Neurocirugia (English Edition)最新文献

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Association of the C-reactive protein/albumin ratio with the prognosis of Aneurysmal Subarachnoid Hemorrhage: A systematic review C 反应蛋白/白蛋白比值与动脉瘤性蛛网膜下腔出血预后的关系:系统综述。
Neurocirugia (English Edition) Pub Date : 2025-05-01 DOI: 10.1016/j.neucie.2024.11.009
Gerardo Luna-Peralta , Alvaro Lopez-Luza , Claudia Cruzalegui-Bazán , Miguel Cabanillas-Lazo
{"title":"Association of the C-reactive protein/albumin ratio with the prognosis of Aneurysmal Subarachnoid Hemorrhage: A systematic review","authors":"Gerardo Luna-Peralta ,&nbsp;Alvaro Lopez-Luza ,&nbsp;Claudia Cruzalegui-Bazán ,&nbsp;Miguel Cabanillas-Lazo","doi":"10.1016/j.neucie.2024.11.009","DOIUrl":"10.1016/j.neucie.2024.11.009","url":null,"abstract":"<div><div>The C-Reactive Protein/Albumin Ratio (CAR) is being studied as a potential predictor of severe outcomes in various diseases. Our study aimed to review current evidence on the prognostic value of CAR in patients with aneurysmal subarachnoid hemorrhage (aSAH). We conducted a systematic search in PubMed, Embase, Scopus, Web of Science, and Google Scholar up to April 2023 and assessed the risk of bias using the NewCastle-Ottawa tool. A narrative synthesis was performed, and the GRADE system was used to evaluate the certainty of the evidence. Out of 534 articles, 4 were selected. We found that a higher CAR level is moderately associated with a lower score on the Glasgow Outcome Scale at 3 months and a higher incidence of in-hospital mortality. However, no significant association was found with the modified Rankin scale or delayed cerebral ischemia. Although the evidence is limited, CAR could be a useful tool for predicting poor prognosis in aSAH patients, but more prospective studies are needed to determine optimal cut-off points and include CAR in long-term prognostic models.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 185-193"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693589","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}
引用次数: 0
Ossification of posterior longitudinal ligament of the cervical spine: A review article. 颈椎后纵韧带骨化:一篇综述文章。
Neurocirugia (English Edition) Pub Date : 2025-03-24 DOI: 10.1016/j.neucie.2025.500668
Shengyu Cui, Jinze Li, Xiaoxu Yu, Hongyu Zhao, Fengzeng Jian
{"title":"Ossification of posterior longitudinal ligament of the cervical spine: A review article.","authors":"Shengyu Cui, Jinze Li, Xiaoxu Yu, Hongyu Zhao, Fengzeng Jian","doi":"10.1016/j.neucie.2025.500668","DOIUrl":"10.1016/j.neucie.2025.500668","url":null,"abstract":"<p><p>This article reviews the literature on the status of cervical OPLL in recent years, and reviews the etiology, clinical manifestations, imaging features, treatment and prognosis. Evidence was collected through PubMed and Google Scholar databases. After screening, weight removal and irrelevant articles, 57 articles were finally included in the review. Imaging is the only way to confirm the diagnosis, and CT and MRI are used to assess the patient's ossified material and spinal cord compression. Because there are hundreds of surgical approaches to cervical OPLL, each with advantages and disadvantages, clinicians must develop a personalized surgical plan based on the patient's preoperative relevant factors to maximize prognosis. Clinicians should also actively follow up on discharged patients, carefully analyze cases with a poor prognosis, and summarize their experiences.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500668"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733467","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}
引用次数: 0
Symptomatic thrombosed venous aneurysm after stereotactic radiosurgery for brain arteriovenous malformation: Case report of a late complication mimicking radiation necrosis. 立体定向放射治疗脑动静脉畸形后的症状性血栓性静脉动脉瘤:一例模拟放射坏死的晚期并发症。
Neurocirugia (English Edition) Pub Date : 2025-03-24 DOI: 10.1016/j.neucie.2025.500669
Gino A Mendoza-Vega, Jason Riveros-Ruiz, Juan E Basilio-Flores
{"title":"Symptomatic thrombosed venous aneurysm after stereotactic radiosurgery for brain arteriovenous malformation: Case report of a late complication mimicking radiation necrosis.","authors":"Gino A Mendoza-Vega, Jason Riveros-Ruiz, Juan E Basilio-Flores","doi":"10.1016/j.neucie.2025.500669","DOIUrl":"10.1016/j.neucie.2025.500669","url":null,"abstract":"<p><p>Late complications of radiosurgery for brain arteriovenous malformation include cystic formation, chronic encapsulated hematoma and radiation-induced tumors. Other complications are rarely reported. We present a case of an adult patient who received radiosurgery for treatment of an unruptured parietal arteriovenous malformation. He was followed-up for 10 years and angiographic cure was documented. Fifteen-years after radiosurgery, he complained of new-onset progressive focal seizures associated with a thrombosed venous aneurysm with persistent arteriovenous shunt angiographically occult but evidenced intraoperatively. After resection of the lesion, symptoms disappeared. This case depicts a symptomatic thrombosed venous aneurysm presenting as a rare delayed complication of radiosurgery for the treatment of brain arteriovenous malformation, which can be associated with angiographically-occult persistent arteriovenous shunt.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500669"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733501","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}
引用次数: 0
Removal of a giant musculocutaneous nerve schwannoma under intraoperative neurophysiological monitoring: Case report video and review of the literature. 术中神经生理监测下切除巨大肌皮神经鞘瘤:病例报告录像及文献复习。
Neurocirugia (English Edition) Pub Date : 2025-03-24 DOI: 10.1016/j.neucie.2025.500667
Edward Emerson Susanibar Mesías, Alba León Jorba, Antoni Raventós Estellé, Christian Abel Schinder, David Rodriguez Rubio
{"title":"Removal of a giant musculocutaneous nerve schwannoma under intraoperative neurophysiological monitoring: Case report video and review of the literature.","authors":"Edward Emerson Susanibar Mesías, Alba León Jorba, Antoni Raventós Estellé, Christian Abel Schinder, David Rodriguez Rubio","doi":"10.1016/j.neucie.2025.500667","DOIUrl":"10.1016/j.neucie.2025.500667","url":null,"abstract":"<p><p>Schwannomas of the musculocutaneous nerve (MCN) are rare benign tumors of the peripheral nerve sheath. Due to their slow growth, they are often diagnosed late. In the upper limbs, schwannomas typically affect longer peripheral nerves at a distal level, making MCN cases uncommon. Ultrasound (US) and magnetic resonance imaging (MRI) are essential tools for early detection. While most schwannomas can be surgically removed without damaging the nerve, intraoperative neurophysiological monitoring (IONM) is critical if fascicular involvement exists. We present a 73-year-old right-handed Jehovah's Witness with a history of mild polio affecting the right arm. MRI showed a slow-growing, cystic mass in the right biceps, originating from the MCN and suggestive of schwannoma. Surgery achieved gross total resection without nerve damage. Histopathology confirmed a cystic schwannoma. In atypical proximal upper limb tumors, MCN schwannoma should be considered, with US/MRI crucial for diagnosis. IONM-assisted removal can minimize postoperative complications.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500667"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733470","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}
引用次数: 0
Contralateral subdural effusion following decompressive hinged craniotomy: A case report and narrative review. 减压铰链开颅术后对侧硬膜下积液一例报告及叙述回顾。
Neurocirugia (English Edition) Pub Date : 2025-03-14 DOI: 10.1016/j.neucie.2025.500660
Artem Kuptsov, Alessandra Rocca, Cristina Gómez-Revuelta, Ana Flores-Justa, J Fernández-Villa, J A Nieto-Navarro
{"title":"Contralateral subdural effusion following decompressive hinged craniotomy: A case report and narrative review.","authors":"Artem Kuptsov, Alessandra Rocca, Cristina Gómez-Revuelta, Ana Flores-Justa, J Fernández-Villa, J A Nieto-Navarro","doi":"10.1016/j.neucie.2025.500660","DOIUrl":"10.1016/j.neucie.2025.500660","url":null,"abstract":"<p><p>Hinged craniotomy (HC) is an alternative surgical technique that can be used in place of decompressive craniectomy (DC) to treat refractory intracranial hypertension. This procedure has the advantage of avoiding the need for a second surgery to replace the bone, while giving a good control of intracranial pressure. However, there is no consistent literature about complications of HC. In particular, there are no reported cases of contralateral subdural effusion (CSE) after HC. In this article we present a case of a 55-years-old man who developed CSE after a hinged craniotomy (HC) for intracranial hypertension, and how we handled it. Therefore, we explored literature to better understand the pathogenesis of CSE, treatments and possible prevention strategies.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500660"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639931","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}
引用次数: 0
Craniopharyngioma and abscess: When tumor and infection co-exist. 颅咽管瘤和脓肿:当肿瘤和感染并存时。
Neurocirugia (English Edition) Pub Date : 2025-03-06 DOI: 10.1016/j.neucie.2025.500657
Luis Miguel Moreno-Gómez, Pablo M Munarriz, Aurelio Hernández-Laín, Alfonso Lagares
{"title":"Craniopharyngioma and abscess: When tumor and infection co-exist.","authors":"Luis Miguel Moreno-Gómez, Pablo M Munarriz, Aurelio Hernández-Laín, Alfonso Lagares","doi":"10.1016/j.neucie.2025.500657","DOIUrl":"10.1016/j.neucie.2025.500657","url":null,"abstract":"<p><p>Pituitary abscesses are rare entities that may occur in a previously healthy gland or in the setting of a pituitary tumor. Only eleven cases of abscesses associated with craniopharyngioma have been reported in the literature. The etiology is unknown and the diagnosis is difficult because there are no specific clinical or radiologic features that allow us to suspect the synchrony of both entities before surgery. Intraoperative findings and culture are the only definitive signs to confirm this association. Here we present the first surgical video showing this unique association and highlighting the technical pearls of the procedure. In a 9-year-old boy, we performed a transphenoidal approach to resect the tumor and saw pus during surgery. Pathology revealed a papillary craniopharyngioma, with microbiology showing Staphylococcus aureus. The tumor resection resulted in ophthalmologic improvement but pituitary insufficiency. A brief review of the literature is presented.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500657"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569048","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}
引用次数: 0
Fully percutaneous posterior transarticular C1-C2 stand-alone screw instrumentation: A case series and technical note. 完全经皮后路经关节C1-C2独立螺钉内固定:一个病例系列和技术说明。
Neurocirugia (English Edition) Pub Date : 2025-03-05 DOI: 10.1016/j.neucie.2025.500665
Ivan Lvov, Andrey Grin, Anton Kordonskiy, Zaali Barbakadze, Aleksandr Talypov, Aleksandr Tupikin
{"title":"Fully percutaneous posterior transarticular C1-C2 stand-alone screw instrumentation: A case series and technical note.","authors":"Ivan Lvov, Andrey Grin, Anton Kordonskiy, Zaali Barbakadze, Aleksandr Talypov, Aleksandr Tupikin","doi":"10.1016/j.neucie.2025.500665","DOIUrl":"10.1016/j.neucie.2025.500665","url":null,"abstract":"<p><p>Magerl's technique remains a widely accepted method for achieving C1-C2 fusion. Although two approaches using intermuscular corridors and biplanar X-ray guidance have been reported, there are no published studies dedicated to fully percutaneous techniques employing cannulated screws.</p><p><strong>Objective: </strong>To demonstrate the feasibility of a fully percutaneous C1-C2 fixation technique using cannulated screws and to analyze the short- and long-term outcomes of the initial case series.</p><p><strong>Material and methods: </strong>This case series included patients over 15 years of age who were presented with acute or subacute atlantoaxial instability at C1-C2 due to fractures of the odontoid process, C1 vertebra, or C2 vertebral body. Surgical details and fusion criteria were described. Due to the absence of comparison groups, only descriptive statistical methods were employed.</p><p><strong>Results: </strong>A total of 11 patients (8 men, 3 women; mean age 41.5 ± 18.2 years) underwent fully percutaneous transarticular C1-C2 fixation. The mean operative time was 115.0 ± 30.8 min for patients stabilized using a Halo device and 80.6 ± 33.2 min for those immobilized with a Mayfield clamp. The mean blood loss across all cases was 38.8 ± 8.7 mL. One patient died from concurrent cardiac pathology. Two patients were lost to follow-up due to relocation, leaving 8 patients for final assessment. At final follow-up, the mean VAS score was 2 ± 1.5 and the mean NDI score was 5.3 ± 5.2. All patients with preoperative neurological deficits improved by one level on the ASIA scale. Fusion was achieved in 7 of 8 cases (87.5%), and 1 patient (12.5%) developed a stable C1-C2 pseudoarthrosis.</p><p><strong>Conclusion: </strong>Our initial clinical experience demonstrated that fully percutaneous posterior transarticular C1-C2 stand-alone screw fixation using cannulated instruments could be a feasible and safe procedure. Critical requirements for this technique include complete reduction of atlantoaxial dislocation, compression in the lateral joint region, adequate intraoperative visualization, and strict adherence to specific screw trajectories.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500665"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588465","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}
引用次数: 0
ALIF in a Spanish female cohort: No urinary and sexual complications or a gender bias? ALIF在西班牙女性队列中:没有泌尿和性并发症还是性别偏见?
Neurocirugia (English Edition) Pub Date : 2025-03-05 DOI: 10.1016/j.neucie.2025.500662
Cristina Romero-López, Santiago Rocha-Romero, María de Los Ángeles Cañizares-Méndez, Julio Valencia-Anguita
{"title":"ALIF in a Spanish female cohort: No urinary and sexual complications or a gender bias?","authors":"Cristina Romero-López, Santiago Rocha-Romero, María de Los Ángeles Cañizares-Méndez, Julio Valencia-Anguita","doi":"10.1016/j.neucie.2025.500662","DOIUrl":"10.1016/j.neucie.2025.500662","url":null,"abstract":"<p><strong>Background: </strong>The objective of the present study is to analyze urinary and sexual functions in females treated with ALIF and to describe possible complications not previously reported in the literature.</p><p><strong>Methods: </strong>We conducted a retrospective study of urinary and sexual functions in females treated with this technique in our hospital between 2019 and 2022. Inclusion criteria were: females treated with ALIF who provided informed consent.</p><p><strong>Results: </strong>22 patients consented to participate. The median age was 51.5 years, the median follow-up was 11.5 months, and there was an improvement in low back pain of 4 points on the postoperative (postop) visual analogue scale (VAS). Overall, 36.3% of patients reported postoperative urinary deterioration, including 27.3% with new-onset urinary incontinence. The international consultation on incontinence questionnaire-short form score worsened by 3.5 points. 77.2% maintained an active sexual life; within this group, there was a worsening of 2.4 points in the postop female sexual function index and 35.2% described worsening in sexual function. We hypothesized that age, underlying lumbar pathology and changes in postoperative VAS scores could be confounding factors; however, only the relationship between age and postoperative urinary deterioration reached statistical significance (p = 0.034).</p><p><strong>Conclusions: </strong>The present study describes deterioration in urinary function in 36.3% and in sexual function in 35.2% after the procedure, findings also supported by specific scales. In view of the above, we cannot discount a possible gender bias in the literature. Despite that, we believe that ALIF is still an adequate technique, but studies of higher level of evidence should be conducted to improve the information process of our patients.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500662"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588458","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}
引用次数: 0
Topical and systemic effects of medical ozone therapy on epidural fibrosis: Experimental research. 医用臭氧治疗硬膜外纤维化的局部和全身效应:实验研究。
Neurocirugia (English Edition) Pub Date : 2025-03-05 DOI: 10.1016/j.neucie.2025.500663
Nur Balcin, Mine Ozsen, Pinar Eser, Tamer Kala, Gokhan Ocakoglu, Seref Dogan
{"title":"Topical and systemic effects of medical ozone therapy on epidural fibrosis: Experimental research.","authors":"Nur Balcin, Mine Ozsen, Pinar Eser, Tamer Kala, Gokhan Ocakoglu, Seref Dogan","doi":"10.1016/j.neucie.2025.500663","DOIUrl":"10.1016/j.neucie.2025.500663","url":null,"abstract":"<p><strong>Introduction: </strong>Epidural fibrosis (EF) causes adhesions in the epidural distance, resulting in chronic low back and leg pain symptoms during the postoperative period. Currently, ozone is used for treating lumbar disk herniation and low back pain. However, its effect on epidural fibrosis is largely unknown.</p><p><strong>Material and methods: </strong>This rodent study examined the histopathological and biochemical effects of ozone therapy on epidural fibrosis. Forty-seven male Sprague-Dawley rats were divided into four groups, as follows: Control Group (CG) (n = 12): Laminectomy was performed, and no substance was applied. Saline Group (SG) (n = 11): Rats underwent intraoperative washing with 50 mL saline after laminectomy. Local Ozone Group (LOG) (n = 12): Rats underwent intraoperative washing with 50 mL ozonated distilled water after laminectomy. Systemic Ozone Group (SOG) (n = 12): Ozone was administered intraperitoneally (0.7 mg/kg) for 7 consecutive days postoperatively. At the end of 4 weeks, all subjects were sacrificed. Histopathological and biochemical data obtained from the tissues were analyzed in terms of EF.</p><p><strong>Results: </strong>No statistically significant differences regarding EF, spinal cord retraction, inflammation, and fibroblast density were observed between the groups (p = 0.728; p = 0.813; p = 0.152; and p = 0.226, respectively). Hydroxyproline levels were higher in LOG than in SOG (p = 0.007); however, no statistically significant differences were observed among other groups (p > 0.05).</p><p><strong>Conclusions: </strong>In our study, we could not record the positive effect of ozone therapy in terms of histopathology and biochemistry with the current doses and application methods. We think that caution should be exercised in the ozone dose and method of application in the clinical approach. In addition, we are of the opinion that statistically significant results can be obtained by creating a treatment protocol that includes different dose applications.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500663"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588472","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}
引用次数: 0
Continuous sitting position during the postoperative period as an intervention to reduce risk of cerebrospinal fluid leak after endoscopic endonasal surgery. 内镜鼻内窥镜手术后持续坐位作为降低脑脊液漏风险的干预措施。
Neurocirugia (English Edition) Pub Date : 2025-03-04 DOI: 10.1016/j.neucie.2025.500658
José de Jesús Martínez-Manrique, Ricardo A Palacios-Rodríguez, Luis A Rodríguez-Hernández, Jorge F Aragón-Arreola, Marcos V Sangrador-Deitos, Juan Luis Gómez-Amador
{"title":"Continuous sitting position during the postoperative period as an intervention to reduce risk of cerebrospinal fluid leak after endoscopic endonasal surgery.","authors":"José de Jesús Martínez-Manrique, Ricardo A Palacios-Rodríguez, Luis A Rodríguez-Hernández, Jorge F Aragón-Arreola, Marcos V Sangrador-Deitos, Juan Luis Gómez-Amador","doi":"10.1016/j.neucie.2025.500658","DOIUrl":"10.1016/j.neucie.2025.500658","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>In recent decades, endoscopic endonasal surgery for skull base tumours has modified the way in which this region is approached. One of the most feared complications is the cerebrospinal fluid leak. It has been shown in different publications about CSF physiology that changes in the position modify the pressure of the CSF (pCSF). With this background, it is proposed as a viable, noninvasive, and very low-risk option, the continuous sitting position in patients during their hospital stay after endoscopic endonasal surgery as an adjuvant intervention to reduce the risk of CSF leak in patients considered to be at high risk. The objective is to demonstrate that the continuous sitting position in the postoperative period is a useful adjuvant intervention for the prevention of CSF leak in endoscopic endonasal surgery.</p><p><strong>Methods: </strong>This is a retrospective, observational, cross-sectional, comparative study. It included patients over 18 years of either sex, intervened by endoscopic endonasal surgery with intraoperative CSF leak observed and with advanced reconstruction technique realized. A continuous sitting position (between 70 ° and 90 °) was considered when the patient remained in this position from the immediate postoperative period until the hospital discharge.</p><p><strong>Results: </strong>A total of 60 patients were included. No statistically significant difference was found on all the variables studied, except when patients were stratified into sitting and non-sitting patients (p = 0.045). OR of 0.12 (95% CI 0.002-1.03) was observed. In the sitting group, only 1 patient (6.67%) had CSF leak, which was resolved with non-surgical treatment. The average length of hospital stay was 18 days (7-38) for sitting patients and 14 days (5-80) for non-sitting patients, with statistical significance stablished by the dispersion of the data (p = 0.023).</p><p><strong>Conclusions: </strong>The continuous sitting position during the immediate postoperative period is an intervention that shows a decrease in the risk of CSF leak in patients intervened by endoscopic endonasal approach, included extended routes.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500658"},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574985","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}
引用次数: 0
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