BMC Surgery最新文献

{"title":"Clinical efficacy analysis of one-stage posterior debridement, bone graft fusion, and internal fixation for the treatment of lumbar brucellosis spondylitis.","authors":"Yanchuan Yang, Xiaojun Ma","doi":"10.1186/s12893-025-03143-w","DOIUrl":"https://doi.org/10.1186/s12893-025-03143-w","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical efficacy of one-stage posterior debridement with bone grafting, fusion, and internal fixation in the treatment of Brucellosis Spondylitis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 45 patients (30 males and 15 females) with lumbar Brucellosis Spondylitis who met the inclusion criteria and were treated at the Department of Spinal Orthopedics, General Hospital of Ningxia Medical University between January 2010 and February 2025.Patients ranged in age from 30 to 74 years (mean 52.7 ± 10.4 years) and had spinal lesions involving no more than two segments between T12 and S1. All patients received strict oral anti-brucellosis medication before and after surgery, and underwent one-stage posterior debridement with bone grafting, fusion, and internal fixation. Clinical parameters including hospital stay duration, operative time, intraoperative blood loss, and postoperative drainage volume were recorded. Follow-up assessments included Visual Analog Scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores for low back pain, ASIA impairment scale for neurological function, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), standard agglutination test (SAT), kyphotic Cobb angle of the affected segments, and postoperative complications such as implant loosening or rod fracture at various time points before and after surgery.</p><p><strong>Results: </strong>All 45 patients achieved surgical site healed primarily without cerebrospinal fluid leakage or neurological complications. Within one week after the surgery, mild activities (such as standing beside the bed and short-distance walking) can be performed with the aid of a brace to promote blood circulation and prevent complications, with significant improvement in low back pain and neurological symptoms. All patients with preoperative neurological deficits recovered to ASIA grade E by 24 months postoperatively. Significant improvements (P < 0.05) were observed in mean VAS scores, JOA scores, ESR, CRP levels, and Cobb angles at all postoperative time points compared to preoperative values. At final follow-up, all patients demonstrated SAT titers below 1:160. The bone fusion rate reached 91.11% (41/45) according to Bridwell's classification criteria. Based on the modified MacNab criteria, the excellent and good rate was 95.56% (43/45). No cases of disease recurrence, implant loosening, or rod/screw breakage were observed during the follow-up period.</p><p><strong>Conclusion: </strong>For lumbar Brucellosis Spondylitis, one-stage posterior debridement with bone grafting, fusion, and internal fixation, when combined with standardized pharmacological treatment, represents an effective therapeutic approach. This comprehensive treatment strategy facilitates thorough lesion eradication, improves spinal function, and achieves satisfactory clinical outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"391"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of remote and virtual surgical training in expanding cardiothoracic surgical capacity in low-resource regions.","authors":"Achanga BillSmith Anyinkeng, Samuel Mesfin Girma, Taryim Maurice, Efuetlateh JohnPaul, Tsion Hiwot, Ahmed K Awad","doi":"10.1186/s12893-025-03142-x","DOIUrl":"https://doi.org/10.1186/s12893-025-03142-x","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"393"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective study comparing three approaches for keloids: surgery + radiotherapy, surgery + pharmacological injection, and surgery alone.","authors":"ShengHua Chen, Xu Mu, Lin Zhang, Wei Liu, YuYang Han, Hanhua Li, Wen Lai, Zhifeng Huang","doi":"10.1186/s12893-025-03095-1","DOIUrl":"https://doi.org/10.1186/s12893-025-03095-1","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the differential efficacy of various treatment modalities adjunct to surgical excision of keloids and to analyze prognostic factors influencing outcomes.</p><p><strong>Methodology: </strong>A retrospective observational study approach was employed. Clinical data from 121 patients with keloids who met the inclusion criteria were collected for analysis of clinical characteristics and evaluation of treatment efficacy. The patients were categorized into three groups based on the adjuvant treatment modalities utilized post-surgical excision of keloids: surgical + radiotherapy group (group A), surgical + radiotherapy + pharmacological injection group (group B), and surgical group (group C). Factors potentially influencing treatment outcomes-such as treatment modality, gender, age, lesion distribution, lesion size, duration of the condition, and prior treatments-were subjected to a statistical analysis. Significant risk factors were identified through univariate analysis.</p><p><strong>Results: </strong>The efficacy rates for group A, group B, and group C were 93.88%, 87.04%, and 55.56%, respectively. Statistical analysis indicated that age and treatment modality were significant risk factors for recurrence.</p><p><strong>Conclusion: </strong>The application of radiotherapy post-surgery, or a combination of radiotherapy and pharmacological injections postoperatively, has been demonstrated to significantly reduce the recurrence rate of keloids. Conversely, the efficacy of treatments that solely rely on surgery is comparatively lower. For elderly patients, early intervention upon the manifestation of clinical symptoms is strongly advocated, with a preference for adjunctive postoperative radiotherapy to mitigate the risk of recurrence.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"386"},"PeriodicalIF":1.8,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An easily acquirable predictive model for strangulated bowel obstruction: the BAR-N.","authors":"Cuifeng Zheng, BaoWei Xu, Pingxia Lu, Weixuan Xu, Shenhui Lin, Xianqiang Chen, Junrong Zhang, Zhengyuan Huang","doi":"10.1186/s12893-025-03045-x","DOIUrl":"https://doi.org/10.1186/s12893-025-03045-x","url":null,"abstract":"<p><strong>Background: </strong>Small bowel obstruction (SBO) is a prevalent gastrointestinal disorder that consists primarily of two types: simple bowel obstruction (SiBO) and strangulated bowel obstruction (StBO). Due to life-threatening complications such as septic shock and multiple organ dysfunction syndrome, there is an urgent need for an easy-to-acquire predictive model for StBO based on clinical symptoms and laboratory.</p><p><strong>Methods: </strong>A total of 453 patients diagnosed with SBO were randomly divided into training and validation datasets at a ratio of 7:3. The demographic, clinical, and laboratory data were collected. Least absolute shrinkage and selection operator (LASSO) regression was employed to identify relevant variables, and a multivariable logistic regression (LR) model was subsequently developed. The performance of the model was evaluated using receiver operating characteristic (ROC) curve analysis, and diagnostic metrics, including accuracy, sensitivity, specificity, and area under the curve (AUC), were calculated.</p><p><strong>Results: </strong>Of the 453 patients diagnosed with SBO, 62 (13.7%) had StBO, and 391 (86.3%) had SiBO. Univariate analysis revealed significant associations between bowel ischemia and the following variables: body mass index (BMI, p = 0.027), neutrophil percentage (N, p = 0.002), aspartate aminotransferase (AST, p = 0.024), serum creatinine (p = 0.030), serum urea (p = 0.019), glucose (p = 0.029), prothrombin time (PT, p = 0.043), cessation of defecation and flatus (p = 0.013), tenderness (p = 0.004), and rebound tenderness (p < 0.001). A LASSO regression model with optimized regularization parameters (α = 0.3, λ = 0.0202; log[λ] = - 3.902) was used to select 10 predictors. Rebound tenderness (OR, 6.64; 95% CI, 2.97-15.48; p < 0.001), BMI (OR, 0.02; 95% CI, 0.00-0.37; p = 0.010), N (OR, 1.05; 95% CI,1.01-1.09; p = 0.009), and AST (OR, 1.97; 95% CI, 1.01-4.06, p = 0.055) were significantly associated with intestinal ischemia via multivariable LR. The final predictive model (BAR-N) had a strong performance, with an AUC of 0.784 in the training cohort and 0.750 in the validation cohort. Additionally, the model exhibited high specificity (90.3%) and accuracy (80.7%), although its sensitivity remained relatively low at 31.8%.</p><p><strong>Conclusions: </strong>We developed an easy-to-acquire predictive model (BAR-N) for the diagnosis of StBO that incorporates both clinical and laboratory data. This model shows promise as an adjunctive decision-support tool, particularly in resource-limited or high-acuity settings. However, its generalizability is limited by the absence of external validation, underscoring the need for future multicenter studies to confirm its broader applicability.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"385"},"PeriodicalIF":1.8,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative C-reactive protein to albumin ratio as early predictive factors for prolonged postoperative hospital stay after highly advanced hepatobiliary-pancreatic surgery: a single-center retrospective study.","authors":"Masahiro Fukada, Noriki Mitsui, Takeshi Horaguchi, Itaru Yasufuku, Yuta Sato, Jesse Yu Tajima, Shigeru Kiyama, Yoshihiro Tanaka, Katsutoshi Murase, Nobuhisa Matsuhashi","doi":"10.1186/s12893-025-03112-3","DOIUrl":"https://doi.org/10.1186/s12893-025-03112-3","url":null,"abstract":"<p><strong>Background: </strong>Postoperative length of hospital stay (PLOS) is an important indicator of surgical quality. Prolonged PLOS (PPLOS) escalates treatment costs and delays the transition from surgery to adjuvant chemotherapy. Additionally, PPLOS can negatively affect long-term prognosis. The predictive factors for PPLOS, particularly following highly advanced hepatobiliary-pancreatic surgery (HBPS), remains insufficiently studied. In this study, we defined PPLOS as a PLOS exceeding the 75th percentile of the cohort and aimed to identify perioperative predictors of PPLOS following highly advanced HBPS.</p><p><strong>Methods: </strong>This single-center retrospective study included 737 patients who underwent highly advanced HBPS at Gifu University Hospital, Japan, between January 2010 and December 2023. Perioperative predictive factors associated with PPLOS were analyzed in patients with severe postoperative complications within 30 days of surgery (n = 181; Clavien-Dindo classification grades III or IV) using univariate and multivariate analyses.</p><p><strong>Results: </strong>Among the included patients, 45 experienced PPLOS, with the 75th percentile of PLOS being 53 days. Univariate analysis identified intra-abdominal abscess, pancreatic fistula, postoperative bleeding, hepatic failure, unplanned intubation, C-reactive protein to albumin ratio (CAR) on postoperative day (POD)3, and neutrophil to lymphocyte ratio (NLR) on POD3 as significantly correlated with PPLOS. Multivariate analysis revealed that CAR on POD3 > 5.0 was the only independent predictor for PPLOS (odds ratio, 3.22; 95% confidence interval, 1.11-10.17; p = 0.03).</p><p><strong>Conclusions: </strong>PLOS was significantly prolonged in patients undergoing highly advanced HBPS who developed severe postoperative complications, regardless of surgery type (hepatobiliary or pancreatic). Among these patients, an elevated CAR on POD3 emerged as an early independent predictor of PPLOS. These findings highlight the significance of early postoperative monitoring and intervention based on CAR to reduce the risk of PPLOS following highly advanced HBPS and thus, minimize severity of postoperative complications.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"387"},"PeriodicalIF":1.8,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial splenectomy and pericardial devascularization for symptomatic patients with portal hypertension: a single-center retrospective study.","authors":"Ying Zhang, Shengzhi Wang, Jinghui Yang, Jinxiang Bu, Feng Liang","doi":"10.1186/s12893-025-03091-5","DOIUrl":"https://doi.org/10.1186/s12893-025-03091-5","url":null,"abstract":"<p><strong>Background: </strong>The dilemma of current treatments for symptomatic patients with portal hypertension is how to resolve the problems of the varices and hypersplenism simultaneously and meanwhile preserve the splenic function. Partial splenectomy and pericardial devascularization is a potential alternative to currently used approaches, but it is incompletely defined. This study aimed to evaluate the efficacy and safety of partial splenectomy and pericardial devascularization.</p><p><strong>Methods: </strong>This study followed 132 symptomatic patients with portal hypertension who underwent partial splenectomy and pericardial devascularization in the General Surgery Department of the Fifth Medical Center of PLA General Hospital from 2016 to 2023. Clinical, laboratory, endoscopic examination and imaging data were collected and compared between preoperative and postoperative levels at intervals using a mixed linear model.</p><p><strong>Results: </strong>All 132 patients with portal hypertension successfully underwent partial splenectomy and pericardial devascularization without intraoperative uncontrolled massive bleeding or death. Leucocyte and platelet counts increased to normal levels at intervals from 1 year to ≥ 4 years postoperatively. Among the patients followed for six months postoperatively, 23 (52.27%) showed improvement in esophagogastric varices, 19 (43.18%) had no significant changes in their condition, and 2 (4.55%) experienced worsening of the varices. At subsequent follow-ups, the majority of patients either showed improvements or no change in their esophagogastric varices, with only a small fraction experiencing worsening of the condition. The splenic remnant survived in most patients, and regrowth was very limited postoperatively, while 13 (9.85%) patients splenic remnant necrosis during follow-up. Liver failure was observed in 5 (3.79%) patients postoperatively, and 3 (2.27%) of them died perioperatively. Portal vein thrombosis was found in 90 (75%) patients the 7th days after surgery. With the progression of follow-up time, the proportion of patients with postoperative portal vein system thrombosis decreased over time. 3 (2.27%) patients experienced postoperative abdominal bleeding, which improved after emergency surgery for hemostasis.</p><p><strong>Conclusions: </strong>Partial Splenectomy and Pericardial Devascularization appears to be a safe and effective approach to treat symptomatic patients with Portal Hypertension, while preserving the potential function of the spleen.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"388"},"PeriodicalIF":1.8,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative clinical outcome study of power-assisted vs. manually-operated circular staplers for deep colorectal anastomosis.","authors":"Tarik Mahdjoub, Nicolas Michot, Elias Karam, Martine Le Verger, Urs Giger-Pabst, Mehdi Ouaïssi","doi":"10.1186/s12893-025-03139-6","DOIUrl":"https://doi.org/10.1186/s12893-025-03139-6","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study is to compare the perioperative clinical outcomes between power-assisted circular staplers (PCS) and manually-operated circular staplers (MCS) with directional stapling technology (DST) for deep colorectal anastomoses.</p><p><strong>Materials and methods: </strong>A retrospective analysis of a prospective database of 64 consecutive patients who underwent elective surgery for low colorectal anastomosis (< 7 cm from the anal verge) between February 2020 and December 2022 at a tertiary referral center for colorectal surgery at the University Hospital of Tours, France. Patients were divided into two groups according to the stapler used: PCS group II; (n = 35) and MCS (group I; n = 29). Data collected included demographic characteristics, intraoperative parameters, postoperative complications (Dindo-Clavien), and oncological outcomes.</p><p><strong>Results: </strong>The PCS group had significantly lower overall rates of postoperative complications compared to the MCS group (31.4% vs. 62%, p = 0.022). In particular, anastomotic bleeding (AB) was less frequent in the PCS group (0% vs. 17.2%, p = 0.015). While no significant differences in recurrence or survival events were observed between groups during follow-up, the PCS group demonstrated a lower incidence of symptomatic anastomotic leaks (8.6% vs.13.6%, p = 0.069) and postoperative ileus (0% vs. 20.7%, p = 0.025).</p><p><strong>Conclusion: </strong>In our study, the use of PCS for deep rectal anastomosis was associated with a significantly lower overall postoperative complication rate, rate of symptomatic anastomotic leackage (AL) and AB. Our data support the potential preferential use of PCS in clinical practice. However, larger prospective randomized trials should be conducted to further investigate the potential clinical benefits and cost-effectiveness of using PCS in selected patient populations.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"383"},"PeriodicalIF":1.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of augmented reality technology assisted by 3D-CT reconstruction in microvascular decompression for hemifacial spasm craniotomy.","authors":"Hailiang Shi, Kuo Zhang, Yang Li, Haowei Shi, Xiaolong Wen, Tao Qian","doi":"10.1186/s12893-025-03026-0","DOIUrl":"https://doi.org/10.1186/s12893-025-03026-0","url":null,"abstract":"<p><strong>Background: </strong>We aimed to assess the efficacy of augmented reality technology assisted by three-dimensional (3D) computed tomography (CT) reconstruction, in facilitating microvascular decompression (MVD) during craniotomy for hemifacial spasm.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 80 patients who underwent MVD for hemifacial spasm at Hebei General Hospital between January 2, 2020, and March 24, 2021. Among them, 43 patients received traditional craniotomy (assigned to the traditional group), while 37 patients underwent modified craniotomy (assigned to the modified group). The distinctive feature in the modified group involved employing 3D-CT reconstruction assisted by augmented reality technology, specifically utilizing Sina software, for precise localization of scalp incision. The impact of the modified method on surgery was assessed based on operation time, incision length, postoperative complications, long-term efficacy, and patient-reported outcomes.</p><p><strong>Results: </strong>No significant differences in age, sex, disease duration, and disease side were observed between the two groups (P > 0.05). The modified group exhibited a significantly shorter average craniotomy time (29.68 ± 4.89 min vs. 34.19 ± 4.55 min, P < 0.001) and time to close the skull (25.22 ± 3.12 min vs. 28.95 ± 2.54 min, P < 0.001) compared to the traditional group. Additionally, the incision length in the modified group (59.69 ± 10.71 mm) was evidently lower than that in the traditional group (70.84 ± 11.27 mm, P < 0.001). The overall rate of any postoperative complication was significantly lower in the modified group (5.4%) compared to the traditional group (23.3%; P = 0.018). While overall immediate postoperative complication rates were not statistically different, the modified group showed a trend towards fewer complications, particularly no CSF leakage. At 1-year follow-up, the modified group had a lower spasm recurrence rate (2.7% vs. 7.0%, P = 0.348), significantly lower postoperative pain scores at 7 days (VAS: 2.8 ± 0.9 vs. 3.6 ± 1.1, P = 0.002), and higher patient satisfaction (94.6% vs. 86.0%, P = 0.184).</p><p><strong>Conclusion: </strong>Employing 3D-CT reconstruction assisted by augmented reality technology in MVD for hemifacial spasm significantly improves surgical efficiency, is associated with favorable long-term outcomes, and enhances patient-reported satisfaction, suggesting its potential value for clinical application and potentially contributing to enhanced safety, particularly in reducing specific complications like CSF leakage.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"382"},"PeriodicalIF":1.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study of modified midline lumbar interbody fusion and modified transforaminal lumbar interbody fusion for the treatment of single-level lumbar degenerative diseases.","authors":"Yuanpeng Yue, Yihui Liu, Ce Dong, Zhenyu Wang","doi":"10.1186/s12893-025-03100-7","DOIUrl":"https://doi.org/10.1186/s12893-025-03100-7","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and efficacy of modified cortical bone trajectory (MCBT) screw combined with transarticular screw (TASS) fixation (MCBT-TASS) in modified midline lumbar interbody fusion (M-MIDLIF) for single-level lumbar degenerative disease (LDD).</p><p><strong>Methods: </strong>We retrospectively included 104 patients with L4-5 or L5-S1 single-segment LDD who had indications for decompression, fusion, and internal fixation surgery from 2019 to 2022. They were subsequently divided into M-MIDLIF and modified transforaminal lumbar interbody fusion (M-TLIF) groups according to the surgical approach. Basic demographic, surgical, and radiological data, as well as clinical outcomes (Oswestry Disability Index (ODI) and visual analog scale (VAS) scores), were collected.</p><p><strong>Results: </strong>Basic demographic data, fusion rates, postoperative hospital stays, and follow-up times did not significantly differ between the two groups. Compared with those in the M-TLIF group, the intraoperative blood loss (68.57 ± 14.84 mL) and postoperative drainage volume (33.93 ± 9.17 mL) in the M-MIDLIF group were lower (intraoperative blood loss: 171.79 ± 12.78 mL, p < 0.05; postoperative drainage volume: 65.36 ± 10.36, p < 0.05). In the M-MIDLIF group, there was no significant difference in the radiographic recognizable rate (91.07%) or intraoperative visual recognizable rate (87.50%) of internal inverted chevron-shaped (V-shaped) crests. The optimal position screw rates for the MCBT, TASS, and traditional pedicle screw (TPS) methods were 94.64%, 94.64%, and 87.5%, respectively, and the differences were not significant. MCBT technology preserved the integrity of the posterior ligamentous complex (PLC) in 92.85% of patients in the M-MIDLIF group. The facet joint violation (FJV) rate of MCBT screws (3.57%) was lower than that of TPS screws (14.29%). Compared with the M-TLIF group, the M-MIDLIF group presented greater reductions in the ODI and VAS scores for both low back and leg pain at 1 week postoperatively (P < 0.05). However, no statistically significant differences in these scores were observed between the two groups at later time points (p > 0.05).</p><p><strong>Conclusion: </strong>M-MIDLIF can achieve decompression, fixation, and fusion via a median incision while preserving the integrity of the posterior ligamentous complex. In the treatment of single-level lumbar degenerative disease, M-MIDLIF has comparatively enhanced minimally invasive advantages over M-TLIF during the perioperative period while maintaining non-inferior clinical safety and efficacy relative to M-TLIF.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"384"},"PeriodicalIF":1.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of small vestibular schwannomas using microscopic with endoscopic surgery: a single-center retrospective analysis.","authors":"Peng Zhou, Jiandong Zhu, Liang Sun, Jinxin Lu, Chengyuan Ji, Zhengquan Yu, Jiang Wu, Jiyuan Bu","doi":"10.1186/s12893-025-03138-7","DOIUrl":"https://doi.org/10.1186/s12893-025-03138-7","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to retrospectively analyze the clinical data of 24 patients with small vestibular schwannomas, explore the surgical outcomes, and summarize the surgical experience.</p><p><strong>Methods: </strong>Patients with small vestibular schwannomas who underwent surgery between January 2019 and December 2022 at the Department of Neurosurgery of the First Affiliated Hospital of Soochow University were included. Clinical data from all patients were collected and analyzed.</p><p><strong>Results: </strong>Total tumor resection was achieved in all patients. Microscopic surgery alone was sufficient for complete resection in 7 patients, while the remaining 17 patients required combined microscopic and endoscopic approaches for complete removal. At the final follow-up, 16 patients maintained preoperative facial nerve function, 6 patients experienced improvement, while 2 patients experienced deterioration. And there were 13 patients maintained preoperative hearing function, 9 patients experienced improvement, while 2 patients experienced deterioration. Compared with microscopic resection alone, there was no significant difference in the Facial nerve function and Hearing function of patients underwent microscopic and endoscopic resection. During the follow-up period, all patients showed favorable prognosis without disease progression.</p><p><strong>Conclusions: </strong>Compared with microscopic surgery, the microscopic with endoscopic surgery for small vestibular schwannomas lead to the better results in the degree of tumor resection, with no difference in functional protection.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"379"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}