World neurosurgery最新文献

{"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 , H. Francis Farhadi , Ryan Hofler , R. Carter Cassidy , 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}

{"title":"Intraoperative neurophysiological monitoring during scoliosis surgery in patients with spinal muscular atrophy","authors":"Li Bin MD ,&nbsp;Deng Yaolong MD ,&nbsp;Sui Wenyuan MD ,&nbsp;Liu Jiaxin MD ,&nbsp;Liu Fuyun MD ,&nbsp;Hu Weiming MD ,&nbsp;Yang Junlin MD","doi":"10.1016/j.wneu.2025.123906","DOIUrl":"10.1016/j.wneu.2025.123906","url":null,"abstract":"<div><h3>Study design</h3><div>A retrospective study</div></div><div><h3>Objective</h3><div>To evaluate the efficacy and characteristics of monitoring data and outcomes during scoliosis surgery in patients with spinal muscular atrophy from Mainland China.</div></div><div><h3>Method</h3><div>We analyzed somatosensory evoked potential (SSEP), motor evoked potential (MEP) records of 27 consecutive patients with spinal muscular atrophy and 59 patients with adolescent idiopathic scoliosis (AIS), who underwent spinal deformity surgery in our scoliosis center from July 2019 through August 2022.</div></div><div><h3>Results</h3><div>SSEP were elicitable in all SMA and AIS patients. The values of latencies prolonged and the amplitudes were significantly lower in SMA patients. MEP monitoring is similar in abductor pollicis brevis (APB) muscles in upper extremities of both SMA and AIS patients and combined recording from the adductor (ADD), quadriceps (QUA), tibialis anterior (TA), abductor hallucis (AH) muscles in lower extremities was necessary and effective although the elicitation rate and amplitudes in SMA patients was lower than those in AIS patients.</div></div><div><h3>Conclusion</h3><div>Routine multimodality intraoperative neurophysiological monitoring (IONM) of spinal cord sensory and motor function was feasible and safe during surgical correction of scoliosis in patients with SMA, particularly when MEPs were recorded from the AH muscle combined with ADD, QUA and TA muscles.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123906"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671087","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":"Spinal Cord Injury in the 21^st Century Part III: A Systematic Meta-Analysis on the Timing of Surgery.","authors":"Breanna L Sheldon, Caitlin Scott, Lisa Goudman, Marisa DiMarzio, R John Hurlbert","doi":"10.1016/j.wneu.2025.123916","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123916","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123916"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671169","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 and Radiographic Presentation and Surgical Outcomes of T-Box Pituitary Transcription Factor (TPIT) Silent Corticotroph Pituitary Neuroendocrine Tumors: A Multi-institutional Experience and Review of the Literature","authors":"Spencer Raub ,&nbsp;Ben Fixman ,&nbsp;Thomas Hanks ,&nbsp;Dominic Nistal ,&nbsp;Racheal Peterson ,&nbsp;Jessica Eaton ,&nbsp;Evgeniya Tyrtova ,&nbsp;Luis Gonzalez-Cuyar ,&nbsp;Kathryn Weaver ,&nbsp;Asha Pathak ,&nbsp;Anthony DeSantis ,&nbsp;R. Alan Failor ,&nbsp;Brent Wisse ,&nbsp;Norman E. Garrett III ,&nbsp;Samuel Emerson ,&nbsp;David J. Cote ,&nbsp;Robert G. Briggs ,&nbsp;Gabriel Zada ,&nbsp;Manuel Ferreira Jr. ,&nbsp;Jacob Ruzevick","doi":"10.1016/j.wneu.2025.123791","DOIUrl":"10.1016/j.wneu.2025.123791","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study is to characterize the incidence, aggressiveness, and clinical outcomes of silent TPIT+ PitNETs, as well as treatment strategies in the event of recurrence/progression. We also review the current literature surrounding TPIT+ silent corticotrophs.</div></div><div><h3>Methods</h3><div>An institutional review board–approved retrospective study of prospectively acquired patients undergoing resection of PitNETs at the University of Washington and University of Southern California between 2011 and 2023 was performed. A prospectively maintained Research Electronic Data Capture database at each institution was queried for patients with tumors immunostaining positive for TPIT and included for study regardless of adrenocorticotropic hormone (ACTH) status. Exclusion criteria included patients with biochemically confirmed Cushing disease. Patient demographics, preoperative radiographic findings, and surgical outcomes were documented. Descriptive statistics were reported for the patient cohort and recurrence/progression free survival analysis was measured and visualized using Kaplan-Meier and Swimmer plots.</div></div><div><h3>Results</h3><div>A total of 1475 patients underwent surgical resection of PitNET with a total of 107 TPIT-immunoreactive tumors. Of these, 37 (34.6%) patients were diagnosed with Cushing disease preoperatively and were excluded from the analysis, leaving 70 (65.4%) patients with TPIT+ silent corticotroph PitNETs. A total of 56 (80%) tumors were only TPIT+, while 14 (20%) stained positive for multiple transcription factors including steroidogenic factor-1, pituitary-specific positive transcription factor 1, or both. The cohort consisted of 45 (64.3%) ACTH+ tumors and 25 (35.7%) ACTH tumors. There were 19 (27.1%) men and 51 (72.9%) women, with mean age 51.3 years. Radiographically, growth beyond the sella into the suprasellar space 54 (77.1%), cavernous sinus 41 (51.4%), and clival/sphenoid 12 (17.1%) compartments was common. A total of 67 (95.7%) of cases were treated via an endoscopic endonasal approach. Gross total resection (GTR) was achieved in 47 (70.1%) of cases. Of those undergoing GTR, two (4.3%) experienced tumor recurrence. Of those undergoing subtotal resection, four (20%) experienced tumor progression (<em>P</em> = 0.06). The median recurrence/progression free survival of TPIT+ tumors was 51.3 months. When stratified by extent of resection, median recurrence free survival was 38.3 months for GTR versus median progression free survival of 51.3 months for subtotal resection (<em>P</em> = 0.88).</div></div><div><h3>Conclusions</h3><div>With the addition of TPIT staining, the diagnosis of silent corticotroph PitNETs increased substantially versus those defined by ACTH immunostaining alone. Regardless of hormone status, these tumors continue to exhibit high rates of extrasellar growth and high rates of recurrence/progression.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123791"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426448","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":"Comparing Postoperative Opioid Use in Primary and Revision Lumbar Fusion: A Propensity-Matched Analysis","authors":"Jonathan Dalton,&nbsp;Jarod Olson,&nbsp;Nicholas B. Pohl,&nbsp;Rajkishen Narayanan,&nbsp;Omar H. Tarawneh,&nbsp;Yunsoo Lee,&nbsp;Michael V. Carter,&nbsp;Gokul Karthikeyan,&nbsp;Logan Witt,&nbsp;Aayush Mehta,&nbsp;John J. Mangan,&nbsp;Mark F. Kurd,&nbsp;Jose A. Canseco,&nbsp;Alan S. Hilibrand,&nbsp;Alexander R. Vaccaro,&nbsp;Gregory D. Schroeder,&nbsp;Christopher K. Kepler","doi":"10.1016/j.wneu.2025.123800","DOIUrl":"10.1016/j.wneu.2025.123800","url":null,"abstract":"<div><h3>Objective</h3><div>This study compared postoperative opioid use for patients undergoing short segment primary versus revision lumbar fusion.</div></div><div><h3>Methods</h3><div>Patients who underwent primary or revision 1–2 level lumbar fusion (2017–2021) were included in this study. The state Prescription Drug Monitoring Program was reviewed for all patients to quantify preoperative and postoperative opioid, benzodiazepine, muscle relaxant, and gabapentin use. A 1:1 propensity match was performed to match primary lumbar fusion patients with revision lumbar fusion patients. Revision lumbar fusion patients were substratified into those with or without persistent postoperative opioid use to identify demographic differences between these patient cohorts.</div></div><div><h3>Results</h3><div>The final cohort included 216 primary and 216 revision 1–2 level lumbar fusion patients. The average time between index procedure and revision was 7.54 ± 9.22 years. Opioid use was similar within 1-year preoperatively and at all postoperative time points (up to 1 year) between primary and revision fusion patients. Benzodiazepine, muscle relaxants, and gabapentinoid use was also similar at all preoperative and postoperative time points. Further stratification of revision lumbar fusion patients found that persistent postoperative opioid use patients had a higher incidence of preoperative opioid use within the year prior to surgery with increased number of prescriptions (7.22 ± 7.62 vs. 1.38 ± 2.32; <em>P</em> &lt; 0.001) and morphine milligram equivalents totals (298 ± 565 vs. 45.6 ± 84.4; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Postoperative opioid requirements were similar amongst patients undergoing primary versus revision lumbar fusion. In the revision cohort, persistent postoperative opioid users had higher preoperative opioid use, which is supported by prior literature. Although revision lumbar fusion has been reported to lead to less pain improvement, this study's findings suggest these procedures may not lead to higher rates of persistent opioid use postoperatively.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123800"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459658","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":"The Biopsy Site is Critical for Bacterial Culture After Percutaneous Biopsy in Patients with Pyogenic Spondylodiscitis","authors":"Kai Tang ,&nbsp;Xi Zhang ,&nbsp;Yongchao Li ,&nbsp;Tinglong Lan ,&nbsp;Jun Fan ,&nbsp;Yuan Li ,&nbsp;Heng Wang ,&nbsp;Wanli Kang ,&nbsp;Shibing Qin ,&nbsp;Weijie Dong","doi":"10.1016/j.wneu.2025.123904","DOIUrl":"10.1016/j.wneu.2025.123904","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have found that the positive rate of bacterial culture after percutaneous needle biopsy in patients with suspected pyogenic spondylodiscitis is influenced by a number of factors. At the same time, the choice of puncture site in percutaneous biopsy has been controversial. The objective of this study is to explore the factors influencing the positive rate of bacterial culture after percutaneous biopsy in patients with pyogenic spondylodiscitis.</div></div><div><h3>Methods</h3><div>The medical records of 186 patients with suspected spinal infection who underwent C-type arm-guided percutaneous biopsy in Beijing Chest Hospital Affiliated to Capital Medical University from January 2023 to December 2023 were retrospectively analyzed. According to inclusion and exclusion criteria, a total of 116 patients with suspected pyogenic spondylodiscitis were included. The positive rate of bacterial culture was calculated, and the effects of age, gender, course of disease, preoperative fever, preoperative antibiotic use, preoperative white blood cell count, C-reactive protein (CRP), erythrocyte sedimentation rate, and puncture site on the positive rate of culture were discussed. Logistic regression analysis was used to identify the relevant factors affecting the positive rate of culture.</div></div><div><h3>Results</h3><div>Among the 116 patients, 63 were males and 53 were females. Age ranged from 13 to 87 years, with a median age of 59.5 years. The results of bacterial culture in 42 patients were positive, with a positive rate of 36.2% (42/116), including <em>Staphylococcus aureus</em> in 12 cases, streptococcus in 5 cases, Brucella in 5 cases, <em>Escherichia coli</em> in 4 cases, <em>Staphylococcus epidermidis</em> in 3 cases, <em>Pseudomonas aeruginosa</em> in 2 cases, <em>Enterococcus faecalis</em> in 2 cases, anaerobic bacteria in 2 cases, and other bacteria in 7 cases. The positive rate of bacterial culture was 22.6% (14/62) in patients with vertebral body puncture and 51.9% (28/54) in patients with intervertebral disc puncture, and there was a significant difference between the 2 groups (<em>P</em> = 0.001). Logistic regression analysis showed that the course of disease, the increase of CRP before puncture, and the site of puncture were the factors influencing the positive rate of culture.</div></div><div><h3>Conclusions</h3><div>The course of disease, the elevation of CRP before puncture, and the site of puncture were the factors influencing the positive rate of bacterial culture in percutaneous biopsy of pyogenic spondylodiscitis patients. The positive rate of obtaining intervertebral disc in percutaneous puncture was significantly higher than that of vertebral body, suggesting that intervertebral disc is a more critical puncture site.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123904"},"PeriodicalIF":1.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664846","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":"Improving Short-Term Outcomes of Cubital Tunnel Syndrome Decompression with Intraoperative Dexamethasone","authors":"Tianyou Hu,&nbsp;Yujie Bian,&nbsp;Tao Zhou,&nbsp;Qiankun Wang,&nbsp;Ding Zhou,&nbsp;Liang He,&nbsp;Zifu Wang,&nbsp;Hongxiang Zhou","doi":"10.1016/j.wneu.2025.123885","DOIUrl":"10.1016/j.wneu.2025.123885","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of intraoperative dexamethasone on short-term clinical outcomes following decompression procedures for cubital tunnel syndrome (CuTS) and its role in controlling postoperative inflammation.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 114 patients with severe CuTS, categorized into a dexamethasone group (n=55) and a control group (n=59). All patients underwent anterior ulnar nerve transposition. The dexamethasone group received 10 mg of dexamethasone injected subepineurally after decompression. Outcomes were assessed at 4 weeks and 6 months postoperatively using visual analog scale, patient-reported ulnar nerve evaluation, Modified Bishop score, two-point discrimination, and electromyography.</div></div><div><h3>Results</h3><div>At 4 weeks, the dexamethasone group showed significantly better improvements in visual analog scale (3.56 ± 0.88 vs. 4.03 ± 0.99, <em>P</em> = 0.014), patient-reported ulnar nerve evaluation (40.87 ± 7.82 vs. 43.49 ± 7.16, <em>P</em> = 0.045), and Bishop scores (8.69 ± 1.18 vs. 7.49 ± 0.88, <em>P</em> &lt; 0.001) compared to the control group. Electrophysiological testing at 6 months also revealed higher motor nerve conduction velocity (50.04 ± 3.92 vs. 46.49 ± 4.84 m/s, <em>P</em> &lt; 0.001) and sensory nerve conduction velocity (49.06 ± 4.60 vs. 47.10 ± 5.63 m/s, <em>P</em> = 0.041) in the dexamethasone group. No adverse effects were observed.</div></div><div><h3>Conclusions</h3><div>Intraoperative dexamethasone effectively reduces inflammation and edema, promoting early nerve recovery and improved short-term outcomes in CuTS decompression. It is a safe and effective adjunctive treatment strategy.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"197 ","pages":"Article 123885"},"PeriodicalIF":1.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664767","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}