World neurosurgery最新文献

{"title":"Adapting Awake Surgery to a New Philosophy of Quality of Life in Low-Grade Glioma Patients: From Basic Neurological Functions to Complex Human Behavior","authors":"Hugues Duffau","doi":"10.1016/j.wneu.2025.124086","DOIUrl":"10.1016/j.wneu.2025.124086","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"200 ","pages":"Article 124086"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080527","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":"Fibrinogen Levels Below a Critical Threshold Serve as a Protective Factor Against In-Stent Stenosis Following Flow Diverter Treatment for Intracranial Aneurysms: A Multicenter Retrospective Cohort Study.","authors":"Zhikun Jia, Jiahe Yin, Xuetao Wang, Tao Quan, Bin Luo, Mengshi Huang, Zhixi Li, Xin Jin, Xifeng Li, Yanchao Liu, Chuanzhi Duan, Xin Zhang","doi":"10.1016/j.wneu.2025.124072","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124072","url":null,"abstract":"<p><strong>Background: </strong>In-stent stenosis (ISS) remains a significant adverse event following flow diverter (FD) placement for intracranial aneurysms. This study investigated whether admission fibrinogen levels could predict ISS occurrence.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study of 394 consecutive patients who underwent FD treatment for intracranial aneurysms across four comprehensive stroke centers between March 2016 and October 2024. The primary predictor was admission fibrinogen level, and the primary endpoint was angiographically confirmed ISS during 12.63±9.29 months of follow-up. Multiple variables were collected, including patient demographics, aneurysm characteristics, procedural details, and vascular risk factors. The association between fibrinogen levels and ISS was analyzed using Cox logistic regression and threshold effect analysis with two-piecewise linear regression models.</p><p><strong>Results: </strong>Among the cohort, 80 patients (20.3%) were diagnosed with ISS,all of whom exhibited asymptomatic stenosis with a stenosis rate (SR) of ≥25%. Threshold effect analysis identified a non-linear relationship between fibrinogen levels and ISS risk, with an inflection point at 2.71 g/L. Below this threshold, each unit increase in fibrinogen was associated with a significantly lower risk of ISS (adjusted odds ratio 0.27; 95% confidence interval 0.58 - 1.47; P=0.006).</p><p><strong>Conclusion: </strong>Low admission fibrinogen (<2.71 g/L) independently predicts ISS risk after FD treatment. With each additional unit of fibrinogen level, there was a 0.73-fold reduction in the risk of ISS after FD treatment at follow-up. These results may help identify patients at higher risk for ISS who might benefit from more intensive.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124072"},"PeriodicalIF":1.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080862","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":"Letter to the Editor Regarding “Facet Distraction Distance Independently Predicts Cage Subsidence Following Anterior Cervical Discectomy and Fusion”","authors":"Shoaib Majeed ,&nbsp;Tu Jie","doi":"10.1016/j.wneu.2025.124065","DOIUrl":"10.1016/j.wneu.2025.124065","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124065"},"PeriodicalIF":1.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080871","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":"Full-Endoscopic Transforaminal Decompression with Modified Reaming Technique on Lateral Recess Stenosis: Outcomes of 155 Cases and Five Years' Experience. A Case Series Study","authors":"Chun-Yi Li ,&nbsp;Ming-Hsien Hu ,&nbsp;Chi-Huan Li ,&nbsp;Yu-Hsuan Chung","doi":"10.1016/j.wneu.2025.124073","DOIUrl":"10.1016/j.wneu.2025.124073","url":null,"abstract":"<div><h3>Objective</h3><div>Lateral recess stenosis is a degenerative condition caused by a bulging disc, hyperplasia of the superior articular process, and hypertrophy of the ligamentum flavum. The advancement of transforaminal endoscopic lumbar approaches provides effective treatment not only for migrated herniation but also for stenosis. We outlined a modified nonsequential foraminoplasty technique utilizing a trephine and conducted a comprehensive review of our cases to demonstrate safety and efficacy of the procedure.</div></div><div><h3>Methods</h3><div>Patients with lumbar radiculopathy refractory to conservative treatment, diagnosed with magnetic resonance imaging and diagnostic root blocks, and underwent full-endoscopic transforaminal decompression with the modified nonsequential foraminoplasty technique between April 2017 and September 2022 were included. Those with multiple-level stenosis, previous surgery at the same level, unstable spondylolisthesis, lumbar herniated disc without stenosis, infection, fracture, or tumor were excluded. The study recorded the visual analog scale, Oswestry Disability Index, Modified Macnab criteria, as well as intraoperative and postoperative complications.</div></div><div><h3>Results</h3><div>One hundred fifty-five patients were included in the study. Clinical and postoperative outcomes revealed significantly lower back and leg visual analog scale scores, as well as Oswestry Disability Index scores at various postoperative time points compared to preoperative values (<em>P</em> &lt; 0.01). At the final follow-up, the modified MacNab criteria were rated as follows: excellent in 65 patients (41.9%), good in 60 patients (38.7%), fair in 2 patients (1.2%), and poor in 28 patients (18.0%).</div></div><div><h3>Conclusions</h3><div>Full-endoscopic transforaminal decompression using a modified nonsequential foraminoplasty technique is an effective and safe treatment for lumbar lateral recess stenosis.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124073"},"PeriodicalIF":1.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080867","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":"Cerebral Air Embolism After Percutaneous Kyphoplasty: A Case Report and Systematic Review of Mechanisms and Management.","authors":"Tianci Fang, Zhifang Xue, Lianda Yang, Zhaohui He, Huilin Yang, Hao Liu, Junxin Zhang, Feng Zhou","doi":"10.1016/j.wneu.2025.124074","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124074","url":null,"abstract":"<p><strong>Background: </strong>Cerebral air embolism (CAE) is an exceptionally rare yet life-threatening complication of percutaneous kyphoplasty (PKP). This study integrates a literature review (2000-2023) with a novel case to explore CAE pathogenesis and preventive strategies.</p><p><strong>Case presentation: </strong>An 84-year-old male developed sudden coma post-PKP, confirmed as CAE via cranial CT. Despite hyperbaric oxygen therapy (HBOT), the patient progressed to a vegetative state.</p><p><strong>Conclusions: </strong>CAE necessitates urgent HBOT and meticulous intraoperative practices (e.g., airtight sealing). Preoperative protocol-driven management may mitigate risks.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124074"},"PeriodicalIF":1.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080696","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":"Surgical outcomes in patients with primary or metastatic spinal leiomyosarcoma: a systematic review and meta-analysis.","authors":"Paul Serrato, Mihir Gupta, Devan Hawkins, Sathish Prabu Sathyamangalam Samiappan, Priyanshu Saha, Daniel Lubelski, Sang Hun Lee","doi":"10.1016/j.wneu.2025.124067","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124067","url":null,"abstract":"<p><strong>Objective: </strong>To describe clinical features, treatments, and surgical outcomes of spinal leiomyosarcoma (sLMS).</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of 56 studies (January 1, 2000 to January 18, 2024) reporting on 109 patients: 39 (36%) with primary spinal lesions, 67 (61%) with metastases, and 3 (3%) with lesions of unknown origin. We compared clinical features, treatments, and outcomes between primary and metastatic sLMS.</p><p><strong>Results: </strong>Lesions were thoracic in 56% of primary and 42% of metastatic cases (P = .07). En bloc resection was performed at a higher rate for metastases (22%) than for primary lesions (15%), and laminectomy/decompression was performed at a higher rate for metastases (25%) than for primary lesions (10%) (P = .07). Metastases received chemotherapy more frequently (49%) than primary lesions did (15%) (P = .002). Median overall survival was 46 months (95% confidence interval: 20-72 months) for metastases and was not reached for primary lesions. Median progression-free survival was 13 months (95% confidence interval: 10-19 months) for metastases and not reached for primary lesions. The following were associated with a greater likelihood of death: thoracic location (adjusted hazard ratio [aHR] 27.6, P < .01), lumbar location (aHR 26.9, P = .03), myelopathy (aHR 26.4, P = .01), metastatic lesion (aHR 11.8, P < .001), and male sex (aHR 4.68, P = .01).</p><p><strong>Conclusions: </strong>We identified factors that may be associated with foreshortened survival after surgical resection for sLMS. Studies with longer follow-up are warranted to examine these relationships.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124067"},"PeriodicalIF":1.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080889","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":"Full-endoscopic minimally-invasive trans-Magendie approach to the fourth ventricle: an anatomical feasibility study.","authors":"Augusto Leone, Francesco Carbone, Francesco Corrivetti, Alberto Morello, Sergio Corvino, Antonio Colamaria, Giorgio Iaconetta, Filippo Flavio Angileri, Uwe Spetzger, Matteo de Notaris","doi":"10.1016/j.wneu.2025.124062","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124062","url":null,"abstract":"<p><strong>Introduction: </strong>The telovelar approach provides access to the caudal two-thirds of the fourth ventricle without requiring vermian splitting. Indeed, the traditional microsurgical approach is often limited by a restricted cranial angle of attack and visualization, making it challenging to evaluate the patency of the aqueduct. To address this limitation, resection of the posterior arch of C1 is frequently performed.</p><p><strong>Aim: </strong>To describe and evaluate the feasibility of a full-endoscopic, retractorless trans-Magendie approach to the inferior third of the fourth ventricle, avoiding removal of the posterior arch of C1 through a minimally invasive burr-hole suboccipital craniotomy.</p><p><strong>Methods: </strong>Four formalin-fixed, injected cadaveric heads were investigated. A step-by-step anatomic description of the proposed approach is provided.</p><p><strong>Results: </strong>Adequate cranial and lateral visualization of the aqueduct and fourth ventricle floor was achieved without removing the posterior arch of C1.</p><p><strong>Conclusion: </strong>The full-endoscopic trans-Magendie approach enables adequate visualization of the inferior two-thirds of the fourth ventricle and the caudalmost portion of the aqueduct while avoiding the need for a C1 laminectomy and significantly reducing the craniotomy size.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124062"},"PeriodicalIF":1.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080865","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":"Subarachnoid Fat Deposition After Lumber and Sacral Fractures: Case imaging.","authors":"Keisuke Suzuki, Kenji Dohi","doi":"10.1016/j.wneu.2025.124071","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124071","url":null,"abstract":"<p><p>A 28-year-old man with lumbar and sacral fractures after trauma developed intracisternal fat deposition, detected on head computed tomography (CT) five days post-admission. Spinal fusion surgery revealed no macroscopic dural injury, but CT myelography showed dural bulging without cerebrospinal fluid leakage. Magnetic resonance imaging findings indicated low intracranial pressure, suggesting dural damage as the entry point for fat into the subarachnoid space. Despite these imaging abnormalities, the patient remained asymptomatic, and follow-up CT confirmed persistent intracranial fat with gradual resolution of a subdural hematoma. This case highlights a rare phenomenon of fat deposition in the subarachnoid space after trauma and emphasizes the value of sequential imaging in complex cases.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124071"},"PeriodicalIF":1.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Subcutaneous Fat Thickness and Its Association with Sagittal Parameters and Clinical Outcomes Following Laminoplasty in Patients with Cervical Spondylotic Myelopathy","authors":"Bin Zheng,&nbsp;Zhenqi Zhu,&nbsp;Yan Liang,&nbsp;Panfeng Yu,&nbsp;Chen Guo,&nbsp;Haiying Liu","doi":"10.1016/j.wneu.2025.124069","DOIUrl":"10.1016/j.wneu.2025.124069","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between cervical subcutaneous fat thickness, sagittal alignment parameters, and clinical outcomes following laminoplasty in patients with cervical spondylotic myelopathy (CSM).</div></div><div><h3>Methods</h3><div>A total of 131 patients with CSM who underwent single-door cervical laminoplasty between January 2021 and June 2023 were retrospectively analyzed, with an average follow-up period of 14.02 ±1.45 months. Subcutaneous fat thickness at the C5 vertebral level and skin-to-lamina distance were measured. Demographic characteristics, cervical sagittal parameters, surgical details, and postoperative outcomes were collected. Interobserver reliability was assessed using intraclass correlation coefficient. Binary logistic regression and receiver operating characteristic curve analyses were conducted to identify predictors of postoperative axial symptoms.</div></div><div><h3>Results</h3><div>Patients with greater subcutaneous fat thickness exhibited higher body mass index, greater body weight, shorter cervical length, smaller C2–C7 Cobb angles, higher T1 slope, and more severe paraspinal muscle fatty infiltration (all <em>P</em> &lt; 0.05). The average of follow-up time is 14.02 ±1.445 months. There are no differences in final Japanese Orthopaedic Association and visual analog scale follow-up. But thicker subcutaneous fat patients have a higher incidence of postoperative axial symptoms (<em>P</em> = 0.02). Subcutaneous fat thickness was identified as the strongest independent predictor of axial symptoms (B = 0.828, <em>P</em> = 0.002), with receiver operating characteristic analysis showing moderate predictive ability (area under the curve = 0.64) and an optimal cutoff value of 1.357 cm.</div></div><div><h3>Conclusions</h3><div>Greater cervical subcutaneous fat thickness is associated with abnormal sagittal alignment and increased risk of postoperative axial symptosms after laminoplasty. Subcutaneous fat thickness may serve as a practical localized predictor to optimize surgical planning and postoperative management in CSM patients.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124069"},"PeriodicalIF":1.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080822","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 Uniportal Endoscopic Decompression Combined with Biportal Endoscopic Lumbar Interbody Fusion versus Minimally Invasive Quadrant Transforaminal Lumbar Interbody Fusion for Single-Level Lumbar Spinal Stenosis","authors":"Ming-Ling Ma ,&nbsp;Zi-Jian Ma ,&nbsp;Bin-Yu Wang ,&nbsp;Jun Cai","doi":"10.1016/j.wneu.2025.124070","DOIUrl":"10.1016/j.wneu.2025.124070","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the clinical outcomes between group A (hybrid endoscopic technique: percutaneous uniportal endoscopic decompression combined with biportal endoscopic lumbar interbody fusion [LIF]) and group B (minimally invasive Quadrant transforaminal LIF) for lumbar spinal stenosis.</div></div><div><h3>Methods</h3><div>This study included 68 consecutive patients (group A: 32 patients; group B: 36 patients) retrospectively enrolled and treated between June 2019 and June 2021. Perioperative data were prospectively collected, including radiological outcomes (intervertebral disc height, sagittal Cobb angle, lumbar lordosis) and clinical outcomes (Oswestry Disability Index, visual analog scale [VAS], and Short Form 36 Health Survey [SF-36]). Paravertebral muscle injury was assessed by serum creatine phosphokinase levels. Additionally, fusion rate and perioperative complication rates were compared between the two groups.</div></div><div><h3>Results</h3><div>At 1 month postoperatively, group A demonstrated significantly better outcomes in VAS-Back, VAS-Leg, and SF-36 scores compared to group B (<em>P</em> &lt; 0.05). At 3 months postoperatively, group A demonstrated significantly better outcomes in VAS-Back, Oswestry Disability Index, and SF-36 scores compared to group B (<em>P</em> &lt; 0.05). Creatine phosphokinase levels in group A were significantly lower than those in group B at 1, 3, and 7 days postoperatively (<em>P</em> &lt; 0.05). However, no significant intergroup differences were observed in intervertebral disc height, sagittal Cobb angle, and lumbar lordosis at 1 and 12 months postoperatively (<em>P</em> &gt; 0.1). Additionally, fusion rates and surgical complication rates did not differ significantly between groups (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>The hybrid endoscopic technique (percutaneous uniportal endoscopic decompression combined with biportal endoscopic LIF) demonstrates comparable clinical outcomes and fusion rates to minimally invasive Quadrant transforaminal LIF for lumbar spinal stenosis, while achieving reduced postoperative pain and improved early functional recovery.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124070"},"PeriodicalIF":1.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080875","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}