Surgical neurology international最新文献

{"title":"A case of recurrent spinal cord compression at craniocervical junction due to type IV mucopolysaccharidosis.","authors":"Jun Hashimoto, Toshinari Kawasaki, Tamaki Kobayashi, Yoshihiko Ioroi, Motohiro Takayama","doi":"10.25259/SNI_333_2025","DOIUrl":"10.25259/SNI_333_2025","url":null,"abstract":"<p><strong>Background: </strong>Mucopolysaccharidosis type VI (MPS VI) is an autosomal recessive lysosomal genetic storage disorder caused by the accumulation of glycosaminoglycans in tissues and organs. A 10-month-old male with MPS VI had originally undergone foramen magnum decompression (FMD)/C1 followed by lifelong enzyme replacement therapy (ERT). At age 15, the patient underwent successful surgical treatment for retro-odontoid disease and recurrent cranio-cervical junction (CCJ) stenosis through a C1-C3 laminectomy and expansive duroplasty.</p><p><strong>Case description: </strong>A 10-month-old male with MPS VI and brain stem/spinal cord compression originally underwent a cervical FMD/C1 laminectomy. Despite ERT administration, signs of gait disturbances and myelopathy recurred before 1 year of age. At age 15, both computed tomography and magnetic resonance imaging revealed a retro-odontoid mass causing foramen magnum stenosis/upper cervical cord compression. Following an extended FMD that included a C1-C3 laminectomy and expansive duroplasty, his gait disturbance gradually improved.</p><p><strong>Conclusion: </strong>Patients with MPS VI may experience recurrent CCJ stenosis and spinal cord compression despite the early initiation of ERT.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"255"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628386","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":"Neuroplastic surgery for adulthood myelomeningocele: Advancement flap reconstruction.","authors":"Erik Burgos-Sosa, Gustavo Melo-Guzman, Diana Carolina Paz-Hernandez, Miguel Jesus Bernes-Rodriguez, Ruben Acosta-Garces, Alfredo Lima-Romero, Mario Alberto Taylor-Martinez","doi":"10.25259/SNI_11_2025","DOIUrl":"10.25259/SNI_11_2025","url":null,"abstract":"<p><strong>Background: </strong>While it is widely recognized that surgical intervention is crucial at birth, the occurrence of giant myelomeningocele in adulthood is exceedingly uncommon. This case study aims to provide a comprehensive overview of a rare presentation of myelomeningocele accompanied by a tethered cord in an adult patient, highlighting the clinical features, diagnostic imaging, and surgical repair technique employed.</p><p><strong>Case description: </strong>This patient is a 58-year-old woman with a history of spinal dysraphism that was diagnosed during childbirth. Due to her family's low sociocultural status, she did not receive timely treatment. She was referred to our institution because of a persistent increase in volume in the lumbar region, accompanied by a continuous and intense pulsating headache. An magnetic resonance imaging revealed a giant spinal defect caused by lumbar dysraphism. A surgical rotational flap procedure and untethering of the spinal cord using microsurgical techniques were performed. During follow-up, the patient experienced a complete recovery of her clinical symptoms.</p><p><strong>Conclusion: </strong>Surgical treatment can benefit adult patients with symptomatic myelomeningocele. This would influence the quality of life for the patient. For large lesions in the spine, adequate flap rotation demands knowledge of how to do it.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"249"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628425","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":"Visual symptoms after flow-diverter stenting of internal carotid artery aneurysms: A retrospective cohort study.","authors":"Yuko Tanaka, Yoshikazu Matsuda, Tomoyuki Tsumoto, Tomoaki Terada","doi":"10.25259/SNI_306_2025","DOIUrl":"10.25259/SNI_306_2025","url":null,"abstract":"<p><strong>Background: </strong>Visual field defect and visual impairment are important but poorly characterized complications after flow-diverter (FD) stent placement for internal carotid artery (ICA) aneurysms.</p><p><strong>Methods: </strong>We retrospectively analyzed 31 consecutive patients with 32 ICA aneurysms treated by FD stent implantation between October 2015 and April 2021. Aneurysms were classified into two groups those with visual symptoms before and after FD stenting (symptomatic group) and those without (asymptomatic group). We analyzed patients' background characteristics, treatment details, and imaging findings.</p><p><strong>Results: </strong>Visual symptoms were present in 25% (8/32) of aneurysms and worsened after treatment in 9.4% (3/32). Aneurysm enlargement was more common in the symptomatic group than the asymptomatic group (50% vs. 4.1%; odds ratio 23.0, 95% confidence interval [CI] 2.0-262.6, <i>P</i> = 0.0086). Poor visualization of the ophthalmic artery after procedure was observed in 50% versus 12.5% (odds ratio 7.0, 95% confidence interval 1.1-44.1, <i>P</i> = 0.047). No central retinal artery occlusion or cerebral ischemic events were observed. All three deteriorating cases improved after high dose steroids: one required additional FD stenting.</p><p><strong>Conclusion: </strong>In this single-center retrospective cohort, visual symptoms after FD stenting were relatively common but were usually reversible. Aneurysm enlargement and early loss of ophthalmic-artery flow identify patients at higher visual risk. Early steroid therapy and, when necessary, further endovascular treatment may mitigate visual deterioration.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"250"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628453","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":"Abscess formation within brain metastasis.","authors":"Emilio González Martínez, Giancarlo Daniel Mattos Piaggio","doi":"10.25259/SNI_62_2025","DOIUrl":"10.25259/SNI_62_2025","url":null,"abstract":"<p><strong>Background: </strong>Brain abscesses are a potentially curable but life-threatening medical condition. Their occurrence within brain metastases has been exceptionally reported. In this study, we describe in detail this rare entity.</p><p><strong>Case description: </strong>A previously healthy 64-year-old female was referred to our neurosurgical department with right-sided deviation of the oral commissure and a 7-day history of holocranial headache. Magnetic resonance imaging revealed a tumor in the right frontal lobe, exhibiting an iso-intense signal on T1-weighted images with heterogeneous enhancement. On diffusion-weighted imaging, the lesion displayed a hyperintense signal. A body computed tomography scan identified a lung tumor in the left superior lobe and a potential metastasis in the right adrenal gland. Intraoperative findings and histopathological examination revealed metastasis from lung adenocarcinoma. In addition, purulent content was noted within the abscess, and cultures identified <i>Staphylococcus epidermidis</i> and <i>Streptococcus mitis</i>.</p><p><strong>Conclusion: </strong>Abscess formation within metastases is rarely diagnosed preoperatively, primarily because these lesions do not present with characteristic clinical or radiological features. Early recognition of this entity is crucial for establishing an appropriate treatment plan.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"236"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628398","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":"Assessing surgical outcomes in pituitary adenoma: A comparison of microscopic and endoscopic techniques.","authors":"Gopal Krishna, Meghna Chauhan, Ishwar Singh, Varun Aggarwal, Vivek Kumar","doi":"10.25259/SNI_1092_2024","DOIUrl":"10.25259/SNI_1092_2024","url":null,"abstract":"<p><strong>Background: </strong>The advantages of endoscopic resection of pituitary adenomas over microscopic have been exhaustively documented in the literature, though controversy persists regarding the superiority of either technique. The microscopic technique being more common at our center, we compared the outcome of patients operated by microscopic transsphenoidal surgery (MTS) and endoscopic transsphenoidal surgery (ETS) approach.</p><p><strong>Methods: </strong>Retrospective data on transsphenoidal surgery for nonfunctional adenomas between 2019 and 2023 were analyzed. The symptoms, resection rates, surgical time, blood loss, and postoperative complications were compared with 1-year follow-up. The Statistical Package for the Social Sciences version 25 was used for statistical analysis.</p><p><strong>Results: </strong>We identified 91 patients who met the inclusion criteria. The MTS group included 48 (52.75%) patients, while the ETS category comprised 43 (47.25%). Headache was present in 47.91% of MTS and 72.09% of ETS cases (<i>P</i> = 0.0001). Other clinical symptoms were uniformly distributed in both groups. The operative time and blood loss were significantly lower in MTS (254.22 ± 37.65 vs. 289.53 ± 23.98) with p values of 0.0164 and 0.0001, respectively. Gross-total resection was achieved in 70.83% and 81.39% of patients in the MTS and ETS groups, respectively. No significant difference was observed in clinical and endocrinological outcomes, tumor recurrences, and complications until 1-year follow-up, except for sinusitis, which was higher in the ETS category (<i>P</i> = 0.05).</p><p><strong>Conclusion: </strong>Both surgical techniques are well established for pituitary adenoma resection and are comparable in terms of complications. The surgeon's experience plays a critical role in pituitary surgery and its outcomes. However, tumor characteristics and patient-specific factors are also important determinants of the approach.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"234"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628400","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":"Sticking after detachment procedure of coil with floating detachment link with ball joint due to excessively bent junction: A case report and a bench-top experiment.","authors":"Natsuki Akaike, Hiroyuki Ikeda, Mai Tanimura, Minami Uezato, Masanori Kinosada, Yoshitaka Kurosaki, Masaki Chin","doi":"10.25259/SNI_366_2025","DOIUrl":"10.25259/SNI_366_2025","url":null,"abstract":"<p><strong>Background: </strong>We present a case of coil sticking, likely caused by an excessively bent junction of the coil and the delivery pusher, with a bench-top experiment to determine the cause of coil sticking in this case.</p><p><strong>Case description: </strong>A coil embolization procedure was performed for an internal carotid artery aneurysm. During the framing with the Axium Prime Frame coil, the tip of the microcatheter was advanced to the center of the coil mass within the aneurysm to insert the coil. After detachment, the coil became stuck. Pulling the delivery pusher allowed the coil to detach from the delivery pusher within the microcatheter. After flushing the microcatheter with heparinized saline, the proximal end of the coil fortuitously settled within the aneurysm and the procedure was concluded without complications. A bench-top experiment suggested that an excessively bent junction of the coil and the delivery pusher causes the ball joint of the floating detachment link to hook into the circular opening.</p><p><strong>Conclusion: </strong>When using coils with a floating detachment link that has a ball joint, forcibly advancing the microcatheter while the tip of the microcatheter is aligned with the junction may cause excessive bending of the junction, resulting in coil sticking.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"244"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628444","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":"Contrast-induced encephalopathy after coil embolization for a ruptured anterior communicating artery aneurysm with perfusion from bilaterally developed A1 segments.","authors":"Natsuki Akaike, Hiroyuki Ikeda, Makoto Wada, Mai Tanimura, Minami Uezato, Masanori Kinosada, Yoshitaka Kurosaki, Masaki Chin","doi":"10.25259/SNI_369_2025","DOIUrl":"10.25259/SNI_369_2025","url":null,"abstract":"<p><strong>Background: </strong>We report a case of contrast-induced encephalopathy (CIE) following coil embolization of a ruptured anterior communicating artery (AComA) aneurysm with bilateral A1 segment development. The aneurysm was visualized by forcefully injecting contrast medium from a distal access catheter (DAC) positioned distally in the internal carotid artery (ICA).</p><p><strong>Case description: </strong>A 50-year-old female was diagnosed with subarachnoid hemorrhage. Computed tomography (CT) angiography revealed an AComA aneurysm with perfusion from well-developed bilateral A1 segments. Emergency coil embolization was performed. Clear visualization of the aneurysm from the right side required advancing the DAC to the C2 segment of the right ICA and forcefully injecting the contrast medium. Postoperatively, CT revealed extensive contrast leakage predominantly in the right cerebral hemisphere. The patient subsequently developed left-sided incomplete hemiparesis and left hemispatial neglect, leading to a diagnosis of CIE. The symptoms improved early with fluid replacement and antiepileptic drug administration.</p><p><strong>Conclusion: </strong>Forced injection of contrast medium from a DAC positioned distally in the ICA to visualize an aneurysm may have contributed to the onset of CIE. Alternative imaging approaches, such as ipsilateral angiography with contralateral blood flow suppression or contralateral angiography, may enhance aneurysm visualization while reducing the risk of CIE.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"242"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628319","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":"Optimal intervention for ruptured cerebral arteriovenous malformation during pregnancy.","authors":"Youhei Takeuchi, Hiroyuki Sakata, Tomohisa Ishida, Masayuki Ezura, Hidenori Endo","doi":"10.25259/SNI_320_2025","DOIUrl":"10.25259/SNI_320_2025","url":null,"abstract":"<p><strong>Background: </strong>Cerebral arteriovenous malformation (AVM) is a significant cause of hemorrhagic stroke in pregnant women. The risk of rebleeding after an initial hemorrhage during pregnancy is high, necessitating aggressive intervention and careful management. However, the optimal timing and method of intervention remain unclear. In particular, there has been little discussion regarding cases in which rebleeding occurred despite aggressive intervention. We present a case of cerebral AVM with intraventricular hemorrhage during pregnancy, which subsequently rebled after a cesarean section.</p><p><strong>Case description: </strong>A 30-year-old primigravida at 27 weeks of gestation presented with a sudden headache and was diagnosed with intraventricular hemorrhage. Magnetic resonance imaging revealed a flow void in the left fusiform gyrus, confirming a Spetzler-Martin Grade 2 AVM. Due to the deep location and limited safety data on Onyx use during pregnancy, surgery was postponed until after delivery. Cesarean section was planned at 32 weeks to ensure fetal viability. No rebleeding occurred preoperatively. At 32 weeks and 2 days, a cesarean section was performed under spinal anesthesia, delivering a male infant weighing 1,567 g. Postoperative computed tomography revealed intraventricular rebleeding, although no neurological deterioration occurred. Emergency transarterial embolization (TAE) with Onyx was performed the following day, followed by another TAE and AVM resection. Angiography confirmed complete lesion removal, and both the mother and child recovered favorably.</p><p><strong>Conclusion: </strong>Considering the high rates of rebleeding and the significant maternal and fetal mortality, prioritizing rebleeding prevention may be a key component of the intervention strategy for ruptured AVMs during pregnancy.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"238"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628435","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":"Short review/perspective: Critical early treatment of infections including meningitis and/or ventriculitis due to recurrent postoperative lumbar cerebrospinal fluid leaks, lumbar drains, or intracranial devices/implants.","authors":"Nancy E Epstein, Marc A Agulnick","doi":"10.25259/SNI_535_2025","DOIUrl":"10.25259/SNI_535_2025","url":null,"abstract":"<p><strong>Background: </strong>Early treatment of cerebrospinal fluid (CSF) infections, including meningitis and/or ventriculitis (MV) is critical to minimize morbidity/mortality. Infections/MV are typically attributed to; recurrent postoperative lumbar CSF fistulas with drainage through the skin (12.2-33.3%), lumbar drains, and/or various intracranial devices (i.e. external ventricular drains, intracranial pressure monitors).</p><p><strong>Methods: </strong>Lumbar MR examinations best document recurrent postoperative dural fistulas with subcutaneous extension leading to leaking wounds; the longer these leaks persist, the greater the risk of CSF infection and MV. Classical cranial MR findings of MV due to prior lumbar surgery, lumbar drains or multiple intracranial devices include; ventricular debris, ependymal enhancement, hydrocephalus, extra-axial fluid collections, infarcts (arteritis/ventriculitis), abscesses, and granulomas.</p><p><strong>Results: </strong>Surgery for recurrent postoperative lumbar CSF leaks typically warrant wound reexploration with direct sutured-dural repairs, use of muscle patch grafts (avoid fat - it resorbs), fibrin sealants/fibrin glues (FS/FG), lumbar drains, lumboperitoneal and/or pseudomeningocele-peritoneal shunts. For patients who additionally develop meningitis/ventriculitis, one should consider adding intraventricular (IVT) or lumbar intrathecal (IT) antibiotic therapy to routine intravenous antibiotics. Notably, all efforts should be made to avoid the high mortality rates associated with VM (i.e., 13% to 60%).</p><p><strong>Conclusion: </strong>Recurrent postoperative lumbar CSF leaks (i.e., especially after CSF breaches the skin), lumbar drains, and/or intracranial devices/implants may cause infections including meningitis and ventriculitis (MV). It is critical to recognize and treat these infections/MV early to avoid high morbidity and mortality rates.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"240"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628441","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":"Nutritional status is associated with inferior clinical outcomes: A National Surgical Quality Improvement Project analysis of surgically treated spinal vascular lesions.","authors":"Taylor Furst, Sajal Akkipeddi, Prasanth Romiyo, Derek David George, Tyler Schmidt, Thomas Mattingly, Tarun Bhalla, Vincent Nguyen, Matthew Bender","doi":"10.25259/SNI_346_2025","DOIUrl":"10.25259/SNI_346_2025","url":null,"abstract":"<p><strong>Background: </strong>Spinal arteriovenous shunts (sAVSs) consist of direct arterial-venous connections without intervening capillaries. Although rare, if left untreated, permanent neurological injury can occur. The present study aims to assess preoperative risks associated with 30-day unplanned readmission, 30-day unplanned reoperation (RTOR), nonhome discharge, and postoperative complications.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Project database was employed to isolate cases of surgically treated sAVSs from 2012 to 2022. Univariate comparisons and multivariate logistic regression analyses were performed.</p><p><strong>Results: </strong>Among the cohort, there were 18 (5.0%) 30-day readmissions, 18 (5.0%) RTOR, 145 (40.0%) nonhome discharges, and 52 (14.0%) cases with a postoperative complication. Preoperative hypoalbuminemia was a risk for 30-day readmission (<i>P</i> = 0.03), nonhome discharge (<i>P</i> < 0.001), and postoperative complications (<i>P</i> = 0.003) in univariate testing, while normoalbuminemia decreased the odds of nonhome discharge in multivariate analysis (OR = 0.2 [0.05-0.89], <i>P</i> = 0.03). Postoperative complications were associated with RTOR in both univariate and multivariate analyses (OR = 5.1 [1.44-17.94], <i>P</i> = 0.01). 30-day readmissions (72.2%, <i>P</i> = 0.008), RTOR (70.6%, <i>P</i> = 0.01), postoperative complications (63.5%, <i>P</i> < 0.001), and lower preoperative hematocrit (<i>P</i> = 0.004) resulted in more nonhome discharges in univariate analyses, while thoracic (odds ratio [OR] = 15.2 [1.08-213.74], <i>P</i> = 0.04) and thoracolumbar (OR = 20.9 [1.32-330.05], <i>P</i> = 0.03) sAVS and preoperative steroid use (OR = 11.1 [1.19-103.73], <i>P</i> = 0.04) increased the odds of postoperative complications in multivariate analysis.</p><p><strong>Conclusion: </strong>Preoperative hypoalbuminemia increases the odds of 30-day readmissions, nonhome discharges, and postoperative complications, stressing the importance of preoperative optimization. 30-day readmission and RTOR are associated with increased rates of postoperative complications, while 30-day readmissions, RTOR, and postoperative complications resulted in more nonhome discharges.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"237"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628426","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}