World neurosurgery最新文献

{"title":"Spinal Cord Stimulation with Implantation of Surgical Leads is a Sufficient Salvage Therapy for Patients Suffering from Persistent Spinal Pain Syndrome-A Retrospective Single-center Experience.","authors":"Anton Früh, Tarik Alp Sargut, Melanie Brüßeler, Laura Hallek, Anja Kuckuck, Peter Vajkoczy, Simon Bayerl","doi":"10.1016/j.wneu.2024.09.140","DOIUrl":"10.1016/j.wneu.2024.09.140","url":null,"abstract":"<p><strong>Objective: </strong>Persistent spinal pain syndrome (PSPS) poses a significant medical challenge, often leading to diminished quality of life for affected individuals. In response to this clinical dilemma, spinal cord stimulation (SCS) has emerged as a promising intervention aimed at improving the functional outcomes and overall well-being of patients suffering from this debilitating syndrome. In case a therapy with percutaneous lead fails (e.g., due to a dislocation), surgical lead can be used as a stable alternative. This results in a more invasive procedure and does not allow for intraoperative monitoring. The aim of this study is to investigate the efficacy and safety of the use of surgical leads, as there have been only a few case series published so far.</p><p><strong>Methods: </strong>We included PSPS patients that gave consent to a SCS therapy and were treated with surgical leads. Outcome scores concerning the quality of life (Short Form Health Survey [SF-36]), pain related disability (Oswestry disability index [ODI]), sleeping quality (Pittsburgh Sleep Quality Index [PSQI]), and pain intensity (numeric rating scale [NRS]) were obtained prior to surgery and at outpatient visits after permanent implantation.</p><p><strong>Results: </strong>In this study, 36 patients were implanted with a surgical lead SCS system. One patient developed a new neurologic deficit characterized by left-sided leg paresis attributable to postoperative hemorrhage, and another patient experienced a wound infection. These complications contributed to an overall morbidity rate of 5.6%. In 5 patients (20.8%), the electrodes were explanted within the first month. Follow-up data of 24 patients with a median follow-up time of 21 (interquartile range [IQR] 15-47) months were available. The mean pain intensity at rest and in motion was reduced. Further pain depending disability improved from a median ODI_preop = 38% [IQR 30%-57%] to ODI_follow-up = 21% [IQR 9%-35%] (P < 0.01). Additionally, the Sleeping Quality and the Quality of Life improved concerning the physical (median PCS _preop = 22.5 [IQR 20.4-30.4] vs. PCS_follow-up = 41.8 [IQR 35.2-47.0], P < 0.01) and mental (median MCS_preop = 45.4 [IQR 31.1-55.5] vs. MCS_follow-up = 58.1 [IQR 47.6-59.8], P = 0.018) component.</p><p><strong>Conclusions: </strong>SCS with surgical leads is a safe secondary technique to treat PSPS, where treatment with percutaneous leads fail. The results show a promising long-term effect concerning pain intensity and functional outcome.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476202","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":"Random Forest Prognostication of Survival and 6-Month Outcome In Pediatric Patients Following Decompressive Craniectomy For Traumatic Brain Injury.","authors":"Ryan D Morgan, Brandon W Youssi, Rafael Cacao, Cristian Hernandez, Laszlo Nagy","doi":"10.1016/j.wneu.2024.10.075","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.075","url":null,"abstract":"<p><strong>Introduction: </strong>There is a dearth of literature regarding prognostic and predictive factors for outcome following pediatric decompressive craniectomy (DC) following traumatic brain injury (TBI). The aim of this study was to develop a random forest machine learning algorithm to predict outcomes following DC in pediatrics.</p><p><strong>Methods and materials: </strong>This is a multi-institutional retrospective study assessing the 6-month postoperative outcome in pediatric patients that underwent DC. We developed a machine learning model using classification and survival random forest algorithms (CRF and SRF respectively) for the prediction of outcomes. Data was collected on clinical signs, radiographic studies, and laboratory studies. The outcome measures for the CRF were mortality and good or bad outcome based on Glasgow Outcome Scale (GOS) at 6-months. A GOS score of 4 or higher indicated a good outcome. The outcomes for the SRF model assessed mortality at during the follow-up period.</p><p><strong>Results: </strong>A total of 40 pediatric patients were included. There was a hospital mortality rate of 27.5%, and 75.8% of survivors had a good outcome at 6-month follow up. The CRF for 6-month mortality had a ROC AUC of 0.984; whereas, the 6-month good/bad outcome had a ROC AUC of 0.873. The SRF was trained at the 6-month timepoint with a ROC AUC of 0.921.</p><p><strong>Conclusion: </strong>CRF and SRF models successfully predicted 6-month outcomes and mortality following DC in pediatric TBI patients. These results suggest random forest models may be efficacious for predicting outcome in this patient population.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547929","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":"Traumatic Brain Injury Increasing Risk of Meningioma? From the Genetic Evidence.","authors":"Chunming He, Tao Long, Huaiyu Zhou, Chuan Zeng, Peng Xiong, Xinyu Qiu, Haimin Song","doi":"10.1016/j.wneu.2024.10.003","DOIUrl":"10.1016/j.wneu.2024.10.003","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have demonstrated a strong association between traumatic brain injury (TBI) and an increased risk of meningioma. However, this correlation remains controversial. This study utilized Mendelian randomization to explore this relationship from the perspective of genetic evidence.</p><p><strong>Methods: </strong>We employed 6 TBI genome-wide association study datasets from the integrative epidemiology unit genome-wide association study database. Summary statistics for meningioma were sourced from the FinnGen R10 database. We assessed heterogeneity and horizontal pleiotropy within the analyzed data. The primary method was inverse variance weighting (IVW) to investigate the causal relationship between TBI and meningioma, excluding cases with horizontal pleiotropy. Four supplementary analysis methods were also used, with abnormal results excluded based on leave-one-out sensitivity analysis.</p><p><strong>Results: </strong>All 6 Mendelian randomization analyses indicated no causal relationship between TBI and meningiomas (focal brain injury IVW P value = 0.98; diffuse brain injury IVW P value = 0.41; TBI without concussion IVW P value = 0.45; intracranial trauma IVW P value = 0.34; traumatic subdural hemorrhage IVW P value = 0.80; traumatic subarachnoid hemorrhage IVW P value = 0.92).</p><p><strong>Conclusions: </strong>The Mendelian randomization study revealed that TBI does not increase the risk of meningioma based on genetic evidence.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393734","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":"Neuroendoscopic Surgery for Intraventricular Cavernous Malformations: A Review on Indications and Surgical Considerations","authors":"Bianca Bossi,&nbsp;Luca Ferlendis,&nbsp;Désirée Dallago,&nbsp;Immacolata Mazzetto,&nbsp;Marco Scarlino,&nbsp;Antonio Tabano,&nbsp;Davide Locatelli","doi":"10.1016/j.wneu.2024.10.002","DOIUrl":"10.1016/j.wneu.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Intraventricular cavernous malformations (IVCs) are rare vascular lesions of the central nervous system. Surgical resection remains a challenging endeavor, with conventional microsurgical techniques associated with morbidity due to direct brain tissue manipulation. Neuroendoscopic approaches offer a minimally invasive alternative, though their efficacy and safety in treating IVCs remain underexplored.</div></div><div><h3>Methods</h3><div>A narrative review was conducted to analyze all documented cases of IVCs treated exclusively with endoscopic transventricular approaches. Reviews, original research papers, and case reports published from 1990 to May 2024 were included. When available, surgical videos were also reviewed.</div></div><div><h3>Results</h3><div>Seventeen patients with IVCs primarily located in the foramen of Monro were identified. The mean size of the IVCs was 17 mm (range: 7–29 mm). Neuroendoscopic procedures achieved gross total resection in all cases, leading to the resolution of clinical symptoms. Except for one patient who experienced memory impairment postsurgery, no persistent neurological dysfunctions were observed. Intraoperative bleeding, a significant challenge in IVC resection, was managed with continuous warm irrigation and dedicated coagulation instruments. Additionally, 6 cases of neuroendoscopic procedures such as endoscopic third ventriculostomy and septum pellucidotomy were reported for managing hydrocephalus.</div></div><div><h3>Conclusions</h3><div>Neuroendoscopic surgery offers several advantages in treating IVCs, including minimally invasive access, precise visualization, and reduced brain tissue manipulation. Our findings support the efficacy and safety of endoscopic transventricular approaches, underscoring its potential as a valuable therapeutic strategy for selected IVCs.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393820","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":"Role of Early Postoperative Measurement of Copeptin in Prediction of Diabetes Insipidus Following Pituitary Surgery in Adults: A Systematic Review Plus Meta-analysis","authors":"Alireza Sharifi ,&nbsp;Peter H. Hwang ,&nbsp;Ali Kouhi ,&nbsp;Mohaddeseh Zojaji ,&nbsp;Mohammad E. Ghaffari ,&nbsp;Sahar Ghaedsharaf","doi":"10.1016/j.wneu.2024.10.006","DOIUrl":"10.1016/j.wneu.2024.10.006","url":null,"abstract":"<div><h3>Background</h3><div>Early diagnosis of diabetes insipidus (DI), a complication following pituitary surgery, can avoid catastrophic results such as lethargy or even death. Measurement of arginine vasopressin (AVP) may help the early diagnosis, but its direct assaying is challenging. Copeptin, which is co-secreted in equimolar quantities to AVP, is suggested to be a reliable marker in prediction of postoperative DI. Therefore, this systematic review plus meta-analysis aims to discover this possible role.</div></div><div><h3>Methods</h3><div>Google Scholar, PubMed, Scopus, Web of Science, Embase, and Cochrane library were systematically searched up to August 2024. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Two authors independently reviewed the eligible articles and assessed the quality of them. A meta-analysis was conducted to assess the discriminative performance of copeptin.</div></div><div><h3>Results</h3><div>In total, 8 cohort studies including 1255 participants met the inclusion criteria. The median copeptin levels were significantly lower in DI groups compared with non-DI groups in all included studies (<em>P</em> &lt; 0.005). Meta-analysis of areas under the curve demonstrated that early measurement of copeptin level had an accuracy of 0.791 (standard error: 0.0198, 95% CI: 0.752 to 0.830), which was statistically significant (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Copeptin level was significantly lower in DI patients than in non-DI patients who underwent pituitary surgery. Early measurement, as soon as possible (from the first hour to 48 hours after the operation) of copeptin after pituitary surgeries has good, but not excellent, accuracy to exclude postoperative DI.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406965","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":"Predicting Functional Outcomes of Endovascular Thrombectomy in Acute Ischemic Stroke Using a Clinical-Radiomics Nomogram.","authors":"Yuan Zhang, Tingting Zheng, Hao Wang, Jie Zhu, Shaofeng Duan, Bin Song","doi":"10.1016/j.wneu.2024.10.073","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.073","url":null,"abstract":"<p><strong>Background: </strong>Endovascular thrombectomy (EVT) is recommended for acute ischemic stroke (AIS) due to large-vessel occlusion. However, approximately 50% of patients still face poor outcomes post-procedure. This study aimed to assess whether a nomogram model that integrates CT angiography radiomics features and clinical variables can predict EVT outcomes in AIS patients.</p><p><strong>Methods: </strong>159 EVT patients were randomly divided into training and validation groups at a 7:3 ratio. A modified Rankin Scale (mRS) ≤ 2 at 90 days indicated a favorable outcome. We used univariate and multivariate logistic regression to identify analytic and radiomic predictors and create predictive models. Model performance was evaluated using the AUC, Hosmer-Lemeshow test, and decision curve analysis for discrimination, calibration, and clinical utility.</p><p><strong>Results: </strong>A 19-feature radiomic signature reached an AUC of 0.79. Combining it with age, baseline NIHSS, diabetes, and statin use raised the clinical-radiomics nomogram's AUC to 0.85. Both decision curve and calibration curve analyses showed strong performance.</p><p><strong>Conclusion: </strong>Combining radiomics nomogram with clinical predictors could effectively forecast EVT outcomes in acute anterior circulation large vessel occlusion stroke patients.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547928","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 History and Current State of Neurosurgery in the Republic of Moldova: Celebrating the 25th Anniversary of the Founding of the Department of Neurosurgery","authors":"Grigore Zapuhlîh ,&nbsp;Gail Rosseau ,&nbsp;Nathan A. Shlobin ,&nbsp;Marcel Ivanov ,&nbsp;Valeriu Matcovschi ,&nbsp;Vladimir Dolghi ,&nbsp;Radu Safta ,&nbsp;Aurel Bodiu ,&nbsp;Valeriu Vicol ,&nbsp;Victor Andronachi ,&nbsp;Anatol Litovcenco ,&nbsp;Angela Leanca ,&nbsp;Adrian Danu ,&nbsp;Iulian Glavan ,&nbsp;Vioral Gaina ,&nbsp;Dan Lisii ,&nbsp;Viorel Guranda ,&nbsp;Vasile Postolati ,&nbsp;Augustin Zapuhlîh ,&nbsp;Nicu Ribac ,&nbsp;Oxana Grosu","doi":"10.1016/j.wneu.2024.10.004","DOIUrl":"10.1016/j.wneu.2024.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Five billion people worldwide lack access to safe, timely, and affordable surgical and anesthesia care. This deficit is greatest in low- and middle-income countries, especially for specialty surgical services including neurosurgery, due to insufficient personnel, resources, and infrastructure. The southeastern European nation of the Republic of Moldova is one such middle-income country.</div></div><div><h3>Methods</h3><div>Discussions with key individuals involved in neurosurgical care in Moldova were conducted to characterize the history and current state of neurosurgery in Moldova. Via a process of chain referral sampling, all practicing neurosurgeons in Moldova were invited to participate in the execution and authorship of this project.</div></div><div><h3>Results</h3><div>Developing from origins in the Soviet Union, neurosurgery became part of the national health system in the 1940s, with the creation of the first neurosurgery department in 1999. Eleven hospitals, including eight public and 3 private, offer neurosurgical services, with 239 beds and 5330 cases performed in 2023. Most attending neurosurgeons and residents are male, but this is changing as women comprise over one-third of residents in training. There is one neurosurgery residency program and a 2-year fellowship in endovascular neurosurgery in Moldova, with further fellowship training received outside of the country. Computed tomography and magnetic resonance imaging are available at most centers.</div></div><div><h3>Conclusions</h3><div>This article provides the first-ever description of the history and current state of neurosurgery in Moldova and presents key recommendations to guide the international neurosurgery community in developing neurosurgical care in countries with an unmet need.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406966","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 Updated Review on Treatment of Cervical Synovial Cyst","authors":"Tzu-Chiang Peng ,&nbsp;Ping-Chuan Liu ,&nbsp;Chih-Chang Chang ,&nbsp;Hsuan-Kan Chang ,&nbsp;Chin-Chu Ko ,&nbsp;Tsung-Hsi Tu ,&nbsp;Li-Yu Fay ,&nbsp;Jau-Ching Wu ,&nbsp;Wen-Cheng Huang ,&nbsp;Chao-Hung Kuo","doi":"10.1016/j.wneu.2024.09.135","DOIUrl":"10.1016/j.wneu.2024.09.135","url":null,"abstract":"<div><div>Cervical synovial cyst (CSC) is a rare condition that often leads patients to seek medical attention due to cervical stenosis symptoms. There's ongoing debate about the best management strategy. To address this, a review of literature from the past 20 years (2003–2023) was conducted using keywords like \"cervical synovial cyst,\" \"cervical ganglion cyst,\" and \"cervical juxtafacet cyst.\" Data on patient demographics, imaging characteristics, treatment methods, and clinical outcomes were collected. A total of 79 patients were diagnosed with CSCs, averaging 62.3 years old, with a slight male predominance (45 males, 34 females). Most cysts were located at the C1-2 and C7-T1 joints, with myelopathy being the most common symptom. Subaxial CSCs had a higher incidence of radiculopathy compared to axial CSCs. Most cases were treated surgically, with decompression performed with or without fusion. Patients generally reported symptom improvement regardless of the surgical method. Overall, surgical intervention effectively improved neurological symptoms associated with CSCs.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ROS-responsive hydrogel loaded with allicin suppresses cell apoptosis for the treatment of intervertebral disc degeneration in a rat model.","authors":"Ting Zhang, Qing Huang, Liangjie Lu, Ke Zhou, Keqi Hu, Kaifeng Gan","doi":"10.1016/j.wneu.2024.10.056","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.056","url":null,"abstract":"<p><strong>Background: </strong>Intervertebral disc degeneration (IVDD) is a common cause of lower back pain, and cell apoptosis plays a key role in its progression. This study explores the therapeutic potential of a reactive oxygen species (ROS)-responsive hydrogel loaded with allicin for treating IVDD.</p><p><strong>Methods: </strong>Allicin was encapsulated in a ROS-responsive hydrogel, and its controlled release was studied in vitro. Nucleus pulposus (NP) cells were treated with hydrogen peroxide to induce apoptosis, and the effects of the hydrogel were examined using qPCR and Western blotting. An in vivo rat model of IVDD was also established to assess the efficacy of the treatment.</p><p><strong>Results: </strong>The ROS-responsive hydrogel effectively inhibited apoptosis in NP cells by reducing ROS levels and modulating the expression of apoptotic and anti-apoptotic genes. In the rat model, the hydrogel loaded with allicin significantly reduced IVDD, preserving disc morphology and matrix integrity.</p><p><strong>Conclusions: </strong>ROS-responsive hydrogel loaded with allicin shows potential as a therapeutic approach for IVDD by inhibiting cell apoptosis and reducing disc degeneration in vivo.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569736","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":"Percutaneous Mesh-Container-Plasty versus Percutaneous Kyphoplasty in the Treatment of Osteoporotic Compression Fractures with Up-Endplate Injury: A Retrospective Study.","authors":"Haifu Sun, Zhiyong Sun, Wenxiang Tang, Chengyue Wang, Jingjie Wang, Yonggang Li, Yimeng Wang","doi":"10.1016/j.wneu.2024.09.142","DOIUrl":"10.1016/j.wneu.2024.09.142","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous mesh-container-plasty (PMCP), a modified traditional percutaneous kyphoplasty (PKP) technique, is increasingly being used to treat osteoporotic vertebral compression fractures with up-endplate injury. This retrospective study aimed to compare the clinical and radiological results of PKP and PMCP for the treatment of this disease.</p><p><strong>Methods: </strong>We retrospectively analyzed the medical records of patients with osteoporotic compression fractures and upper endplate injuries treated at our hospital between January 2019 and December 2021. A total of 192 patients who met the inclusion and exclusion criteria were enrolled. Of these, 103 underwent PKP and 89 underwent PMCP. Key outcome measures included surgical safety, clinical efficacy, and radiological results.</p><p><strong>Results: </strong>Both the PKP and PMCP groups showed significant improvements in visual analog scale and Oswestry Disability Index scores postoperatively. Additionally, anterior vertebral body height ratio and Cobb's angle improved in both groups, though no statistically significant difference was observed between them. The hospital stay duration was similar between the 2 cohorts. Notably, the PMCP group required a larger volume of bone cement injection yet exhibited a significantly lower incidence of cement leakage and adjacent vertebral fractures (9/89 and 2/89, respectively) compared to the PKP group (24/103 and 11/103, respectively) (P < 0.05). Moreover, the PMCP group had shorter operation times (34.64 ± 9.88 minutes) and reduced fluoroscopy frequency (35.43 ± 5.46 instances) compared to the PKP group (27.23 ± 8.54 minutes and 23.87 ± 5.59 instances, respectively) (P < 0.05).</p><p><strong>Conclusions: </strong>PMCP provided superior clinical outcomes for the management of osteoporotic compression fractures with upper endplate injuries. It was associated with reduced operation and fluoroscopy times, as well as lower risks of adjacent vertebral fractures and cement leakage, compared to PKP.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393821","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}