Brain & spine最新文献

{"title":"The current state of cranioplasty in Europe – Results from a European cranioplasty survey","authors":"Paul Vincent Naser ,&nbsp;Parmenion Tsitsopoulos ,&nbsp;Friederike Zacharias ,&nbsp;Ana M. Castaño-Leon ,&nbsp;Andras Buki ,&nbsp;Bart Depreitere ,&nbsp;Thomas Van Essen ,&nbsp;Tommi K. Korhonen ,&nbsp;Harry Mee ,&nbsp;Iftakher Hossain ,&nbsp;Jussi Posti ,&nbsp;Laura Lippa ,&nbsp;Marios C. Papadopoulos ,&nbsp;Nicole Terpolilli ,&nbsp;Niklas Marklund ,&nbsp;Ondra Petr ,&nbsp;Peter Toth ,&nbsp;Teemu Luoto ,&nbsp;Sandro M. Krieg ,&nbsp;Andreas W. Unterberg ,&nbsp;Christos Tsitsipanis","doi":"10.1016/j.bas.2025.104214","DOIUrl":"10.1016/j.bas.2025.104214","url":null,"abstract":"<div><h3>Introduction</h3><div>Cranioplasty, a surgical procedure to restore skull integrity and aesthetic contour following decompressive craniectomy, poses challenges in material selection and timing, driven by the lack of guidelines and ongoing regulatory changes.</div></div><div><h3>Research question</h3><div>This study aimed to provide an overview of current cranioplasty practices in Europe, explicitly addressing a potential shift towards alloplastic materials and the management of patients with concomitant hydrocephalus.</div></div><div><h3>Material and methods</h3><div>An online survey was conducted among European neurosurgical centers from January to March 2024, collecting data on material preferences, timing of procedures, and management strategies for cranioplasty. Descriptive and statistical analyses were performed on 110 complete responses.</div></div><div><h3>Results</h3><div>Respondents favored alloplastic materials over autologous bone for cranioplasty, citing regulatory constraints and reduced infection risk as primary reasons. Variability was observed in the timing of procedures and the management of patients with hydrocephalus, with most centers adopting staged approaches.</div></div><div><h3>Discussion and conclusion</h3><div>The shift towards alloplastic materials in cranioplasty reflects regulatory pressures rather than material-specific considerations. Despite variability in practice, our findings underscore the need for standardized guidelines and further research to optimize patient outcomes. This study provides valuable insights into current practices and highlights areas for future investigation in cranioplasty.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104214"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the adoption of innovation in spine surgery: An international survey of AO spine network","authors":"Arun Kumar Viswanadha ,&nbsp;Luca Ambrosio ,&nbsp;Pieter-Paul A. Vergroesen ,&nbsp;Zorica Buser ,&nbsp;Hans Joerg Meisel ,&nbsp;Nancy Santesso ,&nbsp;Jason P.Y. Cheung ,&nbsp;Yabin Wu ,&nbsp;Hai V. Le ,&nbsp;Gianluca Vadalà ,&nbsp;Amit Jain ,&nbsp;Andreas K. Demetriades ,&nbsp;Sam K. Cho ,&nbsp;Patrick C. Hsieh ,&nbsp;Ashish Diwan ,&nbsp;Tim Yoon ,&nbsp;Sathish Muthu ,&nbsp;AO Spine Knowledge Forum Degenerative","doi":"10.1016/j.bas.2025.104206","DOIUrl":"10.1016/j.bas.2025.104206","url":null,"abstract":"<div><h3>Introduction</h3><div>Knowledge translation from research to clinical practice can often be challenging, and practice modification patterns among surgeons may stem from a variety of sources, including personal experience, peer influence, ongoing education, and evolving research findings.</div></div><div><h3>Research question</h3><div>This study aimed to investigate the adoption patterns amongst surgeons for newer innovations and to analyse the factors affecting the implementation of the same in clinical practice. We used the adoption of osteobiologics as a case example.</div></div><div><h3>Methods</h3><div>An international expert survey was conducted among AO Spine users and members. The survey, comprising 30 items, explored surgeons' demographics, risk aversion, and factors influencing practice change. We categorized the innovation-adoptive nature of the surgeons and scored their risk-adoptive behaviour.</div></div><div><h3>Results</h3><div>A total of 458 responses were received from surgeons across 81 countries including 433 male (95%), orthopaedic surgeons (n = 263; 57%) from university-affiliated hospitals (n = 185; 40%). Most were in the early majority phase of the innovation-adoption cycle (n = 174; 38%) with a majority in the ‘high-moderate’ risk-adoption category (n = 396; 86%). This risk adoption behaviour had a significant correlation with their appetite for innovation (r = 0.182,p=&lt;0.001). About 67.9% of respondents preferred scientific literature and conference presentations showcasing solid clinical evidence to be the most influential factor in driving change in their clinical practice. Material logistics (55%) is considered an important barrier to practice modification followed by familiarity (50%) and financial reimbursements (25%).</div></div><div><h3>Discussion &amp; conclusion</h3><div>A complex interplay exists between risk-adoptive behaviour amongst surgeons and the factors influencing a change in their clinical practice. Although most surgeons were in the early adoptive phase in accepting the innovations into their clinical practice, they were also equally noted to be risk tolerant. Hence, a successful adoption of practice-changing innovation hinges on addressing not only logistical and financial challenges but also on providing robust scientific evidence to drive the necessary change in clinical practice.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104206"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic and prognostic capability of artificial intelligence in spinal cord injury: A systematic review","authors":"Saran Singh Gill ,&nbsp;Hariharan Subbiah Ponniah ,&nbsp;Sho Giersztein ,&nbsp;Rishi Miriyala Anantharaj ,&nbsp;Srikar Reddy Namireddy ,&nbsp;Joshua Killilea ,&nbsp;DanieleS.C. Ramsay ,&nbsp;Ahmed Salih ,&nbsp;Ahkash Thavarajasingam ,&nbsp;Daniel Scurtu ,&nbsp;Dragan Jankovic ,&nbsp;Salvatore Russo ,&nbsp;Andreas Kramer ,&nbsp;Santhosh G. Thavarajasingam","doi":"10.1016/j.bas.2025.104208","DOIUrl":"10.1016/j.bas.2025.104208","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) models have shown potential for diagnosing and prognosticating traumatic spinal cord injury (tSCI), but their clinical utility remains uncertain.</div></div><div><h3>Method</h3><div>ology: The primary aim was to evaluate the performance of AI algorithms in diagnosing and prognosticating tSCI. Subsequent systematic searching of seven databases identified studies evaluating AI models. PROBAST and TRIPOD tools were used to assess the quality and reporting of included studies (PROSPERO: CRD42023464722). Fourteen studies, comprising 20 models and 280,817 pooled imaging datasets, were included. Analysis was conducted in line with the SWiM guidelines.</div></div><div><h3>Results</h3><div>For prognostication, 11 studies predicted outcomes including AIS improvement (30%), mortality and ambulatory ability (20% each), and discharge or length of stay (10%). The mean AUC was 0.770 (range: 0.682–0.902), indicating moderate predictive performance. Diagnostic models utilising DTI, CT, and T2-weighted MRI with CNN-based segmentation achieved a weighted mean accuracy of 0.898 (range: 0.813–0.938), outperforming prognostic models.</div></div><div><h3>Conclusion</h3><div>AI demonstrates strong diagnostic accuracy (mean accuracy: 0.898) and moderate prognostic capability (mean AUC: 0.770) for tSCI. However, the lack of standardised frameworks and external validation limits clinical applicability. Future models should integrate multimodal data, including imaging, patient characteristics, and clinician judgment, to improve utility and alignment with clinical practice.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104208"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subject: Letter to the Editor on \"Diagnostic and prognostic performance of urine ubiquitin carboxy-terminal hydrolase L1 across multiple acute brain injury types – A longitudinal prospective cohort study\"","authors":"Muhammad Ibrahim","doi":"10.1016/j.bas.2025.104209","DOIUrl":"10.1016/j.bas.2025.104209","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104209"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of subarachnoid haemorrhage: Systematic evaluation of CT head diagnostic accuracy and comparison with the 2022 NICE guidelines","authors":"Conor S. Gillespie ,&nbsp;John Gerrard Hanrahan ,&nbsp;Roxana Mahdiyar ,&nbsp;Keng Siang Lee ,&nbsp;Mohammad Ashraf ,&nbsp;Ali M. Alam ,&nbsp;Justyna O. Ekert ,&nbsp;Orla Mantle ,&nbsp;Simon C. Williams ,&nbsp;Jonathan P. Funnell ,&nbsp;Nihal Gurusinghe ,&nbsp;Raghu Vindlacheruvu ,&nbsp;Peter C. Whitfield (Prof) ,&nbsp;Rikin A. Trivedi ,&nbsp;Adel Helmy ,&nbsp;Peter J. Hutchinson (Prof)","doi":"10.1016/j.bas.2025.104200","DOIUrl":"10.1016/j.bas.2025.104200","url":null,"abstract":"<div><h3>Introduction</h3><div>Aneurysmal subarachnoid haemorrhage has a high incidence, and morbidity. It has been suggested that a negative non-contrast CT head can rule out SAH if performed within 6 h of symptom onset.</div></div><div><h3>Research question</h3><div>What is the sensitivity of CT head at ruling out SAH stratified by time-point, and what is the potential impact of omitting Lumbar Puncture (LP) from the diagnostic pathway?</div></div><div><h3>Material and methods</h3><div>Systematic review and meta-analysis (PROSPEROID CRD42022379929). Three databases were searched, and articles published between January 2000–May 2022 included (Search date 27^th November 2022). Primary objective was diagnostic accuracy of CT scans for detecting SAH at &lt;6 h from symptom onset, including reported sensitivity, and specificity values.</div></div><div><h3>Results</h3><div>63 articles were included (38,237 patients, 7673 with SAH). Pooled CT head sensitivity was 0.94 for excluding SAH (22 studies, 95% Confidence Interval [CI] 0.90–0.97). At &lt;6 h, CT head sensitivity was 0.995 (6 studies, 95% CI 0.941–1.000). Most studies (57.1%, n = 36/63) were classified as high risk of bias. If LP was removed from the diagnostic pathway in the UK, assuming an incidence of 4800 SAH per-year, 336 SAH would be missed per-year, 24 per-year if LP was removed for negative CT &lt; 6 h (95% CI 0–278) and 58 per-year if mean sensitivity is used (95% CI 0–240).</div></div><div><h3>Discussion and conclusion</h3><div>CT head appears to be highly sensitive at excluding SAH &lt;6 h from symptom onset. High quality, prospective data is required to further established the utility of early (&lt;6 h) negative CT head. We recommend that if there is strong clinical suspicion of SAH, yet CT head is reported negative &lt;6 h of symptom onset, that a LP be performed.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104200"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motion attenuation surgery in the degenerative lumbar spine: Is cement discoplasty a safe and effective option?","authors":"Derek T. Cawley","doi":"10.1016/j.bas.2025.104220","DOIUrl":"10.1016/j.bas.2025.104220","url":null,"abstract":"<div><div>Cement discoplasty (CD) was initially described in 2015. This novel treatment involves injecting polymethylmethacrylate (PMMA) into the degenerate disc cavity. This is particularly applicable to elderly patients with disc degeneration and collapse, where restoration of disc height improves lordosis and sagittal balance, treating symptoms of degenerative scoliosis, foraminal stenosis, adjacent segment degeneration, or flatback syndrome, who would otherwise have significant risks for major spine surgery. In all cases, symptoms are associated with intradiscal vacuum phenomenon (IDVP), a radiological finding associated with advanced disc degeneration. The technique is neither a motion preserving nor fusion procedure. While cement acts best in compression, the concept of stabilising but not fusing the spine in such cases lacks certainty and clarity as to its clinical effectiveness. This narrative review discusses the concepts of this technique, 12 clinical series and four metanalyses, mostly advocating for its use, particularly where it delivers a solution with an acceptable safety profile, short length of stay and short recovery time.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104220"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and natural development of thoracolumbar kyphosis in achondroplasia: A systematic review and meta-analysis","authors":"Chady Omara ,&nbsp;Rania A. Mekary ,&nbsp;Carmen L.A. Vleggeert-Lankamp","doi":"10.1016/j.bas.2024.104177","DOIUrl":"10.1016/j.bas.2024.104177","url":null,"abstract":"<div><h3>Introduction</h3><div>Thoracolumbar kyphosis (TLK) is a frequently reported spinal deformity in achondroplasia, which in combination with the characteristic narrow spinal canal in achondroplasia predisposes for symptomatic spinal stenosis. There is however no consensus on the optimal treatment, due to limited data on diagnostic criteria, the natural development and the prevalence of TLK.</div></div><div><h3>Research question</h3><div>This study aims to assess the prevalence, natural development, and diagnostic criteria for pathological TLK in individuals with achondroplasia.</div></div><div><h3>Material and methods</h3><div>A systematic review and meta-analysis were conducted. Studies involving achondroplasia patients, which reported TLK measurement methods were included. The primary outcome was the pooled prevalence of TLK, stratified by age.</div></div><div><h3>Results</h3><div>Eight studies, encompassing 852 patients, met the inclusion criteria. Pathological TLK was most frequently defined as a Cobb angle of 20° or greater, between T10 and L2. TLK was present in 87% (95% CI 80%–91%) of patients under two years old, decreasing to 33% (24%–43%) at age three, 26% (19%–35%) between five and ten years, and 23% (16%–31%) in patients aged 10–20 years.</div></div><div><h3>Discussion and conclusion</h3><div>Pathological TLK in achondroplasia, defined as a Cobb angle of 20° or greater, appears primarily in early childhood and often resolves by walking age. However, approximately one-fourth of cases persist into adulthood, with factors such as developmental motor delay and vertebral wedging contributing to this persistence. Routine clinical and radiological evaluations during childhood, along with conservative management, are recommended to mitigate the need for surgery during adulthood.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104177"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the spatiotemporal dynamics of vascular injury and regeneration following experimental Spinal Cord Injury","authors":"Christian J. Entenmann ,&nbsp;Emily J. von Bronewski ,&nbsp;Lilly Waldmann ,&nbsp;Lea Meyer ,&nbsp;Katharina Kersting ,&nbsp;Laurens T. Roolfs ,&nbsp;Lasse M. Schleker ,&nbsp;Melina Nieminen-Kelhä ,&nbsp;Irina Kremenetskaia ,&nbsp;Frank L. Heppner ,&nbsp;Michael G. Fehlings ,&nbsp;Peter Vajkoczy ,&nbsp;Vanessa Hubertus","doi":"10.1016/j.bas.2025.104191","DOIUrl":"10.1016/j.bas.2025.104191","url":null,"abstract":"<div><h3>Introduction</h3><div>The loss of vasculature in Spinal Cord Injury (SCI) contributes to secondary injury, expanding the injury to unharmed spinal cord (SC) regions. Understanding these mechanisms is crucial for developing therapeutic interventions.</div></div><div><h3>Research question</h3><div>Comprehensive analysis of the temporospatial dynamics of vascular injury and regeneration following SCI.</div></div><div><h3>Materials and methods</h3><div>Adult C57BL/6J mice were subjected to clip-compression SCI (Th 6/7, 5g, 60s, n = 20) or sham injury (laminectomy, n = 4), and sacrificed at 1, 3, 7, 14, and 28 days (d) post-injury following intracardial fluorescein isothiocyanate (FITC)-Lectin perfusion. Histological analysis (CD31, FITC-Lectin, Ki-67, IgG, TER-119) assessed vascular changes, permeability, and proliferation within the injury epicenter (region 0 (R0), ± 0,5 mm) and two adjacent SC regions (R1: ± 1 mm, R2: ± 2.5 mm).</div></div><div><h3>Results</h3><div>Perfusion loss (FITC-Lectin+/CD31+), was most severe in R0 and R1 at d3 (p &lt; 0.01). Significant vascular loss in R2 started at d3 (p = 0.043). Perfusion was restored at d28 in R0 and R1, and at d7 in R2. Vessel density (CD31⁺) returned to baseline quicker (R0: d3, R1 and R2: d14). Vascular proliferation (CD31+/Ki-67+) manifested across all regions at d3 (p &lt; 0.01), and most notably in R2 (p &lt; 0.01). Vascular permeability for IgG remained disrupted until d3 in R0 and R1 and until d14 in R2.</div></div><div><h3>Discussion and conclusion</h3><div>Vascular injury is most severe initially and spreads to the surrounding SC regions. Gradual vascular regeneration occurs early and up to a considerable distance from the injury epicenter, highlighting the potential of early therapeutic interventions targeted at vascular repair and regeneration.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104191"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic aspiration alone or Ommaya placement and aspiration followed by stereotactic radiosurgery for cystic brain metastasis: A systematic review and meta-analysis","authors":"David R. Peters ,&nbsp;Alfredo Conti ,&nbsp;Marc Levivier ,&nbsp;Luis Schiappacasse ,&nbsp;Mohamed Faouzi ,&nbsp;Mioara Florentina Trandafirescu ,&nbsp;Constantin Tuleasca","doi":"10.1016/j.bas.2025.104184","DOIUrl":"10.1016/j.bas.2025.104184","url":null,"abstract":"<div><h3>Introduction</h3><div>Cystic brain metastases (BMs) are often more challenging to treat than solid BMs. Stereotactic cyst aspiration for volume reduction followed by stereotactic radiosurgery (SRS) is an alternative treatment modality that may benefit patients with large cystic BMs not favorable for SRS alone nor microsurgical resection.</div></div><div><h3>Research question</h3><div>Here, we perform a systematic review and meta-analysis of stereotactic aspiration alone or reservoir (Ommaya) placement plus aspiration followed by SRS for cystic BMs.</div></div><div><h3>Material and methods</h3><div>Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we reviewed articles published between 1968 and December 31^−th, 2022. We retained 10 studies reporting 280 patients.</div></div><div><h3>Results</h3><div>Overall rate of tumor control for combined treatment of Ommaya placement plus aspiration plus SRS was 81.2% (62.5–99.9%, p &lt; 0.001) and for stereotactic aspiration plus SRS was 64.7% (46.1–83.3%, p &lt; 0.001). Overall rate of further intervention for combined treatment of Ommaya placement plus aspiration plus SRS was 15.8% (p = 0.08) and for stereotactic aspiration plus SRS was 14.8% (5.3–24.4%, p = 0.002). Overall complication rate for combined treatment of Ommaya placement plus aspiration plus SRS was 12.8% (2.3–23.3%, p = 0.01) and for stereotactic aspiration plus SRS was 1.5% (p = 0.12).</div></div><div><h3>Discussion and conclusion</h3><div>Combined treatment of Ommaya placement plus cyst aspiration plus SRS in cystic BMs yields better local control as compared to stereotactic aspiration plus SRS, with similar rate of further intervention between procedures. Aspiration of the cyst plus SRS should be considered for patients with cystic metastases not able to undergo open surgery or upfront SRS.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104184"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations on the management of meningioma and sex hormone therapy: The results of a collaborative effort between neurosurgical, endocrine and gynecological societies","authors":"Gilles Reuter,&nbsp;Iulia Potorac,&nbsp;Carlien de Herdt,&nbsp;Linda Ameryckx,&nbsp;Géraldine Brichant,&nbsp;Sébastien Froelich,&nbsp;Bertrand Baussart,&nbsp;Steven De Vleeschouwer,&nbsp;Tomas Menovsky,&nbsp;Tony Van Havenberghe,&nbsp;Patrice Finet,&nbsp;Michael Bruneau,&nbsp;Axelle Pintiaux","doi":"10.1016/j.bas.2024.104154","DOIUrl":"10.1016/j.bas.2024.104154","url":null,"abstract":"<div><h3>Introduction</h3><div>Exogenous and endogenous sex hormones, especially Progesterone agonists, may be causally linked to meningioma progression. Cessation of treatment leads to stabilization or regression of Progestin-induced meningioma. In many cases, avoiding sex hormone therapy may be possible in the context of meningioma treatment. However, hormonal treatment is not always easily replaceable and concise real-world recommendations regarding sex hormones and meningioma are lacking.</div></div><div><h3>Material and methods</h3><div>A combined effort was initiated between Neurosurgical, Gynaecological and Endocrinological societies of Belgium to gather relevant information regarding sex hormone therapies and meningioma. After complete literature review, consensual recommendations were established.</div></div><div><h3>Results</h3><div>Collegial recommendations regarding sex hormones therapies and meningioma in the context of oral contraceptives, menopause hormonal treatment, fertility treatment, pregnancy and gender-affirming therapies are emitted and nuanced.</div></div><div><h3>Discussion and conclusion</h3><div>Withdrawal and monitoring of sex hormone therapies are discussed in detail.</div><div>A decision tree regarding Meningioma and Combined contraception, Progestin Contraception, Menopause Hormonal treatment, Progestin and Gender-affirming therapy is suggested.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104154"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}