Neurocirugia最新文献

{"title":"Relationship between optic nerve length and interoptic angle in the prediction of optic chiasm location","authors":"Reyhan Kasab ,&nbsp;Selcuk Yilmazlar ,&nbsp;Oguz Altunyuva ,&nbsp;Recep Fedakar","doi":"10.1016/j.neucir.2024.09.003","DOIUrl":"10.1016/j.neucir.2024.09.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The sellar region is an area in the base of the skull that is among the most common sites for tumors of the central nervous system. Surgical interventions are currently performed via different routes. While the optic chiasm occupies its expected position in 70% of the population, it can deviate from this position. In such cases, surgery involving this region becomes more difficult as the known surgical routes are narrowed. Advance awareness of these variations can help surgeons to identify the optimal route for safe surgical intervention in the sellar region. By performing simple measurements of both the lengths of the optic nerves and the angle between them, a surgeon can predict the location of the chiasm.</div></div><div><h3>Materials and methods</h3><div>Twenty specimens collected from autopsies performed at Bursa Forensic Medicine İnstitute were examined to determine the optic chiasm types and the relationships between the surrounding subchiasmal structures.</div></div><div><h3>Results</h3><div>Among the 20 specimens, we found two prefixed (10%), 10 normo-fixed (50%), and eight postfixed chiasms (40%). The mean interoptic angle was 81.03 (±17.41)⁰. Prefixed chiasms had angles in the range 115.36°–124.76 ° (mean 120.06 [±6.65]⁰), normo-fixed chiasm angles were between 83.11° and 97.53 ° (mean 86.07 [±6.73]⁰), and postfixed chiasms ranged between 53.01 ° and 78.71 ° (mean 69.20 [±9.13]⁰). The length of the right optic nerve ranged between 6.95 and 13.83 mm (mean 10.25 [±1.81] mm), and the length of the left between 7.25 and 12.51 mm (mean 10.40 [±1.47] mm). Obtuse angles indicated that the chiasm was prefixed, and acute angles were indicative of a postfixed chiasm. There was a strong negative correlation between optic nerve lengths and the interoptic angle; thus, as the length of the nerves increases, the interoptic angle becomes more acute.</div></div><div><h3>Conclusions</h3><div>We have proposed a simple measurement of the optic nerve lengths and the angle between them to predict the relative location of the OC, which can be done easily on MRI.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 1","pages":"Pages 39-46"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisión de los fracasos terapéuticos de la descompresión microvascular en la neuralgia del trigémino en un hospital terciario","authors":"Emilio González Martínez,&nbsp;Giancarlo Mattos-Piaggio,&nbsp;David Santamarta Gómez","doi":"10.1016/j.neucir.2024.09.005","DOIUrl":"10.1016/j.neucir.2024.09.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Microvascular decompression (MVD) is a non-ablative technique aimed at relieving pain in trigeminal neuralgia (TN) by resolving a neurovascular conflict. Despite reported high success rates, a significant percentage of patients experience therapeutic failure.</div></div><div><h3>Methods</h3><div>Retrospective observational study of patients with suspected TN undergoing MVD was performed with the goal of identifying factors contributing to the persistence and recurrence of pain.</div></div><div><h3>Results</h3><div>In the present study, 31 patients undergoing 38 MVD procedures for TN were included (7 patients underwent reoperation after the failure of the initial operation). The mean age was 58.5 years with a male predominance (58.1%). The mean duration of pain was 6.4 years, mainly affecting branches V2 and V3 (46.7%). The most frequently described neurovascular conflict was with the superior cerebellar artery (54.8%), predominantly resolved with Teflon (75.9%).</div><div>In our case series, MVD achieved pain control in 80.6% of patients at one-year post-intervention and 61.3% at the end of the follow-up period. Twelve patients experienced MVD failure: 5 cases of persistent pain and 7 cases of pain recurrence. A detailed analysis of these failures identified misdiagnosis as the reason of persistent pain in 4 patients, while inadequate surgical technique could be the cause of pain recurrence in 6 patients.</div></div><div><h3>Conclusion</h3><div>In our study, therapeutic failures could mainly be attributed to two factors: misdiagnosis or the use of inappropriate materials. These factors should be considered when optimizing the management of DMV in patients with NT.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 1","pages":"Pages 47-53"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuestra experiencia en la cirugía de lesiones petroclivales mediante un abordaje transmaxilar contralateral","authors":"Juan Ramón Gras-Cabrerizo ,&nbsp;Maria Casasayas-Plass ,&nbsp;Katarzyna Kolanczak ,&nbsp;Fernando Muñoz Hernández ,&nbsp;María Martel Martin ,&nbsp;Esther Granell Moreno","doi":"10.1016/j.neucir.2024.10.009","DOIUrl":"10.1016/j.neucir.2024.10.009","url":null,"abstract":"<div><div>Petroclival lesions represent a surgical challenge during the endonasal endoscopic approach, as they may involve maneuvers with severe comorbidity. To avoid the morbidity caused by these maneuvers, a contralateral transmaxillary approach (CTA) has been proposed to complement the endoscopic endonasal approach. The aim of our study is to review the safety and efficacy of this approach.</div><div>We included three patients with lesions affecting the petroclival region, one cholesterol granuloma and two macroadenomas, who were surgically treated with a combined ipsilateral transpterygoid approach and a CTA. The latter was performed by wide osteotomy on the anterior wall of the maxillary sinus through a gingivolabial incision.</div><div>Complete resection was achieved in the patient with a cholesterol granuloma and subtotal resection in the two patients diagnosed with macroadenoma. One patient presented ecchymosis of the malar area as the only complication.</div><div>The contralateral transmaxillary approach may improve exposure and dissection of the petroclival area compared to the homolateral endoscopic endonasal approach allowing reaching the most lateral and posterior region of this territory without the need to manipulate the internal carotid artery.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 1","pages":"Pages 54-58"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular treatment of chronic subdural hematoma in a dual-trained neurosurgical unit: Results and proposal of a randomized controlled trial protocol","authors":"Sergio García García ,&nbsp;Ignacio Arrese Regañón ,&nbsp;Santiago Cepeda Chafla ,&nbsp;Rosario Sarabia Herrero","doi":"10.1016/j.neucir.2024.07.008","DOIUrl":"10.1016/j.neucir.2024.07.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic subdural hematoma (cSDH) is a prevalent neurosurgical condition with an increasing incidence due to the rising life expectancy and the widespread use of anticoagulant and antiplatelet therapies. Insights into the inflammatory origins of cSDH led to the exploration of Middle Meningeal Artery (MMA) embolization as a therapeutic strategy. In recent years the endovascular treatment of MMA has gained momentum. Herein we present the initial experience of a dual trained neurovascular unit implementing this therapeutic technique.</div></div><div><h3>Methods</h3><div>This single-center, prospective pilot study aimed to evaluate the feasibility, safety, and efficacy of MMA embolization in the treatment of cSDH. Following ethical approval and informed consent, demographic, clinical, and radiological data were collected. Patients requiring emergent surgical treatment were excluded. The study focused on assessing clinical outcomes, including the Modified Rankin Score (mRS) and volumetric analysis of cSDH, before and after embolization.</div></div><div><h3>Results</h3><div>Fifteen patients underwent MMA embolization, with a predominance of males (80%) and a mean age of 72.4 years. The most common presenting symptom was headache (53.3%). The average hospital stay was 3.9 days. Various embolization techniques were employed, with DMSO-EVOH being the most frequent. All procedures were successfully conducted without complications. Although not statistically significant, trends suggested better outcomes in patients with homogeneous cSDH on the CT scan, displaying the cotton wool sign on angiography and treated with EVOH-DMSO.</div></div><div><h3>Conclusion</h3><div>MMA embolization for cSDH demonstrates promise as a safe and effective treatment, potentially reducing the need for surgical intervention and recurrence rates. This study lays the groundwork for a larger, randomized controlled trial which protocol is herein presented.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 1","pages":"Pages 28-38"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propuesta de un listado de verificación quirúrgica complementario para la cirugía de columna vertebral","authors":"Antonio José Vargas López ,&nbsp;Gador Ramos Bosquet ,&nbsp;Carlos Fernández Carballal","doi":"10.1016/j.neucir.2024.07.002","DOIUrl":"10.1016/j.neucir.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Once the World Health Organization (WHO) generic surgical checklist has been standardized and following the itinerary proposed, it is up to the different specialties to continue advancing in the improvement and adjustment of the checklists to their specific procedures.</div></div><div><h3>Methods</h3><div>Through a Failure Mode and Effects Analysis (FMEA), in which professionals from the surgical area of the Torrecárdenas University Hospital, Jaén Hospital Complex and Gregorio Marañón General University Hospital participated, aspects that threaten patient safety in spine surgery and that are not included in the WHO generic surgical checklist were proposed. The authors scored each of the proposed items incrementally based on the degree of suitability. Based on the score obtained, they selected those which would be incorporated into the specific safety checklist.</div></div><div><h3>Results</h3><div>A total of 21 candidate items were proposed to be part of the specific check list. These obtained scores between 15 and 11 points. After scoring them, it was decided to include the 13 best rated in the definitive surgical checklist, 7 of them in the initial phase, 2 in the phase prior to the incision and another 4 in the final part of the checklist prior to the completion of the procedure.</div></div><div><h3>Conclusions</h3><div>Professionals in the surgical area of Neurosurgery can identify aspects not included in the generic checklist whose non-compliance can affect patient safety in spine surgery to at least the same extent as those included in WHO checklist.</div><div>It is possible to propose a specific complementary checklist for spinal surgery, responsible for collecting aspects related to safety and success in these procedures.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 1","pages":"Pages 1-7"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuronavegación electromagnética en neuroendoscopia. Protocolo de navegación para el ventriculoscopio LOTTA. Nota técnica","authors":"Mario Gomar-Alba ,&nbsp;José Javier Guil-Ibáñez ,&nbsp;Fernando García-Pérez ,&nbsp;María José Castelló-Ruíz ,&nbsp;Leandro Saucedo ,&nbsp;Antonio José Vargas-López ,&nbsp;José Masegosa-González","doi":"10.1016/j.neucir.2024.07.007","DOIUrl":"10.1016/j.neucir.2024.07.007","url":null,"abstract":"<div><h3>Background and objective</h3><div>Neuronavigation in ventriculoscopy has been described in several papers. However, there are different ventriculoscopes and navigation systems. Because of these different combinations, it is difficult to find detailed navigation protocols for each ventriculoscope. We describe, step by step, a simple method to navigate both the trajectory to reach the ventricular system and the intraventricular work for the LOTTA ventriculoscope.</div></div><div><h3>Material and methods</h3><div>We used a rigid ventriculoscope (LOTTA, KarlStorz) with an electromagnetic stylet (S8-StealthSystem, Medtronic) as the main navigation tool. The protocol is based on a 3D printed trocar or alternatively, on a modification of the original trocar for extraventricular phase navigation and a modified pediatric nasogastric tube for intraventricular phase navigation.</div></div><div><h3>Results</h3><div>The protocol can be set up in less than 10<!--> <!-->minutes. The extraventricular part is navigated by inserting the electromagnetic stylet inside the 3D printed trocar or inside the original modified trocar. Intraventricular navigation is performed by combining a modified pediatric nasogastric tube with the electromagnetic stylet inside the working channel of the endoscope. The most critical point is to obtain a blunt, bloodless approach to the ventricle and to achieve perfect alignment of all target structures by means of previously planned pure straight trajectories.</div></div><div><h3>Conclusions</h3><div>This protocol is easy to set up, avoids rigid head fixation, bulky optical navigation accessories, while allows continuous navigation of both parts of the surgery. Since we have implemented this protocol, we have seen a significant improvement in both simple and complex neuroendoscopy procedures as the surgery is dramatically simplified.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 1","pages":"Pages 17-27"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propuesta de un listado de verificación quirúrgica complementario para la cirugía de los tumores cerebrales","authors":"Antonio José Vargas López ,&nbsp;Gador Ramos Bosquet ,&nbsp;Carlos Fernández Carballal","doi":"10.1016/j.neucir.2024.07.006","DOIUrl":"10.1016/j.neucir.2024.07.006","url":null,"abstract":"<div><h3>Background and objective</h3><div>Once the WHO generic surgical checklist has been standardized and following the itinerary proposed, it is up to the different specialties to continue advancing in the improvement and adjustment of the checklists to the procedures and interventions in their field.</div></div><div><h3>Methods</h3><div>Through a Failure Mode and Effects Analysis (FMEA) in which professionals from the surgical area of the Torrecárdenas University Hospital, Jaén Hospital Complex and Gregorio Marañón General University Hospital participated, aspects that could condition patient safety in the surgery of the brain tumors and that are not included in the WHO generic surgical checklist were recognized. The three authors gave a score between 1 and 5 to each of the proposed items incrementally depending on the degree of suitability. Based on the score obtained, they selected those who would be incorporated into the specific surgical checklist.</div></div><div><h3>Results</h3><div>A total of 24 candidate items were identified to be included in the specific check list. These obtained scores between 14 and 10 points. After this weighting, it was decided to include the 12 best-rated items in the final surgical checklist, six of them in the initial phase, three in the phase prior to the incision and another three in the final part of the checklist prior to the completion of the procedure.</div></div><div><h3>Conclusions</h3><div>Professionals in the surgical area of Neurosurgery can identify aspects not included in the generic checklist whose non-compliance can condition the patient's safety at least to the same extent as those included in the generic list.</div><div>It is possible to propose a specific complementary checklist for brain tumor surgery, in charge of collecting aspects related to the safety and success of these procedures.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 1","pages":"Pages 8-16"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic normal pressure hydrocephalus: A critical analysis of its underrepresentation across Italian medical-scientific societies in the last 5 years","authors":"Gianpaolo Petrella ,&nbsp;Giuseppe Demichele ,&nbsp;Daniele Armocida ,&nbsp;Graziano Taddei ,&nbsp;Alessandro Frati ,&nbsp;Angelo Pompucci ,&nbsp;Alessandro Pesce","doi":"10.1016/j.neucir.2024.10.011","DOIUrl":"10.1016/j.neucir.2024.10.011","url":null,"abstract":"<div><h3>Background</h3><div>The scientific debate concerning clinical, translational and surgical aspects of iNPH could still be limited in respect to the incidence of this condition. The aim of this paper is to systematically assess the extent of the debate on INPH in the context of the congresses of the relevant medical and scientific societies in our Country.</div></div><div><h3>Methods</h3><div>We thoroughly examined the websites and scientific programs of 12 leading scientific societies linked to medical specialities involved in diagnosis and management of INPH, among which the neurological, neurosurgical, neurophysiological, rehabilitation medicine and urologic societies. The amount of time (in hours) was examined in a time span of events which took place between 2019 and 2023.</div></div><div><h3>Results</h3><div>Notably, across 4 years (2019–2023), a total of 7 out of 12 (58.3%) of the aforementioned leading scientific societies dedicated a total of zero minutes to the topic “iNPH”, two further societies hosted talks for a total of less than one hours concerning such condition. The amount of time dedicated to giant intracranial aneurysms and vestibular schwannomas was in respect to the incidence of the conditions, significantly longer than the time spent debating on iNPH.</div></div><div><h3>Conclusions</h3><div>The results demonstrates that in our country, despite the high and increasing incidence of INPH, the awareness raised on the topic could still be limited, especially compared to other, significantly rarer intracranial conditions such as giant intracranial aneurysms and vestibular schwannomas.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 1","pages":"Pages 59-68"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor fibroso solitario gigante del surco olfatorio. Un simulador inusual en una localización inusual","authors":"Fernando García Pérez ,&nbsp;Ascensión Contreras Jiménez ,&nbsp;Beatriz Agredano Ávila ,&nbsp;José Masegosa González","doi":"10.1016/j.neucir.2024.07.001","DOIUrl":"10.1016/j.neucir.2024.07.001","url":null,"abstract":"<div><div>Solitary fibrous tumors are rare mesenchymal neoplasms that can develop in any part of the body, with those that settle intracranially being confused with meningiomas as a general rule. We present the case of a 57-year-old man referred to our hospital due to bifrontal headache, anosmia, and behavioral alterations of 6 months’ duration. Radiological studies revealed the existence of a large tumor mass with an extra-axial appearance and location in the anterior cranial fossa, initially compatible with a giant meningioma of the olfactory groove. Gross total resection of the mass was carried out. The pathological diagnosis was unexpected: a solitary fibrous tumor (WHO grade 1, 2021). Given the aggressive nature of these lesions, with a tendency to recurrence, malignant transformation and even metastasis, surgery with macroscopically complete resection intention should constitute the first therapeutic option. Close clinical-radiological follow-up after the procedure is justified.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 6","pages":"Pages 323-328"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective method of pedicle screw fixation in patients with neurologically intact thoracolumbar burst fractures: a systematic review of studies published over the last 20 years","authors":"Andrey Grin,&nbsp;Vasiliy Karanadze,&nbsp;Ivan Lvov,&nbsp;Anton Kordonskiy,&nbsp;Aleksandr Talypov,&nbsp;Vladimir Smirnov,&nbsp;Petr Zakharov","doi":"10.1016/j.neucir.2024.07.005","DOIUrl":"10.1016/j.neucir.2024.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>To conduct a systematic review of studies on various posterior pedicle screw fixation (PSF) methods used for treating neurologically intact thoracolumbar burst fractures and to identify the most effective and safe approaches.</div></div><div><h3>Methods</h3><div>We conducted a systematic review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with the study registered in PROSPERO (CRD42024531093). The inclusion criteria were: (1) publication dates from January 1, 2004, to December 31, 2023; (2) availability of full-text articles in English; (3) thoracolumbar burst fractures without neurological deficits; (4) patients aged over 18; (5) reports on treatment outcomes or complications; (6) a mean follow-up period of at least 12 months.</div></div><div><h3>Results</h3><div>A total of 69 articles covering 116 patient groups were included. Our analysis highlighted the advantages of short-segment fixation without fusion over monosegmental, short-segment and long-segment fusion in terms of shorter operation times and reduced intraoperative blood loss (p = 0.001 and p &lt; 0.001, respectively). Extensive fusion was associated with a significantly higher frequency of deep surgical site infections compared to other PSF methods (p = 0.043). Percutaneous pedicle screw fixation, applied to patients with lower body compression rates and kyphotic deformities, led to less potential for correction (p = 0.004), yet significantly decreased blood loss (p = 0.011), operation duration (p &lt; 0.0001), and hospitalization duration (p &lt; 0.0001). No significant benefits were observed with the use of additional intermediate screws in short-segment PSF.</div></div><div><h3>Conclusions</h3><div>Short-segment pedicle screw fixation could be the optimal surgical treatment method for neurologically intact thoracolumbar burst fractures. The use of posterior lateral fusion in this context may increase the deep surgical site infection rate without reducing the frequency of implant-related complications or improving long-term treatment outcomes. The percutaneous approach remains the preferred technique; however, its limited reduction capabilities should be carefully considered during surgical planning for patients with severe kyphotic deformities. The application of intermediate screws in such patients has not demonstrated significant advantages. Removing the fixation system has not led to a significant decrease in implant-related complications or improvement in quality of life. The data obtained from the systematic review may assist surgeons in selecting the most appropriate surgical treatment method for patients with neurologically intact thoracolumbar burst fractures, thereby avoiding ineffective procedures and improving both short-term and long-term outcomes.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 6","pages":"Pages 299-310"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}