World neurosurgery最新文献

{"title":"Synovial Cyst of Thoracic Spine: A Systematic Literature Review and Meta-Analysis","authors":"Prabin Shrestha,&nbsp;Satoshi Yamaguchi,&nbsp;Jangbo Lee,&nbsp;Hiroyuki Oya,&nbsp;Hiroto Kawasaki,&nbsp;Kirill V. Nourski,&nbsp;Matthew A. Howard III,&nbsp;Patrick W. Hitchon","doi":"10.1016/j.wneu.2025.124385","DOIUrl":"10.1016/j.wneu.2025.124385","url":null,"abstract":"<div><h3>Objective</h3><div>Thoracic spine synovial cysts (TSSC) are rare. Only case reports and a few small series, but no systematic review, have been published so far. This article aimed to update all the TSSC cases and analyze data in addition to reporting three cases.</div></div><div><h3>Methods</h3><div>This is a retrospective systematic review and metanalysis of reported cases of TSSC, located between T1-2 and T12-L1, until 2024. Data extraction and collection were done by multiple reviewers, and statistical analysis was performed.</div></div><div><h3>Results</h3><div>A total of 39 reports were identified and 62 cases of TSSC were analyzed, the mean age being 64.05+/−18.14 years. Males were more numerous (61.66%) and were significantly older than females (<em>P</em> = 0.035). Myelopathy with gait difficulty was the most common presenting symptom (56.5%). Motor weakness was significantly associated with older age (<em>P</em> = 0.034) and back pain with females (<em>P</em> = 0.020). Resection of cysts without fusion was performed in 90% of cases. Surgical outcome did not vary with or without fusion. The three reported cases in this study are two males and one female. Two were at T11-12 and one at T1-2, underwent surgical resection of the cyst without fusion and had a satisfactory outcome.</div></div><div><h3>Conclusions</h3><div>TSSC are more common in elderly males, mostly occur in the lower thoracic spine, below T7. Most of them present with myelopathy and motor weakness and are cured with resection of the cyst without the need for spinal fusion. There was no report of recurrence or revision surgery.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"202 ","pages":"Article 124385"},"PeriodicalIF":2.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862517","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":"Transhorizontal fissure approaches to the middle cerebellar peduncle: quantitative anatomical analyses of the retrosigmoid, extended retrosigmoid, and presigmoid-retrolabyrinthine approaches.","authors":"Irakliy Abramov, Redi Rahmani, Thomas J On, Lena Mary Houlihan, Giancarlo Mignucci-Jimenez, Mohamed A Labib, Mark C Preul, Michael T Lawton","doi":"10.1016/j.wneu.2025.124379","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124379","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pontine cavernous malformation (CM) resection requires thorough surgical planning to minimize morbidity and recurrence. This study compared posterolateral middle cerebellar peduncle (MCP) access after opening the interlobular triangle via the retrosigmoid (RS), extended retrosigmoid (xRS), and presigmoid-retrolabyrinthine (PSRL) approaches.</p><p><strong>Methods: </strong>The 3 approaches were performed in 6 cadaveric heads (12 sides). The interlobular triangle was configured over the MCP after dissecting the transhorizontal fissure. Quantitative comparisons of the MCP exposure area, volume of surgical freedom (VSF), and anteroposterior and rostrocaudal angles of attack (AOA) at the posterolateral MCP were completed.</p><p><strong>Results: </strong>No significant difference was found for MCP exposure. The PSRL approach produced a VSF similar to the xRS approach (120 [44.8] mm³ vs 114.7 [47.3] mm³, p=0.80), and the PSRL and xRS had significantly greater VSF than the RS approach (63 [23.4] mm³; p<0.001 for both). The xRS (41.6° [7.4°]) and PSRL (47° [7.8°]) approaches had significantly larger anteroposterior AOAs than the RS (38.5° [7.4°]) approach (p<0.001, p=0.007). The PSRL approach had a mean (SD) 15.3° (5.4°) and 29° (5.2°) anterior angle advantage in the anteroposterior AOA over the xRS and RS approaches, respectively.</p><p><strong>Conclusion: </strong>The PSRL- and xRS-transhorizontal fissure approaches were superior to the RS-transhorizontal fissure approach for all instrument maneuverability parameters in the posterolateral MCP. The former 2 approaches were preferable for access to lateral pontine CMs, especially those with dorsal extensions. The xRS approach compensates for disadvantages of the RS and PSRL approaches to achieve surgical corridors for extensive central pontine CM resection.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124379"},"PeriodicalIF":2.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862518","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":"Endovascular Management and Long-Term Outcomes of Aneurysmal Subarachnoid Hemorrhage Among a Large Cohort of Patients Managed at a Specialist Hospital in KwaZulu-Natal, South Africa from 2012 to 2021","authors":"Rohen Harrichandparsad ,&nbsp;Ahmed Iqbal Bhigjee ,&nbsp;Duncan Royston ,&nbsp;Stephen Olivier","doi":"10.1016/j.wneu.2025.124386","DOIUrl":"10.1016/j.wneu.2025.124386","url":null,"abstract":"<div><h3>Background</h3><div>Aneurysmal subarachnoid hemorrhage (aSAH) is a severe stroke subtype with high morbidity and mortality, particularly in low- and middle-income countries. Endovascular treatment is underused in Africa due to resource constraints. This study evaluates clinical characteristics, radiological findings, treatment outcomes, and long-term follow-up of aSAH patients treated endovascularly at a South African quaternary hospital.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 445 aSAH patients treated endovascularly at the Inkosi Albert Luthuli Central Hospital (2012–2021) was conducted. Inclusion criteria were spontaneous aSAH confirmed by computed tomography/lumbar puncture and saccular aneurysm identified via computed tomography angiogram. Data on demographics, clinical presentation, World Federation of Neurological Societies and Modified Fisher grades, aneurysm characteristics, treatments, complications, and outcomes (modified Rankin Scale [mRS] and Raymond-Roy Occlusion Classification [RROC]) were analyzed. Logistic regression identified predictors of mortality, hydrocephalus, and vasospasm.</div></div><div><h3>Results</h3><div>Median age was 47 years (67% female, 75% Black African). Most (81%) had World Federation of Neurological Societies grades 1–3; 90% had anterior circulation aneurysms (median size 5.7 mm). Of 217 patients with known human immunodeficiency virus status, 48% were living with human immunodeficiency virus. Coil embolization (59%) and balloon-assisted coiling at 21% were common. At discharge, 73% achieved mRS 0–3 and 84% RROC 1. Long-term, 82% had mRS 0–3 and 90% RROC 1. Mortality was 8.3%. Complications included hydrocephalus (36%), vasospasm (22%), and meningitis (10%). Predictors of mortality included hydrocephalus and intraoperative complications; absence of intraventricular hemorrhage was protective.</div></div><div><h3>Conclusions</h3><div>This study, the largest in an African cohort, confirms safety, efficacy, and durability of endovascular management of aSAH in resource-constrained settings, supporting its expansion in Africa.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"202 ","pages":"Article 124386"},"PeriodicalIF":2.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862516","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":"Vascular Encasement Score as a Prognostic Tool for Outcome in Skull Base Tumor Resection","authors":"Iryna Bulakh ,&nbsp;Robert Lucaciu ,&nbsp;Nikola Duerr ,&nbsp;Martin Scholz ,&nbsp;Bogdana Suchorska","doi":"10.1016/j.wneu.2025.124375","DOIUrl":"10.1016/j.wneu.2025.124375","url":null,"abstract":"<div><h3>Objective</h3><div>Involvement of major cerebral arteries in skull-base tumors poses a significant surgical challenge and is associated with increased peri- and postoperative complication rates. The aim of the current study is to introduce a vascular encasement score (VES) to assess intraoperative risk and predict patient outcomes.</div></div><div><h3>Methods</h3><div>Patients undergoing surgery for skull base tumors involving at least one major cerebral artery between April 2019 and March 2022 were included. Tumor-vessel contact was assessed on preoperative magnetic resonance imaging, evaluating both the longitudinal and circumferential encasement of arteries. Each parameter was graded from 1 to 5. The VES was calculated by multiplying the summed grades of both dimensions. Neurological outcomes were dichotomized into “good” and “poor” and correlated with VES.</div></div><div><h3>Results</h3><div>Forty-eight patients were enrolled, most diagnosed with meningioma (79.17%). The mean resection rate was 77.23%, and the median VES was 32.5. Sixteen patients (33.3%) had poor outcomes. Higher VES scores were significantly associated with poor outcomes (<em>P</em> = 0.019). A receiver operating characteristic–derived threshold of 75 defined high-risk cases. Logistic regression confirmed that high VES (&gt;75) predicted worse outcomes (<em>P</em> = 0.018). All patients with low VES had favorable outcomes and resection rates &gt;90%. In contrast, 62.5% of patients with high VES had poor outcomes, influenced by a lower extent of resection (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The magnetic resonance imaging–based VES provides a practical method to quantify vascular involvement in skull base tumors. It may support risk-adapted surgical planning and serve as a foundation for Artificial Intelligence–based tools enabling automated preoperative risk assessment.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"202 ","pages":"Article 124375"},"PeriodicalIF":2.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859691","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":"Radiosurgery for Glossopharyngeal Neuralgia: A Systematic Review and Meta-Analysis","authors":"Bardia Hajikarimloo ,&nbsp;Ibrahim Mohammadzadeh ,&nbsp;Ali Mortezaei ,&nbsp;Azin Ebrahimi ,&nbsp;Mohammad Amin Habibi","doi":"10.1016/j.wneu.2025.124389","DOIUrl":"10.1016/j.wneu.2025.124389","url":null,"abstract":"<div><h3>Background</h3><div>Glossopharyngeal neuralgia (GPN) is a rare craniofacial pain disorder accounting for 1% of all craniofacial pain syndromes. Pharmacological agents are the first-line option for GPNs, but failure occurs in up to 50% of the cases. Microvascular decompression (MVD), rhizotomy (RHZ), and stereotactic radiosurgery (SRS) are the 3 main options for GPNs. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of SRS in patients with GPNs.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Embase, Scopus, and Web of Science on February 20, 2025. Studies that reported pain-related outcomes were included. The Barrow Neurological Institute (BNI) considered a completely pain-free status, and BNI I-IIIb was deemed acceptable for pain relief. The short-term was considered the first post-SRS follow-up, and the long-term was defined as the last follow-up.</div></div><div><h3>Results</h3><div>Six studies with 75 GPN patients were included. The meta-analysis revealed a pooled rate of short-term complete and acceptable pain relief of 44% (95% CI: 32%–56%) and 86% (95% CI: 76%–94%), respectively. The meta-analysis indicated a pooled rate of long-term complete and acceptable pain relief of 46% (95% CI: 34%–59%) and 79% (95% CI: 49%–98%), respectively. Additionally, the meta-analysis showed a pooled adverse radiation effect (ARE) rate of 1% (95% CI: 0%–6%) and a recurrence rate of 39% (95% CI: 27%51%).</div></div><div><h3>Conclusion</h3><div>SRS is an efficient and safe alternative for GPNs, with promising pain-related outcomes and minimal likelihood of complications, especially in high-risk patients for invasive surgical interventions.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"202 ","pages":"Article 124389"},"PeriodicalIF":2.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859689","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 Outcome of Redo-Surgery for Recurrent Chronic Subdural Hematoma: A Systematic Review and Meta-Analysis Combined with a Case Series","authors":"Maud J. de Rooij,&nbsp;Arthur T.J. van der Boog,&nbsp;Sophie H. Carter,&nbsp;Pierre A.J.T. Robe,&nbsp;Albert van der Zwan,&nbsp;Hamid R. Niknejad","doi":"10.1016/j.wneu.2025.124377","DOIUrl":"10.1016/j.wneu.2025.124377","url":null,"abstract":"<div><h3>Objective</h3><div>Chronic subdural hematoma (CSDH) is becoming more prevalent, particularly in aging populations, with a 20% recurrence rate postsurgery. Burr hole craniostomy is the standard treatment, but recurrence remains a significant challenge. This study evaluates the incidence of second CSDH recurrence, its management, and clinical outcomes following various hematoma evacuation procedures in the literature and our cohort.</div></div><div><h3>Methods</h3><div>A systematic review identified 8 studies with 183 patients. Additionally, we analyzed 63 consecutive patients undergoing reoperation for recurrent CSDH at our center, assessing second recurrence rates, clinical outcomes, and the impact of comorbidities and antithrombotic medication.</div></div><div><h3>Results</h3><div>Meta-analysis showed a pooled second recurrence rate of 20% (95% confidence interval 13%–30%), versus 15.9% in our cohort. Most second recurrences occurred within a month postsurgery. Clinical outcomes were unfavorable, with most patients having residual symptoms and achieving only moderate-to-poor functional recovery (modified Rankin Scale 2–4). Comorbidities such as diabetes did not significantly influence recurrence rates. In contrast to previous reports, the use of antithrombotic medication was associated with a significantly lower recurrence rate in our cohort.</div></div><div><h3>Conclusions</h3><div>Redo-surgery is currently the primary treatment for (subsequent) recurrent CSDH and leads to unfavorable outcomes. Given the high recurrence rates and poor functional recovery, there is a need for improved treatment approaches to address the underlying pathophysiology of CSDH. Further research is needed to evaluate the effectiveness of middle meningeal artery embolization in the context of recurrence and improving clinical outcomes.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"202 ","pages":"Article 124377"},"PeriodicalIF":2.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859688","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":"An Open Source Tool to Conduct 3D Morphometric Analysis of Microneurosurgical Corridors: Technical Note and Anatomical Validation Study using Surface Scanning Techniques.","authors":"Filippo Andrea Sinosi, Roberto Rodriguez Rubio","doi":"10.1016/j.wneu.2025.124378","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124378","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124378"},"PeriodicalIF":2.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859686","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":"Cervical Sagittal Alignment Revisited on the Path to Personalized Spine Surgery: A Big Picture Perspective Through Bibliometric Analysis and Visualization","authors":"Luke L. Jouppi ,&nbsp;Clifford Pierre ,&nbsp;Anna Gorbacheva ,&nbsp;Julius Gerstmeyer ,&nbsp;Colin Gold ,&nbsp;Cameron Hogsett ,&nbsp;Nicholas Minissale ,&nbsp;Mark Kraemer ,&nbsp;Stephen Lockey ,&nbsp;Amir Abdul-Jabbar ,&nbsp;Rod J. Oskouian ,&nbsp;Jens R. Chapman","doi":"10.1016/j.wneu.2025.124387","DOIUrl":"10.1016/j.wneu.2025.124387","url":null,"abstract":"<div><h3>Objective</h3><div>Spinal alignment has become a focal point of spine deformity surgery amid an increased emphasis on global balance. Following a strong focus on thoracolumbar alignment, the cervical spine has recently emerged as a key area for further investigations. We applied formal bibliographic analytic techniques to assess trends regarding cervical sagittal alignment over time.</div></div><div><h3>Methods</h3><div>Data was collected from the Clarivate Web of Science, PubMed, and Scopus databases on 08/02/2025 utilizing the keyword search (\"cervical\" OR \"cervical spine\") AND (\"sagittal imbalance\" OR \"sagittal balance\" OR \"sagittal alignment\" OR \"sagittal malalignment\"). Excel was used to create the publication years, citations per year, publishing journals, countries, author figures. VosViewer was used to create the network visualizations of keyword co-occurrence, cocitation, country copublication, and coauthorship analyses.</div></div><div><h3>Results</h3><div>We identified an over ten-fold increase every fifteen years in cervical sagittal alignment-related publications, starting with one study published in 1994 rising to 161 published in 2023. This trend outpaces global increases in spine publications by over sixfold. Notable jumps occurred from both 2012–2013 and 2016–2017, with over 50% increases in publications year over year. In the last five years, there has been an increasing focus on deformity, laminectomy, and motion.</div></div><div><h3>Conclusions</h3><div>Cervical sagittal alignment has received a rapid and disproportionate increase in publications in the last ten years which may reflect increased interest in personalized surgery through deformity correction and motion preservation. Our study provides a graphic perspective on this topic and reflects the importance of spinal alignment in all sections of the spinal column.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"202 ","pages":"Article 124387"},"PeriodicalIF":2.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859687","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 Application of the Prevertebral Fascia in the Surgical Approach to the Craniocervical Junction: Cadaveric Dissection Studies and Clinical Case Demonstrations","authors":"Zhong Liu ,&nbsp;Yu-Sheng Wang ,&nbsp;Tian-Kang Yi ,&nbsp;Jie Liu","doi":"10.1016/j.wneu.2025.124376","DOIUrl":"10.1016/j.wneu.2025.124376","url":null,"abstract":"<div><h3>Background</h3><div>The suboccipital muscles at the craniocervical junction exhibit high anatomical complexity. Inadequate use of correct anatomical planes during surgery complicates exposure of deep structures and increases the risk of damaging the carotid sheath (CS) and parotid gland (PG). This study aims to identify key anatomical landmarks for protecting the PG and optimizing CS exposure in far lateral approach (FLA) and extreme lateral approach (ELA).</div></div><div><h3>Methods</h3><div>Ten cadaver head specimens underwent anatomical dissection to simulate FLA and ELA. The prevertebral fascia (PVF) was identified as a critical structure for surgical exposure and subsequently used as a landmark in 12 clinical cases of FLA/ELA.</div></div><div><h3>Results</h3><div>Neck fascia was anatomically classified into superficial (investing fascia), middle (pretracheal fascia), and deep (PVF) layers, with paired CS. The PVF acted as a complete barrier between the PG and suboccipital muscles and a key landmark separating the CS from suboccipital muscles. Leveraging PVF anatomy minimized CS exposure/injury during FLA while ensuring safe access to the CS or jugular foramen in 12 clinical surgeries; using PVF as a landmark proved safe and effective, with no intraoperative PG/CS complications.</div></div><div><h3>Conclusions</h3><div>The PVF is a critical anatomical landmark for protecting CS and PG in FLA or ELA. Utilizing its anatomical principles enhances surgical orientation, efficiency, and safety.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"202 ","pages":"Article 124376"},"PeriodicalIF":2.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856525","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":"Novel Radiologic Parameter to Simulate Decompression Efficacy in Cervical Laminoplasty: The Magnetic Resonance Imaging Laminar Line","authors":"Piyao Ji,&nbsp;Yantao Zhang,&nbsp;Jianghua Ming,&nbsp;Yaming Li,&nbsp;Yonggang Ma,&nbsp;Yan Zhou","doi":"10.1016/j.wneu.2025.124373","DOIUrl":"10.1016/j.wneu.2025.124373","url":null,"abstract":"<div><h3>Background</h3><div>The goal of this study was to investigate the clinical value of magnetic resonance imaging (MRI) laminar line (LL)-simulated decompression for predicting the efficacy of cervical laminoplasty (CLP).</div></div><div><h3>Methods</h3><div>Data of 60 patients who underwent CLP for cervical spondylotic myelopathy were retrospectively analyzed. LL was defined as the line between the anterior–inferior margin of the superior lamina and the anterior–superior margin of the inferior lamina at the decompression segment, and the anterior dural border to the midsagittal diameter of LL was measured. The diameter of the dural sac in the compression segment of preoperative MRI and the spinal canal of postoperative MRI were measured. The correlation between the actual spinal decompression degree and the MRI LL simulation decompression was compared. The modified Japanese Orthopedic Association score, visual analog scale score, and Neck Disability Index score were assessed.</div></div><div><h3>Results</h3><div>The midsagittal diameter of actual decompression and LL-simulated decompression was significantly increased compared with preoperative measurements. The predictive accuracy rate of the median sagittal diameter of LL was 91.7% (55/60) compared with the actual decompression effect. The mean and median diameters of LL-simulated decompression and actual decompression in 35 patients with C2–C7 Cobb ≥20° were wider than those in 20 patients with C2–C7 Cobb &lt;20° (<em>P</em> &lt; 0.05). The modified Japanese Orthopedic Association, visual analog scale, and Neck Disability Index scores were significantly higher at the final follow-up than preoperation (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The application of MRI LL-simulated decompression can predict radiological outcomes of spinal cord decompression and aid in the preoperative planning of CLP.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"202 ","pages":"Article 124373"},"PeriodicalIF":2.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849263","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}