Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Patient-reported functional outcomes of endoscopic lumbar microdiscectomy: A non-inferiority meta-analysis","authors":"Mireya Rahman MD ,&nbsp;Emma Butler ,&nbsp;Justin Choy","doi":"10.1016/j.inat.2025.102037","DOIUrl":"10.1016/j.inat.2025.102037","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Lumbar Disc Herniation (LDH) is a condition characterized by the displacement of intervertebral disc material and represents the most common cause of radiculopathy. Conservative treatment for LDH focuses on lifestyle changes and pharmacologic interventions to manage symptoms. Surgery for LDH is indicated when conservative treatment fails, particularly in cases of progressive or persistent neurological deficits and debilitating back or leg pain. Currently, open discectomy and microdiscectomy are the most common treatment methods used today for surgical management of LDH. Literature has yet to establish meaningful differences in functional outcome between the two modalities. The objective of this study is to describe the efficacy of endoscopic microdiscectomy compared to open microdiscectomy as measured by patient-reported functionality outcomes.</div></div><div><h3>Methods</h3><div>A literature search was performed using the PubMed and Scopus databases for randomized control trials using the Oswestry Disability Index (ODI) and Visual Analogue Scales (VAS) for leg and back pain for lumbar disc herniation surgery at 12 months post-operative via endoscopic or microscopic approaches. Ten studies were included in the <em>meta</em>-analysis.</div></div><div><h3>Results</h3><div>The estimated coefficients for ODI (−0.201, p = 0.065), as well as VAS back (−0.037, p = 0.615) and VAS leg (−0.022, p = 0.805) indicate no significant relationship between surgical approach and patient-reported functional outcome at 12 months post-operative.</div></div><div><h3>Conclusion</h3><div>Endoscopic microdiscectomy is an alternative to traditional open and microscopic techniques, demonstrating non-inferiority in functionality and pain outcomes for patients with lumbar disc herniation.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102037"},"PeriodicalIF":0.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927934","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 effects of transcranial direct current stimulation on neuropathic pain following spinal cord injury: Practical research results from Vietnam","authors":"Anh Minh Nguyen ,&nbsp;Phuoc Trong Do ,&nbsp;Dung Tuan Hoang Bui ,&nbsp;Viet-Thang Le","doi":"10.1016/j.inat.2025.102043","DOIUrl":"10.1016/j.inat.2025.102043","url":null,"abstract":"<div><div><strong>Subjects:</strong> This study aimed to assess the efficacy of transcranial direct current stimulation (tDCS) targeting the primary motor cortex (M1) in treating neuropathic pain (NP) following spinal cord injury (SCI). <strong>Material and methods:</strong> Twenty patients with NP after SCI were enrolled. Before treatment, single-pulse transcranial magnetic stimulation (TMS) was utilized to locate the M1 regions. Subsequently, patients underwent tDCS stimulation with the anode over M1 region and the cathode over the contralateral orbitofrontal (COF) region. Treatment involved a 2 mA anode current for 20 min daily, five days per week, for four consecutive weeks. Douleur Neuropathique en 4 Questions (DN4) and Numerical Rating Scale (NRS) (0–10) were assessed before treatment, immediately after treatment and during the 1 and 3-month follow-up periods. <strong>Results:</strong> Significant improvements were seen right after treatment, with the DN4 score dropping from 5.4 (± 2.8) to 3.6 (± 2.3) and NRS from 5.8 (± 1.8) to 3.8 (± 1.9). This effect was sustained for one month after treatment cessation. Common side effects included drowsiness and a transient stinging sensation in the scalp, which were self-resolving. <strong>Conclusion:</strong> tDCS stimulation in the M1 region can effectively alleviate NP symptoms after SCI in the short term, with no severe side effects. Further research with larger sample sizes is warranted to determine optimal regimens for enhancing pain relief effectiveness and extending the duration of pain relief for patients.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102043"},"PeriodicalIF":0.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089108","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":"Sub-ablative thermo-stimulation with high-intensity focused ultrasound targeting the nucleus accumbens for severe alcohol use disorder: a feasibility study","authors":"Kun-Hong Li ,&nbsp;Wei-Chun Chen ,&nbsp;Pei-Han Wu ,&nbsp;Wei-Chieh Chang","doi":"10.1016/j.inat.2025.102049","DOIUrl":"10.1016/j.inat.2025.102049","url":null,"abstract":"<div><div>Ablative neurosurgical approaches targeting the nucleus accumbens (NAc) have been explored for treating substance use disorders, including alcohol use disorder (AUD). However, the neuropsychologic morbidity paid special consideration to the indications of these surgical techniques. This study presents the outcomes of two male patients, aged 42 and 47 years, diagnosed with severe AUD who underwent magnetic resonance-guided focused ultrasound (MRgFUS) sub-ablative thermo-stimulation targeting the bilateral NAc. At 1-month and 3-month follow-ups, Patient 1 exhibited reductions of 14 % and 54 % in Alcohol Use Disorders Identification Test (AUDIT) scores, 11 % and 56 % in craving visual analogue scale (VAS) scores, and 90 % and 50 % in Beck Depression Inventory-II (BDI-II) scores. Patient 2 demonstrated reductions of 3 % and 27 % in AUDIT scores, 14 % and 43 % in VAS scores, and 44 % and 28 % in BDI-II scores. Single-photon emission computed tomography (SPECT) imaging at 3 months revealed significant changes in regional brain activity comparing with baseline images for both patients. These findings highlight the potential of MRgFUS sub-ablative thermo-stimulation as an alternative minimally invasive intervention for AUD.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102049"},"PeriodicalIF":0.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912275","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":"Fluorescein sodium for resection of high-grade astrocytoma: A single-center prospective study in Vietnam","authors":"Anh Minh Nguyen ,&nbsp;Nguyen Thanh Lam ,&nbsp;Nguyen Duc Vu ,&nbsp;Hoa Viet Nguyen ,&nbsp;Nguyen Phan Thanh Tu ,&nbsp;Dang Cao Son","doi":"10.1016/j.inat.2025.102036","DOIUrl":"10.1016/j.inat.2025.102036","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to assess the feasibility, safety, and efficacy of using fluorescein sodium (FS) with the YELLOW 560 nm filter as an adjunct in the resection of high-grade astrocytomas.</div></div><div><h3>Methods</h3><div>Between October 2019 and October 2023, 62 patients diagnosed with high-grade astrocytoma were prospectively enrolled. Thirty-two patients underwent FS-guided microsurgical resection using a YELLOW 560 nm filter (Group I), and 30 patients underwent standard white-light microsurgical resection (Group II). FS was administered intravenously at a dose of 5–10 mg/kg prior to anesthesia induction. All patients underwent postoperative neurological evaluations and MRI at 72 h, and at 6 and 12 months. The primary endpoint was the accuracy of FS in delineating tumor margins via intraoperative biopsies. Secondary endpoints included extent of resection (EOR) and perioperative safety.</div></div><div><h3>Results</h3><div>Group I was further stratified into Subgroup 1 (non-eloquent area tumors, n = 24) and Subgroup 2 (tumors adjacent to eloquent cortex, n = 8). Mean preoperative tumor volume was 40.97 cm³ in Subgroup 1 and 53.78 cm³ in Subgroup 2. GTR was achieved in 83.3 % of Subgroup 1 but not in Subgroup 2 (mean EOR: 87.47 %). In Group II, 43.3 % achieved GTR. Subgroup 1 showed significantly higher GTR rates than Group II (p = 0.0045). FS-guided margin delineation showed sensitivity of 80.95 %, specificity of 91.48 %, and positive predictive value of 92.72 % across 110 tissue samples. No serious adverse events were noted, except for transient yellow urine discoloration.</div></div><div><h3>Conclusions</h3><div>FS with the YELLOW 560 nm filter is a safe and effective intraoperative tool that enhances tumor visualization and supports maximal safe resection in high-grade astrocytoma surgery, particularly in non-eloquent regions.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102036"},"PeriodicalIF":0.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918323","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":"Intracranial intermediate-grade meningeal melanocytoma: A 5-month-old child case report","authors":"Wangbin Deng,&nbsp;Guofu Li,&nbsp;Yonkang Zhang","doi":"10.1016/j.inat.2025.102040","DOIUrl":"10.1016/j.inat.2025.102040","url":null,"abstract":"<div><h3>Background</h3><div>Intermediate-grade meningeal melanocytoma (IGM) represents a rare subtype of central nervous system melanocytic tumors, classified as a distinct pathological entity in the 2021 WHO Classification of Central Nervous System Tumors. Pediatric cases, particularly in infants under 1 year of age, are exceedingly rare. Preoperative diagnosis is frequently delayed due to nonspecific clinical manifestations and radiological features overlapping with common pathologies such as gliomas or hemorrhagic lesions. Case report:The older twin brother, a 5-month-old boy, presented with a 3-month history of seizures at our department. Initial evaluation at a local hospital revealed a hyperdense left temporal lobe lesion on computed tomography (CT), misdiagnosed as spontaneous hemorrhage. Subsequent magnetic resonance imaging (MRI) demonstrated a T1-weighted hyperintense, T2-weighted hypointense lesion with mild gadolinium enhancement. Detailed physical examination identified two cutaneous melanocytic lesions. Eelectroencephalography(EEG) showed short bursts of slow waves were observed in the left temporal region in both wakefulness and sleep states; Video-EEG monitoring captured clinical seizures of left temporal origin. In particular, the younger twin had no symptoms. The patient underwent left temporal craniotomy with gross total resection of the lesion. Histopathological analysis confirmed IGM, characterized by bland melanocytic proliferation, rare mitotic figures (&lt;1/10 HPF), and strong immunohistochemical positivity for Melan-A, HMB45, and SOX10. Molecular profiling of the tumor failed to identify known pathogenic mutations. Postoperative recovery was uneventful, and the patient remained seizure-free on sodium valproate<!--> <!-->throughout<!--> <!-->a 12-month follow-up period. Discussion:<!--> <!-->This case highlights the diagnostic complexity of pediatric IGM, emphasizing the importance of integrating multimodal data (clinical, radiological, and histopathological) to differentiate it from hemorrhage or glioma. While MRI features such as T1 hyperintensity and mild enhancement provide clues, definitive diagnosis relies on histopathological confirmation. The absence of symptoms in the monozygotic twin supports a somatic rather than germline origin. Current management prioritizes gross total resection, though adjuvant therapies remain undefined due to limited pediatric data. Further studies are needed to elucidate molecular drivers (e.g., GNAQ/GNA11 mutations) and optimize risk-adapted strategies.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102040"},"PeriodicalIF":0.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918197","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":"ZAP-X Radiosurgery: First experience of 50 consecutive cases in Korea","authors":"In-Ho Jung ,&nbsp;Kyo Chul Shin ,&nbsp;Tae Woong Bae ,&nbsp;Sung Jin Kim ,&nbsp;Jaewoo Chung ,&nbsp;Jung-Ho Yun ,&nbsp;Young Jin Kim ,&nbsp;Chun-Sung Cho ,&nbsp;Sang Koo Lee","doi":"10.1016/j.inat.2025.102039","DOIUrl":"10.1016/j.inat.2025.102039","url":null,"abstract":"<div><h3>Objective</h3><div>On January 31, 2024, our institution became the first institution in Korea to implement ZAP-X radiosurgery. This study aimed to provide a detailed overview of our initial experience with ZAP-X radiosurgery.</div></div><div><h3>Methods</h3><div>Fifty consecutive patients underwent stereotactic radiosurgery using the ZAP-X system. Key parameters such as patient selection, treatment planning, and follow-up outcomes were evaluated.</div></div><div><h3>Results</h3><div>A total 50 of patients were enrolled in this study, including 20 (40.0 %) with metastatic brain tumors and 18 (36.0 %) with meningiomas. In those with metastatic brain tumors, local control failure occurred in only one patient (local control rate, 93.3 %; median follow-up period, 1.0 month). No other adverse effects occurred except for temporary partial alopecia in five patients.</div><div>The ZAP-X system showed key advantages such as superior dose conformity, reduced radiation leakage and scatter, and elimination of the need for a stereotactic frame. However, we also identified certain limitations to the system, such as its software’s current capabilities and the need for improved image quality.</div></div><div><h3>Conclusion</h3><div>The ZAP-X system offers a highly effective and accessible option for the radiosurgical management of intracranial lesions. It showed promising results in terms of local control and patient outcomes in the first cohort of 50 patients treated using the approach in Korea.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102039"},"PeriodicalIF":0.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892198","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":"Accuracy of Deep brain stimulation (DBS) lead Placement: A Comparative study of bilateral and Four-Lead implantation Techniques","authors":"Patrick Fricke ,&nbsp;Cordula Matthies ,&nbsp;Vera Nickl ,&nbsp;Maria Breun ,&nbsp;Martin M Reich ,&nbsp;Robert C Nickl","doi":"10.1016/j.inat.2025.102042","DOIUrl":"10.1016/j.inat.2025.102042","url":null,"abstract":"<div><h3>Objective</h3><div>Deep Brain Stimulation (DBS) is an established treatment modality for various movement disorders and psychiatric conditions. The effectiveness of DBS largely hinges on the precise placement of electrode leads. However, inaccuracies in electrode positioning can lead to reduced treatment efficacy and adverse side effects.</div></div><div><h3>Methods</h3><div>52 patients with 128 leads, (40 patients, in the bilateral group with 80 leads &amp; 12 in the four-lead group with 48 leads) who received DBS implantations with MER-recordings at the University Hospital of Wuerzburg between 2013 and 2019 were reviewed. Preoperative planning and postoperative imaging were assessed for lead placement accuracy. Clinical outcomes, surgical sequelae, and stimulation parameters were evaluated through patient records.</div></div><div><h3>Results</h3><div>The bilateral group exhibited a mean radial deviation of 1.40 mm from the planned trajectory, with a significant difference in accuracy between the first and second implanted leads. In the four-lead group, while there was an increasing trend in deviation between the first and the fourth electrode, it was not statistically significant.</div></div><div><h3>Conclusions</h3><div>This study contributes novel insights into the complexities of implanting multiple leads in a single DBS session. It highlights the importance of minimizing brain shifts during surgery to improve lead placement accuracy. The findings recommend prioritizing the implantation of the most clinically significant lead first, given the observed decrease in placement accuracy for subsequent leads or a staged procedure. The study represents the largest systematically assessed cohort analyzing electrode placement accuracy in four-lead DBS procedures to date.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102042"},"PeriodicalIF":0.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881681","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":"A cavernous malformation of the trigeminal nerve: A case report and pathology highlight","authors":"Thomas Hanks ,&nbsp;Katie Krause ,&nbsp;Hannah Boudreaux ,&nbsp;Steven Ruhoy ,&nbsp;Robert Ryan","doi":"10.1016/j.inat.2025.102041","DOIUrl":"10.1016/j.inat.2025.102041","url":null,"abstract":"<div><h3>Background</h3><div>Cavernous malformations of the cranial nerves are rare, especially of the trigeminal nerve. The following case report highlights the course and treatment of this patient, particularly focusing on the imaging and pathology highlights of the case.</div></div><div><h3>Case Description</h3><div>A 70-year-old male who presented with one year history of decreased sensation on the right side of the face prior to admission, progressed to complete ipsilateral facial numbness, as well as severe ataxia, vertigo, and nausea. Physical exam demonstrated lack of sensation in the V1-3 distribution on the right side, as well as nystagmus and hearing loss on the right side. CTA displayed a cryptic vascular malformation, and MRI demonstrated a lesion with surrounding contrast enhancement. The patient underwent a procedure for microsurgical resection of the hemorrhagic lesion.</div></div><div><h3>Discussion</h3><div>Frozen intraoperative pathology suggested a hyalinized vascular lesion, which was later confirmed to be a cavernous malformation. The patient experienced significant improvement in ataxia and balance following resection but had persistent right sided facial numbness with only mild improvement in sensation. Cavernous malformations of the trigeminal nerve can present with focal neurologic deficits and in some cases, trigeminal neuralgia. This patient uniquely presented with facial numbness and not trigeminal neuralgia, as seen in previous reports.</div></div><div><h3>Conclusion</h3><div>Early removal of cavernous malformations, ideally prior to hemorrhage, can result in improved patient outcomes and improvement of neurologic symptoms.</div><div>1 Background.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102041"},"PeriodicalIF":0.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886006","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":"Surgical nuances in the management of pineal region tumors via the occipital transtentorial approach without using brain retractor","authors":"Lingmin Shao,&nbsp;Mohammad Rohul Amin,&nbsp;Jia Liu,&nbsp;Renzhong Liu,&nbsp;Zhihong Jian","doi":"10.1016/j.inat.2025.102026","DOIUrl":"10.1016/j.inat.2025.102026","url":null,"abstract":"<div><h3>Objective</h3><div>Access to the pineal region has always represented a formidable challenge to the neurosurgeons. This study aims to explore the surgical techniques of the occipital transtentorial approach (OTA) without using brain retractor for excision of pineal region tumors based on the author’s experience and literature review.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed of patients who underwent surgery for pineal tumors via OTA using dynamic retraction at our institution from 2018 to 2022. The clinical data, surgical procedure, and results were examined.</div></div><div><h3>Results</h3><div>Twelve patients underwent surgery via OTA for treatment of pineal tumors. In all cases, it was feasible to complete surgery without using brain retractor. Gross total resection was achieved in 10 cases (83.3 %), while subtotal resection in 2 cases (16.7 %). There were no mortalities. Three patients presented with upper gaze palsy after surgery, 2 of them experienced complete recovery at the third month follow-up. Only one patient had residual neurologic deficit. Two patients reported transit diplopia after surgery. No postoperative hemianopsia was observed in this series.</div></div><div><h3>Conclusion</h3><div>The occipital transtentorial approach is effective for the removal of tumors in the pineal region. Dynamic retraction with handheld instruments and meticulous dissection of arachnoid membrane around the deep veins can provide a sufficient working space.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102026"},"PeriodicalIF":0.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892197","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":"Efficacy and safety of erythropoietin in patients with degenerative lumbar spinal stenosis undergoing multi-level lumbar interbody fusion: A case-control study","authors":"Dong Wang ,&nbsp;Ying Liu ,&nbsp;Shuang Cao ,&nbsp;Ying Wu ,&nbsp;Zhihao Ni ,&nbsp;Rende Ning","doi":"10.1016/j.inat.2025.102031","DOIUrl":"10.1016/j.inat.2025.102031","url":null,"abstract":"<div><div>Study Design.</div><div>Retrospective case-control study.</div></div><div><h3>Objective</h3><div>To assess the efficacy of short-term and high-dose application of erythropoietin (EPO) in patients with degenerative lumbar spinal stenosis (DLSS) undergoing multi-level lumbar interbody fusion (LIF) by assessing mean transfusion volume, transfusion rate, hematologic parameters, postoperative complications, and length of stay.</div><div>Summary of Background Data.</div><div>It has been reported to confirm the efficacy and safety of EPO in major surgeries like neurosurgery, cardiac surgery, and orthopedics. Still, there was little information on the application of EPO in patients with DLSS undergoing multi-level LIF.</div><div>Methods.</div><div>458 DLSS patients between January 2015 and December 2022 were selected and divided into EPO (group A), n = 112, and no EPO (group B), n = 105, according to treatment technique. Evaluation indexes included hemoglobin (Hb), hematocrit (Hct), red blood cells (RBC), postoperative complications, operative time, intraoperative bleeding, drainage volume, mean transfusion volume, transfusion rate, and length of stay.</div><div>Results.</div><div>The mean follow-up time was 21.7 months (18–24 months). Postoperative complications, surgical time, intraoperative bleeding, and drainage volume were not statistically different across groups. The Hb, Hct, and RBC values on postoperative days 1, 3, and 5 were significantly higher in group A than in B, and the difference was statistically significant (P &lt; 0.05). The mean transfusion rate was significantly lower in group A than in B (P &lt; 0.001). The mean transfusion volume was significantly lower in group A than in B (P &lt; 0.001). The length of stay was significantly lower in group A than in B (<em>P</em> &lt; 0.001).</div><div>Conclusion.</div><div>Short-term and high-dose perioperative EPO in DLSS patients undergoing multi-level LIF improves anemia-related hematologic parameters, reduces transfusion requirements, and shortens hospital stay without increasing deep vein thrombosis or wound infection.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102031"},"PeriodicalIF":0.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873139","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}