World neurosurgery最新文献

{"title":"Corrigendum to “Pedicle Screw Fixation Plus Cement Augmentation or Cement augmentation Only for Osteoporotic Vertebral Compression Fracture: A Systematic Review and Meta-Analysis” [World Neurosurgery 197 (2025) 123952]","authors":"Ya-Wei Chu , Cheng-Tang Lv , Chao Wang","doi":"10.1016/j.wneu.2025.124148","DOIUrl":"10.1016/j.wneu.2025.124148","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124148"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481311","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":"Patient-Reported Outcomes in Recurrent Lumbar Disc Herniation Surgery: Clinical Results and a Decision-Making Algorithm for Endoscopic Technique Selection.","authors":"Xavier Castel, Henri d'Astorg, Thais Dutra Vieira, Marc Szadkowski","doi":"10.1016/j.wneu.2025.124207","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124207","url":null,"abstract":"<p><strong>Objective: </strong>To compare clinical outcomes and patient-reported measures between primary and revision full-endoscopic lumbar discectomy (FELD) in patients with lumbar disc herniation and to propose a decision-making algorithm for selecting the endoscopic surgical approach in revision cases.</p><p><strong>Methods: </strong>This retrospective study included 843 patients undergoing FELD at a single center: 742 for primary herniation and 101 for recurrent herniation. Patients with >6 months follow-up were assessed. Outcomes included Visual Analog Scale (VAS) for leg and back pain, Oswestry Disability Index (ODI), SF-12 (Physical and Mental Component Scores), and patient satisfaction. Statistical comparisons and ANCOVA adjustments were performed to control for baseline differences.</p><p><strong>Results: </strong>Both groups showed significant and comparable improvements in leg pain, back pain, disability, and quality of life. Final follow-up scores were slightly higher (worse) in the recurrent group (adjusted differences: VAS leg +0.66, VAS back +0.71, ODI +4.72; all p<0.05), though changes from baseline were not significantly different. Complication and reoperation rates were low and similar in both groups (∼2%). Patient satisfaction was slightly lower in the recurrent group (excellent/good: 77.6% vs 92%, p=0.0001). The transforaminal approach was favored in revision cases to avoid scar tissue, contributing to the low complication rate.</p><p><strong>Conclusion: </strong>FELD is a safe and effective technique for recurrent lumbar disc herniation, yielding clinical outcomes comparable to primary discectomy. Slightly lower satisfaction in revision cases suggests the importance of managing expectations. An algorithmic approach to endoscopic technique selection may optimize outcomes in revision settings.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124207"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512579","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":"Surgical Invasiveness, Hidden Blood Loss, and Outcomes of Two Endoscopic Lumbar Fusion Techniques for Degenerative Disease: A Comparative Study.","authors":"Muhadasi Tuerxunyiming, Xingang Wang, Shihao Zhou, Xiaowan Xu, Jianpeng Zheng, Mengru Guan, Qiuyun Lin, Yamin Li","doi":"10.1016/j.wneu.2025.124208","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124208","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The rapid advancement of spinal endoscopic techniques has underscored the need for comparative evaluations of various surgical approaches. This study compares unilateral biportal endoscopic lumbar interbody fusion (ULIF) and fully endoscopic transforaminal lumbar interbody fusion (Endo-PLIF) in the treatment of lumbar degenerative diseases (LDD), with a focus on surgical invasiveness, hidden blood loss (HBL), and clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 120 patients diagnosed with LDD were enrolled between January 2021 and January 2024. Of these, 63 patients underwent ULIF, and 57 received Endo-PLIF. Perioperative indicators were recorded, including operative time, hospital stay, incision length, intraoperative blood loss, and changes in intervertebral disc and foraminal height.Clinical outcomes were assessed using visual analog scale (VAS) scores for back and leg pain, the Oswestry Disability Index (ODI), and the modified Macnab criteria at the final follow-up. Assessments were conducted preoperatively and at 3 days, 3 months, 6 months, and 12 months postoperatively. Fusion rates and complication incidences were also documented.Muscle injury was quantified by measuring serum levels of creatine kinase (CK) and C-reactive protein (CRP) preoperatively and on postoperative days 1, 3, and 5. Descriptive statistics and multiple comparison tests were applied to assess differences in clinical indicators between the two surgical groups. The VAS score served as the primary clinical outcome. Longitudinal data were analyzed using a generalized linear mixed model to evaluate intergroup differences over time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline demographic and surgical data were comparable between the two groups. The CRP and CK levels in the Endo-PLIF group were generally lower than those in the ULIF group, particularly on postoperative day 3 for CRP and on postoperative day 1 for CK. Compared to the ULIF group, the Endo-PLIF group exhibited significantly reduced total blood loss, postoperative blood loss, and hidden blood loss. No significant difference was observed in postoperative hospital stay duration between the groups. Both groups showed improvements in VAS pain scores and ODI. A significant reduction in VAS back pain was observed on the third day after ULIF, while leg pain improved significantly at 3 days and 3 months post-surgery. At the final follow-up, no further differences in clinical outcomes were observed between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Both surgical methods resulted in significant relief of back pain and functional improvement. Although ULIF showed a distinct advantage in early postoperative pain control and functional recovery, outcomes for both techniques became comparable during long-term follow-up. However, Endo-PLIF exhibited a significant advantage in terms of reduced surgical trauma and blood loss. Overall, both methods represent viable treatment option","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124208"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512581","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":"Clinical characteristics and prognostic outcomes of spinal cord gliomas with intracranial metastasis: An integrated analysis based on individual cases.","authors":"Jiaoming Li, Tao Chang, Yan Zeng, Weichao Ma, Jingsong Liu, Tianjian Ren, Xiaodong Niu","doi":"10.1016/j.wneu.2025.124205","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124205","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the clinicopathological features and identify survival predictors in rare spinal cord gliomas with intracranial metastasis (IM), with the goal of guiding clinical decision-making and optimizing management strategies.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 62 histopathologically verified spinal cord gliomas (12 low-grade and 50 high-grade) with IM based on published cases and case series. Survival outcomes were analyzed using Kaplan-Meier methods with time-dependent variables. Kaplan-Meier analysis was used to evaluate survival patterns, and Cox proportional hazards regression was applied to identify prognostic factors associated with survival outcomes.</p><p><strong>Results: </strong>Univariate analysis showed symptom duration and EOR significantly affected DTIM (EOR as an independent factor, p < 0.05). Overall survival (OS) analysis demonstrated that the IM site, pathology type and IMTO significantly influenced patient prognosis (p < 0.05). Multivariate analysis confirmed DTIM and IMTO as independent predictors of OS (p < 0.05).</p><p><strong>Conclusions: </strong>Maximal safe resection with adjuvant therapy remains of paramount importance. Extending the DTIM and IMTO through tailored therapeutic strategies significantly enhances survival outcomes in patients with spinal cord gliomas complicated by intracranial metastasis (IM).</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124205"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512577","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":"Effectiveness and safety of body-temperature irrigation fluid in percutaneous transforaminal endoscopic discectomy: A prospective study.","authors":"He Zhu, Liang Zheng, Shuang Wang, Jia-Qi Zhang, Yu Chen","doi":"10.1016/j.wneu.2025.124206","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124206","url":null,"abstract":"<p><strong>Study design: </strong>Prospective study OBJECTIVE: Investigation into the effect of body-temperature irrigation fluid during percutaneous transforaminal endoscopic discectomy (PTED) on patients.</p><p><strong>Methods: </strong>Patients undergoing PTED at the Orthopedic Department of our hospital from January to October 2024 were selected as study subjects. Patients were screened according to the inclusion and exclusion criteria, and those meeting the criteria were randomly allocated to the experimental group or the control group. The control group used room-temperature irrigation fluid during surgery, whereas the experimental group used body-temperature irrigation fluid. The differences in postoperative inflammatory and other parameters between the two groups were analyzed. The visual analog scale (VAS) scores were evaluated to compare the severity of low back pain at different postoperative time points among patients. During the surgical procedure, the body temperature changes were continuously monitored. In addition, the complication rates caused by body-temperature and room-temperature irrigation fluid were compared during and after surgery.</p><p><strong>Results: </strong>A total of 71 patients were enrolled after screening. They were randomly allocated to the experimental group (n=34) and the control group (n=37). In the experimental group, 30 patients completed follow-up, and 32 patients completed follow-up in the control group. The general clinical data of the two groups showed no statistically significant differences, indicating comparability (P>0.05). The levels of c-reactive protein (CRP), interleukin-6 (IL-6), serum amyloid a (SAA) were significantly different between the two groups at 1 day postoperatively (P < 0.05), with the experimental group having lower values than the control group. The VAS scores of low back pain in the experimental group were significantly lower than those in the control group until 1 days postoperatively, with statistically significant differences (P < 0.05). The body temperatures of both groups gradually declined. After 60 min of surgery, at multiple subsequent time points, the experimental group exhibited higher body temperatures than the control group, demonstrating statistically significant differences (P < 0.05). There was no statistically significant difference in the incidence of complications between the two groups during surgery, at 1 day postoperatively, and at 1 month postoperatively (P > 0.05).</p><p><strong>Conclusion: </strong>In PTED, the use of body-temperature irrigation fluid not only provides the same safety profile as room-temperature irrigation fluid but also achieves better clinical outcomes.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124206"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512578","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":"Navigate transcranial magnetic stimulation is more reliable than tractography for placing subdural electrodes used for CCEP recording.","authors":"R Carrai, F Battista, C Bonaudo, C Martinelli, F Baldanzi, F Fedi, E Visocchi, Andreea C Aldea, M Spalletti, L Bucciardini, A Amadori, A Grippo, Della Puppa A","doi":"10.1016/j.wneu.2025.124201","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124201","url":null,"abstract":"<p><strong>Objective: </strong>The aim of study is to verify whether preoperative nTMS is a reliable tool for the positioning of subdural electrodes for CCEPS recording in presence of minicraniotomy.</p><p><strong>Methods: </strong>This is a monocentre, prospective, observational cohort study in which we included adults with lesions compressing o infiltrating the peri-sylvian area. In the pre-operative phase, we performed navigated transcranial magnetic stimulation (nTMS) to identify language areas. During the intervention we performed CCEP recordings using subdural strip electrodes positioned according to the surgical conditions or according to nTMS indications or in accordance with tractography. CCEPs were recorded continuously throughout the intervention with the exception of the phases in which it was necessary to monitor a different type of evoked potentials. To evaluate the association between the possibility of registering CCEPs and the method used for the positioning of the subdural electrodes the patients were dichotomized as CCEP present and CCEP not identifiable.</p><p><strong>Results: </strong>We evaluated 33 subjects but only 28 were included in the analysis. No statistically significant differences were present between these two-patient group's. The CCEPs were substantially stable during the surgical procedure in 25 patients (89.3%). When strip was positioned according to nTMS (n°:24/28; 85.7%) the CCEP were always recorded while when strip was positioned according to tractography CCEP were not identifiable in 4 (14.4%).</p><p><strong>Conclusions: </strong>Compared to tractography, nTMS shows a higher reliability in the placement of subdural electrodes used for CCEP recordings.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124201"},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508603","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":"In Reply to the Letter to the Editor Regarding: Current State of the Neurotrauma Registry Implementation in Africa (NEUTRIA STUDY) and Challenges.","authors":"Yao Christian Hugues Dokponou","doi":"10.1016/j.wneu.2025.124209","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124209","url":null,"abstract":"<p><p>Neurotrauma, encompassing traumatic brain injuries and spinal cord injuries, poses a substantial public health challenge in Africa. This response to the letter to the Editor delves into the critical need for establishing neurotrauma registries in African nations and outlines strategies for their effective implementation through equitable partnerships. The response underscores the importance of considering local contexts, resources, and healthcare systems when developing these registries. It highlights the advantages of collaborations among African institutions, international organizations, and global experts to ensure that registry initiatives are customized to local needs, promote capacity building, and foster sustainability. The letter addresses various challenges in executing large-scale health initiatives in Africa, such as stakeholder engagement, coordination, partnerships, and resource access. It also emphasizes the importance of equitable access to prevent exacerbating existing inequalities. We conclude by proposing a comprehensive strategy that addresses health system challenges, involves multiple stakeholders, and leverages existing resources to generate momentum for the implementation of neurotrauma registries in Africa.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124209"},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508602","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":"In Reply to the Letter to the Editor Regarding Early versus Late Decompressive Craniectomy in Pediatrics with Traumatic Brain Injuries: A Retrospective Study.","authors":"Amer Jaradat, Atef F Hulliel","doi":"10.1016/j.wneu.2025.124199","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124199","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124199"},"PeriodicalIF":1.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498190","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":"Treatment outcome in elderly traumatic brain injury patients at a Level 2 trauma care facility in a low-middle income country.","authors":"Dibya Jyoti Mahakul, Tushar Sharma, Dinesh Bhandarkar, Anita Jagetia, Daljit Singh, Jaya Agarwal","doi":"10.1016/j.wneu.2025.124203","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124203","url":null,"abstract":"<p><p>A slower recovery and worse clinical outcome seen in elderly patients with TBI have made it a matter of concern. The medical literature is replete with studies on the outcomes of elderly TBI patients managed at Level 1 and Level 2 trauma centers in developed countries. However, the healthcare services in lower-middle-income countries are far from an ideal scenario, and hence the outcome will naturally be different. To bridge this knowledge gap, we retrospectively analyzed the medical records of all the elderly TBI patients admitted to a Level 2 trauma center over three consecutive years. In contrast to the existing medical literature, the most common mode of injury was road traffic accidents (63%), followed by falls (47%). On subgroup analysis, 60-70 years age group constituted the maximum proportion of cases (n = 82, 68.33%), had the highest proportion of severe TBI (n = 57, 69.5%) and in-hospital deaths within 48 hours of hospital admission (n = 7, 18.92%). The overall in-hospital mortality of 42.5% (n = 51) was lower compared to earlier studies, but the proportion of patients with poor outcomes was 85% (n = 102). In multivariate analysis lower GCS at admission, specifically a lower motor score, had a statistically significant association with poor outcomes. The injury profile and outcome of elderly TBI patients in a low-middle-income nation are markedly different, and the resources should be tailored accordingly, with a greater attention to strengthening home care services and conditioning programs.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124203"},"PeriodicalIF":1.9,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477011","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":"Analysis of risk factors for the occurrence of rebleeding following surgery for haemorrhagic moyamoya disease.","authors":"Ming Yang, Lili Cheng, Yanan Li, Yan Feng, Jingchen Li, Wenbo Meng, Chen Li, Lin Zhao, Fuguang Hu","doi":"10.1016/j.wneu.2025.124202","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124202","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical characteristics and factors influencing the occurrence of rebleeding following cerebral revascularisation surgery in adult patients with haemorrhagic moyamoya disease (MMD).</p><p><strong>Methods: </strong>Clinical data were collected from patients diagnosed with haemorrhagic MMD who underwent superficial temporal artery-middle cerebral artery bypass grafting combined with cerebral-dural-temporal muscle patching. Seventy-five patients meeting the inclusion criteria were followed up and categorised into rebleeding and non-rebleeding groups. Their clinical data were comparatively analysed.</p><p><strong>Results: </strong>Of the 75 patients (32 men, 43 women; mean age 46.8 ± 5.1 years), 12 experienced postoperative rebleeding. The age of onset was significantly lower in the rebleeding group (t = 4.165, P = 0.045). Hypertension was more prevalent in the rebleeding group (83.3%) than in the non-rebleeding group (47.7%) (χ² = 15.166, P = 0.023). Ventricular haemorrhage was more frequent in the rebleeding group (χ² = 4.018, P = 0.045). Significant differences were also observed in Suzuki stages III and V (χ² = 4.018, P = 0.045; χ² = 7.717, P = 0.005, respectively). Postoperative blood pressure control and the presence of aneurysms were more common in the rebleeding group (χ² = 10.595, P = 0.001; χ² = 5.969, P = 0.015, respectively).</p><p><strong>Conclusion: </strong>The study identified significant differences in the age of onset, history of hypertension, postoperative blood pressure control, ventricular haemorrhage, Suzuki stages (III and V) and the presence of aneurysms between the rebleeding and non-rebleeding groups of patients with haemorrhagic MMD.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124202"},"PeriodicalIF":1.9,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477010","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}