World Neurosurgery: X最新文献

{"title":"Ventriculoperitoneal shunt infection rate and other associated complications of VP shunt insertion in Abuja, Nigeria","authors":"Obinna M. Ayogu ,&nbsp;Kenechukwu K. Igbokwe ,&nbsp;Kassim M. Jabir ,&nbsp;Efeomo D. Onobun ,&nbsp;Cyril I. Okpata ,&nbsp;Ugochukwu Ugwuanyi ,&nbsp;Ikechi Ekpendu ,&nbsp;Edidiong A. Essiet","doi":"10.1016/j.wnsx.2024.100332","DOIUrl":"10.1016/j.wnsx.2024.100332","url":null,"abstract":"<div><h3>Background</h3><p>Complications associated with ventriculoperitoneal shunt insertion constitute a significant cause of morbidity and mortality among hydrocephalus patients. Despite this, VP shunt placement has remained the mainstay of treatment for hydrocephalus. The aim of this study is to evaluate the complications of VP shunt surgery in our environment and to identify the risk factors associated with it.</p></div><div><h3>Methodology</h3><p>Patients who had VP shunt surgery over a period of two years (Jan 2015–December 2016) were evaluated retrospectively by reviewing their hospital records. The patients’ demography, aetiology and clinical presentation of the hydrocephalus, and complications were analysed using SPSS version 26.0. Results were presented in tables and figures.</p></div><div><h3>Results</h3><p>A total of 69 patients who had VP shunt over the study period had complete medical records available for review. Their age ranged between 2days and 68years with a male to female ratio of 1.8:1. Overall complication rate was 30.4%. Shunt malfunction (11.5%) and shunt infection (7.2%) were the commonest complications recorded. Late presentation was the most important risk factor for shunt complications.</p></div><div><h3>Conclusion</h3><p>The rate of shunt complications seen in this study compares fairly with studies in other parts of the world.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100332"},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000632/pdfft?md5=d8800e53bb9ecb0193bec708817a9619&pid=1-s2.0-S2590139724000632-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140089556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline and average platelet count can predict the outcome of patients with aneurysmal subarachnoid hemorrhage","authors":"Christoph Rieß ,&nbsp;Marvin Darkwah Oppong ,&nbsp;Thiemo-Florin Dinger ,&nbsp;Jan Rodemerk ,&nbsp;Laurèl Rauschenbach ,&nbsp;Meltem Gümüs ,&nbsp;Benedikt Frank ,&nbsp;Philipp Dammann ,&nbsp;Karsten Henning Wrede ,&nbsp;Ulrich Sure ,&nbsp;Ramazan Jabbarli","doi":"10.1016/j.wnsx.2024.100302","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100302","url":null,"abstract":"<div><h3>Background</h3><p>Baseline values and the change of platelet count (PLT) during disease were reported to be associated with prognosis of patients with cancer and intensive care treatment. We aimed to evaluate the association between PLT with the course and prognosis of aneurysmal subarachnoid hemorrhage (SAH).</p></div><div><h3>Methods</h3><p>Admission (AdmPLT) and the 14-days mean PLT (MeanPLT) values of 763 SAH patients treated between 01/2005 and 06/2016 were recorded and, for further analysis, divided into four categories: &lt;150, 150–260, 261–400 and &gt; 400 × 10⁹/L. Primary endpoints were cerebral infarcts in follow-up computed tomography scans, in-hospital mortality and unfavorable outcome at 6-months follow-up defined as modified Rankin scale&gt;3. Adverse events during SAH were assessed as secondary endpoints.</p></div><div><h3>Results</h3><p>Higher PLT values were independently associated with lower risk of cerebral infarction (MeanPLT: aOR = 0.65 per-PLT-category-increase, <em>p</em> = 0.001), in-hospital mortality (AdmPLT: aOR = 0.64, <em>p</em> = 0.017; MeanPLT: aOR = 0.23, <em>p</em> &lt; 0.0001) and unfavorable outcome (AdmPLT: aOR = 0.70, <em>p</em> = 0.031; MeanPLT: aOR = 0.35, <em>p</em> &lt; 0.0001). Moreover, individuals with poorer outcome were less prone to PLT increase during SAH (mean values: -+20.3 vs + 30.5 × 10⁹/L for cerebral infarction; +9.3 vs + 32.8 × 10⁹/L for in-hospital mortality; +14.4 vs + 31.1 × 10⁹/L for unfavorable outcome). The following adverse events during SAH were related to AdmPLT and/or MeanPLT: non-aneurysm related secondary rebleeding, intracranial hypertension requiring conservative treatment or decompressive craniectomy, sepsis and acute kidney failure.</p></div><div><h3>Conclusion</h3><p>Low PLT at admission and their less prominent increase during SAH were strongly linked with poor outcome of SAH. Further analysis is required to clarify the background of this association and potential therapeutic implications.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"22 ","pages":"Article 100302"},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000334/pdfft?md5=39c0fc7f75560fc5344872ee85d87570&pid=1-s2.0-S2590139724000334-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140042441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience in awake glioma surgery in a South American center. Correlation between intraoperative evaluation, extent of resection and functional outcomes","authors":"Guido Caffaratti ,&nbsp;Mauro Ruella ,&nbsp;Facundo Villamil ,&nbsp;Greta Keller ,&nbsp;Darío Savini ,&nbsp;Andrés Cervio","doi":"10.1016/j.wnsx.2024.100357","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100357","url":null,"abstract":"<div><h3>Introduction</h3><p>Gliomas are the second most frequent primary brain tumors. Surgical resection remains a crucial part of treatment, as well as maximum preservation of neurological function. For this reason awake surgery has an important role.</p><p>The objectives of this article are to present our experience with awake surgery for gliomas in a South American center and to analyze how intraoperative functional findings may influence the extent of resection and neurological outcomes.</p></div><div><h3>Materials and methods</h3><p>Retrospective single center study of a cohort of adult patients undergoing awake surgery for brain glioma, by the same neurosurgeon, between 2012 and 2022 in the city of Buenos Aires, Argentina.</p></div><div><h3>Results</h3><p>A total of 71 patients were included (mean age 34 years, 62% males). Seventy seven percent of tumors were low grade, with average extent of resection reaching 94% of preoperative volumetric assessment. At six months follow up, 81.7% of patients presented no motor or language deficit.</p><p>Further analysis showed that having a positive mapping did not have a negative impact in the extent of resection, but was associated with short term postoperative motor and language deficits, among other variables, with later improvement.</p></div><div><h3>Conclusion</h3><p>Awake surgery for gliomas is a safe procedure, with the proper training. In this study it was observed that guiding the resection by negative mapping did not worsen the results and that positive subcortical mapping correlated with short term postoperative neurological deficits with posterior improvement within six months in most cases.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"22 ","pages":"Article 100357"},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000887/pdfft?md5=9e5b7e808b12f68281ab60a6c99e3652&pid=1-s2.0-S2590139724000887-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140042442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Middle meningeal artery embolization for chronic subdural hematoma- pathophysiology and radiological findings","authors":"Raphael Bastianon Santiago ,&nbsp;Camille Jastrzebski ,&nbsp;Elias Dakwar ,&nbsp;Badih Adada ,&nbsp;Hamid Borghei-Razavi ,&nbsp;Michal Obrzut","doi":"10.1016/j.wnsx.2024.100296","DOIUrl":"10.1016/j.wnsx.2024.100296","url":null,"abstract":"","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100296"},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000279/pdfft?md5=c008677b71fc92b23512f24cf7d2e7b2&pid=1-s2.0-S2590139724000279-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140088613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of machine learning algorithms to predict 30-day hospital readmission following cement augmentation for osteoporotic vertebral compression fractures","authors":"Andrew Cabrera ,&nbsp;Alexander Bouterse ,&nbsp;Michael Nelson ,&nbsp;Luke Thomas ,&nbsp;Omar Ramos ,&nbsp;Wayne Cheng ,&nbsp;Olumide Danisa","doi":"10.1016/j.wnsx.2024.100338","DOIUrl":"10.1016/j.wnsx.2024.100338","url":null,"abstract":"<div><h3>Objective</h3><p>Osteoporosis is a common skeletal disease that greatly increases the risk of pathologic fractures and accounts for approximately 700,000 vertebral compression fractures (VCFs) annually in the United States. Cement augmentation procedures such as balloon kyphoplasty (KP) and percutaneous vertebroplasty (VP) have demonstrated efficacy in the treatment of VCFs, however, some studies report rates of readmission as high as 10.8% following such procedures. The purpose of this study was to employ Machine Learning (ML) algorithms to predict 30-day hospital readmission following cement augmentation procedures for the treatment of VCFs using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.</p></div><div><h3>Methods</h3><p>ACS-NSQIP was queried to identify patients undergoing either KP or VP from 2011 to 2014. Three ML algorithms were constructed and tasked with predicting post-operative readmissions within this cohort of patients. Results: Postoperative pneumonia, ASA Class 2 designation, age, partially-dependent functional status, and a history of smoking were independently identified as highly predictive of readmission by all ML algorithms. Among these variables postoperative pneumonia (p &lt; 0.01), ASA Class 2 designation (p &lt; 0.01), age (p = 0.002), and partially-dependent functional status (p &lt; 0.01) were found to be statistically significant. Predictions were generated with an average AUC value of 0.757 and an average accuracy of 80.5%.</p></div><div><h3>Conclusions</h3><p>Postoperative pneumonia, ASA Class 2 designation, partially-dependent functional status, and age are perioperative variables associated with 30-day readmission following cement augmentation procedures. The use of ML allows for quantification of the relative contributions of these variables toward producing readmission.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100338"},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000693/pdfft?md5=9dc75f213a86e0be8b2fdab96ec09bda&pid=1-s2.0-S2590139724000693-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140086651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a regional-based predictive model of incidence of traumatic spinal cord injury using machine learning algorithms","authors":"Seyed Behnam Jazayeri ,&nbsp;Seyed Farzad Maroufi ,&nbsp;Shaya Akbarinejad ,&nbsp;Zahra Ghodsi ,&nbsp;Vafa Rahimi-Movaghar","doi":"10.1016/j.wnsx.2024.100280","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100280","url":null,"abstract":"<div><h3>Objective</h3><p>To develop a predictive model of incidence of traumatic spinal cord injury (TSCI).</p></div><div><h3>Methods</h3><p>The data for training the model included both the incidence data and the covariates. The incidence data were extracted from systematic reviews and the covariates were extracted from data available in the international road federation database. Then the feature processing measures were taken. First we defined a hyper-parameter, missing-value threshold, in order to eliminate features that exceed this threshold. To tackle the problem of overfitting of model we determined the Pearson correlation of features and excluded those with more than 0.7 correlation. After feature selection three different models including simple linear regression, support vector regression, and multi-layer perceptron were examined to fit the purposes of this study. Finally, we evaluated the model based on three standard metrics: Mean Absolute Error, Root Mean Square Error, and R².</p></div><div><h3>Results</h3><p>Our machine-learning based model could predict the incidence rate of TSCI with the mean absolute error of 4.66. Our model found “Vehicles in use, Total vehicles/Km of roads”, “Injury accidents/100 Million Veh-Km”, “Vehicles in use, Vans, Pick-ups, Lorries, Road Tractors”, “Inland surface Passengers Transport (Mio Passenger-Km), Rail”, and \"% paved” as top predictors of transport-related TSCI (TRTSCI).</p></div><div><h3>Conclusions</h3><p>Our model is proved to have a high accuracy to predict the incidence rate of TSCI for countries, especially where the main etiology of TSCI is related to road traffic injuries. Using this model, we can help the policymakers for resource allocation and evaluation of preventive measures.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100280"},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000115/pdfft?md5=26f35796eaa4d00194a504d7b8e8f55e&pid=1-s2.0-S2590139724000115-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140062000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposed novel classification of circumscribed Lower-Grade Gliomas (cLGG) vs. infiltrating Lower-Grade Gliomas (iLGG): Correlations of radiological features and clinical outcomes","authors":"Ahsan Ali Khan ,&nbsp;Muhammad Usman Khalid ,&nbsp;Mohammad Hamza Bajwa ,&nbsp;Faiza Urooj ,&nbsp;Izza Tahir ,&nbsp;Meher Angez ,&nbsp;Fahad Zahid ,&nbsp;Muhammad Waqas Saeed Baqai ,&nbsp;Kiran Aftab ,&nbsp;Shahabuddin Ansari ,&nbsp;Ummul Wara Khan ,&nbsp;Ali Azan Ahmed ,&nbsp;Syed Ather Enam","doi":"10.1016/j.wnsx.2024.100356","DOIUrl":"10.1016/j.wnsx.2024.100356","url":null,"abstract":"<div><h3>Purpose</h3><p>We hypothesize that lower grade gliomas (LGG) can be identified and classified into two distinct subtypes: radiologically circumscribed Lower-Grade Gliomas (cLGG) and infiltrating Lower-Grade Gliomas (iLGG) based on radiological parameters and that these two different subtypes behave differently in terms of clinical outcomes.</p></div><div><h3>Methods</h3><p>We conducted a retrospective cohort study on surgical patients diagnosed with lower grade glioma over five years. Patient records and MRIs were reviewed, and neurosurgeons classified tumors into cLGG and iLGG groups.</p></div><div><h3>Results</h3><p>From the 165 patients in our cohort, 30 (18.2%) patients were classified as cLGG and 135 (81.8%) patients were classified as iLGG Mean age in cLGG was 31.4 years while mean age in iLGG was 37.9 years (<em>p</em> = 0.004). There was significant difference in mean blood loss between cLGG and iLGG groups (270 and 411 ml respectively, <em>p</em> = 0.020). cLGG had a significantly higher proportion of grade II tumors (<em>p</em> &lt; 0.001). The overall mean survival time for the iLGG group was 14.96 ± 1.23 months, and 18.77 ± 2.72 months for the cLGG group. In univariate cox regression, the survival difference between LGG groups was not significant (HR = 0.888, <em>p</em> = 0.581), however on multivariate regression cLGG showed a significant (aHZ = 0.443, <em>p</em> = 0.015) positive correlation with survival. Intense contrast enhancement (HZ = 41.468, <em>p</em> = 0.018), blood loss (HZ = 1.002, <em>p</em> = 0.049), and moderately high Ki-67 (HZ = 4.589, <em>p</em> = 0.032) were also significant on univariate analyses.</p><p>Conclusion: cLGG and iLGG are radiologically distinct groups with separate prognoses, surgical experience, and associations.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100356"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000875/pdfft?md5=b2f93e16b6a909b313e4de8b0dac2be9&pid=1-s2.0-S2590139724000875-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140083412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of SWI sequence during the preoperative targeting of the subthalamic nucleus for deep brain stimulation in Parkinson's disease: A retrospective cohort study","authors":"Luigi Gianmaria Remore ,&nbsp;Leonardo Tariciotti ,&nbsp;Giorgio Fiore ,&nbsp;Elena Pirola ,&nbsp;Linda Borellini ,&nbsp;Filippo Cogiamanian ,&nbsp;Antonella Maria Ampollini ,&nbsp;Luigi Schisano ,&nbsp;Dario Gagliano ,&nbsp;Stefano Borsa ,&nbsp;Mauro Pluderi ,&nbsp;Giulio Andrea Bertani ,&nbsp;Sergio Barbieri ,&nbsp;Marco Locatelli","doi":"10.1016/j.wnsx.2024.100342","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100342","url":null,"abstract":"","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"22 ","pages":"Article 100342"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000735/pdfft?md5=2e9cdf4b195f51894fe306fdcfc49f25&pid=1-s2.0-S2590139724000735-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute low back pain: Epidemiology, etiology, and prevention: WFNS spine committee recommendations","authors":"Joachim Oertel ,&nbsp;Salman Sharif ,&nbsp;Corinna Zygourakis ,&nbsp;Christoph Sippl","doi":"10.1016/j.wnsx.2024.100313","DOIUrl":"10.1016/j.wnsx.2024.100313","url":null,"abstract":"<div><h3>Objective</h3><p>Acute low back pain is a highly prevalent condition that poses significant challenges to healthcare systems worldwide. In this manuscript, we present the most current, evidence-based guidelines from the World Federation of Neurosurgical Societies (WFNS) Spine Committee on the epidemiology, etiology, and prevention of acute low back pain (LBP) lasting ≤ 4 weeks.</p></div><div><h3>Methods</h3><p>We performed a literature review 2012–2022 using the PubMed, Medline, and CENTRAL databases with the keywords “acute low back pain”, “acute back pain”, “low back pain”, “epidemiology”, “etiology”, “costs”, “risk factor”, “cultural”, “developed”, “developing” and “prevention”. Systematic screening criteria were applied, resulting in 13 final articles on epidemiology and etiology of LBP, 2 manuscripts on costs, 5 articles on risk factors, and 23 articles on prevention strategies for acute LBP. These were presented at two separate international meetings, where members of the WFNS Spine Committee voted on five final consensus statements presented here.</p></div><div><h3>Results</h3><p>and Conclusions: There is a high incidence and prevalence of acute LBP, particularly in high-income countries, which is felt to be at least partially due to demographic shifts with an aging population and lifestyle changes including higher rates of obesity and physical inactivity. Acute LBP has a significant impact on quality of life and ability to work, resulting in high direct and indirect costs worldwide. Early diagnosis and appropriate management of acute LBP is recommended to prevent this pain from turning into chronic LBP. The WFNS Spine Committee's recommendations respresent the latest guidelies to help improve patient care for acute LBP worldwide.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"22 ","pages":"Article 100313"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000449/pdfft?md5=2ff772a9cad403170903bf77f3dfc8da&pid=1-s2.0-S2590139724000449-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140083598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome and complications of operatively treated subaxial cervical spine injuries: A population-based retrospective cohort study","authors":"Joel Alve ,&nbsp;Jukka Huttunen ,&nbsp;Ville Leinonen ,&nbsp;Henna-Kaisa Jyrkkänen ,&nbsp;Nils Danner","doi":"10.1016/j.wnsx.2024.100283","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100283","url":null,"abstract":"<div><h3>Objective</h3><p>The aim was to study the outcome and complications of operative treatment for subaxial cervical spine injuries with respect to injury morphology and surgical strategy.</p></div><div><h3>Methods</h3><p>A population-based cohort of 271 consecutive patients treated at Kuopio University Hospital from 2003 to 2018 was retrospectively reviewed.</p></div><div><h3>Results</h3><p>The mean age was 52.4 (range 12–90) years and 78.6% were male. The AOSpine morphological classification was C in 56.5%, B in 24.7% and A in 17.0% of cases. The surgical approach was anterior in 70.8%, posterior in 20.3% and combined in 8.9% of patients. Fixation alignment was maintained in 96.9% of patients. Instrumentation failures were observed only in patients operated anteriorly but no statistical difference was found between the surgical approaches. The American Spinal Injury Association Impairment Scale (AIS) grade improved in 22.1% of patients. Patients with preoperative AIS grade C had significant potential for neurological improvement (OR 10.44; 95% CI 1.77–61.56; <em>p</em> = 0.010). Postoperative, mostly mild, complications manifested in 22.5% of patients. The posterior approach was associated with fewer postoperative complications (OR 0.18; 95% CI 0.06–0.51; <em>p</em> = 0.001). Preoperative AIS grade A was a significant predisposing factor for complications (OR = 4.90; 95% CI = 1.49–16.10; <em>p</em> = 0.009). The perioperative (90-day) mortality rate was 3.3%. The mean follow-up period was 64.7 ± 25.9 (radiological)/136.7 ± 174.8 (clinical) days.</p></div><div><h3>Conclusions</h3><p>Operative treatment is safe and effective but the surgical approach should be patient- and injury-specific. The prognosis for neurological recovery from spinal cord injury is superior in patients with partially preserved motor function.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"22 ","pages":"Article 100283"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000140/pdfft?md5=e3140e4a5c12c92a6fdcaa0ac14c2512&pid=1-s2.0-S2590139724000140-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140062214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}