Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Postoperative changes in occlusal force after craniotomy in older adults: A prospective study","authors":"Osamu Akiyama,&nbsp;Yuzaburo Shimizu,&nbsp;Mario Suzuki,&nbsp;Akihide Kondo","doi":"10.1016/j.inat.2025.102054","DOIUrl":"10.1016/j.inat.2025.102054","url":null,"abstract":"<div><h3>Background</h3><div>This prospective observational study aimed to evaluate how craniotomy with temporal muscle transection affects occlusal force and nutritional status in elderly patients. Given the small sample size (n = 10) and the paired nature of the data, the Wilcoxon signed-rank test was used to compare preoperative and postoperative occlusal force values.</div></div><div><h3>Methods</h3><div>We prospectively analyzed 10 patients aged ≥65 years. Occlusal force was measured preoperatively and at 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively using a specialized device. Nutritional status was assessed via blood tests for total protein and albumin levels at each follow-up. In addition, temporal muscle thickness was objectively evaluated using axial CT scans preoperatively and at 12 months postoperatively. Statistical analysis was conducted using the Wilcoxon signed-rank test (p &lt; 0.05).</div></div><div><h3>Results</h3><div>Occlusal force significantly declined at 1 week and 6 months postoperatively (both p = 0.037) but recovered to preoperative levels by 12 months. CT-based measurements showed no significant atrophy of the temporal muscle. Albumin levels decreased at 3 months (p = 0.024), while total protein remained stable. Aspartate aminotransferase and alanine aminotransferase levels were significantly reduced at 1 (p = 0.08 and 0.08), 6 (p = 0.005 and 0.035), and 12 months (p = 0.021 and 0.037). Sodium levels increased at 1 (p = 0.046), 6 (p = 0.046), and 12 months (p = 0.047).</div></div><div><h3>Conclusions</h3><div>Craniotomy in elderly patients leads to temporary occlusal weakness and nutritional decline, highlighting the need for clinicians to monitor occlusal strength and nutritional markers, such as albumin. Our findings emphasize the importance of postoperative occlusal training and nutritional management to optimize recovery.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102054"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the incidence and risk factors for ventriculoperitoneal shunt sepsis at Dr George Mukhari Academic hospital in Pretoria, South Africa","authors":"Andries Pretorius ,&nbsp;Adrian Kelly ,&nbsp;Patrick Lekgwara","doi":"10.1016/j.inat.2025.102067","DOIUrl":"10.1016/j.inat.2025.102067","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with increased pressure hydrocephalus are a common referral to the Department of Neurosurgery at our institution.</div></div><div><h3>Materials and methods</h3><div>A descriptive cross-sectional study performed by consecutively enrolling 335 subjects who underwent a ventriculoperitoneal shunt insertion between the 01 January 2014 – 30 November 2022, aimed to establish our local ventriculoperitoneal shunt sepsis incidence, and further evaluate the known risk factors for ventriculoperitoneal shunt sepsis at 3- month follow-up.</div></div><div><h3>Results</h3><div>In our study 335 ventriculoperitoneal shunts were inserted, 190 (57 %) were inserted in children and 145 (43 %) were inserted in adults. With regards the cause of hydrocephalus in 90/335 (26.9 %) subjects this was congenital, in 45/335 (13 %) subjects this was a primary intra-axial CNS tumor, in 40/335 (12 %) subjects this was intraventricular hemorrhage, and in 38/335 (11 %) subjects this was in subjects with a myelomeningocele. Considering the ventriculoperitoneal shunt infection incidence 28/335 (8.4 %) subjects developed this complication within 3 months of the procedure. In evaluating the significance of the known risk factors for ventriculoperitoneal shunt sepsis, our study demonstrated that having a ventriculoperitoneal shunt insertion performed in the emergency theatre (p = 0.02, OR 1.87, CI 0.83–4.23), having a ventriculoperitoneal shunt inserted at night (p = 0.03, OR 3.92, CI 1.13–13.58), having a history of ventriculoperitoneal shunt sepsis (p = 0.004, OR 7.34, CI 2.20–24.55), being clinically immunosuppressed at the time of the ventriculoperitoneal shunt insertion procedure (p = 0.03, OR 3.01, CI 1.09–8.32), and having a post-operative cerebrospinal fluid leak (p = 0.04, OR 5.19, CI 0.91–29.71), demonstrated significance in predicting that ventriculoperitoneal shunt sepsis would occur.</div></div><div><h3>Conclusion</h3><div>Our study confirmed that our institutional ventriculoperitoneal shunt sepsis rate is 8.4 % and furthermore confirmed the significance of several of the known risk factors as taken from the literature.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102067"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Chiari type 0 malformation: A case study and literature review of surgical approaches, clinical and radiological outcomes","authors":"Chin Hong Ngai ,&nbsp;Chin Lik Tan ,&nbsp;Chee Kwang Kee ,&nbsp;Vincent Diong Weng Nga","doi":"10.1016/j.inat.2025.102058","DOIUrl":"10.1016/j.inat.2025.102058","url":null,"abstract":"<div><h3>Background</h3><div>Chiari malformation type 0 (CM0) is a rare subtype of Chiari malformations characterized by typical Chiari type 1 symptoms without cerebellar tonsillar herniation. There is currently no consensus on surgical treatment for CM0.</div></div><div><h3>Case</h3><div>We report a 53-year-old female presenting with neck and left upper limb pain since March 2022. Neurological examination was unremarkable, and MRI revealed a long-segment syrinx extending from C2 to T7 without tonsillar herniation, confirming CM0. She underwent foramen magnum decompression (FMD), with intraoperative findings of adequate tonsillar pulsations and satisfactory cerebrospinal fluid (CSF) flow. Postoperatively, the patient reported significant symptom relief and a six-month follow-up MRI showed reduced syrinx size.</div><div>FMD is the primary treatment strategy to restore CSF flow and alleviate symptoms, and several adjunct procedures have been described. A literature review of eight studies (33 patients) identified various surgical techniques, including C1 laminectomy, duraplasty, and intradural lysis of adhesions. Despite positive clinical outcomes, a standardized surgical protocol remains lacking. The heterogeneity in CM0 presentation and management necessitates individualized treatment strategies.</div></div><div><h3>Conclusion</h3><div>CM0 presents significant diagnostic and therapeutic challenges due to its rarity and the variability in patient presentations and surgical outcomes. The standard surgical approach often centers on FMD, typically supplemented with additional techniques such as C1 laminectomy and duraplasty. In this report, we present a case of CM0 in which the patient demonstrated significant symptomatic and radiological improvement following FMD alone without the need for duraplasty. These findings suggest that FMD alone may be sufficient in select cases of CM0.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102058"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in robotic-assisted spine surgery: A literature review and technology comparison","authors":"Jonathan Hammond ,&nbsp;Stefano Priola","doi":"10.1016/j.inat.2025.102056","DOIUrl":"10.1016/j.inat.2025.102056","url":null,"abstract":"<div><h3>Background</h3><div>Since the first spinal robotic system was developed in 2004, there have been many innovations in the field of neurosurgery including new robotic systems that utilize optical tracking systems (OTS) like the Mazor X Stealth Edition. OTS is an effective navigation system with high accuracy, yet it does have certain limitations like line-of-sight obstructions. Recently, alternative technology like electromagnetic navigation has been explored to address this challenge and shown promising results.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was completed using databases such as PubMed, Google Scholar, and ScienceDirect to identify all current spinal robotic systems. Information regarding 8i Robotics was obtained directly from the manufacturer based on company-reported specifications.</div></div><div><h3>Discussion</h3><div>There are currently six spinal robotic systems available, all of which utilize OTS for navigation. One of the main challenges of this type of navigation is line of sight obstructions which can result in decreased accuracy and cause delays in time. Recent development involves the use of EM navigation which has not been done in spine surgery thus far. Since EM navigation eliminates the need for line of sight, it creates an efficient and flexible environment for the surgeon to work in. However, EM navigation is not without challenges, including electromagnetic interference from metallic objects, which can disrupt signals and decrease accuracy.</div></div><div><h3>Conclusion</h3><div>OTS remains the gold standard in robotic spine surgery due to its proven safety and accuracy. However, EM navigation presents a promising alternative by addressing line-of-sight limitations while maintaining high accuracy.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102056"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of spinal cord stimulation treatment on patients with prolonged disorders of consciousness and their caregivers: A follow-up study","authors":"Jing Liu ,&nbsp;GuangXu Zhang ,&nbsp;Feng Cao","doi":"10.1016/j.inat.2025.102061","DOIUrl":"10.1016/j.inat.2025.102061","url":null,"abstract":"<div><h3>Objective</h3><div>Prolonged disorders of consciousness (pDoC) are conditions characterized by a long-term reduction in consciousness level due to severe brain injury, including vegetative state and minimally conscious state. The rehabilitation for these patients is prolonged, significantly impacting the psychological stress, physical burden, and family life of their caregivers. This study aims to evaluate the effects of spinal cord stimulation (SCS) on the treatment of patients with pDoC and its impact on the burden and mental health of primary caregivers.</div></div><div><h3>Methods</h3><div>The study reviewed 32 patients with pDoC and their caregivers who underwent SCS at the Affiliated Brain Hospital of Nanjing Medical University between August 2020 and December 2023. Patients were assessed using Coma Recovery Scale-Revised scale (CRS-R), and caregivers were evaluated using the Zarit Burden Interview (Zarit), Zung Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS) at pre-surgery and 1, 6, and 12 months post-surgery follow-ups.</div></div><div><h3>Results</h3><div>After receiving SCS treatment, 23 patients showed significant improvement in consciousness. Caregivers’ Zarit, SDS, and SAS scores significantly decreased post-surgery, indicating alleviation of family burden, depression, and anxiety. The improvement in CRS-R scores was significantly correlated with the reduction in caregiver burden.</div></div><div><h3>Conclusion</h3><div>Spinal cord stimulation positively impacts consciousness recovery in patients with pDoC, while indirectly reducing caregiving burden and psychological stress for their caregivers, thus improving their mental state.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102061"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of an intensive non-invasive program including spinal decompression on MRI-assessed structural changes in cervical disc herniation","authors":"Vincenzo Di Modica ,&nbsp;Giuseppe J. Sciarrone","doi":"10.1016/j.inat.2025.102063","DOIUrl":"10.1016/j.inat.2025.102063","url":null,"abstract":"<div><h3>Background</h3><div>Despite the critical role of the cervical spine, evidence describing the effectiveness of specific non-invasive protocols for treating cervical disc herniation (CDH) remains limited, even though these approaches are often preferred over surgical solutions. The aim of the present case series study is to present the results of an intensive non-invasive treatment program primarily based on non-surgical spinal decompression (NSSD) therapy, evaluated using objective MRI image processing methods.</div></div><div><h3>Materials and methods</h3><div>Three subjects diagnosed with CDH through MRI, exhibiting radiculopathy symptoms, and unresponsive to standard physiotherapy, participated in an extensive non-invasive treatment protocol lasting for a period ranging from three to five months. Progress was monitored by quantitative evaluation of structural changes observed on MRI scans taken before and after treatment.</div></div><div><h3>Results</h3><div>Quantitative indicators confirmed an improvement in the extent of CDH in all patients who underwent the intensive treatment program, ranging from approximately 32% to 55%.</div></div><div><h3>Conclusions</h3><div>This case series suggests that an intensive, non-invasive protocol incorporating NSSD therapy may promote symptom relief in CDH, with MRI observations indicating possible structural changes. However, due to inherent study limitations, generalizable conclusions or assessments of NSSD’s overall efficacy for CDH cannot be established. Larger-scale investigations, with expanded patient cohorts and a control group, are needed to validate these preliminary findings and determine the therapeutic impact of NSSD on CDH with greater accuracy.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102063"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upper cervical spine trauma in Niamey: A 3-Year retrospective analysis of 27 cases","authors":"Roméo Bujiriri Murhega ,&nbsp;Assoumane Issa Ibrahim ,&nbsp;IBN HALID Nana Rachida ,&nbsp;Aminath Kelani","doi":"10.1016/j.inat.2025.102055","DOIUrl":"10.1016/j.inat.2025.102055","url":null,"abstract":"<div><h3>Background</h3><div>Traumatic injuries of the upper cervical spine are complex and often life-threatening. This study presents novel insights into the clinical, radiological, and therapeutic characteristics of upper cervical trauma cases managed in Niamey, Republic of Niger.</div></div><div><h3>Methods</h3><div>We conducted a retrospective descriptive study involving 27 patients admitted for upper cervical spine trauma between January 1, 2020, and March 31, 2023. All patients underwent CT imaging, and MRI was used selectively. Fracture classification was validated by two independent neurosurgeons. Statistical analyses were performed using JAMOVI 2.3.28.0.</div></div><div><h3>Results</h3><div>The cohort had a mean age of 33.9 ± 15.4 years; 51.9 % were under 30 years old. Motorcycle accidents were the leading cause (55.6 %). Neurological deficits were observed in 33.3 %, and 66.6 % were ASIA grade E. C2 injuries predominated (70.4 %), primarily odontoid fractures (81.8 %) with 33.3 % being Anderson and Alonzo type II with a horizontal fracture line. Surgical treatment was indicated in 74.1 % of cases. The Harms technique was the most used method (30 %).</div></div><div><h3>Conclusion</h3><div>C2 Type II odontoid fractures are the most frequent pattern in upper cervical trauma in Niamey. Despite limited resources, surgical stabilization is feasible and necessary. These findings highlight the need for strengthened road safety and improved diagnostic access in sub-Saharan settings.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102055"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular markers in Gliomas: A practical review and algorithm proposal","authors":"Maria Isabel Ocampo-Navia ,&nbsp;Felipe Marín Navas ,&nbsp;Mariana Agudelo-Arrieta ,&nbsp;Alex Taub-Krivoy ,&nbsp;Oscar Hernando Feo Lee","doi":"10.1016/j.inat.2025.102062","DOIUrl":"10.1016/j.inat.2025.102062","url":null,"abstract":"<div><div>Gliomas, a diverse group of glial cell malignancies, are notorious for their invasive nature and represent a significant portion of central nervous system (CNS) tumors. Glioblastoma, the most prevalent and aggressive primary malignant brain tumor, stands out for its poor prognosis and represents a substantial burden in neuro-oncology. In children and adolescents, gliomas are also the most common CNS tumors, reflecting their impact across all age groups. While the majority of gliomas arise sporadically, certain familial tumor syndromes, such as Turcot syndrome, Li-Fraumeni syndrome, and neurofibromatosis, have been linked to their development.</div><div>The classification of CNS tumors has undergone significant transformation, culminating in the recent WHO CNS5 edition. This latest classification integrates cutting-edge histological and molecular techniques, offering a deeper understanding of tumor biology and enabling more accurate diagnoses. By incorporating molecular profiling and genomic analysis, the CNS5 classification surpasses traditional methods, providing a robust framework for tailoring therapeutic strategies.</div><div>Currently, gliomas are categorized within a broader group that includes gliomas, glioneuronal tumors, and neuronal tumors, with further subdivisions into adult-type diffuse gliomas, pediatric high-grade diffuse gliomas, pediatric low-grade diffuse gliomas, and circumscribed astrocytic gliomas. This article provides a practical review of the WHO CNS5 updates, with a focus on the most relevant molecular biomarkers for diagnosing gliomas in both adult and pediatric populations. Additionally, we propose a molecular diagnostic algorithm designed to enhance clinical decision-making and improve patient outcomes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102062"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryptogenic pituitary abscess: Two case reports from Indonesia highlighting diagnostic challenges and atypical clinical-radiological features","authors":"Donny Wisnu Wardhana ,&nbsp;Farhad Balafif ,&nbsp;Tommy Alfandy Nazwar ,&nbsp;Fachriy Balafif ,&nbsp;Ibrahim Yusuf Nasution ,&nbsp;Saddam Husein Saputra ,&nbsp;Koernia Hezkia Yonathan ,&nbsp;Anisa Nur Kholipah","doi":"10.1016/j.inat.2025.102057","DOIUrl":"10.1016/j.inat.2025.102057","url":null,"abstract":"<div><h3>Background</h3><div>Pituitary abscess is a rare and diagnostically challenging condition, as it often resembles pituitary adenoma in clinical, laboratory, and radiological features. Unlike typical adenomas, abscesses may present with mild and nonspecific signs of infection or hormonal disturbances. This report aims to analyse the clinical manifestations, diagnosis, risk factors for abscess formation, and management of this condition in our two patients, as well as cases reviewed from the literature.</div></div><div><h3>Case presentation</h3><div>Both patients were female, presenting with complaints of headache and visual disturbances, including bitemporal hemianopia caused by optic chiasm compression. Laboratory tests revealed elevated FT4 in patient 1 and hyperprolactinemia in patient 2, without systemic signs of infection such as leukocytosis (white blood cell count normal). MRI demonstrated rim-enhancing sellar lesions with central hypointensity and optic chiasm compression, findings highly suggestive of abscess rather than typical pituitary adenoma. Both patients underwent endonasal transsphenoidal hypophysectomy and received antibiotic therapy. The surgical procedure successfully removed the abscess with minimal complications, although the underlying infectious cause remained unidentified. Metronidazole and ceftriaxone therapy proved effective in improving the patients’ prognosis. The results demonstrated a favourable short-term prognosis; however, follow-up evaluation at three months revealed challenges in long-term management.</div></div><div><h3>Conclusion</h3><div>This finding differs from previous literature reports, none of which documented recurrence. We emphasize the importance of a thorough medical history and a multidisciplinary approach to optimize outcomes. Long-term radiological and clinical monitoring is essential for detecting potential recurrence or complications.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102057"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laminoplasty versus laminectomy for treatment of cervical spondylotic myelopathy: A randomized controlled Trial","authors":"Mohamed Salah Mohamed Ahmed Metwaly,&nbsp;Ahmed Mohamed Ezzat Abdel Fattah Mostafa,&nbsp;Ahmed Mohammed AlaaEldin Abd Elfattah Shalaby,&nbsp;Essam M. Youssef","doi":"10.1016/j.inat.2025.102069","DOIUrl":"10.1016/j.inat.2025.102069","url":null,"abstract":"<div><h3>Background</h3><div>Cervical spondylotic myelopathy (CSM) is a prevalent cause of spinal cord dysfunction in older adults, often requiring surgical intervention for relief of spinal cord compression. This study aimed to compare the outcomes of two common surgical techniques, laminoplasty and laminectomy, in the treatment of multilevel CSM.</div></div><div><h3>Methods</h3><div>In a prospective cohort study, 30 patients with symptomatic multilevel CSM were randomly assigned to undergo either laminectomy or laminoplasty. Preoperative and postoperative evaluations included clinical assessments using the Visual Analog Scale (VAS), Nurick grade, Neck Disability Index (NDI), Japanese Orthopaedic Association (JOA) score, as well as radiological evaluations (MRI, X-ray). Surgical outcomes, complications, and long-term recovery were also assessed.</div></div><div><h3>Results</h3><div>Both groups showed significant postoperative improvements in clinical measures, including VAS, Nurick, and NDI scores. However, the laminoplasty group demonstrated greater improvements in NDI scores (p &lt; 0.001) and lower postoperative VAS scores (p = 0.003). Radiologically, laminectomy provided greater decompression, as evidenced by a larger increase in the dural sac cross-sectional area (p &lt; 0.001). Both groups exhibited similar complication rates, but the laminectomy group had a higher incidence of C5 radiculopathy and axial neck pain (p = 0.003 for both).</div></div><div><h3>Conclusion</h3><div>Overall, both procedures demonstrated significant clinical benefits, and the choice of technique should be tailored to individual patient needs based on factors such as cervical alignment and risk of complications. Further studies with larger cohorts are needed to refine surgical decision-making in CSM treatment.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102069"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}