Pub Date : 2025-02-15DOI: 10.1016/j.wneu.2025.123796
Kasuni H Ranawaka, Felipe Ramirez-Velandia, Thomas B Fodor, Aryan Wadhwa, Mira Salih, Tzak S Lau, Niels Pacheco-Barrios, Imad S Khan, Alejandro Enriquez-Marulanda, Rafael A Vega, Emmanuel Mensah, Martina Stippler, Philipp Taussky, Christopher S Ogilvy, Jennifer Hong
{"title":"Understanding risk factors for post-operative seizure following surgical treatment and middle meningeal artery embolization of chronic subdural hematomas.","authors":"Kasuni H Ranawaka, Felipe Ramirez-Velandia, Thomas B Fodor, Aryan Wadhwa, Mira Salih, Tzak S Lau, Niels Pacheco-Barrios, Imad S Khan, Alejandro Enriquez-Marulanda, Rafael A Vega, Emmanuel Mensah, Martina Stippler, Philipp Taussky, Christopher S Ogilvy, Jennifer Hong","doi":"10.1016/j.wneu.2025.123796","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123796","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123796"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-15DOI: 10.1016/j.wneu.2025.123801
Nicholas B Pohl, Jonathan Dalton, Rachel Huang, Rajkishen Narayanan, Omar H Tarawneh, Yunsoo Lee, Harrison Fellheimer, Maximilliano Buckner, Mark F Kurd, Ian David Kaye, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler
Purpose: This study investigated the association between preoperative body mass index and surgical outcomes, reoperation rate, and one-year patient-reported outcome measures (PROMs) following 1-3 level revision lumbar fusion.
Methods: Patients who underwent a 1-3 level revision lumbar fusion from 2011-2021 were included. Patients were grouped into BMI classes: Normal (18.5-24.99), Overweight (25.0-29.99), Obese Class 1 (30.0-34.99), Obese Class 2+ (≥35.0). Demographics, surgical characteristics, one-year reoperations, 90-day readmissions, and one-year PROMs were compared between cohorts. PROMs included the Short Form-12 Physical Component Score, Mental Component Score, Oswestry Disability Index, Visual Analog Scale (VAS) Back pain score, and VAS Leg pain score.
Results: In total, 743 patients were identified - 115 Normal Weight, 254 Overweight, 206 Obese Class 1, and 168 Obese Class 2+. Operative time (p=0.007) and length of stay (LOS) (p=0.002) were longer in patients with higher BMI. Multivariate regression demonstrated Obese Class 2+ was independently associated with longer operative times (Estimate: 32.43; p=0.008) and LOS (Estimate: 0.68; p=0.044). There were no differences in readmission (p=0.285) or reoperation rates (p=0.727). All patients received a similar benefit between preoperative and 1-year PROMs.
Conclusions: While more obese revision lumbar fusion patients experienced longer operative times and LOS, these patients ultimately experienced similar improvements from surgical intervention at one year postoperatively. Regardless of BMI class, all patients had comparable rates of readmission within 90 days and reoperation. These findings support previous lumbar fusion literature and suggest an indicated revision lumbar fusion in higher BMI class patients does not lead to further reoperations or worse PROMs.
{"title":"The Effect of Body Mass Index on Surgical Outcomes Following Aseptic Short-Segment Revision Lumbar Fusions: A Retrospective Study.","authors":"Nicholas B Pohl, Jonathan Dalton, Rachel Huang, Rajkishen Narayanan, Omar H Tarawneh, Yunsoo Lee, Harrison Fellheimer, Maximilliano Buckner, Mark F Kurd, Ian David Kaye, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler","doi":"10.1016/j.wneu.2025.123801","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123801","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the association between preoperative body mass index and surgical outcomes, reoperation rate, and one-year patient-reported outcome measures (PROMs) following 1-3 level revision lumbar fusion.</p><p><strong>Methods: </strong>Patients who underwent a 1-3 level revision lumbar fusion from 2011-2021 were included. Patients were grouped into BMI classes: Normal (18.5-24.99), Overweight (25.0-29.99), Obese Class 1 (30.0-34.99), Obese Class 2+ (≥35.0). Demographics, surgical characteristics, one-year reoperations, 90-day readmissions, and one-year PROMs were compared between cohorts. PROMs included the Short Form-12 Physical Component Score, Mental Component Score, Oswestry Disability Index, Visual Analog Scale (VAS) Back pain score, and VAS Leg pain score.</p><p><strong>Results: </strong>In total, 743 patients were identified - 115 Normal Weight, 254 Overweight, 206 Obese Class 1, and 168 Obese Class 2+. Operative time (p=0.007) and length of stay (LOS) (p=0.002) were longer in patients with higher BMI. Multivariate regression demonstrated Obese Class 2+ was independently associated with longer operative times (Estimate: 32.43; p=0.008) and LOS (Estimate: 0.68; p=0.044). There were no differences in readmission (p=0.285) or reoperation rates (p=0.727). All patients received a similar benefit between preoperative and 1-year PROMs.</p><p><strong>Conclusions: </strong>While more obese revision lumbar fusion patients experienced longer operative times and LOS, these patients ultimately experienced similar improvements from surgical intervention at one year postoperatively. Regardless of BMI class, all patients had comparable rates of readmission within 90 days and reoperation. These findings support previous lumbar fusion literature and suggest an indicated revision lumbar fusion in higher BMI class patients does not lead to further reoperations or worse PROMs.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123801"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-15DOI: 10.1016/j.wneu.2025.123699
Jian-Rong Yu , Hai Hu , Zhu Da-Qing , Jun-Tao Tan , Qin Zhuang
Background
This retrospective study aimed to identify key prognostic factors for patients with traumatic intracranial hemorrhage (TICH) and develop a comprehensive nomogram for prognostic assessment.
Methods
A retrospective study was carried out on TICH patients at a single-center hospital from October 2013 to September 2022. Using logistic regression analyses, key prognostic factors for TICH were identified and used to create a predictive nomogram model. This model was internally validated for its reliability and accuracy.
Results
The study included 252 TICH patients. Age ≥ 45 years (odds ratio [OR]: 3.13; 95% confidence interval [CI]: 1.27–5.36; P = 0.002), preoperative Glasgow Coma Scale score <5 (OR: 3.93; 95% CI: 2.26–7.35; P < 0.001), traumatic coagulation abnormalities status (OR: 1.67; 95% CI: 1.13–3.32; P = 0.035), and hematoma volume (P < 0.001) were identified as independent prognostic factors for TICH patients. A comprehensive predictive model was constructed based on these factors and internally validated to ensure its reliability and robustness.
Conclusions
Age, Glasgow Coma Scale scores, traumatic coagulation abnormalities status, and hematoma volume are independent prognostic factors for TICH. This model offers a valuable tool for clinicians in assessing TICH patient outcomes, warranting further validation and exploration of additional predictive factors for enhanced prognostic accuracy.
{"title":"A Nomogram for Predicting Prognostic Assessment of Traumatic Intracranial Hematoma: A Retrospective Cohort Study","authors":"Jian-Rong Yu , Hai Hu , Zhu Da-Qing , Jun-Tao Tan , Qin Zhuang","doi":"10.1016/j.wneu.2025.123699","DOIUrl":"10.1016/j.wneu.2025.123699","url":null,"abstract":"<div><h3>Background</h3><div>This retrospective study aimed to identify key prognostic factors for patients with traumatic intracranial hemorrhage (TICH) and develop a comprehensive nomogram for prognostic assessment.</div></div><div><h3>Methods</h3><div>A retrospective study was carried out on TICH patients at a single-center hospital from October 2013 to September 2022. Using logistic regression analyses, key prognostic factors for TICH were identified and used to create a predictive nomogram model. This model was internally validated for its reliability and accuracy.</div></div><div><h3>Results</h3><div>The study included 252 TICH patients. Age ≥ 45 years (odds ratio [OR]: 3.13; 95% confidence interval [CI]: 1.27–5.36; <em>P</em> = 0.002), preoperative Glasgow Coma Scale score <5 (OR: 3.93; 95% CI: 2.26–7.35; <em>P</em> < 0.001), traumatic coagulation abnormalities status (OR: 1.67; 95% CI: 1.13–3.32; <em>P</em> = 0.035), and hematoma volume (<em>P</em> < 0.001) were identified as independent prognostic factors for TICH patients. A comprehensive predictive model was constructed based on these factors and internally validated to ensure its reliability and robustness.</div></div><div><h3>Conclusions</h3><div>Age, Glasgow Coma Scale scores, traumatic coagulation abnormalities status, and hematoma volume are independent prognostic factors for TICH. This model offers a valuable tool for clinicians in assessing TICH patient outcomes, warranting further validation and exploration of additional predictive factors for enhanced prognostic accuracy.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123699"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-15DOI: 10.1016/j.wneu.2025.123721
Nadia V. Haik , Alison E. Burgess , Norris C. Talbot , Patrick Luther , James R. Bridges , Michael Folse , Elizabeth Jee , Jamie Toms
Background
Recent advances within the last decade have allowed robotics to become commonplace in the operating room. In the field of neurosurgery, robotics assist surgeons in pedicle screw placement and vertebral fusion procedures. The purpose of this review is to look at currently used spinal robots available in the market and compare their overall accuracy, cost, radiation exposure, general adverse events, and hospital readmission rates.
Methods
The authors searched databases including PubMed and Google Scholar for studies on robotic spine surgery using robotic systems: Mazor X/Mazor Renaissance, Cirq, ExcelsiusGPS, and ROSA ONE Spine. The literature was examined for robot accuracy, hospital readmission rates, adverse events, radiation exposure, and cost of the robots.
Results
In general, many studies recognize that robot-assisted spinal surgery is of equal or greater accuracy compared to freehand surgical techniques. Limited and conflicting data exist regarding radiation exposure and overall adverse events. The upfront cost of robotic spine-based surgery tends to be more than freehand, but minimal data evaluate the cost-effectiveness among robotic systems.
Conclusions
This review summarizes the findings comparing the individual robotic systems and their comparison to freehand surgery. As robotics become more popular in clinical practice, additional research is needed to assist hospitals and surgeons in making an informed decision about implementing robotics in spinal surgery.
{"title":"Robotic Systems in Spinal Surgery: A Review of Accuracy, Radiation Exposure, Hospital Readmission Rate, Cost, and Adverse Events","authors":"Nadia V. Haik , Alison E. Burgess , Norris C. Talbot , Patrick Luther , James R. Bridges , Michael Folse , Elizabeth Jee , Jamie Toms","doi":"10.1016/j.wneu.2025.123721","DOIUrl":"10.1016/j.wneu.2025.123721","url":null,"abstract":"<div><h3>Background</h3><div>Recent advances within the last decade have allowed robotics to become commonplace in the operating room. In the field of neurosurgery, robotics assist surgeons in pedicle screw placement and vertebral fusion procedures. The purpose of this review is to look at currently used spinal robots available in the market and compare their overall accuracy, cost, radiation exposure, general adverse events, and hospital readmission rates.</div></div><div><h3>Methods</h3><div>The authors searched databases including PubMed and Google Scholar for studies on robotic spine surgery using robotic systems: Mazor X/Mazor Renaissance, Cirq, ExcelsiusGPS, and ROSA ONE Spine. The literature was examined for robot accuracy, hospital readmission rates, adverse events, radiation exposure, and cost of the robots.</div></div><div><h3>Results</h3><div>In general, many studies recognize that robot-assisted spinal surgery is of equal or greater accuracy compared to freehand surgical techniques. Limited and conflicting data exist regarding radiation exposure and overall adverse events. The upfront cost of robotic spine-based surgery tends to be more than freehand, but minimal data evaluate the cost-effectiveness among robotic systems.</div></div><div><h3>Conclusions</h3><div>This review summarizes the findings comparing the individual robotic systems and their comparison to freehand surgery. As robotics become more popular in clinical practice, additional research is needed to assist hospitals and surgeons in making an informed decision about implementing robotics in spinal surgery.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123721"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-14DOI: 10.1016/j.wneu.2025.123682
Chandrima Biswas , Moataz D. Abouammo , Ludovica Pasquini , Guilherme Mansur , Mohammad Bilal Alsavaf , Kyle C. Wu , Ricardo L. Carrau , Daniel M. Prevedello
Background
Epidermoid cysts located completely within the pituitary infundibulum are a rare entity with only 7 reported cases. In this study, we have described our experience with the resection of intra-infundibular epidermoid cysts (IECs) and reviewed the existing literature highlighting its distinguishing features and operative nuances.
Methods
Three consecutive cases of IEC operated at our institute were retrospectively studied. PubMed and EMBASE databases were searched, and 7 case reports of IEC were found. Relevant clinical, radiological, and operative data of 10 cases were analyzed.
Results
The median age at diagnosis was 53.5 years, and 6 cases were males. Preoperatively, although the average tumor size was only 1.62 cm3, 80% of patients had visual disturbance, and 78% of patients had a deficiency in pituitary hormones. Five patients had preoperative diabetes insipidus. Mild diffusion restriction was noted in 4 out of 5 cases that mentioned it. The most common differential diagnosis considered was Rathke's cleft cyst and craniopharyngioma. Adhesion of the cyst wall to the stalk and/or the hypothalamus was a common occurrence resulting in residual wall being left behind in 50% of cases. An expanded endoscopic endonasal approach was utilized in 9 cases, and 1 case underwent frontotemporal craniotomy with resection via pretemporal approach. Postoperative chemical meningitis was demonstrated in 2 cases, and a sterile abscess was noted in another case.
Conclusions
IECs are rare tumors that are often misdiagnosed preoperatively. They have different postoperative morbidity profiles compared to other cystic lesions in the infundibulum. This makes it important to recognize this distinct entity.
{"title":"Intra-Infundibular Epidermoid Cysts: A Distinct and Rare Entity","authors":"Chandrima Biswas , Moataz D. Abouammo , Ludovica Pasquini , Guilherme Mansur , Mohammad Bilal Alsavaf , Kyle C. Wu , Ricardo L. Carrau , Daniel M. Prevedello","doi":"10.1016/j.wneu.2025.123682","DOIUrl":"10.1016/j.wneu.2025.123682","url":null,"abstract":"<div><h3>Background</h3><div>Epidermoid cysts located completely within the pituitary infundibulum are a rare entity with only 7 reported cases. In this study, we have described our experience with the resection of intra-infundibular epidermoid cysts (IECs) and reviewed the existing literature highlighting its distinguishing features and operative nuances.</div></div><div><h3>Methods</h3><div>Three consecutive cases of IEC operated at our institute were retrospectively studied. PubMed and EMBASE databases were searched, and 7 case reports of IEC were found. Relevant clinical, radiological, and operative data of 10 cases were analyzed.</div></div><div><h3>Results</h3><div>The median age at diagnosis was 53.5 years, and 6 cases were males. Preoperatively, although the average tumor size was only 1.62 cm<sup>3</sup>, 80% of patients had visual disturbance, and 78% of patients had a deficiency in pituitary hormones. Five patients had preoperative diabetes insipidus. Mild diffusion restriction was noted in 4 out of 5 cases that mentioned it. The most common differential diagnosis considered was Rathke's cleft cyst and craniopharyngioma. Adhesion of the cyst wall to the stalk and/or the hypothalamus was a common occurrence resulting in residual wall being left behind in 50% of cases. An expanded endoscopic endonasal approach was utilized in 9 cases, and 1 case underwent frontotemporal craniotomy with resection via pretemporal approach. Postoperative chemical meningitis was demonstrated in 2 cases, and a sterile abscess was noted in another case.</div></div><div><h3>Conclusions</h3><div>IECs are rare tumors that are often misdiagnosed preoperatively. They have different postoperative morbidity profiles compared to other cystic lesions in the infundibulum. This makes it important to recognize this distinct entity.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123682"},"PeriodicalIF":1.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-14DOI: 10.1016/j.wneu.2025.123672
João Felippe Donaire Rapozero, Mariana Favero Elias, Jhonny Richard de Souza, Caio Felipe Araujo Matalani
{"title":"Letter to the Editor Regarding “Cognition in Meningioma: Effects of Tumor Location and Tumor Removal”","authors":"João Felippe Donaire Rapozero, Mariana Favero Elias, Jhonny Richard de Souza, Caio Felipe Araujo Matalani","doi":"10.1016/j.wneu.2025.123672","DOIUrl":"10.1016/j.wneu.2025.123672","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123672"},"PeriodicalIF":1.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-14DOI: 10.1016/j.wneu.2025.123709
Yu-xiang Fan , Qing-yu Jiang , Yong-jie Ma , Hong-qi Zhang
{"title":"Arteriovenous Shunts Below the Conus: A Perspective on Developmental Anomalies","authors":"Yu-xiang Fan , Qing-yu Jiang , Yong-jie Ma , Hong-qi Zhang","doi":"10.1016/j.wneu.2025.123709","DOIUrl":"10.1016/j.wneu.2025.123709","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123709"},"PeriodicalIF":1.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-14DOI: 10.1016/j.wneu.2025.123725
Batsha Mehboob Khan , Umer Iqbal , Asad Fateh
{"title":"Letter to the Editor Regarding: “Safety and Efficacy of Ketorolac After Craniotomy for Tumor Resection”","authors":"Batsha Mehboob Khan , Umer Iqbal , Asad Fateh","doi":"10.1016/j.wneu.2025.123725","DOIUrl":"10.1016/j.wneu.2025.123725","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123725"},"PeriodicalIF":1.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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