Brain & spine最新文献

{"title":"Inflammation and macrophage polarization are associated with Modic change type in lumbar radiculopathy","authors":"Wensen Li ,&nbsp;Niek Djuric ,&nbsp;Christiaan Mink ,&nbsp;Carmen L.A. Vleggeert-Lankamp","doi":"10.1016/j.bas.2025.104249","DOIUrl":"10.1016/j.bas.2025.104249","url":null,"abstract":"<div><h3>Introduction</h3><div>Lumbar disc herniation (LDH) typically manifests as sciatica, attributed to nerve root mechanical compression and/or inflammation. Modic changes (MC), classified as type I or type II, are deemed to represent endplate vascular insufficiency and are hypothesized to create an inflammatory environment. Macrophages infiltrating disc tissue can be polarized into pro-inflammatory M1 or anti-inflammatory M2 phenotypes.</div></div><div><h3>Research question</h3><div>This study aims to investigate the interplay among inflammatory cells, including M1 and M2 macrophages, Modic Changes, and hernia size and type in patients suffering from sciatica due to a LDH.</div></div><div><h3>Material and methods</h3><div>This prospective cohort study selected patients undergoing microdiscectomy for LDH. Macrophage infiltration (CD68, CD192, CD163), MC classification on MRI, and hernia parameters were analyzed.</div></div><div><h3>Results</h3><div>132 out of 187 patients demonstrated macrophages in the lumbar disc tissue. Most samples demonstrated severe inflammation (50 %), and most macrophages were of the M1 phenotype (48 %). MC were present in 45 % of patients, and only 19 % of these demonstrated MC type I. MC type I were highly associated with both severe (p = 0.016) and M1 macrophage-dominant inflammation (p = 0.048). Larger and non-contained herniations associated with increased inflammation (p = 0.029/p = 0.002), while larger herniations associated with the presence of MC type II (p = 0.027).</div></div><div><h3>Discussion and conclusions</h3><div>This study elucidates a close association of MC type I and M1 macrophage. MC type II were observed more often in patients with larger HNPs. This is indicative for MC typing as an important factor in prediction modelling and it suggests the potential for personalized treatment strategies.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104249"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800460","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":"Subgaleal drainage with one burr-hole for chronic subdural hematomas: Our two-years’ experience","authors":"Franziska A. Schmidt ,&nbsp;Victoria Schön ,&nbsp;Ondra Petr,&nbsp;Christian F. Freyschlag,&nbsp;Claudius Thomé","doi":"10.1016/j.bas.2025.104185","DOIUrl":"10.1016/j.bas.2025.104185","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104185"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082050","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":"Microbiome dysbiosis in spinal pathology: Mechanisms, evidence, and research limitations","authors":"Muaz Rashid ,&nbsp;Hugo Serra Pereira ,&nbsp;Ahmad Alissa ,&nbsp;Salman Keraidi ,&nbsp;Nicolas Wipf ,&nbsp;Aubrie M. Sowa ,&nbsp;Jake M. McDonnell ,&nbsp;Stacey Darwish ,&nbsp;Joseph S. Butler","doi":"10.1016/j.bas.2025.104272","DOIUrl":"10.1016/j.bas.2025.104272","url":null,"abstract":"<div><h3>Introduction</h3><div>The microbiome's relevance has become increasingly discussed amid the rising prevalence of chronic illnesses. Microbiome research to date focuses predominantly on its relationship with the GI tract while largely ignoring any impact on the rest of the body. This narrative review aims to lay a foundation of knowledge to fill this gap in the literature and discuss other microbiomes within the human body and their relation to spinal health.</div></div><div><h3>Research question</h3><div>What is the relationship between the human microbiome and spinal pathologies?</div></div><div><h3>Materials and methods</h3><div>A narrative review of all available literature (written or translated to English) was performed using PubMed, MEDLINE, and Google Scholar using relevant search terms including: “microbiome”, “spine”, “spinal pathology”, “ankylosing spondylitis”, and “seronegative arthropathies”.</div></div><div><h3>Results</h3><div>This review found that with dysbiosis, specific bacterial such as <em>Bacteroidaceae</em> and <em>Rikenellaceae</em> proliferate, altering the cytokine microenvironment and subsequently increasing gut wall permeability. This immune overactivation and improper cell function results in an increased susceptibility to autoimmunity; specifically ankylosing spondylitis and seronegative arthropathies. This review also highlights the significant gaps in the available literature.</div></div><div><h3>Discussion and conclusion</h3><div>This review aims to equip clinicians with an understanding of how the collection of microbiomes in the human body have specific implications for spinal health. By building on the current literature and integrating this knowledge into practice, more patient-specific practices in the treatment of spinal pathologies can be implemented, ultimately improving and optimizing patient care in a field in which the microbiome is not currently at the forefront of pathology.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104272"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929175","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":"Recurrence prediction in chronic subdural hematomas: a risk stratification score based on 118 consecutive patients","authors":"Francesco M.C. Lioi ,&nbsp;Jon Ramm-Pettersen ,&nbsp;Andrea Fratini ,&nbsp;Gabriele Dentato ,&nbsp;Giovanni Facchinetti ,&nbsp;Niccolo Colella ,&nbsp;Luigi Rosito ,&nbsp;Elena Furno ,&nbsp;Camilla Riva ,&nbsp;Andrea G. Ruggeri ,&nbsp;Luca D'Angelo ,&nbsp;Antonio Santoro ,&nbsp;Alessandro Frati","doi":"10.1016/j.bas.2025.104286","DOIUrl":"10.1016/j.bas.2025.104286","url":null,"abstract":"<div><h3>Background</h3><div>Chronic subdural hematoma (CSDH) is a frequent neurosurgical condition with a significant recurrence rate. Identifying patients at risk of recurrence is a topic of great interest to intercept this population in which to implement further therapeutic strategies.</div></div><div><h3>Objective</h3><div>To develop and internally validate a risk-stratification score using preoperative radiological parameters to predict risk of CSDH recurrency. To establish a stratification approach based on easily available clinical and radiological variables.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 118 consecutive patients surgically treated for CSDH was conducted. Binary logistic regression was used to identify radiological preoperative predictors of recurrence, including Nakaguchi classification, cortical atrophy, and hematoma density.</div></div><div><h3>Results</h3><div>A weighted scoring system has been developed and patients were stratified into three risk categories: low (0–2 points), moderate (3–5 points), and high (6–8 points). This grading system demonstrated a significant correlation with recurrence rates: 0 % in the low-risk group, 11.76 % in the moderate-risk group, and 25.71 % in the high-risk group. The model exhibited good discriminative ability in predicting the risk of CSDH recurrence.</div></div><div><h3>Conclusion</h3><div>Hyperdense appearance, homogeneous or separated Nakaguchi-configuration and presence of cortical atrophy are predictive features of CSDH recurrence and can be incorporated into a score. The proposed grading system provides an effective preoperative tool for assessing CSDH recurrence risk, with a progressive increase in the recurrency rate between the three groups. This model enables personalized postoperative management, facilitating early identification of high-risk patients who may benefit from adjunctive treatments to reduce recurrence.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104286"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169749","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":"Opioid-free anesthesia in craniotomy – Current evidence and Gaps in implementation","authors":"Chayanika Kutum ,&nbsp;Prashant Lakhe","doi":"10.1016/j.bas.2025.104287","DOIUrl":"10.1016/j.bas.2025.104287","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104287"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185383","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":"Letter-to-the-editor to the study by Bartek J et al “Multidisciplinary consensus-based statement on the current role of Middle Meningeal Artery embolization (MMAE) in chronic SubDural Hematoma (cSDH)” – A letter from the international CSDH research group committee, iCORIC","authors":"T.S.R. Jensen ,&nbsp;J. Duerinck ,&nbsp;D. Holl ,&nbsp;C. Iorio-Morin ,&nbsp;J. Soleman ,&nbsp;E. Edlmann ,&nbsp;iCORIC steering committee","doi":"10.1016/j.bas.2024.104169","DOIUrl":"10.1016/j.bas.2024.104169","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104169"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017314","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":"A simple CT score predicts early neurological disability and survival in supratentorial intracerebral hemorrhage - The intracerebral mass and brain edema score (IMBES)","authors":"Ralf Watzlawick ,&nbsp;Panagiotis Fistouris ,&nbsp;Ahmed Elbaz ,&nbsp;Pierre Scheffler ,&nbsp;Alix Bührle ,&nbsp;Marc Hohenhaus ,&nbsp;Ramy Amirah ,&nbsp;Roland Roelz ,&nbsp;Mukesch Shah ,&nbsp;Oliver Schnell ,&nbsp;Samer Elsheikh ,&nbsp;Christian Taschner ,&nbsp;Christian Fung ,&nbsp;Jürgen Beck","doi":"10.1016/j.bas.2025.104226","DOIUrl":"10.1016/j.bas.2025.104226","url":null,"abstract":"<div><h3>Introduction</h3><div>Treatment of spontaneous intracerebral hemorrhage (ICH) remains challenging, and intracerebral mass and brain edema (IMBE) are accused of being the main factors influencing patient course.</div></div><div><h3>Research question</h3><div>CT scan assessment of the space-occupying effect after initial ICH was evaluated using an IMBE-score to detect the sulcal effacement of the subarachnoid space.</div></div><div><h3>Material and methods</h3><div>Supratentorial ICH-patients within a 10 years observation period were identified. Two independent reviewers screened each CT scan in three defined axial planes. Where the combined mass effect of hemorrhage and edema showed sulcal effacement of more than half of the hemisphere, one point was assigned, resulting in an IMBES between 0 and 6. The primary endpoint was neurological outcome measured by the modified Rankin Scale (mRS) and mortality.</div></div><div><h3>Results</h3><div>We identified 762 patients, median age was 75.4 years (IQR: 64.3–81.1) and mean ICH volume was 46.1 cc. Multiple regression for mRS at discharge (mean: 12.5 days, IQR: 7.1–22.3) identified age, presence of intraventricular hemorrhage, ICH volume, renal insufficiency, intake of anticoagulants and IMBES as statistically significant variables. This was confirmed during follow-up examination, although ICH volume was not significantly associated with neurological outcome.</div></div><div><h3>Discussion and conclusion</h3><div>We observed a decreased neurological recovery and an increased mortality for patients with high IMBES during acute care and at early follow-up, indicating that IMBES had the strongest association in all regression analysis. We conclude that the fast and simple IMBES may be a useful tool to estimate patient risk for impaired neurological outcome and death.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104226"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636604","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":"Decompressive craniectomy in subarachnoid hemorrhage compared to other etiologies: An institutional experience of 11 years","authors":"Emilia K. Pesonen ,&nbsp;Aleksi Lammi ,&nbsp;Cheng Qian,&nbsp;Mikael Von und Zu Fraunberg,&nbsp;Tommi K. Korhonen ,&nbsp;Sami Tetri","doi":"10.1016/j.bas.2025.104203","DOIUrl":"10.1016/j.bas.2025.104203","url":null,"abstract":"<div><h3>Introduction</h3><div>Decompressive craniectomy (DC) is a last-tier procedure to lower intracranial pressure in otherwise fatal brain injuries. DC significantly reduces mortality following traumatic brain injury (TBI) and ischemic stroke, but benefits in subarachnoid hemorrhage (SAH) are less clear.</div></div><div><h3>Research question</h3><div>We compared the mortality and functional outcomes in patients who underwent DC after SAH with those who underwent DC following TBI or ischemic stroke.</div></div><div><h3>Materials and methods</h3><div>All DC procedures performed in the Oulu University Hospital between January 2009 and December 2019 were retrospectively identified. Mortality and functional outcomes were assessed during a median follow-up of 20.7 months. Extended Glasgow Outcome Scale scores ≥5 were considered favorable.</div></div><div><h3>Results</h3><div>One hundred twenty-four DCs were conducted to patients aged a median of 40 years (SD 16), of whom 88 (71%) were male. Fifty-eight (47%) DCs were due to TBI and 66 (53%) due to stroke. Of the strokes, 41 (62%) were ischemic and 21 (32%) SAH.</div><div>In multivariate models, the rates of unfavorable outcome were 48% in TBI, 78% in ischemic stroke (OR 2.73, 95% CI 0.70–10.64) and 86% in SAH (OR 3.15, 95%CI 0.67–14.77). Mortality rates were 22% in TBI, 17% in ischemic stroke (OR 0.50, 95%CI 0.11–2.31) and 33% in SAH (OR 0.97, 95%CI 0.24–3.99).</div></div><div><h3>Discussion and conclusion</h3><div>Favorable outcomes were more common in TBI compared to stroke in univariate but not in multivariate analysis. There was no statistically significant difference in the rates of favorable outcomes between SAH and ischemic stroke.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104203"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350171","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":"A case report with a literature review of trigeminal neuralgia secondary to a large posterior communicating artery aneurysm","authors":"Amer A. Alomari ,&nbsp;Fabio Boccacci ,&nbsp;Carlo Giacobbo Scavo ,&nbsp;Guido Cedrone ,&nbsp;Raffaelino Roperto ,&nbsp;Ali Zomorodi ,&nbsp;Luciano Mastronardi","doi":"10.1016/j.bas.2025.104215","DOIUrl":"10.1016/j.bas.2025.104215","url":null,"abstract":"<div><div>This is a case report of a 66-year-old female who developed atypical trigeminal neuralgia over ophthalmic-V1 and maxillary-V2 divisions secondary to a posterior communicating artery aneurysm (1.5 cm). Literature review of similar cases, description of the pain, its distribution, the aneurysm features, the pathophysiology, and the patient's management and outcome are presented.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104215"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704912","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 German Spine Society is affiliated with Brain and Spine: Interdisciplinarity is our strength","authors":"Ralph Kothe (Past President of the German Spine Society 2024) ,&nbsp;Florian Ringel (President of the German Spine Society 2025)","doi":"10.1016/j.bas.2025.104255","DOIUrl":"10.1016/j.bas.2025.104255","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104255"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870442","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}