World neurosurgery最新文献_第8页

Radiosurgical biologically effective dose on trigeminal root division and section for outcomes of idiopathic trigeminal neuralgia type 1: a multicentre retrospective cohort study. 放射外科生物有效剂量对特发性三叉神经痛 1 型的三叉神经根分割和切片疗效：一项多中心回顾性队列研究。

IF 1.9 4区医学

World neurosurgery Pub Date : 2024-10-24 DOI: 10.1016/j.wneu.2024.10.084

Ke Tang, Nan Zhang, Xiaodong Yuan, Liangzhao Chu, Zenghui Qian, Yang Li

{"title":"Radiosurgical biologically effective dose on trigeminal root division and section for outcomes of idiopathic trigeminal neuralgia type 1: a multicentre retrospective cohort study.","authors":"Ke Tang, Nan Zhang, Xiaodong Yuan, Liangzhao Chu, Zenghui Qian, Yang Li","doi":"10.1016/j.wneu.2024.10.084","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.084","url":null,"abstract":"Objective: The wide variability in the efficacy of Gamma Knife surgery (GKS) treating trigeminal neuralgia type 1 (TN1) has not been completely elucidated. We aimed to investigate the association between outcomes of TN1 and the radiosurgical biologically effective dose (BED) on the specific part of the trigeminal root.Methods: We performed a multicentre retrospective cohort study for 548 patients with refractory TN1 treated by GKS. BED-volume histogram was formed for the trigeminal root, responsible division within the trigeminal root affected by TN1 (RD), trigeminal root section adjacent to the root entry zone (S1) and brainstem to generate the maximum BED (DMaxBED), and the volume percentage enclosed by iso-BED 1000 Gy2.47 (V%BED1000) as plan quality metrics. The outcomes included pain relief, recurrence, and complications. Logistic regression and Cox proportional hazards models were used to analyse BED parameters.Results: There were 344 (62.77%), 144 (26.28%), and 54 (9.85%) patients with Barrow Neurological Institute (BNI) pain relief class III within 1 month, recurrence, and facial hypoesthesia. Patient-level analysis screened V%BED1000 of the trigeminal root associated with BNI class III within 1 month and recurrence. DMaxBED of the brainstem + V%BED1000 of the S1 significantly predicted facial hypoesthesia. Division-level analysis showed that DMaxBED + V%BED1000 of the RD significantly predicted BNI class III within 1 month and recurrence.Conclusions: The efficacy and safety of GKS treating TN1 may depend on the sufficient coverage of high BED on the division affected by pain and tolerated BED on the root entry zone.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509242","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}

引用次数: 0

Improving Successful Cannulation of External Ventricular Drain: 3D-Printed Surgical Guide for Inexperienced Neurosurgeons. 提高脑室外引流管插管的成功率：为缺乏经验的神经外科医生提供 3D 打印手术指南。

IF 1.9 4区医学

World neurosurgery Pub Date : 2024-10-24 DOI: 10.1016/j.wneu.2024.09.136

Sai Liang, Rui Zhi Lee, Yuan Guang Lim, Huiling Lim, Fatimah Misbaah, Kai Rui Wan

{"title":"Improving Successful Cannulation of External Ventricular Drain: 3D-Printed Surgical Guide for Inexperienced Neurosurgeons.","authors":"Sai Liang, Rui Zhi Lee, Yuan Guang Lim, Huiling Lim, Fatimah Misbaah, Kai Rui Wan","doi":"10.1016/j.wneu.2024.09.136","DOIUrl":"10.1016/j.wneu.2024.09.136","url":null,"abstract":"Objective: External ventricular drain (EVD) is a fundamental neurosurgical procedure that is commonly performed by junior neurosurgeons. Expedient, successful cannulation of the ventricles can be lifesaving. Yet, the free-hand technique of EVD insertion is associated with significant malpositioning rates. This study aimed to improve EVD placement by junior neurosurgeons with the aid of a customized 3D-printed surgical guide.Methods: A 3D-printed surgical guide was developed and customized to our institution's EVD insertion procedure. First-year neurosurgical residents were taught how to perform preoperative trajectory planning based on coronal brain images and how to use the surgical guide during the standard EVD insertion procedure. Number of passes, accuracy of EVD placement, operative complications, need for revision, and surgeon's experience with the guide were recorded.Results: First-year neurosurgical residents performed guide-assisted EVD insertion in 14 patients. Significantly, 6 (43%) patients had ventricular anatomy distorted by midline shift. All surgeons achieved successful ventricular cannulation using the EVD guide on first pass (100%). Of 14 guide-assisted EVDs, 13 (93%) were optimally placed (Kakarla grade 1). Only 1 (7%) guide-assisted EVD was suboptimally placed (Kakarla grade 2). There were no intraoperative or postoperative complications and no EVD revisions.Conclusions: For inexperienced surgeons, the 3D-printed EVD guide can improve ventricular cannulation even in cases of altered ventricular anatomy. The use of 3D printing would also allow the guide to be widely adopted by other institutions worldwide.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393818","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}

引用次数: 0

Short-Term Bed Rest is not a Risk Factor for Venous Thromboembolism After Endoscopic Skull Base Surgery. 短期卧床并非内窥镜颅底手术后静脉血栓栓塞的风险因素。

IF 1.9 4区医学

World neurosurgery Pub Date : 2024-10-24 DOI: 10.1016/j.wneu.2024.09.129

Eric H Abello, Joel S Feier, Arash Abiri, Jonathan C Pang, Lauren Liu, Cecilia H H Nguyen, Dean D Chung, Frank P K Hsu, Edward C Kuan

{"title":"Short-Term Bed Rest is not a Risk Factor for Venous Thromboembolism After Endoscopic Skull Base Surgery.","authors":"Eric H Abello, Joel S Feier, Arash Abiri, Jonathan C Pang, Lauren Liu, Cecilia H H Nguyen, Dean D Chung, Frank P K Hsu, Edward C Kuan","doi":"10.1016/j.wneu.2024.09.129","DOIUrl":"10.1016/j.wneu.2024.09.129","url":null,"abstract":"Background: Venous thromboembolism (VTE) increases morbidity in postoperative patients. No current guidelines identify which patients undergoing endoscopic endonasal approach (EEA) to the skull base may be at increased risk. Postoperative care for these patients often includes a period of inactivity to prevent transient intracranial pressure shifts that may impact skull base reconstruction. We sought to characterize if postoperative bed rest puts patients undergoing EEA at increased risk of developing thromboembolic complications.Methods: Retrospective chart review of patients undergoing intradural surgery with primary skull base reconstruction for intraoperative cerebrospinal fluid leak via EEA for any skull base pathology between July 2018 and May 2024 yielded 221 patients who met inclusion criteria. Univariate and multivariable regressions were performed with patient demographics, extent of approach, intraoperative leak flow rate, bed rest duration, presence and length of postoperative lumbar drainage, and use of postoperative mechanical VTE prophylaxis.Results: Mean age of included patients was 52.6 ± 16.8 years, 48% of patients were male, and 3.6% of patients had DVTs. Age (odds ratio [OR] 1.01, 95% confidence interval [CI] 0.96-1.06, P = 0.83), sex (OR 0.40, 95% CI 0.05-2.19, P = 0.31), body mass index (OR 0.98, 95% CI 0.87-1.07, P = 0.74), extended approach (OR 0.80, 95% CI 0.13-4.36, P = 0.80), cerebrospinal fluid leak flow rate (OR 5.71, 95% CI 0.77-118.90, P = 0.14), bed rest duration (OR 1.06, 95% CI 0.77-1.27, P = 0.60), and presence of lumbar drainage (OR 1.10, 95% CI 0.55-2.02, P = 0.76) were not significant predictors of postoperative VTE incidence on multivariable analysis.Conclusions: Short-term bed rest after EEA is not a risk factor for development of VTE in the immediate postoperative period.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401488","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}

引用次数: 0

A strong association between Modic changes type 2 and endplate defects at non-fused segments after ACDF. ACDF 术后，Modic 变异 2 型与非融合节段的终板缺损密切相关。

IF 1.9 4区医学

World neurosurgery Pub Date : 2024-10-24 DOI: 10.1016/j.wneu.2024.10.079

Olga Leonova, Evgeniy Baykov, Aleksandr Krutko

{"title":"A strong association between Modic changes type 2 and endplate defects at non-fused segments after ACDF.","authors":"Olga Leonova, Evgeniy Baykov, Aleksandr Krutko","doi":"10.1016/j.wneu.2024.10.079","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.079","url":null,"abstract":"Purpose: To determine the association between Modic changes (MC) with other MRI parameters and clinical symptoms of cervical degenerative disc disease (DDD).Methods: A retrospective analysis of data on patients with cervical DDD who underwent single-level anterior cervical discectomy and fusion. Preoperative demographic data (age, sex, surgical data) were collected, cervical MRI parameters (disc degeneration grade, MC and endplate defects, each determined at each cervical level) and clinical data (Numerical pain rating scale (NPRS) neck and arm, the Neck Disability Index (NDI)) were compared to preoperative data.Results: The study included 121 patients at Visit 1 and 83 patients at Visit 2. The median follow-up duration was 26.5 [18.9; 33.1] months. Patients with MC had more intense NPRS-based neck pain before surgery compared to patients without MC (p=0.001). There were significant changes in MC rate at the C5-C6 levels due to a significant number of new MCs type 1 and MCs type 2 (p=0.002 and p<0.001, respectively). MC type 2 was associated with disc degeneration, endplate defects defects, patients' age and clinical scales (NDI, NPRS) (p<0.05). The endplate defects defect score threshold for predicting MC type 2 at the С3-С7 cervical levels was 5.Conclusions: The factor predicting MC type 2 at the C3-C7 cervical levels is submaximal damage to the endplate. The MC rate is increased due to MC type 1 and MC type 2. MC types at the cervical levels may not represent consecutive stages of the same process.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509218","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}

引用次数: 0

Unilateral Hemilaminectomy as Primary Treatment for Spinal Cord Tumors: Retrospective Cohort of 38 Cases with a Minimum Follow-Up of 24 Months. 单侧半椎板切除术作为脊髓肿瘤的主要治疗方法：对 38 例病例进行至少 24 个月随访的回顾性队列。

IF 1.9 4区医学

World neurosurgery Pub Date : 2024-10-24 DOI: 10.1016/j.wneu.2024.09.134

F J Onishi, B Mota, E A Iunes, C O Silva, M C Ferraro, G B C Ferreira, S Cavalheiro

{"title":"Unilateral Hemilaminectomy as Primary Treatment for Spinal Cord Tumors: Retrospective Cohort of 38 Cases with a Minimum Follow-Up of 24 Months.","authors":"F J Onishi, B Mota, E A Iunes, C O Silva, M C Ferraro, G B C Ferreira, S Cavalheiro","doi":"10.1016/j.wneu.2024.09.134","DOIUrl":"10.1016/j.wneu.2024.09.134","url":null,"abstract":"Objective: To evaluate the efficacy of hemilaminectomy as an approach to intradural tumors and to assess the risk of postoperative spinal instability.Methods: This is a retrospective cohort study of 38 patients who underwent surgical resection of intradural tumors between November 2014 and March 2019. Clinical and radiologic data were documented in medical records, from which we obtained clinical data including age, gender, tumor etiology, lesion level, type of resection, and postoperative instability during follow-up.Results: Schwannomas and meningiomas were the most commonly treated tumors. The lesion locations were as follows: 8 cervical (21%), 19 thoracic (50%), 10 lumbar (26%), and 1 sacral (3%). The mean follow-up time was 28 months. In all cases, hemilaminectomy allowed for the removal of the tumors without clinical or radiologic evidence of postoperative mechanical instability. Hemilaminectomy was primarily performed on 2 segments but was extended to up to 6 levels in some cases.Conclusions: Unilateral hemilaminectomy is an effective technique that facilitates complete tumor removal with a low rate of postoperative instability in the operated segments.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381764","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}

引用次数: 0

Stereotactic Radiosurgery in Primary Treatment of Sporadic Small to Medium (<3 cm) Vestibular Schwannomas: A Systematic Review and Meta-Analysis. 立体定向放射外科治疗散发性中小型（<3 厘米）前庭许旺瘤：系统回顾与元分析》。

IF 1.9 4区医学

World neurosurgery Pub Date : 2024-10-24 DOI: 10.1016/j.wneu.2024.10.033

Bryce J Bonin, Scott Beckman, Sultan Mahmud, Danielle Terrell, Stephen Garrett Whipple, Ryan Diaz, Mohammad Alfrad Nobel Bhuiyan, Deepak Kumbhare, Chiachien Jake Wang, Bharat Guthikonda, Amey R Savardekar

{"title":"Stereotactic Radiosurgery in Primary Treatment of Sporadic Small to Medium (<3 cm) Vestibular Schwannomas: A Systematic Review and Meta-Analysis.","authors":"Bryce J Bonin, Scott Beckman, Sultan Mahmud, Danielle Terrell, Stephen Garrett Whipple, Ryan Diaz, Mohammad Alfrad Nobel Bhuiyan, Deepak Kumbhare, Chiachien Jake Wang, Bharat Guthikonda, Amey R Savardekar","doi":"10.1016/j.wneu.2024.10.033","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.033","url":null,"abstract":"Purpose: To analyze the current literature regarding use of SRS as primary treatment of VS to further evaluate efficacy and treatment-related neurologic deficits.Methods: Online databases were queried to identify relevant publications from January 2001-December 2020. Full text, English articles for sporadic VS treated primarily with radiosurgery and documented hearing preservation data were reviewed. Papers that had a minimum follow-up period of less than 36 months, did not utilize radiosurgery for primary treatment, or included patients with Neurofibromatosis II were excluded.Results: A total of 33 studies involving 4286 patients with an average follow-up of 62.5 months were included in the final analysis. All 33 studies included eligible hearing data; overall preservation of serviceable hearing was found to be 58.27%. 27 studies with 3822 eligible patients were analyzed for tumor control rates; overall, tumor control was reported in 92.98% of cases. 27 studies were analyzed for post-treatment facial nerve dysfunction which was reported in 1.53% of cases.Conclusions: SRS is a safe and effective primary treatment modality for sporadic vestibular schwannoma as evidenced by the present analysis. Radiosurgery is effective with regard to tumor control and hearing preservation while offering a low rate of post-treatment facial nerve dysfunction.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509257","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}

引用次数: 0

Neurosurgical patients' preferences and experiences of involvement during hospitalisation. 神经外科病人在住院期间对参与的偏好和体验。

IF 1.9 4区医学

World neurosurgery Pub Date : 2024-10-24 DOI: 10.1016/j.wneu.2024.10.074

Tina Wang Vedelø, Ditte Unbehaun, Signe Mygdal Jørgensen, Mikkel Mylius Rasmussen, Jens Christian Hedemann Sørensen, Lotte Ørneborg Rodkjær

{"title":"Neurosurgical patients' preferences and experiences of involvement during hospitalisation.","authors":"Tina Wang Vedelø, Ditte Unbehaun, Signe Mygdal Jørgensen, Mikkel Mylius Rasmussen, Jens Christian Hedemann Sørensen, Lotte Ørneborg Rodkjær","doi":"10.1016/j.wneu.2024.10.074","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.074","url":null,"abstract":"Background: There has been an increased focus on patient involvement in health care worldwide, with studies showing that involving patients in their treatment and care is associated with positive outcomes. However, there is a dearth of knowledge about inpatient preferences and experiences of involvement in neurosurgery in Scandinavian countries. This study aimed to identify inpatients' preferences regarding their involvement in their treatment and the extent to which they experienced being involved in their treatment and care during admission.Methods: A questionnaire survey was administered in a neurosurgical department. Patients' preferences and experiences regarding their involvement in their treatment and care were assessed using a validated questionnaire.Results: One hundred patients were enrolled in the study. Eighty-two percent of them preferred sharing responsibility for their treatment with their doctor, 16% preferred leaving their treatment decisions entirely up to the doctor; and two percent preferred making the final decision about their treatment independently. The average participation score for information, communication, and participation was 4.08, suggesting that the patients experienced a high level of involvement in their care and treatment. Thirty patients reported preferences for changes during admission, while 25 suggested ideas for improvement.Conclusions: The patients mostly preferred shared decision-making about their treatment during hospitalization and generally reported high involvement in their treatment and care. The results showed a desire for improved information sharing and dialog among healthcare professionals, patients, and relatives.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509239","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}

引用次数: 0

Clinical Efficacy of Unilateral Biportal Endoscopic Transforaminal Lumbar Interbody Fusion. 单侧双腹腔镜经椎间孔腰椎椎体融合术的临床疗效。

IF 1.9 4区医学

World neurosurgery Pub Date : 2024-10-23 DOI: 10.1016/j.wneu.2024.10.064

YiBo Dong, YongTao Wang, Yang Yu

引用次数: 0

C1 root decompression as a therapeutic target in non-suboccipital non-Valsalva related headache associated with Chiari I malformation. 将 C1 根减压术作为治疗与 Chiari I 畸形相关的非枕下非 Valsalva 相关性头痛的目标。

IF 1.9 4区医学

World neurosurgery Pub Date : 2024-10-23 DOI: 10.1016/j.wneu.2024.10.049

Batu Hergünsel, Bilal Ertuğrul, Fatih Serhat Erol, Murat Gönen, Metin Kaplan

{"title":"C1 root decompression as a therapeutic target in non-suboccipital non-Valsalva related headache associated with Chiari I malformation.","authors":"Batu Hergünsel, Bilal Ertuğrul, Fatih Serhat Erol, Murat Gönen, Metin Kaplan","doi":"10.1016/j.wneu.2024.10.049","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.049","url":null,"abstract":"Headache is the most common symptom impacting the quality of life of patients with Chiari I malformation. While headaches typically present in the occipital or suboccipital regions, and induced by Valsalva maneuver, complex migraine-like headaches referring to frontal or orbital regions also occur. Our study explores the therapeutic potential of C1 nerve root decompression in addition to increasing intracranial compliance in patients with Chiari I malformation. We retrospectively analyzed cases operated on for Chiari I malformation, focusing on patients with non-suboccipital, non-Valsalva induced headaches. Preoperative and postoperative visual analog scale (VAS) scores and headache frequency were recorded. Surgical technique involved suboccipital craniectomy, C1 laminectomy, cerebellar tonsil reduction, and C1 root decompression. Twelve patients (10 females, 2 males) aged 22-52 were included. Preoperative mean VAS score was 8, which improved to 2 or less in 11 patients postoperatively. The mean headache frequency decreased significantly. Our findings suggest that C1 root compression contributes to atypical headaches in Chiari I malformation and that C1 root decompression may improve surgical outcomes.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509221","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}

引用次数: 0

Spinal neurocutaneous melanosis. 脊髓神经皮肤黑变病

IF 1.9 4区医学

World neurosurgery Pub Date : 2024-10-23 DOI: 10.1016/j.wneu.2024.10.050

Zeferino Demartini, Adriano Keijiro Maeda, Adriane Cardoso-Demartini

引用次数: 0