World Neurosurgery: X最新文献

{"title":"Craniospinal space reduction and malalignment due to atlas assimilation in Basilar Invagination–A case–control study","authors":"Ricardo V. Botelho ,&nbsp;Beatriz Cibin Braga Petranchi ,&nbsp;Pedro B. Botelho ,&nbsp;Diego U.M. Moreira ,&nbsp;Eduardo F. Bertolini ,&nbsp;José M. Rotta","doi":"10.1016/j.wnsx.2024.100418","DOIUrl":"10.1016/j.wnsx.2024.100418","url":null,"abstract":"<div><h3>Introduction</h3><div>Type I Basilar invagination is associated with the assimilation of the anterior arch of the atlas. Observation suggests that the assimilation of the atlas does not allow the development of the normal space between the skull and C1 and displaces the high cervical spine towards the neural structures, posteriorly positioned. Purpose: The objective of this work is to evaluate craniospinal alignment in patients with type I Basilar invagination and AOA in comparison with normal subjects (Type I).</div></div><div><h3>Methods</h3><div>Magnetic resonance images and / or CT SCAN with reconstruction in the midline, in acquisitions at t1 and or t2, from 30 normal subjects and 27 patients with type I Basilar invagination were evaluated. The position of Anterior arch of Atlas and odontoid process in relation to the Basion and distances between C1 and C2 to the anterior border of foramen magnum were compared between groups.</div></div><div><h3>Results</h3><div>The distance from C2 to the Basion was significantly higher in the BI group than in the control group (t test: t = 4.18; p = 0) and the space between the skull and Atlas was reduced. All normal subjects had the Atlas anteriorly located in relation to the Basion. In AOA, all patients had Atlas in line with or posteriorly dislocated in relation to the Basion and the Odontoid process occupying the foramen magnum space.</div></div><div><h3>Conclusion</h3><div>data revealed that AOA prevents a normal position of skull in relation to the Atlas and a presumed “slip-back” cranio-spinal displacement during developmental period.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"25 ","pages":"Article 100418"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416954","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":"Evaluation of the Chetomin effect on histopathological features in a murine acute spinal cord injury model","authors":"Carlos César Bravo-Reyna ,&nbsp;Vladimir Miranda-Galván ,&nbsp;Gervith Reyes-Soto ,&nbsp;R. Vicuña ,&nbsp;Jorge Alanis-Mendizabal ,&nbsp;Manuel Escobar-Valderrama ,&nbsp;David Arango ,&nbsp;Claudia J. Bautista ,&nbsp;Victoria Ramírez ,&nbsp;Gonzalo Torres-Villalobos","doi":"10.1016/j.wnsx.2024.100414","DOIUrl":"10.1016/j.wnsx.2024.100414","url":null,"abstract":"<div><h3>Background</h3><div>Several research studies have been focused on improving the treatment and prognosis of acute spinal cord injury, as part of this initiative we investigated the use of Chetomin to reduce the inflammatory response in this pathology.</div></div><div><h3>Methods</h3><div>An experimental, prospective, cross-sectional study was performed using 42 Wistar rats where we analyzed the effect of Chetomin compared to methylprednisolone administered 1 and 8 h after the spinal cord injury in a murine model.</div></div><div><h3>Results</h3><div>Chetomin administration 8h post-injury decreased IL-6 and VEGF expression; and, and its administration 1h post-injury decreased NF-kB expression.</div></div><div><h3>Conclusions</h3><div>Chetomin has anti-inflammatory effects in acute spinal cord injury, whether these effects are observable with other proinflammatory markers should be investigated.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"25 ","pages":"Article 100414"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416003","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":"Early clinical outcomes and medical complications following long segment fusion for adult spinal deformity with and without three column osteotomy","authors":"Simon G. Ammanuel,&nbsp;Paul S. Page,&nbsp;Garret P. Greeneway,&nbsp;Darius Ansari,&nbsp;James A. Stadler","doi":"10.1016/j.wnsx.2024.100415","DOIUrl":"10.1016/j.wnsx.2024.100415","url":null,"abstract":"<div><h3>Background</h3><div>Surgical treatment of adult spinal deformity (ASD) commonly involves long-segment fusion with or without three column osteotomies (3CO) to provide satisfactory correction of sagittal and coronal balance. While some clinical studies have implicated 3CO as a driver of high surgical complication rates, these prior investigations are limited by small sample size. Herein, we compare early outcomes and adverse events in patients undergoing long segment posterior spinal fusion for ASD with and without 3CO.</div></div><div><h3>Methods</h3><div>A multicenter administrative database was queried for patients undergoing elective posterior spinal fusion for ASD. Patients were stratified based upon long segment fusion with and without 3CO. Preoperative patient demographics, procedural characteristics, hospitalization events, and postoperative complication rates were evaluated. Student's <em>t</em>-test and Fisher's exact test were utilized where appropriate to compare differences between the two groups for continuous and categorical variables.</div></div><div><h3>Results</h3><div>340 cases met the inclusion criteria, of which 156 involved 3CO. Patients who required 3CO had a lower rate of preoperative diabetes (22.3 % vs 10.3 %, <em>p</em> = 0.003), higher rates of non-home discharge (26.2 % vs 57.1 %, <em>p</em> &lt; 0.001), longer operation time (245.62 ± 9.45 vs. 434.40 ± 11.65, <em>p</em> &lt; 0.001), and longer length of stay (4.17 ± 0.66 vs. 7.76 ± 0.83, <em>p</em> &lt; 0.001). In terms of complications, 3CO patients had higher rates of deep surgical site infection (0 % vs 3.2 %, <em>p</em> = 0.02), reintubation (0 % vs 4.5 %, <em>p</em> = 0.004), inability to wean off ventilator (0 % vs 2.6 %, <em>p</em> = 0.04), and perioperative blood transfusion (20.1 % vs 76.3 %, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>In this retrospective analysis, posterior 3CO was frequently undertaken but associated with higher risk for postoperative adverse events following spinal deformity correction.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"24 ","pages":"Article 100415"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322677","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":"Minimally invasive exoscope-assisted coccygectomy: A novel approach for chronic refractory coccydynia","authors":"Barnabas Obeng-Gyasi,&nbsp;Danielle Wilmes,&nbsp;Matthew P. Blackwell,&nbsp;Jae H. Kwon,&nbsp;Gordon Mao","doi":"10.1016/j.wnsx.2024.100412","DOIUrl":"10.1016/j.wnsx.2024.100412","url":null,"abstract":"<div><h3>Background</h3><div>This technical note presents a novel minimally invasive exoscope assisted coccygectomy to treat chronic refractory coccydynia. Traditional treatments often fail to provide adequate relief for this debilitating condition, prompting the need to explore surgical approaches.</div></div><div><h3>Case Description</h3><div>A 40-year-old female patient with persistent pain unresponsive to conservative treatments underwent this advanced procedure. Utilizing the Synaptive exoscope-microscope system, the surgery allowed for precise dissection and removal of affected coccygeal segments, with a focus on minimizing skin and soft tissue disruption to optimize wound healing and surgical site pain.</div></div><div><h3>Conclusion</h3><div>Postoperative recovery showcased significant pain reduction and improved quality of life, emphasizing the method's potential for better outcomes and fewer complications. Despite the promising results, the limitations of a single-case study necessitate further research to establish long-term effectiveness across a broader patient population.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"25 ","pages":"Article 100412"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416002","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":"Placement of spinal cord stimulation paddle leads in the thoracic spine using en bloc laminoplasty: A technical note","authors":"Samuel D. Stegelmann ,&nbsp;Roman Rahmani ,&nbsp;Jae Min Yim ,&nbsp;Zubair Ahammad","doi":"10.1016/j.wnsx.2024.100400","DOIUrl":"10.1016/j.wnsx.2024.100400","url":null,"abstract":"<div><h3>Objective</h3><div>Spinal cord stimulation (SCS) has become a successful treatment option for managing chronic pain syndromes. Conventional methods for placing SCS leads include percutaneous insertion or open laminectomy in cases requiring better visualization. However, achieving accurate placement of paddle leads while minimizing surgical invasiveness remains a challenge in cases with anatomic constraints such as dural scarring.</div></div><div><h3>Methods</h3><div>We present a novel surgical technique for the placement of SCS paddle leads in the thoracic spine using en bloc laminoplasty, which is currently employed at our institution for patients with chronic pain syndromes.</div></div><div><h3>Conclusions</h3><div>This technique can provide accurate placement of paddle leads in patients with anatomic constraints or dural scarring that impede percutaneous implantation. Additionally, it offers potential structural advantages over laminectomy by reconstituting posterior stabilization and protection of the paddle leads.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"24 ","pages":"Article 100400"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319327","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":"Assessment of donor-vessel after STA-MCA bypass for moyamoya disease using handheld Doppler to confirm bypass patency and predict perioperative hyperperfusion","authors":"Satoshi Takahashi,&nbsp;Masahiro Toda","doi":"10.1016/j.wnsx.2024.100398","DOIUrl":"10.1016/j.wnsx.2024.100398","url":null,"abstract":"<div><div>The study included 12 hemispheres of 9 patients with moyamoya disease who underwent direct-indirect revascularization. The parameters (peak systolic velocity (PSV), mean flow velocity (MV), resistance index (RI), flow volume (FV)) of the superficial temporal artery (STA) on the operated side were measured using a handheld Doppler before and after surgery in all the patients. The examination was conducted in a similar manner on postoperative day (POD)1 on 9 sides of 7 patients except for 3 sides of the first 2 patients. Patency of the superficial temporal artery-middle cerebral artery (STA-MCA) bypass was confirmed by magnetic resonance angiography (MRA) performed on all 12 sides of 9 patients within the first 2 PODs. There was a statistically significant increase in the PSV (<em>p</em> = 0.0201) and the MV (<em>p</em> = 0.0110) and a decrease in the RI (<em>p</em> = 0.0177) in the STA after surgery when compared with those measured before surgery. None of the changes from the immediate postoperative period to POD1 were statistically significant. Postoperative transient neurological events (TNEs) occurred in 3 patients (25 %) in the first 2 weeks, and all of them were attributed to hyperperfusion. The FV of the three sides associated with TNEs was significantly higher than that of the nine sides that were not (<em>p</em> = 0.0273). From the early stage after moyamoya disease bypass surgery, it was clarified that the parameter of the STA changed in which the PSV and the MV increased and the RI decreased. It was clarified that the increase in the FV, which is the blood flow rate that flows through the STA in the immediate postoperative period, may be a predictor of the development of hyperperfusion during the perioperative course.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"24 ","pages":"Article 100398"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724001297/pdfft?md5=4c850ba6c3bc2f9fa53d0ec1e5fedf75&pid=1-s2.0-S2590139724001297-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311618","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":"Diabetes and heart disease do not affect short-term lumbar fusion outcomes accounting for other risk factors in a matched cohort analysis","authors":"Ryan S. Gallagher ,&nbsp;Connor A. Wathen ,&nbsp;Ritesh Karsalia ,&nbsp;Austin J. Borja ,&nbsp;Tara Collier ,&nbsp;Jianbo Na ,&nbsp;Scott McClintock ,&nbsp;Paul J. Marcotte ,&nbsp;James M. Schuster ,&nbsp;William C. Welch ,&nbsp;Neil R. Malhotra","doi":"10.1016/j.wnsx.2024.100410","DOIUrl":"10.1016/j.wnsx.2024.100410","url":null,"abstract":"<div><h3>Objectives</h3><div>Comprehensive preoperative management involves the identification and optimization of medical comorbidities while avoiding excessive healthcare utilization. While diabetes and heart disease are major causes of morbidity that can worsen surgical outcomes, further study is needed to evaluate how well current perioperative strategies mitigate their risks. This study employs an exact matching protocol to isolate the effects of both diabetes and cardiovascular disease on spine surgery outcomes.</div></div><div><h3>Methods</h3><div>4680 consecutive patients undergoing single-level, posterior-only lumbar fusion were retrospectively enrolled. Univariate logistic regression was performed on comorbidity subgroups, then coarsened exact matching (CEM) was employed for patients with diabetes or cardiovascular disease. Patients were matched 1:1 on ten patient and procedural characteristics known to affect neurosurgical outcomes. Separate pairs of exact-matched cohorts were generated to isolate both cardiovascular disease (matched n = 192), and diabetes (matched n = 380). Primary outcomes were surgical complications; length of stay; discharge disposition (home vs. non-home); and 30- and 90-day Emergency Department (ED) visits, readmissions, reoperations, and mortality.</div></div><div><h3>Results</h3><div>Cardiovascular disease and diabetes subgroups were not associated with short term outcomes after matching to control for confounders. Compared to univariate statistics, this method demonstrates that confounding control variables may drive outcomes more than these comorbidities themselves.</div></div><div><h3>Conclusion</h3><div>Between otherwise exactly matched patients undergoing lumbar fusion, diabetes and cardiovascular disease posed no greater risk of short-term adverse outcomes. This suggests proper selection criteria for surgical candidates and effective current perioperative strategies to mitigate these common comorbidities. Further studies are warranted to assess and optimize the cost-effectiveness of preoperative management for patients with common comorbidities.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"24 ","pages":"Article 100410"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327599","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":"Ambient wing cistern: History, anatomy, imaging and approaches: An overview","authors":"Mohamed R. Emara ,&nbsp;Alkawthar M. Abdulsada ,&nbsp;Abdulaziz S. Alayyaf ,&nbsp;Hussein A. Baban ,&nbsp;Hala A. Al-Hchaimi ,&nbsp;Mustafa Ismail ,&nbsp;Samer S. Hoz","doi":"10.1016/j.wnsx.2024.100395","DOIUrl":"10.1016/j.wnsx.2024.100395","url":null,"abstract":"<div><h3>Background</h3><div>The ambient cistern is a noncommunicating paramedian dorsal paired cistern according to the Liliequist classification. While the ambient wing cistern is described for the first time in 1875, Key and Retzius and firstly named in 1950 by Dr. Bengt Liliequist (1923–2008). Due to its complex tridimensional anatomy, it has been a subject of confusion in neuroanatomy. Historically, it has been given multiple anatomical definitions. Our paper focuses on the history, development, radiology, and lesions of the AC along with the AWC and explains the latter as an independently constant anatomical structure.</div></div><div><h3>Method</h3><div>Pubmed and Google Scholar were both consulted for the advanced literature research using the following search string on Pubmed: (((\"ambient\") AND (\"wing\")) OR (((retrothalamic) OR (retropulvinar)) (intercommunicant))) AND (\"cister∗\")) NOT(\"temprature\"). In addition to the following string on Google scholar: Ambient AND wing cisterna OR cistern.</div></div><div><h3>Results</h3><div>836 results were obtained, after exclusion of unrelated engineering articles and veterinary papers, only 60 papers remained. Ambient wing, retrothalamic, retropulvinar &amp; intercommunicant cisterns were mentioned within the related 60 articles but none of them explained it as a whole research entity independently.</div></div><div><h3>Conclusion</h3><div>The ambient cistern has supratentorial and infratentorial parts and is continuous with basal cisterns posteriorly giving rise to the ambient wing cistern. They are believed to be separate constantly existing anatomical structures despite their intimate communication and axial perpendicularity. The wing of AC has significance importance in the diagnosis and treatment of the masses lying adjacent to the tentorial hiatus. It can be exposed either by sub temporal or occipital interhemispheric approach as it locates inferoposteriorly to the AC.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"25 ","pages":"Article 100395"},"PeriodicalIF":0.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416940","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":"Intracranial pressure changes in traumatic brain injury patients undergoing unilateral decompressive craniectomy with dural expansion","authors":"Idris Shahrom ,&nbsp;Saiful Azli Mat Nayan ,&nbsp;Jafri Malin Abdullah ,&nbsp;Abdul Rahman Izaini Ghani ,&nbsp;Nurul Firdausi Hasnol Basri ,&nbsp;Zamzuri Idris","doi":"10.1016/j.wnsx.2024.100405","DOIUrl":"10.1016/j.wnsx.2024.100405","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study is to assess the ICP changes induced by a unilateral fronto-temporo-parietal DC with dural expansion after moderate to severe TBI. The effect of different bone flap sizes on ICP and the neurological outcomes were also evaluated after the decompressive surgery.</div></div><div><h3>Methods</h3><div>52 TBI patients with clinical and radiological evidences of increased ICP were included in this prospective study. All patients received unilateral fronto-temporo-parietal DC with dural expansion and ventriculostomy at contralateral Kocher's point. Postoperatively, ICP values and the largest antero-posterior (AP) diameter of bone flap removed was measured, and the clinical outcomes were assessed using Extended Glasgow Outcome Scale (GOS-E) at discharge and 6 months after DC.</div></div><div><h3>Results</h3><div>The median ICP significantly decreased with an average of 56.7 % reduction from the initial opening ICP. Similar ICP changes were observed in all groups. This study also found that the large bone flap group (AP diameter &gt;15 cm) demonstrated better postoperative ICP control as compared to the small bone flap group (AP diameter 12–15 cm), although not statistically significant. The SDH and cerebral swelling groups did better in the GOS-E at 6 months after TBI compared with cerebral contusion group.</div></div><div><h3>Conclusion</h3><div>The ICP reduction in moderate to severe TBI patients undergoing unilateral fronto-temporo-parietal DC with dural expansion occurred in accordance with decompressive steps, regardless of intracranial lesions and the surgical procedure should be performed with the bone flap size of at least 12 cm in AP diameter for adequate and sustained ICP control.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"24 ","pages":"Article 100405"},"PeriodicalIF":0.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322676","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":"Using the modified frailty index as a predictor of complications in adults undergoing transforaminal interbody lumbar fusion","authors":"Momin M. Mohis ,&nbsp;Simon G. Ammanuel ,&nbsp;Cuong P. Luu ,&nbsp;James A. Stadler","doi":"10.1016/j.wnsx.2024.100407","DOIUrl":"10.1016/j.wnsx.2024.100407","url":null,"abstract":"<div><h3>Objective</h3><div>To correlate the operative characteristics and complications of transforaminal lumbar interbody fusion (TLIF) to patient frailty status for the first time in a multicenter study.</div></div><div><h3>Methods</h3><div>Using the American College of Surgeons National Surgical Quality Improvement (ACS-NSQIP) database, all patients who underwent TLIF in 2015–2020 were filtered for their demographics, operative characteristics, and 30-day complication outcomes. Patients were stratified into 2 cohorts, low and high frailty, based on their modified frailty index 5 score. Univariate analysis was performed between the 2 cohorts for each collected variable, and multivariable analysis was performed to observe adjusted odds ratios (OR).</div></div><div><h3>Results</h3><div>The frail cohort experienced more unplanned readmission (4.3 vs 6.6 %, <em>p</em> &lt; 0.001). During hospital stays, the frail cohort experienced more overall complications (9.8 vs 13.8 %, <em>p</em> &lt; 0.001). In contrast to the low frailty cohort, the high frailty patients saw longer hospital stays (3.27 vs. 3.69 days, <em>p</em> &lt; 0.001). The high frailty group saw more discharges to an institution beside their home (89.6 vs 77.9 %, <em>p</em> &lt; 0.001). Rates of superficial and deep surgical site infection, organ space infection, wound dehiscence, reintubation, renal insufficiency, urinary tract infection, stroke, cardiac arrest, DVT, sepsis, and septic shock were not significantly different. Multivariable analyses showed high frailty status as an independent predictor of unplanned readmissions, major complications, and preventing discharge to home.</div></div><div><h3>Conclusions</h3><div>mFI-5 serves as an effective predictor of surgical outcomes following TLIF and independently predicts unplanned readmission, discharge to home, and major complications. Noninfectious outcomes were more likely to be significantly different between the high- and low frailty groups, while all infectious outcomes apart from superficial surgical site infection and pneumonia were not significantly different between the cohorts.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"25 ","pages":"Article 100407"},"PeriodicalIF":0.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416942","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}