terminal hydrolase-L1, amyloid-ß, and tau across participant race, either at baseline or following TBI. Additionally, several studies identified genetic polymorphisms associated with TBI outcomes related to apolipoprotein E, <em>ANKK1</em>, and <em>COMT</em> polymorphism and TBI outcome and identified allele frequency variation across population ancestry. The role of race and ancestry on biomarkers associated with TBI outcome remains indeterminate and subsequent work is still required to understand the implications for patients with TBI.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123620"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898653","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":"Topographic Anatomy and Step-Wised Harvest of Intermuscular Occipital Artery in Far Lateral Approach","authors":"Ping Shen ,&nbsp;Xu Wang ,&nbsp;Zhifeng Tian ,&nbsp;Xiaohai Liu ,&nbsp;Ge Chen ,&nbsp;Peng Hu ,&nbsp;Mingchu Li","doi":"10.1016/j.wneu.2025.123657","DOIUrl":"10.1016/j.wneu.2025.123657","url":null,"abstract":"<div><h3>Background</h3><div>The occipital artery (OA) is an important donor artery for intracranial and extracranial bypass surgery, but its path is tortuous, making it difficult to harvest. Part of the traditional intermuscular OA is not covered by muscle and is easily damaged during surgery. Currently, there are few reports on how to protect this segment of the OA.</div></div><div><h3>Objective</h3><div>To clarify the course of the intermuscular OA and its positional relationship with different muscles through anatomical measurements and to explore how to quickly and safely harvest the occipital artery in the far lateral approach.</div></div><div><h3>Methods</h3><div>Thirty-three sides of 17 formalin-fixed adult cadaveric heads (n = 33) were used for anatomical measurements to clarify the positional relationship between the OA and the splenius capitis muscle and the superior nuchal line (SNL). A \"reverse C-shaped\" surgical incision through the far lateral approach was used to find the attachment of the uppermost muscle fiber of the splenius capitis muscle to the SNL, the site where the OA passed through the splenius capitis muscle, and the site where the OA crossed the SNL. The distances between these 3 points were measured, and the proximal and distal diameters of the OA were also measured. We proposed how to safely and quickly harvest the OA using the splenius capitis muscle as a landmark in the far lateral approach.</div></div><div><h3>Results</h3><div>In all specimens, part of the intermuscular OA ran below the tendons and connective tissues in the superficial layer of the muscle. This area was located on the medial side of the uppermost muscle fibers of the splenius capitis muscle, below the SNL, and on the surface of the sternocleidomastoid muscle or trapezius muscle tendons. There were no dense muscle fibers on the surface of the OA in this area, which we referred to as the posterior segment of OA of the splenius capitis muscle, with the length of 29.3 ± 12.1 mm.</div></div><div><h3>Conclusions</h3><div>Through the far lateral approach, the splenius capitis muscle is a useful landmark to expose the OA. We can safely, quickly, and accurately find the OA by dissecting within 13.6 ± 5.2 mm below the uppermost muscle fiber of the splenius capitis muscle.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123657"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955976","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":"Historical Review of Traumatic Brain Injury Caused by Fishing Speargun & a New Suicide Case","authors":"Mary Solou ,&nbsp;Nikolaos Siasos ,&nbsp;John Lakoumentas ,&nbsp;Konstantinos A. Bakopoulos","doi":"10.1016/j.wneu.2024.10.094","DOIUrl":"10.1016/j.wneu.2024.10.094","url":null,"abstract":"<div><h3>Background</h3><div>Traumatic brain injury (TBI) is a severe neurosurgical emergency and a significant public health concern. Fishing-speargun TBIs are included in nonmissile injuries and have been implicated in only few cases of TBI in the past 68 years, mainly of accidental etiology.</div></div><div><h3>Objective</h3><div>To introduce a novel case report of a TBI in a 38-year-old man who shot himself with a speargun in a suicide attempt and to present a thorough review of related case reports along with the management strategies, prognosis, and outcomes.</div></div><div><h3>Methods</h3><div>We conducted a literature review of case reports in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including incidents of TBI by speargun published in PubMed, Scopus, and Web of Science until January 2024.</div></div><div><h3>Results</h3><div>A total of 22 publications, reporting 26 cases of speargun-related TBIs, formulated the 27 investigated cases including the current patient which were used in this descriptive and inferential statistical analysis. Predominantly affecting males (88.89%) with a median age of 29 years, these injuries were primarily due to accidents (65.38%), with a noticeable shift toward suicide. Outcome variability ranged from intact recovery (48.15%) in majority of cases to a range of unfavorable outcomes. Significant factors impacting outcomes included initial Glasgow Coma Scale score &lt;8, major initial computed tomography head findings, and major complications. Survival analysis indicated early manifestation of unfavorable outcomes.</div></div><div><h3>Conclusions</h3><div>In summary, the diverse presentation, management, outcomes, and identified influencing factors highlight the complexity of managing speargun-related injuries, and the need for personalized approaches and further research to enhance care protocols.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123365"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558970","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":"Clinical Outcomes at 2-Year Follow-Up Comparing Open Surgery and Percutaneous Laser Disc Decompression for Radicular Sciatic Pain Patients","authors":"Amir Saied Seddighi,&nbsp;Afsoun Seddighi,&nbsp;Seyedmorteza Hosseini","doi":"10.1016/j.wneu.2024.10.121","DOIUrl":"10.1016/j.wneu.2024.10.121","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to compare the clinical outcomes of percutaneous laser disc decompression (PLDD) and open surgery for patients with radicular sciatic pain caused by lumbar disc herniation over a 2-year follow-up period.</div></div><div><h3>Methods</h3><div>In a prospective randomized controlled trial, 84 patients with chronic radicular pain were assigned to either the open surgery group (n = 42) or the PLDD group (n = 42). Patients were evaluated at baseline, and at 4, 8, 24, 48, and 96 weeks postintervention. Outcome measures included the Roland-Morris Disability Questionnaire, Visual Analog Scale for leg and back pain, and the Short Form-36 bodily pain and physical functioning subscales. Resurgery rates were also recorded.</div></div><div><h3>Results</h3><div>No significant differences in Roland-Morris Disability Questionnaire, Visual Analog Scale for leg and back pain, or Short Form-36 scores were observed between the 2 groups at any follow-up time points. Both groups showed improvement in disability and pain scores over time, with similar patterns of recovery. The median resurgery rates were 19.0% for open surgery and 31.0% for PLDD (<em>P</em> = 0.314), indicating comparable long-term effectiveness of both treatments.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that PLDD and open surgery provide similar long-term outcomes in terms of disability, pain relief, and physical functioning for patients with radicular sciatic pain. While PLDD is associated with a higher resurgery rate, it remains a viable minimally invasive alternative to open surgery. Further research is warranted to refine patient selection criteria and improve procedural efficacy for both interventions.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123392"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569677","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":"IMProve-DURA: Investigations of Molecular Patient Profiles and Anatomical Cadaveric Characteristics of the Dura Mater—A Pilot Study Protocol","authors":"Francesca Graziano ,&nbsp;Gianluca Scalia ,&nbsp;Bipin Chaurasia ,&nbsp;Giuseppe E. Umana ,&nbsp;Rosa Maria Gerardi ,&nbsp;Gianluca Galvano ,&nbsp;Valeria Barresi ,&nbsp;Giada Garufi ,&nbsp;Salvatore Marrone ,&nbsp;Roberta Costanzo ,&nbsp;Salvatore Cardali ,&nbsp;Giovanni Nicoletti","doi":"10.1016/j.wneu.2024.11.074","DOIUrl":"10.1016/j.wneu.2024.11.074","url":null,"abstract":"<div><h3>Background</h3><div>The dura mater, a fibrous membrane protecting the brain and spinal cord, is prone to lacerations during spinal surgery, often leading to complications such as cerebrospinal fluid (CSF) leakage. Anatomical differences in the spinal dura mater, particularly in regions under high biomechanical stress, suggest that chronic inflammatory processes may compromise its structural integrity. This pilot study investigates the molecular and anatomical characteristics of the spinal dura mater, focusing on its response to inflammation and the challenges of surgical repair.</div></div><div><h3>Methods</h3><div>The study involves the collection of 40–60 cadaveric spinal dura mater samples and 100 preoperative blood samples from patients undergoing major spinal surgery. Histological and biomolecular analyses will assess tissue integrity, elastin, collagen content, and the expression of inflammatory biomarkers (heat shock proteins and cytokines). Multiplex assays, mass spectrometry, and Western blot techniques will analyze biomarker profiles in both dura mater and blood samples. Comparative and correlation analyses will be performed to identify common molecular patterns between cadaveric tissue and patient blood samples, with statistical tests applied to detect significant differences.</div></div><div><h3>Results</h3><div>Preliminary power analysis justifies the sample sizes, aiming to detect moderate effect sizes (Cohen's d = 0.5) with 80% power. Histological and biomolecular results will focus on the impact of chronic inflammation on spinal dura integrity, specifically its thinning and vulnerability to laceration. Key findings will include biomarker profiles correlating with tissue damage and postsurgical complications like CSF leakage.</div></div><div><h3>Conclusions</h3><div>This pilot study aims to enhance our understanding of the inflammatory processes affecting the dura mater and their role in frequent lacerations during spinal surgery. Findings are expected to guide future clinical practices in dura repair strategies, potentially improving surgical outcomes and reducing complications related to CSF leakage.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123491"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711304","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":"C1–2 Stenosis Caused by Posterior Osteophytes: An Unusual Cause of Cord Compression","authors":"Luis A. Robles ,&nbsp;Gregory W. Basil ,&nbsp;Ian Côté","doi":"10.1016/j.wneu.2024.11.094","DOIUrl":"10.1016/j.wneu.2024.11.094","url":null,"abstract":"<div><div>Cervical spinal stenosis most commonly occurs at the subaxial spine. C1–C2 stenosis is relatively unusual but can be present in certain congenital or syndromic conditions such as rheumatoid arthritis. In this manuscript, we highlight the case of a 42-year-old lady who presented with neck pain and signs of high cervical myelopathy. Imaging studies showed severe stenosis at C1–C2 caused by posterior osteophytes originating from the C1 arch and C2 lamina. Decompression and stabilization of the segment were performed. This case is unique as this pathology occurred at an uncommon location, leading to an unusual degree of compression and resulting in surgical intervention.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123511"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717270","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":"Craniosynostosis in Africa: Insights from 8 Countries—A Systematic Review and Meta-Analysis","authors":"Kwadwo Darko ,&nbsp;Sonia Pulido ,&nbsp;Muhammad Ammar Haider ,&nbsp;Milan Sivakumar ,&nbsp;Bernice Limann ,&nbsp;Pearl Tenkorang ,&nbsp;Okikioluwa Odesanya ,&nbsp;Peace Odiase ,&nbsp;Mark Farid ,&nbsp;Umaru Barrie ,&nbsp;Bruno P. Braga ,&nbsp;Mabel Banson ,&nbsp;Teddy Totimeh","doi":"10.1016/j.wneu.2024.11.116","DOIUrl":"10.1016/j.wneu.2024.11.116","url":null,"abstract":"<div><h3>Objective</h3><div>Craniosynostosis is a congenital skull deformity that impacts development and quality of life of children if left untreated. This study aimed to evaluate literature regarding presentation, treatment, and outcomes of craniosynostosis in Africa.</div></div><div><h3>Methods</h3><div>A systematic review of the literature using PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</div></div><div><h3>Results</h3><div>Fourteen retrospective/prospective studies with 620 patients and 14 case reports involving 27 cases (8 countries) were included. In 12 articles, 56.6% of patients (317/560) were males, with a mean age of 2.4 years (confidence interval [CI]: 1.1–3.7). Abnormal head shape was the most reported presentation in 77.8% of cases (332/427, 8 articles). Syndromic craniosynostosis was seen in 25.2% (CI: 13.7%–36.6%). Common phenotypes were trigonocephaly in 31.5% (CI: 3.6%–59.4%), anterior plagiocephaly in 23.2% (CI: 5.1%–41.3%), and scaphocephaly in 22.1% (CI: 13.5%–30.8%). Five hundred seventy eight patients, 99.5% (CI: 99.0%–100.0%), underwent surgical treatment. Vault remodeling was performed in 72.9% patients (CI: 47.4%–98.6%). Postoperative complications included cerebrospinal fluid leaks 5.4% (CI: 0.0%–11.6%) and surgical site infections 4.5% (CI: 0.0%–10.8%). Follow-up ranged between 0.2 and 40.9 months; 95.6% of cases (CI: 90.1%–100.0%) exhibited improved deformity and neurological deficits at last follow-up. The mortality rate was 3.1% (CI: 0.0%–6.9%, 2 articles).</div></div><div><h3>Conclusions</h3><div>Few studies on craniosynostosis in Africa highlight the need for more research. Treatment with open techniques yields few complications and a low mortality rate. Early diagnosis and collaborative data reporting will enhance understanding of its burden and variations across Africa.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123533"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772830","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":"Surgical Management and Prognostic Factors for Endolymphatic Sac Tumor: A Single-Institute Experience with a Systematic Review","authors":"Jiancong Weng ,&nbsp;Xiaotian Wen ,&nbsp;Da Li ,&nbsp;Honghong Li ,&nbsp;Huan Li","doi":"10.1016/j.wneu.2024.10.113","DOIUrl":"10.1016/j.wneu.2024.10.113","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical features, surgical outcomes, and predictors of progression-free survival (PFS) in patients with endolymphatic sac tumors (ELSTs).</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 15 cases from Beijing Tiantan Hospital and 237 from the literature (1988–2023), focusing on patients with pathologically confirmed intracranial or skull ELSTs who had comprehensive treatment and follow-up records. Univariate and multivariate Cox regression analyses were used to identify factors influencing PFS.</div></div><div><h3>Results</h3><div>Patients from our institute comprised 10 males and 5 females, with an average age of 39.1 years. Among these patients, 86.7% underwent gross total resection (GTR). During the follow-up period, 2 patients (13.3%) were lost to follow-up. After a mean follow-up of 74.9 months, 1 patient experienced recurrence and another died from unrelated causes. A review of the literature identified 237 additional patients, including 134 females (56.5%), with an average age of 39.8 years; 22.8% of these patients had von Hippel-Lindau disease. The GTR rate was 69.2%. After a mean follow-up of 53.2 months, 33 recurrences occurred, and the median PFS was 48 months. In addition, 8 patients died during the follow-up period; none of the deaths was attributed to ELSTs. Multivariate analysis identified GTR (hazard ratio, 0.279; 95% confidence interval, 0.086–0.903; <em>P</em> = 0.033) as a significant protective factor against recurrence among the pooled cases.</div></div><div><h3>Conclusions</h3><div>GTR is crucial for improving PFS in patients with ELST, emphasizing the need for advanced surgical techniques and long-term follow-up because of potential recurrences.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123384"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569740","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":"Radiographic Predictors of Lateral Translation in Patients With Residual Adolescent Idiopathic Scoliosis and Thoracolumbar/Lumbar Curves: A Focus on L3 Lateral Translation","authors":"Masaya Mizutani ,&nbsp;Toshiaki Kotani ,&nbsp;Yasuchika Aoki ,&nbsp;Shuhei Iwata ,&nbsp;Shun Okuwaki ,&nbsp;Shuhei Ohyama ,&nbsp;Kotaro Sakashita ,&nbsp;Yosuke Ogata ,&nbsp;Yasushi Iijima ,&nbsp;Tsuyoshi Sakuma ,&nbsp;Sumihisa Orita ,&nbsp;Kazuhide Inage ,&nbsp;Yasuhiro Shiga ,&nbsp;Shohei Minami ,&nbsp;Seiji Ohtori","doi":"10.1016/j.wneu.2024.10.133","DOIUrl":"10.1016/j.wneu.2024.10.133","url":null,"abstract":"<div><h3>Background</h3><div>Patients with residual adolescent idiopathic scoliosis (AIS) and thoracolumbar/lumbar curves may present with progression after cessation of growth, with lateral translation as a major risk factor. Nonetheless, radiographic predictors and underlying mechanisms remain indefinite. This study aimed to determine these radiographic predictors and structural mechanisms in patients with residual AIS.</div></div><div><h3>Methods</h3><div>Radiographic and clinical data were collected from 45 consecutive patients with preoperative residual AIS and thoracolumbar/lumbar Cobb angle &gt;40° who subsequently underwent corrective surgery at our institution. Lateral translation was defined as intervertebral slippage ≥6 mm on computed tomography. Statistical analyses included Student’s <em>t</em>-test, Pearson’s correlation coefficients, receiver operating characteristic curve analysis, and multivariate logistic regression analysis.</div></div><div><h3>Results</h3><div>Of 45 patients, 3 were male, whereas 42 were female, with a mean age of 40.6 ± 17.4 years. L3 slippage was observed in 21 patients, resulting in the categorization into the slippage and nonslippage cohorts. Multivariate logistic regression analysis revealed statistically significant disparities in the bilateral facet angles, facet joint opening, and facet joint vacuum phenomenon between the 2 cohorts. The receiver operating characteristic analysis determined a 20.5° cut-off value for predicting L3 slippage. In the nonslippage cohort, a strong correlation was particularly observed between L3 slippage and L2–L3 bridging.</div></div><div><h3>Conclusions</h3><div>Facet joint instability, L4 tilt ≥20.5°, and L3 cranial vertebral bridging are predictive radiographic factors for L3 lateral translation in patients with residual AIS. Thus, patients exhibiting these characteristics require consistent follow-up or early surgical intervention before lateral translation occurs.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123404"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639856","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}