{"title":"Syringobulbia and Syringomyelia Associated with Intramedullary Ependymoma.","authors":"Yuejia Li, Shiyuan Han, Jun Gao","doi":"10.1016/j.wneu.2025.124314","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124314","url":null,"abstract":"<p><p>No cases of bulbar palsy secondary to hemorrhage from intramedullary ependymoma into the peritumoral cavity have been reported. A 23-year-old male presented with persistent hiccups, pneumonia, and progressively worsening respiratory dysfunction. Clinical course and imaging findings raised strongly suggested bulbar palsy from a C4-5 intramedullary hemorrhagic lesion. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain and cervical spine revealed an intramedullary mass at C4-5, accomopanied by syringobulbia and syringomyelia, with signals extending from the lower medulla oblongata to the T1 spinal level. The patient underwent laminectomy, myelotomy, and microsurgical mass excision with intraoperative neurophysiological monitoring. Postoperative pathology confirmed the lesion as an ependymoma. Neurological function improved steadily after surgery. Thus, central respiratory dysfunction should be considered in patients with severe pneumonia without underlying disease. Additionally, contrast-enhanced MRI is essential for differential diagnosis in bulbar palsy cases.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124314"},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699703","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}
Yasmin Sadigh, Yvette de Haan, Eva Joëlle Haasdijk, Iris Verploegh, Thor Löwe Busse, Olga Ciobanu-Caraus, Alexandra-Maria Călăuz, Alessandra Ariana Spinean, Ana-Denisa Lariu, Ruben Dammers, Sepideh Amin-Hanjani, Victor Volovici
{"title":"Indications and Outcomes of Intracranial Bypass: A Systematic Review and Meta-analysis.","authors":"Yasmin Sadigh, Yvette de Haan, Eva Joëlle Haasdijk, Iris Verploegh, Thor Löwe Busse, Olga Ciobanu-Caraus, Alexandra-Maria Călăuz, Alessandra Ariana Spinean, Ana-Denisa Lariu, Ruben Dammers, Sepideh Amin-Hanjani, Victor Volovici","doi":"10.1016/j.wneu.2025.124308","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124308","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis aims to provide an overview of the indications, selection criteria, and outcomes of intracranial direct bypass surgery.</p><p><strong>Methods: </strong>Embase, Ovid Medline, the Web of Science Core Collection, Google Scholar, and Cochrane Central Register of Controlled Trials were searched from inception to February 11<sup>th</sup>, 2025, for original studies reporting indications for bypass surgery including human subjects. Patency, procedure-related neurological complications, postoperative poor clinical outcome, and mortality rates were analysed using a random-effects model. Pooled prevalence rates and 95% confidence intervals (CI) were presented.</p><p><strong>Results: </strong>The search yielded 7,449 articles of which 5,478 remained after removing duplicates. After initial screening, 251 articles remained to be assessed for eligibility based on full-text sifting. Ultimately, 142 articles were included. One hundred-six studies reported 'steno-occlusive disease' as an indication. Postoperative poor clinical outcome occurred in 9% of the patients (95% CI 5.1-13.0; I<sup>2</sup>=78%), and the mortality rate was 3.5% (95% CI 1.6-5.5; I<sup>2</sup>=82%). Forty-one studies reported 'Moyamoya vasculopathy' as an indication. Postoperative poor clinical outcome occurred in 5.5% of the patients (95% CI 0.6-10.4; I<sup>2</sup>=78%), and the mortality rate was 0.6% (95% CI 0.0-1.7; I<sup>2</sup>=0%). Seven studies reported 'urgent bypass' as an indication, seven studies 'ruptured aneurysm treatment', and 29 studies 'complex unruptured aneurysm treatment'.</p><p><strong>Conclusions: </strong>Despite a decline in indications, intracranial bypass surgery remains a highly relevant option for the treatment of diseases such as Moyamoya vasculopathy, as a salvage option in steno-occlusive disease with hemodynamic compromise, and treatment of aneurysms not amenable to microsurgical or endovascular repair.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124308"},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699702","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 proposal for standardized analysis of microvascular decompression results in hemifacial spasm.","authors":"Akinori Kondo, Hiroshi Shimano, Soichiro Yasuda, Hiroshi Miwa, Takashi Yoneda, Takuya Kosaka","doi":"10.1016/j.wneu.2025.124311","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124311","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate subjective satisfaction using a grading system based on postoperative spasm relief and complication rates, reflecting the perceptions of physicians and patients.</p><p><strong>Methods: </strong>Patients with hemifacial spasm (HFS) who underwent microvascular decompression (MVD) and followed-up for 2-15 years were enrolled. Subjective satisfaction was assessed using two scores: the spasm score (E), which categorized residual spasms from E-0 (complete relief) to E-3 (persistent spasms), and the complication score (C), which ranged from C-0 (no complications) to C-2 (severe nerve dysfunction). The sum of E and C scores represented overall patient satisfaction (T).</p><p><strong>Results: </strong>Among 152 patients, spasm scores were E-0 in 118 (77.6 %), E-1 in 29 (19.0 %), and E-2 or E-3 in 5 (3.2 %). Complications were scored as C-0 in 112 patients (73.7 %), with C-1 and C-2 observed in 40 (26.3 %). Overall satisfaction scores were T-0 in 89 patients (58.6 %), T-1 in 41 (26.9 %), T-2 in 18 (11.8 %), and T-3 in 4 (2.6 %).</p><p><strong>Conclusion: </strong>A standardized analysis of MVD outcomes in HFS is essential to evaluate not only patient-reported satisfaction but also to integrate spasm relief, symptom persistence, complications, and recurrence into a single score. MVD results should be assessed through comprehensive satisfaction metrics incorporating subjective evaluations from patients and surgeons.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124311"},"PeriodicalIF":1.9,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683249","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}
Ali Ebada, Christopher J Carron, Nicholas Bever, Kristen Hall, Mazin Al Tamimi, Carlos A Bagley, Jose E Marin Sanchez, Salah G Aoun
{"title":"Propensity Score-Matched Analysis of the Association Between Depression, Anxiety, and Patient-Reported Outcomes Following Lumbar Surgery.","authors":"Ali Ebada, Christopher J Carron, Nicholas Bever, Kristen Hall, Mazin Al Tamimi, Carlos A Bagley, Jose E Marin Sanchez, Salah G Aoun","doi":"10.1016/j.wneu.2025.124305","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124305","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the relationship between a diagnosis of depression or anxiety and postoperative patient-reported outcome measurements (PROMs) following lumbar fusion surgery, utilizing minimal clinically important difference (MCID) thresholds and propensity score matching.</p><p><strong>Methods: </strong>We conducted a propensity score matched retrospective study at a single academic institution between October 2016 and February 2025, analyzing the impact of a diagnosis of depression or anxiety on PROMs following lumbar fusion surgery.</p><p><strong>Results: </strong>Of 207 eligible patients, 70 (33.8%) had a documented diagnosis of depression, anxiety, or both. At baseline, patients with a mental health diagnosis reported significantly worse VAS Back and PROMIS Pain scores. At 12 months, they continued to have significantly worse outcomes across all PROMs, including ODI (p = 0.0002), VAS Back (p = 0.0072), VAS Leg (p = 0.0053), and PROMIS Pain (p = 0.0414). MCID achievement for VAS Leg was significantly lower in the mental health group (p = 0.0080). In univariable and multivariable regression models, mental health diagnosis was associated with lower odds of achieving MCID for VAS Leg pain (p = 0.004). In the propensity-matched sample (n = 122) ODI remained worse in the mental health group (p = 0.0365), and MCID achievement for VAS Leg was significantly reduced (p = 0.002).</p><p><strong>Conclusions: </strong>Patients with preoperative depression or anxiety experienced worse postoperative outcomes following lumbar fusion. Our findings suggest that mental health may be a modifiable risk factor that influences recovery and functional benefit after lumbar spine surgery.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124305"},"PeriodicalIF":1.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675912","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}
Shao-Jun Li, Ya-Chun Zhong, Dan Feng, Qing-Peng Dong
{"title":"Comparative efficacy and safety of Feng's technique versus radiofrequency denervation for cervical and lumbar facet joint pain: a retrospective study.","authors":"Shao-Jun Li, Ya-Chun Zhong, Dan Feng, Qing-Peng Dong","doi":"10.1016/j.wneu.2025.124291","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124291","url":null,"abstract":"<p><strong>Background: </strong>Facet joint-mediated pain represents a major etiology of chronic spinal pain, posing persistent challenges in clinical management. We propose a novel technique-Feng's technique- which provides a novel and effective strategy for the treatment of facet joint-related pain.</p><p><strong>Methods: </strong>This retrospective study analyzed 221 patients with cervical and lumbar facet joint pain treated between May 2020 and December 2021. Participants were divided into two groups: the Feng's technique group and the radiofrequency denervation group. Pain intensity was evaluated using the Visual Analog Scale (VAS), while health-related quality of life (QoL) was assessed via the Short Form 36 (SF-36) questionnaire. Follow-ups were conducted pretreatment, and at 3- and 6-months posttreatment. Patient satisfaction and posttreatment complications were systematically recorded.</p><p><strong>Results: </strong>The mean VAS and SF-36 scores showed statistically significant improvements posttreatment compared to baseline (p < 0.001), with no significant differences observed between the Feng's technique and radiofrequency denervation groups (p > 0.05). However, overall patient satisfaction was significantly higher in the Feng's technique group (81.4% [70/86] vs. 68.9% [84/122], p = 0.042). The incidence of complications was notably lower in the Feng's technique group (8.1% [7/86] vs. 18.0% [22/122], p = 0.043), with a significantly higher prevalence of sensory abnormalities in the radiofrequency denervation group (7.4% [14/122] vs. 1.2% [1/86], p = 0.039).</p><p><strong>Conclusion: </strong>Feng's technique has shown significant potential as a minimally invasive solution for cervical and lumbar facet joint pain, with initial studies indicating excellent safety and therapeutic effectiveness.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124291"},"PeriodicalIF":1.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675936","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}
Maxwell W Pickles, Thomas Z Rohan, Shreya Vinjamuri, Nikolaos Mouchtouris, Roger Murayi, David P Bray, James J Evans
{"title":"Secondary Malignancies in Patients with Meningioma: a Surveillance, Epidemiology, and End Results (SEER) Data Analysis.","authors":"Maxwell W Pickles, Thomas Z Rohan, Shreya Vinjamuri, Nikolaos Mouchtouris, Roger Murayi, David P Bray, James J Evans","doi":"10.1016/j.wneu.2025.124292","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124292","url":null,"abstract":"<p><strong>Background: </strong>The risk of secondary primary malignancies (SPM) in meningioma patients is not well understood. In this unidirectional analysis, we evaluated the risk of SPMs occurring following a primary diagnosis of meningioma.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results (SEER-17) database (2000-2020) was used to identify 124,769 meningioma patients from a total of 9,208,295 cancer cases. Standardized Incidence Ratios (SIRs) were calculated using SEER's statistical analysis package to evaluate SPM risk. Basic demographic and treatment information was collected as well.</p><p><strong>Results: </strong>Of the 124,769 patients, 11,411 (9.2%) received diagnoses of an SPM, which correlates to a higher risk than the general population (SIR, 1.17; 99% CI, 1.15-1.19). Patients with meningiomas had an increased risk of the following cancers: cutaneous melanoma (SIR, 1.40; 99% CI, 1.26-1.56), kidney and renal pelvis (SIR, 1.66; 99% CI, 1.47-1.86), brain and other nervous system (SIR, 3.45; 99% CI, 2.99-3.97), thyroid (SIR, 2.48; 99% CI, 2.19-2.80), and non-Hodgkins's lymphoma (SIR, 1.29; 99% CI, 1.15-1.44). Females were more predisposed to cancers of the lung (SIR, 1.19; 99% CI, 1.12-1.26), digestive system (SIR, 1.06; 99% CI, 1.01-1.12), and breast (SIR, 1.09; 99% CI, 1.04-1.14). Older patients demonstrated an increased risk of SPM development, with the 65-85-year-old group having an odds ratio of 9.06 (p=0.009).</p><p><strong>Conclusion: </strong>SEER data confirm an increased risk of SPMs following meningioma diagnosis. Further research may uncover shared genetic factors between meningioma and these SPMs, and increased awareness of SPM risk could inform future screening strategies.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124292"},"PeriodicalIF":1.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675914","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}
Hussain Salim, Muhammad Ahmed, Zahra Imran, Dua Ali, Shaheer Bin Shafiq, Muhammad Khalid Afridi, Muzammil Farhan, Charles Dominic Ward, Raheel Ahmed, Saad Ahmed Waqas
{"title":"Endovascular Thrombectomy vs. Standard Care for Strokes Involving Medium or Distal Vessel Occlusions: A Systematic Review and Meta-Analysis.","authors":"Hussain Salim, Muhammad Ahmed, Zahra Imran, Dua Ali, Shaheer Bin Shafiq, Muhammad Khalid Afridi, Muzammil Farhan, Charles Dominic Ward, Raheel Ahmed, Saad Ahmed Waqas","doi":"10.1016/j.wneu.2025.124306","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124306","url":null,"abstract":"<p><strong>Background: </strong>Medium and distal vessel occlusions (MeVO/DVO) contribute to significant stroke-related disability, yet their optimal management remains unclear. While EVT is standard for large vessel occlusions, its role in MeVO/DVO strokes is still being evaluated.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials comparing EVT to standard medical therapy for MeVO/DVO strokes. Databases included PubMed, Embase, Scopus, and CENTRAL (through March 2025). Outcomes included mortality, symptomatic intracranial hemorrhage (SICH), and functional independence (modified Rankin Scale [mRS] scores at 3 months).</p><p><strong>Results: </strong>Data from 1,254 patients (627 EVT, 627 standard care) were analyzed. EVT did not significantly reduce mortality or SICH, nor did it improve good functional outcomes (mRS 0-1 or 0-2). Sensitivity analysis excluding specific trials (e.g., ESCAPE-MeVO) suggested potential benefits for functional independence.</p><p><strong>Conclusion: </strong>EVT did not demonstrate significant overall benefit over standard therapy in MeVO/DVO strokes. Further studies are needed to clarify its role in selecting patient subgroups and evolving treatment contexts.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124306"},"PeriodicalIF":1.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675911","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}
Jong-Ho Ha, Ji Eun Moon, Soo-Bin Im, Je Hoon Jeong
{"title":"The efficacy of partial cervical corpectomy reconstructed with flanged polyether ether ketone (PEEK) cages in patients with cervical spondylotic myelopathy (CSM) below one level.","authors":"Jong-Ho Ha, Ji Eun Moon, Soo-Bin Im, Je Hoon Jeong","doi":"10.1016/j.wneu.2025.124309","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124309","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective study evaluates the efficacy and complications of partial cervical corpectomy with flanged PEEK cage reconstruction for short-segment degenerative cervical myelopathy (DCM).</p><p><strong>Methods: </strong>This retrospective study comprised 22 consecutive patients who underwent partial cervical corpectomy with flanged PEEK cage reconstruction for below-one-level DCM CSM from May 2019 to March 2023 (Group 2). Additionally, 23 patients undergoing anterior cervical discectomy and fusion (ACDF) were included as the control group (Group 1). We analyzed demographic data, visual analog scale (VAS) scores, and Nurick grades. The fusion rate was assessed on postoperative plain X-ray or computed tomography scans using a radiographic fusion scale. Lordotic angle and graft subsidence were measured in postoperative radiographs.</p><p><strong>Results: </strong>Demographic parameters indicated no significant differences between the two groups (p > 0.05). Both groups exhibited similar preoperative and follow-up VAS scores (p > 0.05). Nurick grades consistently decreased from the preoperative state to the last follow-up in both groups (p < 0.05). In terms of the regional Cobb angle, the differences between the two groups were marginally non-significant at all three time points (p > 0.05). The occurrence of cage subsidence was similar, with seven cases in each group, showing no statistically significant differences (p > 0.05). Likewise, each group had three cases of non-fusion, with no significant difference between them (p > 0.05).</p><p><strong>Conclusions: </strong>Partial cervical corpectomy reconstructed with flanged PEEK cages is a relatively comparable treatment method for short-segment degenerative cervical myelopathy.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124309"},"PeriodicalIF":1.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675915","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 vs. Fixed Lumbar Spondylolisthesis: Clinical, Radiographic, and Functional Outcomes Following TLIF Surgery.","authors":"Barón Zárate-Kalfópulos, Fernando Pesantez-Mochas, Patricia Rojo-Castillo, Ángel Rigoberto Cruz-Zambrano, Irving Omar Estévez-García, Paola Cruz-Arteaga, Carla García-Ramos","doi":"10.1016/j.wneu.2025.124310","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124310","url":null,"abstract":"<p><strong>Background: </strong>Lumbar spondylolisthesis (LS) is defined by vertebral displacement and can be categorized as dynamic or fixed based on intervertebral instability. Dynamic LS, characterized by greater mobility, may impact surgical outcomes. This study aimed to assess clinical and radiographic differences between dynamic and fixed LS in patients undergoing transforaminal lumbar interbody fusion (TLIF) and to determine an optimal cutoff for defining dynamic instability.</p><p><strong>Methods: </strong>This retrospective cohort included 76 patients with degenerative low-grade LS treated with TLIF between 2018 and 2020, with a minimum follow-up of 24 months. Dynamic and fixed LS were classified based on a displacement cutoff derived from receiver operating characteristic (ROC) curve analysis. Clinical outcomes (ODI, VAS, SF-36) and radiographic parameters were evaluated preoperatively and at 6, 12, and 24 months postoperatively, interrater variability (for two raters) Cohen's kappa (κ = 0.776).</p><p><strong>Results: </strong>ROC analysis identified 2.45 mm as the optimal displacement threshold to distinguish dynamic from fixed LS, with 95.5% sensitivity and 97.1% specificity. Dynamic LS was present in 63.4% of cases and demonstrated significantly higher preoperative listhesis and greater postoperative reduction loss. Despite these radiographic differences, patient-reported outcomes improved similarly in both groups over time.</p><p><strong>Conclusions: </strong>A displacement threshold of 2.45 mm effectively differentiates dynamic from fixed LS and may support surgical decision-making. While dynamic LS presents a higher risk of postoperative reduction loss, TLIF achieves comparable functional outcomes in both LS subtypes. Further prospective studies are needed to validate these findings and optimize surgical strategies.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124310"},"PeriodicalIF":1.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675910","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}
Xiaofeng Shao, Zhangzhe Zhou, Yimeng Wang, Jun Zou, Xuefeng Sun, Zhiyong Sun, Xianxiu Ge
{"title":"Repeated percutaneous kyphoplasty for refracture of the same cemented vertebral body.","authors":"Xiaofeng Shao, Zhangzhe Zhou, Yimeng Wang, Jun Zou, Xuefeng Sun, Zhiyong Sun, Xianxiu Ge","doi":"10.1016/j.wneu.2025.124301","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124301","url":null,"abstract":"<p><strong>Objective: </strong>The refracture of the previously cemented vertebrae occurs rarely following percutaneous kyphoplasty (PKP). The present study was designed to assess the therapeutic efficacy of repeated PKP for refractures.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 36 patients who underwent repeat PKP for refractures in same cemented vertebrae. The study evaluated the cement distribution pattern, restoration of middle vertebral height (MVH), and kyphosis angle (KA). Clinical efficacy was evaluated using Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). A multivariate logistic regression model evaluated age, sex, cement volume, and bone mineral density (BMD), with the group's average pain reduction measured at 4.86 points on the VAS.</p><p><strong>Results: </strong>Preoperative VAS scores averaged 7.75 ± 1.23, significantly decreasing to 2.89 ± 0.92 after surgery (P<0.05).The ODI significantly improved from 73.83 ± 14.58 preoperatively to 35.97 ± 9.85 postoperatively (P<0.05).The MVH significantly increased from 12.49 ± 2.95 preoperatively to 16.83 ± 3.49 postoperatively (P<0.05).The KA significantly increased from 19.22 ± 4.28 preoperatively to 12.01 ± 4.59 postoperatively (P<0.05).The mean of the correction of KA was 7.17 ± 5.10 and the mean of the restoration rate of MVH was 17.09±9.68. Cement volumes of up to 4.5 ml had about a 40% probability of achieving a minimum 4.86-point VAS reduction, while volumes of at least 4.5 ml showed an 84.6% probability.</p><p><strong>Conclusions: </strong>Repeated PKP effectively alleviates pain and restores spinal function in patients with refractures. A minimum cement volume of 4.5 ml appears optimal for achieving significant pain relief.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124301"},"PeriodicalIF":1.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675913","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}