World neurosurgery最新文献

{"title":"Clinical outcome and health-related quality of life in Pediatric intracranial aneurysm, a single-center experience.","authors":"Hui Hu, Hao Chen, Zengpeng Yu, Yudong Zhou, Lusheng Li, Xuan Zhai, Ping Liang, Jun Tang","doi":"10.1016/j.wneu.2025.124500","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124500","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the association of treatment approaches on the clinical outcomes and health-related quality of life (HRQL) of Pediatric intracranial aneurysms (PIAs) at our institution.</p><p><strong>Method: </strong>A retrospective analysis of 37 children with PIAs treated from 2015 to 2022. Clinical outcomes were evaluated using the modified Rankin Score (mRS) and Lovett scale. Additionally, the HRQL was assessed using the PedsQL 4.0 questionnaire.</p><p><strong>Results: </strong>Thirty-seven children were admitted with 41 aneurysms. Of these, 15 patients underwent surgical treatment, 16 received endovascular therapy, and 6 were managed conservatively. After an average follow-up period of 2.8 years, the median mRS was 0 for endovascular therapy against 1.5 for surgical treatment (p=0.443). Similarly, limb muscle strength was higher in the endovascular group (5 vs. 4, p=0.433). PedsQL 4.0 assessments demonstrated excellent reliability (α=0.907), with no significant difference between the endovascular and surgical groups in overall HRQL (p=0.390, 95% CI: -6.892 to 16.978). However, the endovascular group showed a trend toward improved quality of life, including physical, emotional, and social functioning.</p><p><strong>Interprtation: </strong>Active treatments yield favorable outcomes for children with PIAs. Our study is the first to demonstrate that endovascular approach may offer a beneficial long-term improvement in HRQL for children with PIAs.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124500"},"PeriodicalIF":2.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114414","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":"Early Clinical and Radiologic Evaluation of Unilateral Biportal Spinal Endoscopy for Recurrent Lumbar Disc Herniation: A Retrospective Study.","authors":"Chunliang Guo, Tao Ding, Jianqing Zheng, Xiule Fang, Zhiyun Feng, Yuntao Xue","doi":"10.1016/j.wneu.2025.124499","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124499","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the changes in radiologic parameters and clinical outcomes associated with the Unilateral biportal endoscopy (UBE) technique for recurrent lumbar disc herniation (rLDH).</p><p><strong>Methods: </strong>A retrospective study was conducted on 57 patients with rLDH who underwent UBE spinal revision and decompression surgery from 2022 to 2024. Preoperative and postoperative visual analog scale and Oswestry Disability Index scores were collected to assess the impact on activities of daily living. Parameters such as operation time, intraoperative blood loss, postoperative drainage volumes (first and second day), total hospital stay, and postoperative hospital stay were recorded. pre- and postoperative imaging changes in the lumbar spinewere also evaluated. Clinical outcomes were assessed using the MacNab criteria at 6-month follow-up.</p><p><strong>Results: </strong>No nerve or cauda equina injuries occurred. The mean surgical time was 100.79±20.18 minutes, with a mean intraoperative blood loss of 35.95±14.49 ml. The average drainage volumes were 40.48±14.31 ml on postoperative day 1 and 12.74±8.13 ml on postoperative day 2. No postoperative complications, such as wound infection or dehiscence, were observed. At 6-month follow-up, both VAS and ODI scores were significantly lower than preoperative values (P<0.05). Lumbar CT scans showed a significant increase in spinal canal anteroposterior diameter compared to preoperative measurements (P<0.05). All patients exhibited improvement or resolution of clinical symptoms. The 6-month MacNab functional evaluation revealed excellent results in 21 cases, good in 35 cases, fair in 1 case, resulting in an overall good rate of 98.25%.</p><p><strong>Conclusion: </strong>The UBE technique showed favorable midterm follow-up results for rLDH surgery, with long-term outcomes warranting further investigation.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124499"},"PeriodicalIF":2.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114388","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":"Comparison of the predictive value of different segmental bone quality assessments for cage subsidence following anterior cervical discectomy and fusion.","authors":"Chengkun Zhao, Shijie Wang, Jingjing Zhang, Hegang Niu, Yun Cao, Cailiang Shen, Yinshun Zhang","doi":"10.1016/j.wneu.2025.124495","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124495","url":null,"abstract":"<p><strong>Objective: </strong>To compare the predictive value of different segmental bone quality assessments for cage subsidence following single-level and multi-level anterior cervical discectomy and fusion (ACDF) and determine the best one.</p><p><strong>Methods: </strong>From 2019 to 2023, we reviewed patients who underwent single- or multi-level ACDF. The segmental endplate bone quality (SEBQ) score, segmental vertebral bone quality (SVBQ) score, and segmental Hounsfield units (SHU) value were measured using preoperative magnetic resonance imaging (MRI) and computed tomography (CT) scans. Cage subsidence was defined as a loss of segment height (SH) greater than 3 mm. Risk factors for cage subsidence were identified through logistic regression analysis. The predictive value of the different segmental bone quality assessments for cage subsidence was evaluated using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>This study included 128 patients, of whom 61 underwent single-level procedures and 67 underwent multi-level procedures. Logistic regression analysis showed that the SEBQ score, SVBQ score, and SHU value were significantly associated with subsidence (p < 0.05). In the single-level group, the area under the curve (AUC) values for SEBQ score, SVBQ score, and SHU values in predicting subsidence were 0.823, 0.748, and 0.793, respectively. In the multi-level group, the AUC values for SEBQ score, SVBQ score, and SHU values predicting subsidence were 0.843, 0.805, and 0.738, respectively.</p><p><strong>Conclusions: </strong>All segmental bone quality assessments can predict cage subsidence after ACDF. Regardless of whether the procedure is single- or multi-level, the SEBQ score demonstrated superior predictive value compared to the SHU value and SVBQ score.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124495"},"PeriodicalIF":2.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114403","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":"Optimal Application Indices for Shunt Surgery for Idiopathic Normal Pressure Hydrocephalus with an Evans Index Below 0.3.","authors":"Ryosuke Takagi, Taishi Nakamura, Kiyoshi Takagi, Yuriko Takeda, Makoto Ohtake, Shuichiro Asano, Satoshi Hori, Hidetaka Onodera, Takashi Kawasaki, Katsumi Sakata, Kensuke Tateishi, Tetsuya Yamamoto","doi":"10.1016/j.wneu.2025.124494","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124494","url":null,"abstract":"<p><strong>Background: </strong>Normal pressure hydrocephalus (NPH) is a neurological disorder characterized by three primary symptoms (gait disturbance, cognitive impairment, and urinary incontinence), accompanied by specific morphological imaging features. Idiopathic normal-pressure hydrocephalus (iNPH) is characterized by symptoms without identifiable secondary causes. The Evans index (EI) is traditionally used to assess ventricular enlargement, with values >0.3 indicating iNPH. Herein, we investigated the efficacy of shunt surgery in patients with iNPH and EI ≤0.3, who may still benefit from the procedure despite not meeting conventional diagnostic criteria.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive iNPH patients categorized into two groups based on EI: ≤0.3 (atypical iNPH group = discovery group) and >0.3 (probable iNPH group = control group). The shunt response rate was subsequently assessed. Morphological magnetic resonance (MR) markers, including EI and the z-Evans index, were analyzed to identify predictors of shunt response.</p><p><strong>Results: </strong>After applying the inclusion and exclusion criteria, 231 patients were eligible for analysis, including an atypical iNPH group of 48 patients and a probable iNPH group of 183 patients. The mean EI value was 0.33 ± 0.04, and VA shunt surgery significantly improved symptoms (p <0.001), with responder rates of 83.3% and 90.2% in atypical iNPH and probable iNPH group, respectively. In the atypical iNPH group, multivariate analysis identified the z-Evans index as a morphological MR marker of shunt response (p = 0.043).</p><p><strong>Conclusion: </strong>The response rates to shunt surgery were comparable in patients with EI ≤0.3 and EI >0.3 without statistical significance. The z-Evans index is a useful tool for identifying shunt responders among those with a lower EI, potentially expanding the therapeutic options for patients previously considered ineligible.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124494"},"PeriodicalIF":2.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114356","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":"The Efficacy of Robot-assisted Modified Minimally Invasive Surgery in the Treatment of Thoracolumbar Fractures in Patients with Ankylosing Spondylitis.","authors":"Wei Yuan, Xinchun Liu, Lin Cong, Haitao Zhu, Lei Pei, Han Wang, Yue Zhu","doi":"10.1016/j.wneu.2025.124496","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124496","url":null,"abstract":"<p><strong>Objective: </strong>Robotic technology is increasingly used in spine surgery, few studies report its application and outcomes for ankylosing spondylitis (AS)-related thoracolumbar fractures. This study was designed to comprehensively evaluate the efficacy of robot-assisted (RA) modified minimally invasive surgery for treating thoracolumbar fractures in AS patients.</p><p><strong>Methods: </strong>In this retrospective study, patients diagnosed with thoracolumbar fractures with AS were grouped by surgical techniques into two groups: RA modified minimally invasive surgery group (RA group) or fluoroscopy-assisted open posterior fixation surgery group (FA group). Operation time, intraoperative blood loss, fluoroscopy exposure time, radiation dose, hospital stay, and complications of the two groups were recorded. According to Gertzbein-Robbins criteria, the accuracy of screw implantation was evaluated by CT within 1 week after surgery. During the follow-up period, pain and nerve function were evaluated by visual analogue scale (VAS) and American Spinal Injury Association (ASIA) scale.</p><p><strong>Results: </strong>A total of 27 patients with thoracolumbar fractures with AS were included in this study, with 13 patients in the RA group and 14 in the FA group. Baseline characteristics showed no intergroup differences. The RA group demonstrated significantly less intraoperative blood loss (287.5±106.1 ml vs. 561±209.8 ml, P < 0.05), longer fluoroscopy exposure time (116.4±16.5 s vs. 35.6±9.1 s, P < 0.05), higher total radiation dose (163.3±25.7 mGy vs. 80.7±24.8 mGy, P < 0.05), and shorter hospital stay (15.9±3.7 days vs. 22.1±5.9 days, P < 0.05) compared to the FA group. Both groups were followed up for 6 months. Post-operatively, VAS decreased significantly in both groups compared to preoperative values (P<0.05). Notably, the RA group exhibited significantly lower VAS scores than the FA group at both one week and three months post - surgery (P<0.05). In terms of neurological function recovery, no significant differences were found between the two groups (P>0.05). In terms of screw accuracy, the RA group (94.2%, 131/159) had a notably larger proportion of clinically acceptable screws (grades A and B) than the FG group (86.8%, 131/151, p < 0.05).</p><p><strong>Conclusion: </strong>RA modified minimally invasive surgery has merits including reduced blood loss, shortened hospital stay, better pain relief, and improved the accuracy of pedicle screw insertion compared with the FA open surgery in treating thoracolumbar fractures with AS. However, RA technique could increase the intraoperative radiation exposure of patients.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124496"},"PeriodicalIF":2.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114362","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 Anatomy of the Third Ventricle Floor: Implications for Endoscopic Third Ventriculostomy.","authors":"Khulood Mohammed Khalid Al-Khater","doi":"10.1016/j.wneu.2025.124493","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124493","url":null,"abstract":"<p><p>Neuroendoscopy has made a breakthrough in the field of neurosurgery. Since its first application at the start of the 20^th century, it has evolved enormously and become more specialized. Endoscopic Third Ventriculostomy (ETV) is a type of ventriculoscopies where the floor of the third ventricle is opened to divert the CSF from the third ventricle to the subarachnoid space. Nowadays, ETV is the gold-standard treatment for selected cases of hydrocephalus. Its success depends on, among others, the anatomy of the floor of third ventricle. From anterior to posterior, structures related to the floor of the third ventricle are the preoptic area, optic chiasm, tuber cinereum, mammillary bodies, posterior perforated substance, and tegmentum of the midbrain. The infundibulum of the pituitary gland is attached to the tuber cinereum. Inferiorly, the floor is related to the basilar artery complex. A condensation of arachnoid (known as Liliequist membrane) is sometimes present below the floor. Knowledge of the floor anatomy and its relations is crucial for successful ETV. Many anatomical variations have been described in the floor, such as thickened, thinned, partially effaced/erased, or herniated floor. Neurosurgeons have to be acquainted with the normal anatomy of the ventricles, in general, and that of the third ventricle and its variants, in particular, to ensure a successful procedure. Pre and postsurgical MRI are important to assess and manage ETV cases. This article presents an up-to-date review of the anatomical variations in the floor of the third ventricle and their implications for the outcome of ETV.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124493"},"PeriodicalIF":2.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102900","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":"Calculation of the correction angle required for spinal osteotomy in ankylosing spondylitis patients with thoracolumbar kyphosis: Validation of three predictive methods.","authors":"Cheng Chi, Jiandang Zhang, Jiaguang Tang, Jianwei Zhou, Mao Li","doi":"10.1016/j.wneu.2025.124488","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124488","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Retrospective cohort radiographic study PURPOSE: The purpose of this study was to verify the accuracy of three common preoperative calculation methods (the hilus pulmonis (HP) method, the full balance integrated (FBI) method and the spinofemoral angle (SFA) method) for determining the optimal osteotomy size in patients with ankylosing spondylitis with thoracolumbar or lumbar kyphosis and to evaluate their clinical significance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from 62 AS patients with thoracolumbar or lumbar kyphosis who underwent one-level pedicle subtraction osteotomy (PSO) for thoracolumbar kyphosis deformity were retrospectively reviewed. The planned osteotomy angles were calculated from preoperative full-length spinal radiographs using three methods: hilus pulmonis (HP) method, full balance integrated (FBI) method, and spinofemoral angle (SFA) method. Sagittal alignment parameters were measured preoperatively and at the final follow-up using Surgimap software. Functional outcomes, including the Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) score, and visual analog scale (VAS) score for back pain, were recorded preoperatively and at the final follow-up. Postoperative complications were also documented. Paired t-tests were used for statistical analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All sagittal alignment parameters improved significantly postoperatively (all p &lt; 0.001). Sagittal vertical axis (SVA) improved markedly from 139.4 mm to 48.1 mm, and T1 pelvic angle (T1PA) decreased from 41.34° to 12.56° (p = 0.009). In addition, spinosacral angle (SSA) increased from 86.2° to 115.4°, spinopelvic angle (SPA) improved from 127.7° to 158.2°, and pelvic tilt (PT) decreased significantly from 33.6° to 16.8°, reflecting substantial improvements in global and pelvic sagittal alignment.Among the three predictive methods, the HP method significantly overestimated the required correction angle compared with the actual postoperative value (51.8° vs. 42.2°, p &lt; 0.05), whereas SFA (45.2°) and FBI (43.7°) predictions showed no significant difference from the actual correction achieved. Clinically, mean ODI improved from 52.6 to 15.4,JOA from 12.5 to 20.9, and VAS for back pain decreased from 6.4 to markedly lower levels at final follow-up (all p &lt; 0.001). Patient satisfaction was excellent in 63%, moderate in 26%, and poor in 11% of cases. Postoperative complications included 3 transient thoracic nerve root injuries without symptoms, 8 dural tears (6 primarily repaired, 2 with dural patches), 1 deep wound infection requiring debridement, 2 transient lower limb paralyses (both fully recovered), 2 screw loosenings without progression, and 2 proximal junctional kyphoses managed conservatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In AS patients with isolated thoracolumbar or lumbar kyphosis, both the SFA and FBI methods showed good agreement with the actual postoperative correction angle and can ser","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124488"},"PeriodicalIF":2.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102818","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":"The Role of Separation Surgery (SS) and Advanced Radiotherapy (RT) in Metastatic Epidural Spinal Cord Compression (MESCC): A Single Center Retrospective Study Comparing SBRT and 3D-CRT.","authors":"Giuseppina Bevacqua, Valentina Grespi, Eleonora Becattini, Matteo M Ottaviani, Fabio Trippa, Carlo Conti","doi":"10.1016/j.wneu.2025.124491","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124491","url":null,"abstract":"<p><p>This study aims to evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) compared with 3D conformal radiotherapy (3D-CRT) after Separation Surgery (SS), focusing on local disease control (LC) and overall survival (OS), in patients with metastatic epidural spinal cord compression (MESCC).</p><p><strong>Methods: </strong>This retrospective study included 30 patients diagnosed with MESCC and treated with SS, followed by either SBRT (n=14) or 3D-CRT (n=16). Surgical intervention included laminectomy and tumor decompression to achieve a 2-3 mm margin. Postoperatively, patients received either hypofractionated SBRT (20-40 Gy in 2-5 fractions) or conventional 3D-CRT (16-30 Gy in 2-10 fractions). Statistical analysis was performed using Kaplan-Meier survival curves.</p><p><strong>Results: </strong>The mean age of the patients was 64.6 years (range: 31-84), with a predominance of male patients (60%). The most common primary tumors were non-small cell lung cancer (20%) and renal cell carcinoma (20%). At 12 months, LC was significantly higher in the SBRT group (92.3%) compared to the 3D-CRT group (53.3%) (p=0.01). OS at 6, 12 and 15 months was superior in the SBRT cohort (92.8%, 71.4%, 84.6%) compared to the 3D-CRT cohort (53.3%, 40%, 13.3%), with a significant difference in favour of SBRT (p=0.009). SBRT was associated with lower local recurrence rates and better disease control.</p><p><strong>Conclusions: </strong>The combination of SS and SBRT has been demonstrated to result in superior OS and LC outcomes in comparison to 3D-CRT. While the presence of visceral metastases remains a key prognostic factor, this hybrid surgical-radiotherapy approach has proven effective in the management of spinal metastases.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124491"},"PeriodicalIF":2.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103089","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":"Direct mapping between Oswestry Disability Index scores and EQ-5D-3L utilities: the need for utility scores to perform cost-utility analysis.","authors":"Carmen Selva-Sevilla, Fernando Andrés-Pretel, Paula Ferrara, Manuel Gerónimo-Pardo","doi":"10.1016/j.wneu.2025.124489","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124489","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124489"},"PeriodicalIF":2.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102820","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":"Impact of Anterior versus Posterior Reconstruction Techniques on T1 Slope minus Cervical Lordosis Matching in Patients with Multilevel Cervical Spondylotic Myelopathy.","authors":"Tao Liu, Zhongzheng Zhi, Jian Kang, Jinhao Miao, Zhimin He, Zude Liu, Desheng Wu","doi":"10.1016/j.wneu.2025.124492","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124492","url":null,"abstract":"<p><strong>Objective: </strong>To explore the impact of anterior versus posterior reconstruction techniques on T1 slope (T1S) minus cervical lordosis (CL) matching in patients with multilevel cervical spondylotic myelopathy (CSM).</p><p><strong>Methods: </strong>594 multilevel CSM patients were enrolled from medical records spanning 2015 to 2024. The anterior group comprised 305 patients with matching type 157 individuals and mismatching type 148 cases, posterior group included 289 patients with matching type 146 individuals and mismatching type 143 cases. This study retrospectively analyzed perioperative parameters including clinical parameters of Japanese Orthopedic Association (JOA) score, visual analogue scale (VAS) and neck disability index (NDI), and radiologic parameters T1 slope(T1S), cervical lordosis (CL), C2-7 sagittal vertical axis (SVA) and T1S-CL.</p><p><strong>Results: </strong>Prior to surgery, there were no significant differences in factors between two groups (P>0.05) except for blood loss (P<0.001). Postoperatively, radiological parameters (T1S, CL, C2-7 SVA and T1S-CL) and functional indicators (JOA, NDI and VAS) changed significantly (P<0.001) in anterior and posterior group, whether with T1S-CL matching or mismatching type. In anterior group, T1S-CL changed significantly (P<0.05) under 20° in both type. While, T1S-CL changed significantly (P<0.001) under 20° in posterior group with matching type, T1S-CL changed significantly (P<0.001) above 20° in posterior group with mismatching type. In each group and types, T1S-CL showed positive correlations with T1S and negative correlations (P<0.001) postoperatively.</p><p><strong>Conclusion: </strong>Anterior reconstruction surgeries can improve and optimize T1S-CL matching, while a T1S-CL mismatching is more likely to occur or deteriorate after posterior surgeries in patients with multilevel CSM.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124492"},"PeriodicalIF":2.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102892","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}