World neurosurgery最新文献

{"title":"Integrating Single-Cell Sequencing and Transcriptome Analysis to Investigate the Role of Ferroptosis in Ischemic Stroke and the Molecular Mechanisms of Immune Checkpoints","authors":"Weidong Han ,&nbsp;Xiaonan Bian ,&nbsp;Haiyang Fu ,&nbsp;Min Liu ,&nbsp;Hongliang Wang ,&nbsp;Haimei Liu","doi":"10.1016/j.wneu.2025.123908","DOIUrl":"10.1016/j.wneu.2025.123908","url":null,"abstract":"<div><h3>Background</h3><div>Early diagnosis of ischemic stroke (IS) remains challenging. Given the crucial role of ferroptosis in IS, this study aims to identify key genes associated with ferroptosis in IS, providing insights into its molecular mechanisms and potential biomarkers for early detection.</div></div><div><h3>Methods</h3><div>The single-cell transcriptome dataset GSE247474 from the Gene Expression Omnibus. Ferroptosis scores in astrocytes were calculated using the WP_FERROPTOSIS gene set, and differential analysis was conducted to compare ferroptosis activity between the disease and control groups. Key ferroptosis-related genes were identified using Lasso regression and support vector machine algorithms, and their diagnostic potential was assessed through receiver operating characteristic curve analysis. Additionally, we performed immune infiltration analysis and transcription factor network prediction. Pseudotime analysis was used to explore the differentiation trajectories of astrocytes and T-cell subsets.</div></div><div><h3>Results</h3><div>Astrocytes in the disease group showed significantly higher ferroptosis scores than those in the control group. Using machine learning algorithms, we identified 3 key ferroptosis-related genes—SLC3A2 (solute carrier family 3 member 2), FDFT1 (farnesyl-diphosphate farnesyltransferase 1), and BACH1 (BTB and CNC homology 1)—and validated their diagnostic value (area under the curve &gt;0.9). Immune infiltration analysis revealed that SLC3A2 and BACH1 expression levels were positively correlated with CD4⁺ follicular T cells and negatively correlated with CD4⁺ memory T cells. FDFT1 showed positive correlations with both mast cells and CD4⁺ memory T cells. Pseudotime analysis demonstrated dynamic changes in key gene expression along the differentiation trajectories of astrocytes and T cells.</div></div><div><h3>Conclusions</h3><div>SLC3A2, FDFT1, and BACH1 are potential molecular markers for IS diagnosis.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123908"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674607","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":"Ultrasound-Guided External Ventricular Drain Insertion After Decompressive Craniectomy","authors":"Alick P. Wang ,&nbsp;Ryan Sandarage ,&nbsp;Anne-Sophie Parent ,&nbsp;Aneesh Karir ,&nbsp;Husain Shakil ,&nbsp;Brian J. Drake ,&nbsp;John Sinclair","doi":"10.1016/j.wneu.2025.123915","DOIUrl":"10.1016/j.wneu.2025.123915","url":null,"abstract":"<div><h3>Background</h3><div>Ultrasound guidance offers real-time visualization of patient-specific anatomy during external ventricular drain (EVD) insertion. A craniectomy defect provides a sonolucent window, enabling the use of a large, low-frequency probe with deep penetration and a wide field of view. While specialized burr-hole probes exist, use of a curvilinear probe through a craniectomy defect for bedside EVD placement has not been previously described.</div></div><div><h3>Methods</h3><div>Using a curvilinear probe, we performed ultrasound-guided bedside insertion of a left frontal EVD through a hemicraniectomy flap.</div></div><div><h3>Results</h3><div>Bedside ultrasound enabled visualization of the entire supratentorial ventricular system. Drain insertion was successfully performed, with immediate sonographic visualization of the catheter tip in the left frontal horn. Placement was confirmed with a computed tomography scan.</div></div><div><h3>Conclusions</h3><div>Bedside ultrasound-guided EVD insertion in post-craniectomy patients can be a valuable method for safely accessing the ventricle in the face of abnormal or distorted anatomy.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123915"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673658","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":"Utilization of a Telemetric Prechamber in the Management of Patients with Normal Pressure Hydrocephalus","authors":"Miroslav Cihlo ,&nbsp;Pavel Trávníček ,&nbsp;Svatopluk Řehák ,&nbsp;Lucie Kukrálová ,&nbsp;Karel Zadrobílek ,&nbsp;Jan Pospíšil ,&nbsp;Pavel Dostál ,&nbsp;Vlasta Dostálová","doi":"10.1016/j.wneu.2025.123914","DOIUrl":"10.1016/j.wneu.2025.123914","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Normal pressure hydrocephalus is a preventable and treatable cause of dementia. A telemetric prechamber allows individually tailored ventriculoperitoneal shunt valve adjustments in patients treated with the shunting procedure.</div></div><div><h3>Methods</h3><div>In this pilot, prospective randomized trial, 33 adult patients were divided into Group A (with an implanted telemetric prechamber) and Group B (without an implanted telemetric prechamber). The overall condition, Mini-Mental-State-Examination score, and gait test were evaluated 3, 6, 9, and 12 months after surgery. Additionally, the total number of ventriculoperitoneal shunt valve adjustments and their impact on the patient’s condition (assessed by the idiopathic normal pressure hydrocephalus scale) were assessed.</div></div><div><h3>Results</h3><div>There were no differences in the proportion of patients showing improved gait, cognitive functions, or incontinence. Patients with a telemetric prechamber underwent significantly more valve adjustments (1.6 ± 1.1 vs. 0.8 ± 0.6; <em>P</em> = 0.037). Also, a greater difference (reduction) in the shunt initial and final valve setting was observed in the prechamber group (30.71 ± 24.95 vs. 15.26 ± 13.07 mm H₂O; <em>P</em> = 0.049).</div></div><div><h3>Conclusions</h3><div>A telemetric prechamber allowed more valve adjustments during the follow-up period and a greater difference (reduction) between the initial (perioperative) and final valve pressure settings. However, there was no difference in functional parameters between the groups at any time point of the study.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123914"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674081","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":"Predictive Factors for Postoperative Cerebrospinal Fluid Drainage in Neurosurgical Management of Intracranial Aneurysms.","authors":"Xiaohong Guo","doi":"10.1016/j.wneu.2025.123913","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123913","url":null,"abstract":"<p><strong>Background: </strong>Management of intracranial aneurysms often requires complex neurosurgical interventions, with some patients necessitating postoperative cerebrospinal fluid (CSF) drainage. Identifying predictive factors for CSF drainage can enhance patient outcomes through targeted interventions and improved perioperative care.</p><p><strong>Methods: </strong>In this retrospective study, 151 patients who underwent surgical treatment for intracranial aneurysms were included. Demographic data, clinical presentation (Hunt-Hess grade, modified Fisher score), surgical details (operative time, intraoperative complications), and postoperative outcomes were reviewed. Both univariate and multivariable logistic regressions were conducted to identify predictors of postoperative CSF drainage. A subgroup analysis compared patients with anterior versus posterior circulation aneurysms.</p><p><strong>Results: </strong>Overall, 67 patients required postoperative CSF drainage. On multivariable analysis, age ≥60, high Hunt-Hess grade, operative time >5 hours, and intraoperative aneurysm rupture significantly increased the odds of drainage (P<0.05). Subgroup analysis revealed that these risk factors conferred an even higher likelihood of CSF drainage in posterior circulation aneurysms. Gender and modified Fisher score did not show significant associations with drainage.</p><p><strong>Conclusions: </strong>Advanced age, high Hunt-Hess grade, prolonged operative time, and intraoperative rupture predict postoperative CSF drainage in patients with intracranial aneurysms. Incorporating both global and subgroup-based risk assessments can help refine perioperative strategies to reduce complications and improve patient outcomes.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123913"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674617","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":"Spinal Cord Injury in the 21st Century Part I: A New Demographic","authors":"Angelica Alvarez Reyes ,&nbsp;Sruti Bandlamuri ,&nbsp;Travis M. Dumont ,&nbsp;Venkat Ganapathy ,&nbsp;R. John Hurlbert","doi":"10.1016/j.wneu.2025.123917","DOIUrl":"10.1016/j.wneu.2025.123917","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines for the management of acute spinal cord injury are based on a young age group suffering spinal fracture dislocations caused by high-impact trauma. The purpose of this study was to characterize our recent cervical spinal cord injury (cSCI) experience and compare it to this traditional demographic. We hypothesized that most cSCI patients now fall outside the scope of published guideline principles.</div></div><div><h3>Methods</h3><div>Cross-sectional cohort study. A detailed review was performed of cSCI patients admitted to our level 1 trauma institution over a 12-month period identifying demographics, injury types, and coded diagnoses cross-referenced from multiple archival systems</div></div><div><h3>Results</h3><div>Fifty-one patients with cSCI from blunt trauma were identified over the 1-year study period of which 82% did not have a spinal fracture or dislocation. cSCI patients without fracture/dislocation were older (mean age 62), had low-impact injuries (93%), and lower American Spinal Injury Association grades (98%). Patients with fracture/dislocation were younger (mean age 48), had high-impact injuries (77%), and higher American Spinal Injury Association grades (66%). Ninety-eight percent of our cSCI patients without fracture/dislocation presented with sensory and motor changes preferentially involving hands and arms in contrast to 11% of patients with fracture dislocation (<em>P</em> &lt; 00001).</div></div><div><h3>Conclusions</h3><div>cSCI patients without fracture/dislocation now represent the large majority of spinal cord injuries at our level I trauma center. The demographic is most consistent with central cord syndrome, implicating unique pathophysiology and natural history. Extrapolation of management principles from previous guideline efforts is not intuitively generalizable to this patient population.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123917"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674623","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 Unilateral and Bilateral Robot-Assisted Percutaneous Kyphoplasty in Treating Osteoporotic Vertebral Compression Fracture","authors":"Ruoyu Yang,&nbsp;Zhiwei Huang,&nbsp;Shanzhong Shao,&nbsp;Jinrun Liu,&nbsp;Shuyang Xia,&nbsp;Wei Li,&nbsp;Yinshun Zhang,&nbsp;Jun Qian,&nbsp;Fulong Dong,&nbsp;Cailiang Shen,&nbsp;Hui Tao","doi":"10.1016/j.wneu.2025.123911","DOIUrl":"10.1016/j.wneu.2025.123911","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the efficacy and safety of unilateral and bilateral robot-assisted percutaneous kyphoplasty (RAPKP) in treating thoracolumbar osteoporotic vertebral compression fractures.</div></div><div><h3>Methods</h3><div>Our study retrospectively analyzed 78 patients (unilateral group: 48, bilateral group: 30) with osteoporotic vertebral compression fracture treated with RAPKP from January 2020 to July 2022. The operation time, X-ray exposure time, bone cement volume, postoperative bone cement distribution, preoperative and postoperative pain visual analog scale (VAS) scores, Oswestry Dysfunction Index (ODI), Cobb angle, vertebral height, bone cement leakage, adjacent vertebral fracture, and postoperative computed tomography (CT) in both groups were recorded.</div></div><div><h3>Results</h3><div>All patients were successfully treated with RAPKP and followed up for 19.90 ± 5.38 months. Our results showed that the VAS core, ODI, vertebral height, and Cobb angle at postoperative follow-up were significantly improved in both groups compared to the preoperative period (<em>P</em> &lt; 0.05). The operation time in the bilateral group (46.20 ± 6.89 minutes) was not statistically different from the unilateral group (42.54 ± 10.16 minutes) (<em>P</em> &gt; 0.05), while the volume of bone cement injected was significantly more in the bilateral group (5.93 ± 1.81 mL) than in the unilateral group (4.73 ± 0.51 mL) (<em>P</em> &lt; 0.05). In addition, the distribution of bone cement in the bilateral group was significantly better than that in the unilateral group (<em>P</em> &lt; 0.05). There were no significant differences in X-ray exposure dose between the 2 groups (<em>P</em> &gt; 0.05). Bone cement leaked in 9 cases (18.75%) in the unilateral group and 6 cases (20.00%) in the bilateral group (<em>P</em> &gt; 0.05). No neurovascular injury or infection occurred. There were 8 cases (16.67%) of adjacent vertebral fracture in the unilateral group and 4 cases (13.33%) in the bilateral group (<em>P</em> &gt; 0.05). Postoperative CT ratios of adjacent vertebrae (operated vertebra/upper adjacent vertebra: unilateral: 10.65 ± 2.7, bilateral: 11.32 ± 3.1; operated vertebra/lower adjacent vertebra: unilateral: 11.67 ± 3.0, bilateral: 12.48 ± 2.9) (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Unilateral or bilateral RAPKP improves patients’ VAS, ODI, sagittal index, and Cobb angle. Unilateral RAPKP possesses the advantage of fewer puncture injuries. However, bilateral RAPKP has better postoperative cement distribution, and we believe that bilateral RAPKP has a better long-term prognosis, so we recommend bilateral RAPKP.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123911"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply to the Letter to the Editor Regarding “Risk Factors of Pulmonary Embolism in Long-Segment Posterior Thoracolumbar Fusion: Scoring System for Prophylactic Inferior Vena Cava Filter Placement”","authors":"Jonah Heidel ,&nbsp;H. Francis Farhadi ,&nbsp;Ryan Hofler ,&nbsp;R. Carter Cassidy ,&nbsp;Rouzbeh Motiei-Langroudi","doi":"10.1016/j.wneu.2025.123803","DOIUrl":"10.1016/j.wneu.2025.123803","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123803"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459665","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":"An Institutional Experience of Genomic Analysis and Methylation Profiling of Thoracic Spinal Meningiomas","authors":"Prabhath Mannam ,&nbsp;Jimin Shin ,&nbsp;Nathan K. Leclair ,&nbsp;Patrick Halloran ,&nbsp;Arijit Chakraborty ,&nbsp;Akshay Bulsara ,&nbsp;Qian Wu ,&nbsp;Bruce Chozick ,&nbsp;Hilary Onyiuke ,&nbsp;Ian T. McNeill ,&nbsp;Ketan Bulsara","doi":"10.1016/j.wneu.2025.123919","DOIUrl":"10.1016/j.wneu.2025.123919","url":null,"abstract":"<div><h3>Objective</h3><div>Spinal meningiomas (SMs) are less frequently diagnosed than intracranial meningiomas. While recent advancements in tumor biology have identified key driver genes in SMs through targeted sequencing, few studies have yet to characterize the genomic profiles of these tumors together with their methylation signatures. In this study, we present our institutional experience of a combined genomic and epigenetic analysis of 8 thoracic SMs.</div></div><div><h3>Methods</h3><div>We performed targeted genomic sequencing and DNA methylation profiling on 8 primary SMs. We further collected relevant clinical information and tumor imaging through a retrospective chart review.</div></div><div><h3>Results</h3><div>All tumor samples were characterized as World Health Organization Grade I intradural extramedullary meningiomas localized to the thoracic spine. Targeted genomic sequencing revealed mutations in meningioma-driver genes Neurofibromatosis type 2 (62.5%), <em>AKT1</em> (12.5%), and <em>SMARCB1</em> (25%), in addition to several mutations in genes involved in various signaling pathways. DNA methylation profiling classified 6 samples with a benign signature and 2 with an intermediate signature. All patients were treated through surgical excision of the tumor, and clinical follow-up and imaging demonstrated no tumor recurrence or significant residual symptoms.</div></div><div><h3>Conclusions</h3><div>Our data, in concordance with prior studies, demonstrate a diverse genomic and epigenetic landscape of thoracic SMs despite a seemingly homogenous clinical presentation. Understanding and identifying the molecular underpinnings can lead to a more precise and clinically significant classification of SMs, which can further contribute to the development of targeted and improved therapeutic strategies.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123919"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671073","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":"Utilising Natural Language Processing to Identify Brain Tumor Patients for Clinical Trials: Development and Initial Evaluation","authors":"James Booker ,&nbsp;Jack Penn ,&nbsp;Kawsar Noor ,&nbsp;Richard J.B. Dobson ,&nbsp;Naomi Fersht ,&nbsp;Jonathan P. Funnell ,&nbsp;Ciaran S. Hill ,&nbsp;Danyal Z. Khan ,&nbsp;Nicola Newall ,&nbsp;Tom Searle ,&nbsp;Siddharth Sinha ,&nbsp;Lewis Thorne ,&nbsp;Simon C. Williams ,&nbsp;Michael Kosmin ,&nbsp;Hani J. Marcus","doi":"10.1016/j.wneu.2025.123907","DOIUrl":"10.1016/j.wneu.2025.123907","url":null,"abstract":"<div><h3>Background</h3><div>Identifying patients eligible for clinical trials through eligibility screening is time and resource-intensive. Natural Language Processing (NLP) models may enhance clinical trial screening by extracting data from Electronic Health Records (EHRs).</div></div><div><h3>Objective</h3><div>We aimed to determine whether an NLP model can extract brain tumor diagnoses from outpatient clinic letters and link this with ongoing clinical trials.</div></div><div><h3>Methods</h3><div>This retrospective cohort study reviewed outpatient neuro-oncology clinic letters, to detect brain tumor diagnoses. We used an NLP model to perform a Named Entity Recognition + Linking algorithm that identified medical concepts in free text and linked them to a Systematized Nomenclature of Medicine Clinical Terms ontology, which we used to search a clinical trials database. Human annotators reviewed the accuracy of the concepts extracted and the relevance of recommended clinical trials. Search results were shown on a notification dashboard accessible by clinicians and patients on the EHR. We report the model's performance using precision, recall, and F1 scores.</div></div><div><h3>Results</h3><div>The model recognized 399 concepts across 196 letters with macro-precision = 0.994, macro-recall = 0.964, and macro-F1 = 0.977. Linking the model results with a clinical trials database identified 1417 ongoing clinical trials; of these, 755 were highly relevant to the individual patient, who met the eligibility criteria for trial recruitment.</div></div><div><h3>Conclusions</h3><div>NLP can be used effectively to extract brain tumor diagnoses from free-text EHR records with minimal additional training. The extracted concepts can then be linked to ongoing clinical trials. While further analysis is required to assess the impact on clinical outcomes, these findings suggest a potential application for integrating NLP algorithms into clinical care.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123907"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671116","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":"Spinal Cord Injury in the 21st Century Part II: Deficiencies in Data","authors":"Angelica Alvarez Reyes,&nbsp;Sruti Bandlamuri,&nbsp;Travis M. Dumont,&nbsp;R. John Hurlbert","doi":"10.1016/j.wneu.2025.123918","DOIUrl":"10.1016/j.wneu.2025.123918","url":null,"abstract":"<div><h3>Background</h3><div>In Part I of this series we identified spinal cord injury without fracture or dislocation (SCIwoFD) as having become the most common type of spinal cord injury at our level I trauma center. The purpose of this paper was to examine two databases, one local and one national, to determine whether this population could be discovered using traditional search techniques.</div></div><div><h3>Methods</h3><div>We analyzed ICD-10 codes applied by our institution to SCIwoFD patients identified in Part I for accuracy and appropriateness. Concurrently, we queried the National Inpatient Sample (NIS) database between 2015 and 2019 to identify an anticipated increase in SCIwoFD patients compared to patients with more traditional spinal cord injury (SCI) associated with fracture/dislocation.</div></div><div><h3>Results</h3><div>The most common ICD-10 diagnosis provided for SCIwoFD patients at our institution was coded as cervicalgia (33%) followed by cervical spinal stenosis (21%). Five percent were coded for myelopathy, while central cord syndrome was coded in only 2%. Within the NIS, SCIwoFD was reported in only 15% of patients in sharp contrast to 82% of our own patients (<em>P</em> &lt; 0.00001). Conversely, SCI associated with fracture/dislocation comprised 85% of all reported NIS cSCIs holding steady at this level during the study period, as did central cord syndrome (7%) and traumatic spondylopathy (1%).</div></div><div><h3>Conclusions</h3><div>Neither our institutional database nor the NIS allows for appropriate identification of patients suffering SCIwoFD. Properly constructed SCI-specific registries are likely to provide the only opportunity from which to establish best practice parameters for this new 21st-century demographic of SCI.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123918"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671166","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}