World neurosurgery最新文献

{"title":"Letter - Al-Shalchy et al., \"Thalamic Cavernomas: A Systematic Review of Clinical Manifestations, Diagnostic Challenges, and Surgical Outcomes\" published in World Neurosurgery (June 2025).","authors":"Shankar Vangipuram, Siddhartha Ghosh, Srinivasan Paramasivan, Vangipuram Harshil Sai","doi":"10.1016/j.wneu.2025.124118","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124118","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124118"},"PeriodicalIF":1.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175204","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":"Letter to the Editor Regarding: Cerebrospinal Fluid Biomarkers in Idiopathic Normal Pressure Hydrocephalus: Bibliometric Analysis and Literature Review.","authors":"Shoaib Majeed, Noshaba Majeed, Jie Tu","doi":"10.1016/j.wneu.2025.124120","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124120","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124120"},"PeriodicalIF":1.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152058","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":"Penetrating Brain Injury: Bridging Global Disparities in Care and Advancing Management Strategies.","authors":"Ronald Alvarado-Dyer, Ali Mansour, Roxanna Garcia, Sameera Puri, Walter Videtta, Andres Rubiano, Nicolás Ciarrochi, Elaine Lo, Farima Fakhri, Michel Torbey, Fernando D Goldenberg, Christos Lazaridis","doi":"10.1016/j.wneu.2025.124110","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124110","url":null,"abstract":"<p><p>Despite being a global health concern with significant mortality and healthcare costs, particularly in low-to-middle income countries (LMICs), evidence-based guidelines tailored to penetrating brain injury (PBI) remain scarce. The sixth South American Regional Neurocritical Care Society Conference in Buenos Aires, in collaboration with the Argentinian Society of Critical Care and the Latin American Brain Injury Consortium, featured a session highlighting the potential benefits of intracranial pressure monitoring and early decompressive craniectomy, both of which have demonstrated survival advantages in select patient populations but remain underutilized in LMICs. Additionally, a novel imaging-based phenotyping system, the UChicago PBI Imaging Score, was introduced to refine prognostication and guide intervention strategies. These approaches are crucial given PBI's rising global incidence and its mounting toll on healthcare systems. A central theme of the conference was the imperative of comparative effectiveness research (CER) to address disparities in PBI management. By systematically evaluating diverse patient populations, CER can identify the most efficacious and cost-effective interventions, ensuring they are adapted to resource-limited environments. This framework holds promise for establishing standardized guidelines and informing scalable practice models across variable resource settings. Moving forward, fostering international partnerships and data-sharing initiatives will be vital for refining existing protocols and ensuring equitable access to interventions associated with improved survival. These efforts aim to advance care in PBI worldwide.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124110"},"PeriodicalIF":1.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143693","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":"Precision vs. Tradition: A Meta-Analysis Comparing Robotic and Conventional Minimally Invasive Pedicle Screw Instrumentation in Thoracolumbar Fractures.","authors":"Paweł Łajczak, Oguz K Sahin, Eshita Sharma, Ayesha Ayesha, Anna Łajczak","doi":"10.1016/j.wneu.2025.124109","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124109","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted minimally invasive surgery (RA-MIS) is becoming increasingly applied to spinal surgery, offering an alternative to conventional minimally invasive spinal surgery (C-MIS). Recently, RA-MIS has been proposed for pedicle screw instrumentation in thoracolumbar fractures. This review aims to evaluate screw accuracy, RA-MIS and C-MIS among the thoracolumbar fracture population.</p><p><strong>Methods: </strong>This study followed PRISMA and Cochrane guidelines. Five medical databases were searched. Finally, 10 studies were included in the meta-analysis, with a total of 562 patients. Outcomes on operation time, blood loss, pedicle screw accuracy, complications, and cost-effectiveness were evaluated.</p><p><strong>Results: </strong>RA-MIS showed superiority in terms of accurate (GR A) screw placement (OR: 3.58, 95% CI: 2.30-5.58, p<.001) and satisfactory (GR A+B) screw placement (OR: 3.86, 95% CI: 2.14-6.96, p<.001) compared to C-MIS. RA-MIS led to a significantly lower incidence of severely misplaced (GR D+E) screws (OR: 0.26, 95% CI: 0.13-0.51, p<.001) and lower blood loss (MD: -12.03, 95% CI: -20.85 to -3.21, p<.01). However, we found no statistically significant differences in operation time (MD: -4.92, 95% CI: -12.06 to 2.22, p=.18) or complications (screw loosening, nerve injury, or infection). Costs of RA-MIS were significantly higher (MD: ¥8657.61, 95% CI: 6651.39 to 10663.83, p<.01).</p><p><strong>Conclusions: </strong>Robotic-assisted minimally invasive spinal surgery is superior in terms of higher pedicle screw accuracy and reduced perioperative blood loss, at the cost of significantly higher costs of surgery. Furthermore, we observed no clear advantages regarding complication rate and total operation time. Future trials should provide a less biased methodology to confirm the findings.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124109"},"PeriodicalIF":1.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143698","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":"Y-Style Unilateral Biportal Endoscopic Far-lateral Approach for L5S1 Foraminal Stenosis.","authors":"Yao-Chun Yang, Chen Chia-Hsien, Keng-Chang Liu, Chang-Chen Yang","doi":"10.1016/j.wneu.2025.124113","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124113","url":null,"abstract":"<p><strong>Objective: </strong>High iliac crest can pose an anatomical challenge for classic paraspinal unilateral biportal endoscopic far-lateral approach (C-UBEFLA). To overcome this, we devised a modified technique, the Y-style unilateral biportal endoscopic far-lateral approach (Y-Style-UBEFLA), which introduces a lateral working portal. The name derives from the morphological resemblance of the portal arrangement to the letter \"Y\". To compare the effectiveness of the modified unilateral biportal endoscopic far-lateral approach (Y-Style-UBEFLA) with the classic paraspinal approach (C-UBEFLA) in treating L5S1 foraminal stenosis (L5S1FS).</p><p><strong>Methods: </strong>A retrospective review was conducted on 47 patients diagnosed with L5S1FS, with 24 undergoing C-UBEFLA and 23 undergoing Y-Style-UBEFLA. Surgical outcomes were assessed pre- and postoperatively, including pain scores (VAS), disability index (ODI), postoperative lateral facet preservation rates, and MacNab grading at one-year follow-up.</p><p><strong>Results: </strong>Both approaches demonstrated comparable operative times, blood loss, and pain relief outcomes at one year. The Y-Style-UBEFLA group exhibited significantly greater preservation of the superior articular process (100% vs. 70.8%, p < 0.001). Additionally, one-year MacNab outcomes favored the Y-Style-UBEFLA group (p = 0.026).</p><p><strong>Conclusion: </strong>The Y-Style-UBEFLA technique offers improved surgical access to the L5-S1 foramen while enhancing preservation of spinal structures. It effectively addresses the anatomical challenges posed by high iliac crests, providing superior clinical outcomes and better facet preservation. The Y-Style-UBEFLA represents a viable alternative to C-UBEFLA for managing L5S1FS, especially in high iliac crest patients.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124113"},"PeriodicalIF":1.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143675","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":"Access and direct coil placement in complex neurovasculature with a novel 2.0 Fr SwiftNINJA (Leonis Mova selective) steering microcatheter: A technical note.","authors":"Taichiro Imahori, Shigeru Miyake, Reiichi Okino, Ichiro Maeda, Yuya Kagawa, Haruka Enami, Daisuke Yamamoto, Naoki Kaneko, Nobuyuki Sakai, Takashi Sasayama","doi":"10.1016/j.wneu.2025.124112","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124112","url":null,"abstract":"<p><strong>Background: </strong>The 2.0 Fr SwiftNINJA (Leonis Mova Selective, Merit Medical/SB Kawasumi) is the lowest-profile steerable microcatheter available, designed to optimize navigation through tortuous vascular anatomy in neurointerventional procedures.</p><p><strong>Objective: </strong>To assess the clinical utility of the 2.0 Fr SwiftNINJA microcatheter for navigating small-caliber cerebral vessels and delivering therapeutic devices, as demonstrated in a case involving the inferior lateral trunk (ILT), a challenging branch of the internal carotid artery (ICA).</p><p><strong>Methods: </strong>We reviewed the case of a man in his 30s diagnosed with a sphenoid wing meningioma supplied by the ILT. A patient-specific vascular model was created for preprocedural simulation to evaluate access feasibility and guide procedural planning. Both the simulation and subsequent embolization were performed using the 2.0 Fr SwiftNINJA, which features a 2.0 Fr tip and a 0.0160-inch inner lumen, enabling navigation through narrow, sharply branching vessels.</p><p><strong>Results: </strong>Preprocedural simulation accurately predicted the difficulty of accessing the ILT and informed the strategy. During the procedure, the distal tip of the 2.0Fr SwiftNINJA was controlled by rotating the proximal handle dial, allowing the operator to deflect the tip toward the ILT and align it with the target vessel. The microcatheter was advanced as planned, and direct coil embolization was performed. Postprocedural angiography confirmed effective occlusion of the ILT with preservation of adjacent vasculature.</p><p><strong>Conclusion: </strong>The 2.0 Fr SwiftNINJA steerable microcatheter provides precise, controlled access and device delivery in anatomically challenging, small-diameter vessels. This case illustrates its potential to broaden the scope of neurointerventional treatment in complex cerebrovascular anatomies.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124112"},"PeriodicalIF":1.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143113","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":"Advance on Blast-Induced Traumatic Brain Injury","authors":"Zewei Wang,&nbsp;Feng Cheng,&nbsp;Xiuyun Shi,&nbsp;Jing Dai,&nbsp;Hongxu Jin,&nbsp;Ying Liu","doi":"10.1016/j.wneu.2025.124115","DOIUrl":"10.1016/j.wneu.2025.124115","url":null,"abstract":"<div><div>Blast-induced traumatic brain injury (bTBI) is an injury to brain tissue caused by the blast shock wave of an explosive, which is the leading cause of death and disability among military personnel during wartime. By establishing animal models of bTBI that simulate different degrees and types of injuries, it is possible to clarify the neuropathological changes including molecular and cellular mechanisms. The aim of this review is to summarize the establishment of animal models of bTBI, the mechanism, diagnosis, treatment and brain-related diseases of bTBI, which will provide a basis for improving the understanding of bTBI.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124115"},"PeriodicalIF":1.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143307","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 Nerve Decompression At Lower-Extremity For Diabetic Neuropathy: A Systematic Review and Meta-Analysis of Time-Dependent Pain, Sensory Recovery, Amputation, Ulcer Recurrence, and Balance.","authors":"Shahin Naghizadeh, Maryam Zohrabi-Fard, Amir-Ahmad Keramati, Alireza Zali, Kaveh Oraii Yazdani, Sadra Rohani, Saeed Oraee-Yazdani","doi":"10.1016/j.wneu.2025.124114","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124114","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis evaluated the efficacy of surgical nerve decompression in patients with diabetic peripheral neuropathy (DPN), focusing on pain relief over time, comprehensive sensory function, reduction in ulcer recurrence, amputation prevention, and balance improvement.</p><p><strong>Method: </strong>Databases including PubMed, Scopus, and Web of Science were systematically searched up to January 8, 2025. Eighteen studies (four randomized controlled trials [RCTs], fourteen observational studies; total n=837) met inclusion criteria. Primary outcomes were pain relief and sensory recovery; secondary outcomes were ulcer recurrence, amputation rates, and balance. Data synthesis employed random- or fixed-effects models with heterogeneity and publication bias assessments.</p><p><strong>Results: </strong>Surgical decompression significantly reduced pain at short-term (6 months: SMD -2.40, p<0.001), medium-term (12 months: SMD -2.02, p=0.014), and long-term (>12 months: SMD -3.24, p=0.009) follow-ups. Meta-regression revealed modest attenuation of pain relief over time (R²=33.1%). Continuous measures indicated significant sensory improvements (SMD -2.19, p=0.012), though categorical controlled comparisons were inconclusive. Surgical intervention significantly reduced ulcer recurrence (log OR -1.03, p<0.001) and amputation rates (log OR -2.06, p=0.018), while improvements in balance showed a positive, yet non-significant, trend.</p><p><strong>Conclusion: </strong>Surgical nerve decompression demonstrates sustained efficacy in pain management and substantially reduces severe diabetic neuropathy complications. Future high-quality RCTs are necessary to standardize outcomes and confirm long-term benefits.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124114"},"PeriodicalIF":1.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143700","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":"Drainage versus Nondrainage for Thoracolumbar Spine Surgery: An Evidence Synthesis","authors":"Shichao Liu ,&nbsp;Jingyu Zhou","doi":"10.1016/j.wneu.2025.124111","DOIUrl":"10.1016/j.wneu.2025.124111","url":null,"abstract":"<div><h3>Objective</h3><div>Drainage tube placement during posterior thoracolumbar spine surgery is common, yet debated due to conflicting evidence on complication risks. This study compares the safety and efficacy of drainage use versus nonuse.</div></div><div><h3>Methods</h3><div>A systematic review of PubMed, EMBASE, and Cochrane databases identified randomized controlled trials using terms like “Drainage,” “Spine,” and “randomized controlled trial.” Two reviewers independently screened studies, assessed bias, and extracted data on outcomes including surgical site infection (SSI), postoperative epidural hematomas (PEHs), reoperation, transfusions, dressing changes, Oswestry Disability Index, and visual analog scale. Subgroup analyses and Grading of Recommendations, Assessment, Development, and Evaluation evaluation were performed.</div></div><div><h3>Results</h3><div>A total of 11 randomized control trials met the inclusion criteria. Drainage use correlated with significantly lower PEH incidence (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.03–0.40), reduced postoperative fever (OR 0.62, 95% CI 0.39–0.97), and fewer dressing changes (OR 0.33, 95% CI 0.13–0.79) in single-segment surgeries. However, in multisegment procedures, drainage was associated with higher transfusion risk (OR 2.88, 95% CI 1.13–7.32). No significant differences were observed in SSI (OR 0.95, 95% CI 0.42–2.16), reoperation (OR 0.88, 95% CI 0.28–2.83), hospital stay, Oswestry Disability Index, or visual analog scale between groups.</div></div><div><h3>Conclusions</h3><div>The utilization of drainage tubes in posterior thoracolumbar spine surgery does not show significant associations with SSI, reoperation rates, length of hospital stay, or clinical effectiveness. However, their use is associated with an increased frequency of postoperative blood transfusions. In single-segment operations, drainage tube placement demonstrates correlations with a lower occurrence of PEH, reduced probability of postoperative fever, and fewer dressing changes.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"200 ","pages":"Article 124111"},"PeriodicalIF":1.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143728","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 Spectrum of Vascular Injuries Secondary to Traumatic Brain Injury: A Single-Center Study Based on Digital Subtraction Angiography","authors":"Bukola R. Omotoso ,&nbsp;Rohen Harrichandparsad ,&nbsp;Lelika Lazarus","doi":"10.1016/j.wneu.2025.124108","DOIUrl":"10.1016/j.wneu.2025.124108","url":null,"abstract":"<div><h3>Background</h3><div>To profile the spectrum of traumatic neurovascular injuries associated with traumatic brain injury (TBI) and their outcomes over ten years in a single central academic hospital.</div></div><div><h3>Methods</h3><div>Retrospective review of the TBI database to identify patients who underwent digital subtraction angiography (DSA) for suspected underlying intracranial and extracranial vascular injuries managed between January 2012 and December 2022. Medical records were analyzed for demographics, computed tomography (CT) angiography and DSA findings, and neurosurgical intervention.</div></div><div><h3>Results</h3><div>A total of 143 patients (median age 28 years) were included in the study. The majority of patients were male (89.5%). DSA confirmed vascular injuries in 76 (53.1%) patients. Injured blood vessels include internal carotid artery (22.4%), middle cerebral artery (14.0%), middle meningeal artery (3.5%), and others. DSA was negative in 67 (46.9%) of the TBI patients. Mechanisms of penetrating injury include knives, machetes, and screwdrivers. Closed injuries were commonly due to motor vehicle accidents (11.2%) and falls from a height (5.6%). The most common type of vascular injury is pseudoaneurysm 40 (33.1%). Dissection with vessel cut-off, and arteriovenous fistulas accounted for 17%, whilst traumatic carotid cavernous fistulas were seen in 15.4%. Most patients (60.1%) had Glasgow Coma Scale 15 at discharge.</div></div><div><h3>Conclusions</h3><div>The incidence of confirmed traumatic vascular injuries is high in DSA patients with suspected vascular injuries on CT/CT angiography after penetrating head and neck trauma. Vascular injury remains one of the major consequences of penetrating TBI, with associated morbidity and mortality. However, most patients in our series recover well with minimal perioperative and postoperative complications.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124108"},"PeriodicalIF":1.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143672","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}