World neurosurgery最新文献

{"title":"Clinical Efficacy and Complications of Spinal Surgery Unilateral Biportal Endoscopy for Cervical Spondylosis: A Systematic Review and Meta-Analysis","authors":"Zhongjie Li ,&nbsp;Wenming Zhou ,&nbsp;Jian Liang ,&nbsp;Qilong He ,&nbsp;Yaohong He ,&nbsp;Yugang Guo ,&nbsp;Xin Zhang ,&nbsp;Wende Zhuang ,&nbsp;Li Huang ,&nbsp;Qiqi Fan ,&nbsp;Jinman Liu","doi":"10.1016/j.wneu.2024.10.115","DOIUrl":"10.1016/j.wneu.2024.10.115","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review and meta-analysis evaluated the clinical efficacy and complications of unilateral biportal endoscopy (UBE) for treating cervical spondylosis (CS), providing evidence-based guidance for optimal treatment decisions.</div></div><div><h3>Methods</h3><div>Relevant studies on UBE for CS were identified through comprehensive searches of PubMed, Embase, Web of Science, and the Cochrane Library up to April 22, 2024. Studies included patients diagnosed with CS who underwent UBE surgery and reported outcomes such as visual analog scale (VAS) scores, neck disability index scores, and postoperative complications. Data extraction and quality assessment were performed independently by 2 reviewers. Statistical analyses were conducted using Stata 15, employing random-effects models due to significant heterogeneity (I² &gt; 50%).</div></div><div><h3>Results</h3><div>Nine publications, comprising 353 patients and 400 operation levels, met the inclusion criteria. The mean follow-up duration was 17.01 months, and the operative time for a single level was 71.29 minutes. The average VAS score for neck pain decreased from 6.08 preoperatively to 1.52 postoperatively, the average VAS score for arm pain decreased from 7.13 to 1.35, and the average neck disability index decreased from 34.61 to 6.83 at the final follow-up. The mean satisfaction rate (good or excellent using the Macnab criteria) was 91%. The overall complication rate was 5%, with the most frequent complication being a dural tear (1%), followed by nerve root injury or transient hypoesthesia (0.3%).</div></div><div><h3>Conclusions</h3><div>UBE demonstrates strong efficacy and safety in treating CS, with significant improvements in pain and disability scores, shorter operative times, and lower complication rates.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123386"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629064","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":"Preliminary Experience Using Axolotl (Ambystoma mexicanum) Dermis Patches as a Biologic Agent for Wound Management After Neurosurgical Procedures","authors":"Megan D. Malueg ,&nbsp;Ammad A. Baig ,&nbsp;Matthew Moser ,&nbsp;Brianna M. Donnelly ,&nbsp;Justin Im ,&nbsp;Jaims Lim ,&nbsp;Bernard K. Okai ,&nbsp;Steven B. Housley ,&nbsp;Adnan H. Siddiqui ,&nbsp;Kenneth V. Snyder","doi":"10.1016/j.wneu.2024.10.138","DOIUrl":"10.1016/j.wneu.2024.10.138","url":null,"abstract":"<div><h3>Objective</h3><div>In the United States, chronic wounds affect more than 6.5 million people annually—a mean cost of $23,755 among neurosurgery patients. Current wound management solutions have disadvantages, including rejection, disease transmission from mammalian sources, and cultural issues prohibiting some products. Here, we describe preliminary use of xenograft tissue derived from axolotl (<em>Ambystoma mexicanum</em>) dermis for use in wound management after neurosurgical procedures.</div></div><div><h3>Methods</h3><div>Our prospective database was retrospectively searched for consecutive patients who underwent wound closures using axolotl dermis patches (NeoMatriX, NeXtGen Biologics, Alachua, FL). Patient demographics, daily alcohol and tobacco use, radiation history, operation type, and antibiotic regimens postclosure were collected. Rates of postoperative infection, wound dehiscence, and wound revision or repeated irrigation were collected for outcomes assessment.</div></div><div><h3>Results</h3><div>Twenty-three patients underwent wound closure with the patches. At least 1 comorbidity related to delayed wound closure was present in included patients: obesity = 8 (34.8%), diabetes = 3 (13%), chronic obstructive pulmonary disease = 3 (13%), hypertension = 11 (47.8%), hyperlipidemia = 10 (43.5%), hypothyroidism = 3 (13%), benign prostatic hyperplasia = 3 (13%), human immunodeficiency virus = 1 (4.3%), cancer = 7 (30.4%), daily alcohol use = 4 (17.4%), and current smoking = 7 (30.4%). Wounds treated were from decompressive laminectomy, microvascular decompression, thoracolumbar instrumentation revision, and pseudoaneurysm ligation/resection in 1 (4.3%) patient each. Three (13%) patients had wounds from aneurysm clippings, 6 (26.1%) each from craniotomies and wound dehiscence treatments, and 4 (17.4%) from cranioplasties. Patches were applied for primary wound closure in 14 (60.9%) patients and secondary wound closure in 9 (39.1%) patients. Postapplication wound infection or wound dehiscence and/or revision occurred in 2 (8.7%) patients.</div></div><div><h3>Conclusions</h3><div>Axolotl dermis patches support mammalian wound management, demonstrating favorable potential in improving neurosurgical wound closure and healing and overall outcomes.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123409"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629112","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":"Risk Score for Early Prediction of In-Hospital Mortality After Aneurysmal Subarachnoid Hemorrhage: Pooled Analysis With Score Construction and Validation","authors":"Maryam Said ,&nbsp;Meltem Gümüs ,&nbsp;Marvin Darkwah Oppong ,&nbsp;Patrick Dömer ,&nbsp;Simeon O.A. Helgers ,&nbsp;Philipp Dammann ,&nbsp;Karsten H. Wrede ,&nbsp;Johannes Woitzik ,&nbsp;Ulrich Sure ,&nbsp;Ramazan Jabbarli","doi":"10.1016/j.wneu.2024.11.009","DOIUrl":"10.1016/j.wneu.2024.11.009","url":null,"abstract":"<div><h3>Objective</h3><div>Aneurysmal subarachnoid hemorrhage (aSAH) has a high complications burden, with in-hospital mortality as the most devastating outcome. We aimed to develop and validate a risk score for early prediction of in-hospital mortality after aSAH.</div></div><div><h3>Methods</h3><div>Data from 2 university hospitals were pooled (n = 1070), with cohorts for score construction (n = 886) and external validation (n = 184). Several parameters assessable at admission were collected. Independent predictors of in-hospital mortality were used as mortality score components. Diagnostic accuracy of the novel score was compared to the Hunt and Hess Age, Intraventricular Hemorrhage, Rebleed and World Federation of Neurosurgical Societies (WFNS) scores.</div></div><div><h3>Results</h3><div>Overall rate of in-hospital mortality was 19% and 14.7% in construction and validation cohorts, respectively. The novel risk score (aSAH mortality score: 0–12 points) included patients' age (≤55 years: 0 points, 56–70 years: 1 point, &gt;70 years: 2 points), aneurysm rebleeding (2 points), WFNS grade (grade I–II: 0 points, grade III–IV: 2 points, grade V: 5 points), and Hijdra sum score (≤10: 0 points, 11–20: 1 point, 21–30: 2 points, &gt;30: 3 points). In-hospital mortality rates ranged 0.6% (0 points) to 100% (12 points) in the construction cohort, and 0% (0 points) to 60% (10 points) in the validation cohort. In the receiver operating characteristic analysis, the aneurysmal subarachnoid hemorrhage mortality score (area under the curve [AUC]: 0.829 and 0.824 in the construction and validation cohorts, respectively) was superior to the Hunt and Hess Age, Intraventricular Hemorrhage, Rebleed (AUC: 0.811 and 0.813) and WFNS scores (AUC: 0.768 and 0.795).</div></div><div><h3>Conclusions</h3><div>Risk of in-hospital mortality after aSAH can be predicted with high accuracy using baseline characteristics. The novel risk score showed best diagnostic performance in the construction and validation cohorts and can aid in early prognostication and treatment decisions.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123426"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682970","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":"Building and Verifying a Prediction Model for Deep Vein Thrombosis Among Spinal Cord Injury Patients Undergoing Inpatient Rehabilitation","authors":"Fangfang Zhao ,&nbsp;Lixiang Zhang ,&nbsp;Xia Chen ,&nbsp;Chengqian Huang ,&nbsp;Liai Sun ,&nbsp;Lina Ma ,&nbsp;Cheng Wang","doi":"10.1016/j.wneu.2024.11.034","DOIUrl":"10.1016/j.wneu.2024.11.034","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the relevant variables that contribute to deep vein thrombosis (DVT) among spinal cord injury (SCI) patients undergoing inpatient rehabilitation and to build and validate a nomogram model that predicts DVT risk.</div></div><div><h3>Methods</h3><div>By convenience sampling, 558 SCI patients who were hospitalized at a tertiary-level Grade A general hospital in Anhui Province, China between January 2017 and March 2022 were chosen as the study subjects. They were split into 2 groups at random, one for training (<em>n</em> = 446) and the other for validation (<em>n</em> = 112). The ratio was 8:2. The clinical information of patients was gathered, including sociodemographic characteristics, data about disease characteristics, and examinations pertaining to laboratories. The related factors of DVT among SCI patients undergoing inpatient rehabilitation were analyzed using both univariate and multivariate logistic regression. Using the variables identified by the multivariate logistic regression analysis, we constructed a predictive nomogram model with the aid of the R software. The model’s predictive accuracy for assessing the risk of DVT was validated through the use of receiver operating characteristic curves and calibration plots.</div></div><div><h3>Results</h3><div>Prothrombin time, D-dimer, age, and Caprini score were independent related factors for DVT among SCI patients undergoing inpatient rehabilitation, according to multivariate logistic regression analysis (odds ratio &gt; 1, <em>P</em> &lt; 0.05). These 4 variables selected by the multivariate logistic regression analysis were used to build a nomogram risk model, which was found to have strong predictive capacity for predicting the risk of DVT among SCI patients undergoing inpatient rehabilitation. The nomogram model’s area under the receiver operating characteristic curve in the training group and validation group was 0.793 and 0.905, and the 95% confidence intervals were 0.750∼0.837 and 0.830∼0.980, separately, indicating good discrimination of the nomogram model. A good calibration of the model was shown by the calibration curve, which was well consistent between the model’s predicted probability and the actual frequency of DVT in both the training and validation groups.</div></div><div><h3>Conclusions</h3><div>Prothrombin time, D-dimer level, age, and Caprini score are independent related factors for DVT among SCI patients undergoing inpatient rehabilitation. According to the variables mentioned previously, a nomogram model was constructed that can accurately and easily predict DVT risk among SCI patients undergoing inpatient rehabilitation. This facilitates the early identification of high-risk groups and the timely implementation of prevention, treatment, rehabilitation, and nursing strategies by clinical medical staff.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123451"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689068","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":"Enhancing Pedicle Screw Fixation Training: A Novel Approach Using Head-mounted Devices for Video-assisted Debriefing","authors":"Yuming Wang ,&nbsp;Xia Zhang ,&nbsp;Xiangsheng Tang ,&nbsp;Ruichen Jiang ,&nbsp;Shuyue Yang ,&nbsp;Yanzhu Shen ,&nbsp;Ping Yi","doi":"10.1016/j.wneu.2024.11.007","DOIUrl":"10.1016/j.wneu.2024.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Video-assisted debriefing (VAD) is promising for medical skill training, but its effectiveness requires further exploration. The aim of this study was to investigate the effectiveness of point-of-view VAD in spinal surgery training.</div></div><div><h3>Methods</h3><div>Forty surgical residents were randomly divided into control and video-assisted (VA) groups, both of which underwent pedicle screw fixation procedures while being graded by a consulting surgeon in terms of their technical skills (primary outcome). On the second day, both groups received verbal debriefing and coaching from a senior consultant surgeon; for the VA group, this step was performed while watching a recorded point-of-view video of the procedure alongside the resident surgeon. Both groups then underwent a new testing round and participated in a questionnaire survey regarding their debriefing experience.</div></div><div><h3>Results</h3><div>After the debriefing session, the residents in the VA group had significantly greater technical skills than those in the control group (37 ± 9.7 vs. 25 ± 8.5, <em>P</em> &lt; 0.001). The VAD method was better than the traditional method in terms of steps such as recognizing anatomical structures, piloting holes in the bone, tapping, screw insertion and judging the location of the pedicle screws.</div></div><div><h3>Conclusions</h3><div>VAD is more effective than traditional verbal debriefing for improving residents' surgical skills, particularly for obtaining a more comprehensive understanding of anatomical structures, imitating detailed surgical techniques as well as promoting initiative. However, in terms of mastery of surgical skills, VAD is not significantly beneficial for tactile perception of the surrounding tissue, indicating that a certain amount of practice is still necessary.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123424"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693648","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 Application of Combined Transpetrosal Approach With Microneurovascular Transposition in Recurrent Trigeminal Neuralgia Caused by Dolichoectatic Vertebral Artery","authors":"Vich Yindeedej ,&nbsp;Pree Nimmannitya ,&nbsp;Gahn Duangprasert ,&nbsp;Raywat Noiphithak ,&nbsp;Takeo Goto","doi":"10.1016/j.wneu.2024.11.082","DOIUrl":"10.1016/j.wneu.2024.11.082","url":null,"abstract":"<div><h3>Background</h3><div>In general, the superior cerebellar artery is the most prevalent vessel that compresses the trigeminal nerve root exit zone (TGNREZ) and is responsible for trigeminal neuralgia (TGN). Nevertheless, the surgical outcome is less efficacious when the offending vessel is a dolichoectatic vertebrobasilar vessel (DVB). In addition, the potential for postprocedural adhesion and fibrosis renders recurrent TGN after prior surgery, an extremely challenging operation.</div></div><div><h3>Methods</h3><div>We describe our surgical strategy and procedure that effectively resolved recurrent TGN in a patient whose offending vessel was a large DVB following standard microvascular decompression surgery. The size and nature of the offending DVB indicated that there was limited space for mobilization away from the TGNREZ, as evidenced by previous operative findings. Consequently, the patient’s TGN may not be effectively treated by reoperating with the same standard lateral suboccipital approach.</div></div><div><h3>Results</h3><div>Our surgical approach comprised the creation of an expanded area to facilitate the mobilization of the DVB from the TGNREZ, as well as the untethering of the trigeminal nerve and its subsequent mobilization from the DVB using the transposition technique.</div></div><div><h3>Conclusions</h3><div>A combined transpetrosal approach with microneurovascular transposition technique was selected to achieve all objectives. A case illustration with a surgical video is demonstrated.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123499"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695811","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":"Beyond the Operating Room: The Reality of Gender Disparities in Neurosurgical Education Starting in Medical School","authors":"Sarah Ricchizzi ,&nbsp;Katharina Kersting ,&nbsp;Jason Bakos ,&nbsp;Dilara Akkad ,&nbsp;Alin Maximilian Blega ,&nbsp;Melanie Brüßeler ,&nbsp;Omar García Fernández ,&nbsp;Marco Gallus ,&nbsp;Markus Holling ,&nbsp;Jürgen Konczalla","doi":"10.1016/j.wneu.2024.11.091","DOIUrl":"10.1016/j.wneu.2024.11.091","url":null,"abstract":"<div><h3>Objective</h3><div>Despite the growing number of female medical students, there remains a significant disparity between the number of female and male neurosurgeons. This study aims to determine if this trend is also evident among medical students, examine how various medical schools worldwide are addressing this issue, and propose potential solutions.</div></div><div><h3>Methods</h3><div>The data includes anonymous baseline information from congress registrations, the abstract submission system, and 2 surveys designed to assess student experiences before and after the congress. The questionnaires covered socioeconomic background, prior congress experience, knowledge assessment, career aspirations, and perceptions of neurosurgery, using various Likert scales. Data analysis was performed using GraphPad Prism.</div></div><div><h3>Results</h3><div>A total of 171 individuals attended the congress, including 90 women (52.6%). Precongress and postcongress surveys were completed by 27 participants (48.2% female, 51.9% male). Women submitted more abstracts (59.0%) and achieved higher presentation rankings. Both groups rated their interest in pursuing a career in neurosurgery at 5 out of 6. However, women rated the likelihood of achieving a work-life balance in neurosurgery at 4 out of 6, compared to 3 out of 6 by men. After the congress, this rating improved by one point on the Likert scale for both groups.</div></div><div><h3>Conclusions</h3><div>This study highlights gender-based differences in career planning, scientific and practical neurosurgery experiences, and mentoring opportunities during medical education. Initiatives such as congresses and mentoring programs could help address this imbalance by supporting female medical students from the early stages of their careers.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123508"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740542","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":"Chloroma of the Cerebellopontine Angle: A Rare Presentation","authors":"Gabriel S. Eli,&nbsp;Matheus H. Taborda,&nbsp;Bernardo CA. Teixeira","doi":"10.1016/j.wneu.2024.11.099","DOIUrl":"10.1016/j.wneu.2024.11.099","url":null,"abstract":"<div><div>This article presents a case study of a 7-year-old female patient with a history of acute myelogenous leukemia, previously treated with chemotherapy. The patient developed acute right peripheral facial paralysis and right upper limb weakness, leading to the discovery of an extra-axial solid lesion at the right cerebellopontine angle. This lesion extended into adjacent structures with notable contrast enhancement and restricted diffusion on magnetic resonance imaging, indicative of chloroma, an extramedullary solid mass composed of myeloid precursor cells. The article discusses the clinical presentation and radiological findings, emphasizing the importance of magnetic resonance imaging in diagnosis. It details typical imaging characteristics of cerebellopontine angle chloromas and differentiates them from other intracranial tumors.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123516"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755657","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":"Systematic Review of Surgical Success, Complications, Revision Rates, Radiation Dosage, and Operative Time of 3D-Navigated versus Non-Navigated Spinal Procedures","authors":"Ikaasa Suri ,&nbsp;Bahie Ezzat ,&nbsp;Sayahi Suthakaran ,&nbsp;Juan Sebastian Arroyave Villada ,&nbsp;Daniel Kwon ,&nbsp;Lily Martin ,&nbsp;James Hu ,&nbsp;Kurt Yaeger ,&nbsp;Matthew Carr","doi":"10.1016/j.wneu.2024.12.009","DOIUrl":"10.1016/j.wneu.2024.12.009","url":null,"abstract":"<div><h3>Objective</h3><div>Three-dimensional (3D) navigation offers real-time guidance in surgery. However, there is limited and inconsistent data regarding the usability, safety, and efficacy. To address gaps in knowledge about 3D navigation in spinal surgery, we conducted a comprehensive review of success rates, complications, revisions, radiation exposure, and operative time associated with Federal and Drug Administration-approved 3D surgical navigation tools.</div></div><div><h3>Methods</h3><div>This study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used a protocol registered on International Prospective Registration of Systematic Reviews (CRD42023404554). Ovid MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched using relevant keywords for 3D surgical navigation and spinal procedures from 1946 to March 02, 2023. Two independent reviewers assessed the studies using inclusion/exclusion criteria and risk of bias tools. Statistical analyses included one-way analysis of variance, weighted-mean difference, and unpaired t-tests with Welch's correction for associations and comparisons between groups, respectively.</div></div><div><h3>Results</h3><div>Of the total 11,324 studies identified and 7198 screened, 62 studies totaling 3170 adult patients were included in this comprehensive review. Complication and surgical success rates have remained constant since 2004, with overall rates of 5.5% and 94.0%, respectively. When segmented by spinal region, complication rates may be moderately positively correlated with frequency of cervical and thoracic procedures (r = 0.25, <em>P</em> = 0.68). The most commonly reported complication was pedicle screw malposition or breach. A subset of 20 studies, totaling 1554 patients, compared the performance of 3D navigation to two-dimensional fluoroscopy or freehand navigation. There was a significant difference of 6.53% between surgical success rates of the 3D-navigated and control groups (<em>P</em> = 0.03). However, there was no significant difference in radiation exposure or operative time.</div></div><div><h3>Conclusions</h3><div>The 3D navigation in spinal procedures has higher surgical success rates than two-dimensional fluoroscopy and freehand navigation. Included studies exhibited varying limitations, including no patient follow-up (n = 1), less than 10 patients (n = 6), various types of spinal disorders (n = 1), and varying comorbidities among participants (n = 2). Improving 3D navigation tools remains imperative to decrease operative time and radiation exposure.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123550"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795256","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":"Preliminary validation of a diary approach to monitor daily adolescent and parental predictors of post-operative recovery - A longitudinal diary study in adolescents undergoing spinal fusion surgery.","authors":"Jenny Thorsell Cederberg, Vendela Zetterqvist, Rikard K Wicksell, Liesbet Goubert, Sara Laureen Bartels","doi":"10.1016/j.wneu.2025.123744","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123744","url":null,"abstract":"<p><strong>Background: </strong>About one in five adolescents undergoing major surgery develops chronic post-surgical pain (CPSP). Various risk and resilience factors for recovery and CPSP have been identified, including parental processes. However, research commonly relies on nomothetic data, while the psychometric properties of diaries assessing pediatric post-surgical recovery in everyday life are understudied. Therefore, this study aimed to evaluate the preliminary reliability, validity, and variability of diary data in adolescents, and their parents, after spinal fusion surgery.</p><p><strong>Methods: </strong>Adolescents with Idiopathic Scoliosis (AIS) undergoing spinal fusion surgery, and their parents, were asked to complete daily diaries for seven consecutive days at five time points, i.e., before surgery (T0), at 3-week (T1), 6-week (T2), 6-month (T3) and 12-month (T4) post-surgery. Diaries were developed based on validated questionnaires measuring relevant constructs of pediatric post-surgical recovery. Internal consistency, test-retest reliability, convergent, divergent and concurrent criterion validity, and variability were examined.</p><p><strong>Results: </strong>The sample comprised n=95 adolescents and n=95 parents. Overall compliance rate was approximately 80 % in both adolescents and parents, with a total of 5282 diary entries analysed. Internal consistency for multi-item variables ranged from good to excellent (α=.82-.93) for adolescent data and acceptable to excellent (α=.74-.93) for parent data. All test-retest correlations were significant, and large (ρ=.60-.76) for adolescent data, and medium to large for parent data (ρ=.57-.80). Regarding validity, all but three correlations between diary variables were significant. Furthermore, diary variables generally correlated significantly with corresponding questionnaire data. Variability was low in some variables.</p><p><strong>Conclusion: </strong>The results provide the first evidence for the psychometric properties, with regard to reliability, validity and variability, for diary measures to monitor processes of post-surgical recovery in everyday life in adolescents undergoing spinal fusion surgery. However, replication is suggested, for refinement and further validation, with particular attention to variability and evaluation of sensitivity to change.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123744"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123772","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}