World neurosurgery最新文献_第9页

Analysis of Location-Specific Volumetric Cutoffs in Intraparenchymal Hemorrhage: A Case Series of 94 Patients 脑实质内出血的位置特异性容量切断分析：94例病例系列。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-01-01 DOI: 10.1016/j.wneu.2025.124697

Marco Barchi , Alberto Morello , Augusto Leone , Francesco Carbone , Stefano Colonna , Enrico Lo Bue , Andrea Bianconi , Paolo Cerrato , Diego Garbossa , Fabio Cofano

Background

Accurate prognostic assessment is essential for guiding management in intracerebral hemorrhage (ICH). While hematoma volume and location are key determinants, recent evidence highlights the need for a more precise topographic evaluation. We investigated whether newly proposed location-specific volumetric cutoffs improve the prediction of 6-month functional outcome, assessed with the modified Rankin Scale, and 30-day mortality.

Methods

We retrospectively analyzed 94 patients with spontaneous ICH, performing semi-automated hematoma volume segmentation and categorizing its topographic location as lobar, external capsule/putamen, internal capsule/globus pallidus, thalamus, cerebellum, or brainstem. Ordinal logistic regression was used to evaluate the predictive performance of location-specific volumetric cutoffs for 6-month disability (modified Ranking Scale), both as standalone predictors and when incorporated into the ICH and functional outcome scores. Binary logistic regression evaluated their ability to predict 30-day mortality, both as standalone and when integrated into the ICH score.

Results

Location-specific cutoffs improved prediction of 6-month disability compared to the traditional 30-mL threshold (Nagelkerke's R² [R²N]: 0.170 vs. 0.092). Their integration enhanced the performance of both the ICH score (R²N: 0.267 vs. 0.253) and the FUNC score (R²N: 0.262 vs. 0.244). For 30-day mortality, location-specific cutoffs performed better as standalone predictors (area under the curve: 0.757 vs. 0.715) but reduced accuracy when integrated into the ICH score (area under the curve: 0.864 vs. 0.929).

Conclusions

Location-specific volumetric cutoffs improve the prediction of long-term disability and enhance the performance of established prognostic scores. However, this benefit does not extend to short-term mortality, for which the traditional ICH score remains superior. Larger multicenter studies are needed to validate their clinical applicability.

背景：准确的预后评估对指导脑出血（ICH）的治疗至关重要。虽然血肿的体积和位置是关键的决定因素，但最近的证据强调需要更精确的地形评估。我们研究了新提出的位置特异性容量截断是否可以改善6个月功能结局的预测，用改良的Rankin量表（mRS）评估，以及30天死亡率。方法：回顾性分析94例自发性脑出血患者，进行半自动血肿体积分割，并将其地理位置分为大叶、外包膜/壳核、内包膜/苍白球、丘脑、小脑或脑干。使用有序逻辑回归来评估6个月残疾（mRS）的特定位置体积截断值的预测性能，既可以作为独立预测指标，也可以纳入ICH和FUNC评分。二元逻辑回归评估了他们预测30天死亡率的能力，无论是作为独立的还是与ICH评分相结合的。结果：与传统的30-mL阈值（R2N = 0.170 vs . 0.092）相比，位置特异性阈值改善了对6个月残疾的预测。它们的整合提高了ICH评分（R2N 0.267 vs 0.253）和FUNC评分（R2N 0.262 vs 0.244）的表现。对于30天死亡率，地点特异性截止点作为独立预测指标表现较好（AUC 0.757 vs 0.715），但当整合到ICH评分时准确性降低（AUC 0.864 vs 0.929）。结论：特定位置的容量临界值改善了对长期残疾的预测，并提高了已建立的预后评分的性能。然而，这种益处并没有扩展到短期死亡率，传统的ICH评分仍然优于短期死亡率。需要更大规模的多中心研究来验证其临床适用性。

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引用次数: 0

Timing of Tracheostomy After Anterior Cervical Decompression in Traumatic Cervical Spinal Cord Injury: A Systematic Review and Meta-Analysis 外伤性颈脊髓损伤前路减压后气管造口术的时机：系统回顾和荟萃分析。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-01-01 DOI: 10.1016/j.wneu.2025.124707

Michael Coffin, Kyle McGrath, Rebecca Garner, Joseph Cheng, Rani Nasser, Owoicho Adogwa, Benjamin Motley, Justin Virojanpa

Objective

Compare early versus late tracheostomy after anterior cervical decompression in traumatic cervical spinal cord injury for effects on in-hospital outcomes.

Methods

In concordance with PRISMA guidelines, PubMed (MEDLINE), Embase, and Google Scholar were searched. Inclusion was adults with traumatic cervical spinal cord injury undergoing anterior decompression with postoperative tracheostomy timing harmonized. Primary outcomes were in-hospital mortality, duration of mechanical ventilation, and intensive care unit (ICU) length of stay (LOS). Secondary outcomes were pneumonia and anterior cervical surgical-site infection (SSI). Meta-analysis was performed using a random-effects model. Mean differences (MDs) were for continuous outcomes, odds ratios (ORs) for dichotomous outcomes, and heterogeneity with I².

Results

Fourteen studies were included (N = 693). Three comparative cohorts (N = 210) contributed data for duration of mechanical ventilation, ICU LOS, and anterior SSI. Four cohorts (N = 308) contributed mortality data. Early tracheostomy was associated with a shorter duration of mechanical ventilation compared with late tracheostomy (MD −5.3 days; 95% CI −6.33 to −4.28; I² = 0%). ICU LOS was also shorter in the early group with high heterogeneity (MD −5.4 days; 95% CI −10.65 to −0.18; I² = 63%). Mortality (OR 1.64; 95% CI 0.38–7.06; I² = 61%) and anterior SSI rates (OR 0.32; 95% CI 0.06–1.59; I² = 0%) did not differ between groups.

ConclusionS

In anterior cervical decompression cohorts, our results in early tracheostomy were associated with reduced ventilator days and ICU LOS with no observed risk to SSI. Larger prospective, surgery-specific studies with standardized timing and definitions are needed.

目的：比较外伤性颈脊髓损伤（SCI）前路减压术后早期与晚期气管造口术对住院预后的影响。方法：按照PRISMA指南，检索PubMed （MEDLINE）、Embase和谷歌Scholar。纳入了接受前路减压和术后气管造口时间协调的外伤性颈椎脊髓损伤的成人患者。主要结局是住院死亡率、机械通气持续时间和ICU住院时间（LOS）。次要结局是肺炎和宫颈前手术部位感染（SSI）。采用随机效应模型进行meta分析。平均差异（MD）为连续结局，优势比（OR）为二分类结局，异质性为I2。结果：纳入14项研究（N=693）。三个比较队列（N=210）提供了机械通气持续时间、ICU LOS和前路SSI的数据。4个队列（N=308）提供了死亡率数据。与晚期气管造口术相比，早期气管造口术与较短的机械通气时间相关（MD -5.3天；95% CI -6.33至-4.28;I2=0%）。早期组ICU LOS也较短，异质性高（MD -5.4天；95% CI -10.65 ~ -0.18; I2=63%）。死亡率（OR 1.64; 95% CI 0.38-7.06; I2=61%）和前路SSI发生率（OR 0.32; 95% CI 0.06-1.59; I2=0%）组间无差异。结论：在颈椎前路减压队列中，我们的研究结果表明，早期气管造口术与呼吸机天数和ICU LOS减少有关，没有观察到SSI的风险。更大的前瞻性，手术特异性的研究需要标准化的时间和定义。

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引用次数: 0

Geographic and Socioeconomic Predictors of Early Follow-Up Loss in Patients Undergoing Pituitary Neuroendocrine Tumors (PitNETs) Resection: A Retrospective Review of 1143 Cases 垂体神经内分泌肿瘤（PitNETs）切除术患者早期随访缺失的地理和社会经济预测因素：1143例回顾性分析

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-01-01 DOI: 10.1016/j.wneu.2025.124643

Daniel Quintana , Rithvik Ramesh , Robert C. Osorio , Wesley Shoap , Paul McMillan Villalobos , Philip V. Theodosopoulos , Sandeep Kunwar , Jose Gurrola , Ivan H. El Sayed , Manish K. Aghi , Ezequiel Goldschmidt

Objective

Postoperative follow-up after pituitary neuroendocrine tumor (PitNET) resection is essential for monitoring tumor recurrence and endocrinologic deficits. Despite advances in telehealth, loss to follow-up remains a persistent challenge across neurosurgical patients. This study aims to identify factors to identify patients are at higher risk of being lost to follow-up after surgery.

Methods

A retrospective analysis was conducted on 1143 adult patients who underwent PitNET resection between 2012 and 2019 at a single institution. Clinical and radiological data were analyzed to assess loss to follow-up in the cohort. Multivariable logistic and negative binomial regression models were used to identify factors independently associated with follow-up loss.

Results

Of the 1143 patients included, 131 (11.5%) were lost to follow-up within 3 months after surgery. Compared to those with longer follow-up, these patients were younger (median 44.0 vs. 51.0 years, P = 0.032), lived farther from the medical center (515.5 vs. 309.7 km, P = 0.024), experienced longer delays to surgery (148 vs. 104 days, P = 0.027), and had smaller tumors (1.54 vs. 1.74 cm, P = 0.04). Multivariable analysis identified uninsured status (odds ratio 3.43, 95% confidence interval 1.14–10.33, P = 0.02) and greater distance to care (odds ratio 1.01, 95% confidence interval 1.00–1.01, P = 0.03) as independent predictors of early follow-up loss.

Conclusions

To follow-up after PitNET surgery remains a substantial concern, particularly among younger, uninsured patients and those residing farther from the treating center. These findings highlight the importance of early identification and proactive outreach to high-risk individuals.

目的：PitNET切除术后随访是监测肿瘤复发和内分泌功能缺损的重要手段。尽管远程医疗取得了进步，但对神经外科患者的随访损失仍然是一个持续的挑战。本研究旨在确定患者术后失访风险较高的因素。方法：回顾性分析2012年至2019年在同一机构接受PitNET切除术的1143名成年患者。对临床和放射学资料进行分析，以评估随访对队列的损失。采用多变量logistic和负二项回归模型来确定与随访损失独立相关的因素。结果：纳入的1143例患者中，131例（11.5%）在术后3个月内失访。与随访时间较长的患者相比，这些患者更年轻（中位数为44.0岁对51.0岁，p = 0.032），居住距离医疗中心更远（515.5公里对309.7公里，p = 0.024），手术延迟时间更长（148天对104天，p = 0.027），肿瘤较小（1.54厘米对1.74厘米，p = 0.04）。多变量分析发现，未参保状态（OR 3.43, 95% CI 1.14-10.33, p = 0.02）和较远的护理距离（OR 1.01, 95% CI 1.00-1.01, p = 0.03）是早期随访损失的独立预测因素。结论：PitNET手术后的随访仍然是一个重要的问题，特别是在年轻，无保险的患者和居住在远离治疗中心的患者中。这些发现强调了早期识别和主动向高危人群伸出援手的重要性。

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引用次数: 0

Letter to the Editor Regarding “The Key to Percutaneous Balloon Compression Success: Pear or Banana?” 致编辑关于“经皮球囊加压成功的关键：梨还是香蕉？”

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-01-01 DOI: 10.1016/j.wneu.2025.124688

Tom Theys

引用次数: 0

Neuroanatomy Education Access by Country Income Level: A Mixed-Methods Analysis 按国家收入水平划分的神经解剖学教育：一种混合方法分析。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-01-01 DOI: 10.1016/j.wneu.2025.124683

Daniele S.C. Ramsay , Benjamin J. Nicholls , Natasha Dixon , Marimo Rossiter , Lana Al-Nusair , Gideon Adegboyega , Kevin Tsang , Nigel Mendoza

Objective

Neuroanatomy is complex and often perceived as challenging to students and residents. It is important to have an appreciation of neuroanatomy as it directs sound clinical reasoning and may provide inspiration to pursue higher training in a neuroscience-related medical specialty.

Methods

We conduced a cross-sectional analysis of 519 pre-course questionnaire responses. The questionnaire collected basic demographic variables and opinions regarding the provision of neuroanatomy on a Likert scale. A mixed methods approach was undertaken comparing quantitative and free text responses between respondents from high-income countries (HICs) and low-middle income countries (LMICs).

Results

Participants from HICs (N = 383) formed the largest group compared to LMICs (N = 136) and most respondents reported being in medical school (N = 271, 52%). Multivariable proportional ordinal regression, highlighted greater dissatisfaction with neuroanatomy provision by LMIC trainees (odds ratio = 2.34, 95% confidence interval = 1.58–3.48, P < 0.001). Thematic analysis uncovered 4 key barriers to surgical neuroanatomy education including: the need for greater multimodal teaching, a lack of specialist led teaching, systematic barriers, and the complexity of neuroanatomy. LMIC trainees were more likely to report a lack of specialist teaching as a barrier (χ2 = 7.68, P = 0.006).

Conclusions

HIC and LMIC neuroanatomy provision differs, with a lack of specialist teaching highlighted as a barrier in our survey. Greater focus is required to ensure equitable access to neuroanatomy teaching with international online courses providing a useful bridge between HIC and LMIC neuroanatomy provision.

神经解剖学是一门复杂的学科，对学生和住院医生来说是一门具有挑战性的学科。了解神经解剖学很重要，因为它指导合理的临床推理，并可能为追求神经科学相关医学专业的更高培训提供灵感。对519份神经解剖学课程课前问卷进行了分析。问卷收集了基本的人口统计变量和关于提供神经解剖学的意见，以李克特量表。采用混合方法比较高收入国家（HIC）和中低收入国家（LMIC）受访者的定量和自由文本回复。与LMIC （N=136）相比，来自HIC的参与者（N=383）构成了最大的群体，大多数受访者报告在医学院（N=271, 52%）。多变量比例有序回归显示，LMIC学员对神经解剖学提供的不满意程度更高(OR=2.34, 95% CI=1.58-3.48, p

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引用次数: 0

Sagittal Alignment and Clinical Outcomes After Biportal Endoscopic Transforaminal Lumbar Interbody Fusion Using a Single Expandable Cage: One Year Follow-up 双门静脉内镜下经椎间孔腰椎椎体间融合后矢状位对齐和临床结果：1年随访。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-01-01 DOI: 10.1016/j.wneu.2025.124698

Sub-Ri Park , Namhoo Kim , Ji-Won Kwon , Kyung-Soo Suk , Hak-Sun Kim , Seong-Hwan Moon , Si-Young Park , Byung Ho Lee , Jae-Won Shin , Jin-Oh Park

Objective

Advancements in expandable cage technology may overcome limitations, such as narrow working corridor, continuous irrigation, and endplate injury risk in biportal endoscopic transforaminal lumbar interbody fusion (BE-TLIF). We evaluate sagittal realignment, fusion rates, and clinical outcomes over 1 year using a single bullet-type expandable cage.

Methods

This retrospective study included 29 patients (38 levels) who underwent BE-TLIF with a single expandable cage and were followed for at least 12 months. Radiological assessments included disc height (DH), segmental lordosis (SL), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), PI–LL mismatch, and cage subsidence. Clinical outcomes were evaluated using back and leg Visual Analog Scale (VAS), Oswestry Disability Index (ODI), 36-Item Short Form Survey (SF-36), and EuroQol-5 Dimension (EQ-5D). Fusion was evaluated using CT based Bridwell classification at 6 and 12 months.

Results

At 12 months, the fusion rate was 92.1%, with significant subsidence (≥2 mm) in 3 levels. Anterior and posterior DH increased by 3.97 and 4.22 mm, while SL and LL improved by 3.01° and 5.00°, respectively. Back and leg VAS and ODI decreased by 3.0, 5.0, and 12.76 points, while EQ-5D increased by 5.81 points. Greater PI–LL correction correlated with higher fusion rates and better functional recovery. Patients with preoperative sagittal malalignment showed significant improvements. Cage size and type had limited effect on outcomes.

Conclusions

BE-TLIF using a single bullet-type expandable cage achieved favorable outcomes at 1 year, with meaningful sagittal correction and fusion rates, supporting the non-inferiority of this construct in short-segment lumbar fusion.

目的：在双门静脉内镜下经椎间孔腰椎椎体间融合术（BE-TLIF）中，可扩展笼技术的进步可能克服工作通道狭窄、持续灌洗和终板损伤风险等局限性。我们评估了矢状面重新定位、融合率和一年内使用单一子弹型可扩展笼的临床结果。方法：本回顾性研究包括29例（38个级别）采用单个可扩展笼进行BE-TLIF并随访至少12个月的患者。放射学评估包括椎间盘高度（DH）、节段性前凸（SL）、腰椎前凸（LL）、骨盆发生率（PI）、骨盆倾斜（PT）、PI-LL不匹配和椎笼下沉。临床结果采用背部和腿部视觉模拟量表（VAS）、Oswestry残疾指数（ODI）、36项简短问卷调查（SF-36）和EuroQol-5维度（EQ-5D）进行评估。在6个月和12个月时使用基于CT的Bridwell分类评估融合情况。结果：12个月时，融合率为92.1%，3节段明显下沉（≥2mm）。前后DH分别提高了3.97 mm和4.22 mm， SL和LL分别提高了3.01°和5.00°。背部和腿部VAS和ODI分别下降3.0、5.0和12.76分，EQ-5D增加5.81分。更大的PI-LL校正与更高的融合率和更好的功能恢复相关。术前矢状面排列失调的患者有明显改善。笼的大小和类型对结果的影响有限。结论：使用单一子弹型可扩展cage的BE-TLIF在一年内获得了良好的结果，具有意义的矢状面矫正和融合率，支持该结构在短节段腰椎融合中的非自卑性。

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引用次数: 0

Percutaneous Full Endoscopic Interlaminar Decompression Combined with Percutaneous Vertebroplasty in Treatment of Thoracic Vertebral Tumors 经皮全内镜interlamİnar减压联合经皮椎体成形术治疗胸椎肿瘤。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-01-01 DOI: 10.1016/j.wneu.2025.124703

Özkan Çeliker, Murat Kocaoğlu

Objective

Separation surgery is a good alternative as a minimally invasive procedure in the treatment of oncological disease. We applied percutaneous full endoscopic interlaminar decompression (PEID) with vertebroplasty in treatment of thoracic tumors to avoid the morbidity associated with conventional approaches.

Methods

Between May 2023 and June 2025, 6 patients with thoracic vertebral tumors (from T5 to T12) underwent PEID. The patients were administered general anesthesia and positioned in the prone position. PEID with vertebroplasty was performed using the interlaminar approach.

Results

The patients included 3 women and 3 men with a mean age of 53.3 ± 9.7 years (range, 44–66 years). There were improvements in cord compression findings, and mean visual analog scale scores improved from 6.5 ± 1 preoperatively to 3.5 ± 1.1 postoperatively. Pathology showed lymphoma in 2 patients, metastasis in 2 patients, cavernous hemangioma in 1 patient, and plasmacytoma in 1 patient. Mean surgical time was 101 ± 18 minutes.

Conclusions

In this study, we defined a full endoscopic interlaminar separation technique, PEID, that we applied in combination with vertebroplasty in patients with tumors in the thoracic vertebra levels.

目的：分离手术作为一种微创手术是治疗肿瘤病例的良好选择。我们采用经皮腔镜椎板间减压联合椎体成形术治疗胸椎肿瘤，以避免传统手术方法引起的并发症。方法：2023年5月至2025年6月，6例胸椎肿瘤患者（T5 ~ T12）行PEID手术。全麻下，患者均取俯卧位。作者采用椎板间入路椎体成形术进行PEID。结果：女性3例，男性3例，平均年龄53,3±9.7岁（44 ~ 66岁）。脊髓受压情况有所改善，VAS评分从术前6.5±1分提高到术后3.5±1.1分。淋巴瘤2例，转移2例，海绵状血管瘤1例，浆细胞瘤1例。平均手术时间101±18分钟。结论：在这项研究中，我们试图定义一种完整的内窥镜层间分离技术，我们将其与椎体成形术结合应用于胸椎段肿瘤患者。

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引用次数: 0

Efficacy of Hybrid Sleeve-Assisted Surgery for Spinal Dural Arteriovenous Fistula 混合套筒辅助手术治疗硬脊膜动静脉瘘的疗效分析。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-01-01 DOI: 10.1016/j.wneu.2025.124702

Haitong Liu , Jinfang Liu , Juncheng Wang , Peng Gao , Haibo Liu , Benlei Li , Xin Dai , Bin Zhang

Background

This study aimed to evaluate the efficacy of hybrid surgery combined with the sleeve technique in treating spinal dural arteriovenous fistula (SDAVF).

Methods

A retrospective analysis was conducted on the clinical data of 16 patients with SDAVF who underwent hybrid surgery between October 2020 and June 2024. Spinal-cord function was quantitatively assessed preoperatively and postoperatively using the modified Aminoff-Logue Scale. Postoperative follow-up was 1–36 months. A decrease in the Aminoff-Logue Scale score indicated functional improvement, whereas an increase indicated deterioration.

Results

Intraoperative spinal digital subtraction angiography results confirmed the complete disappearance of the fistulas in all the 16 cases. Thirteen patients (81%) exhibited improved spinal-cord function, whereas 3 patients showed no changes.

Conclusions

Hybrid sleeve-assisted surgery integrates the advantages of endovascular interventional therapy and microsurgery, reducing late recurrence and surgical trauma. Consequently, this combined approach represents a valuable, clinically translatable therapeutic modality for the management of SDAVF.

背景：本研究旨在评价混合手术联合套筒技术治疗脊髓硬膜动静脉瘘（SDAVF）的疗效。方法：回顾性分析2020年10月至2024年6月间行混合手术的16例SDAVF患者的临床资料。术前和术后脊髓功能采用改良的Aminoff-Logue量表（ALS）进行定量评估。术后随访1 ~ 36个月。ALS评分降低表明功能改善，而升高表明功能恶化。结果：术中脊髓数字减影血管造影结果证实16例患者瘘管完全消失。13例患者（81%）表现出脊髓功能的改善，而3例患者没有变化。结论：混合套筒辅助手术融合了血管内介入治疗和显微手术的优点，减少了晚期复发和手术创伤。因此，这种联合方法代表了一种有价值的、临床可翻译的治疗SDAVF的治疗方式。

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引用次数: 0

Paddle Lead Spinal Cord Stimulation for Chronic Pain in Octogenarians: A Case Series 桨铅脊髓刺激治疗老年慢性疼痛：一个病例系列。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-01-01 DOI: 10.1016/j.wneu.2025.124666

Stephen Jaffee , Griffin White , Trent Kite , Matthew Perry , Jenna Li , Nestor D. Tomycz

Background

Spinal cord stimulation (SCS) is a surgical technique for chronic pain involving the placement of percutaneous, or paddle leads into the spinal epidural for pain treatment. Paddle lead SCS is a more invasive procedure due to the requirement of bone removal (laminotomy/laminectomy) and may therefore be less commonly offered to older patients.

Methods

A retrospective review was conducted of a database of all paddle lead spinal cord stimulators implanted from January 1st, 2019, to July 1st, 2024, by a single surgeon. Octogenarian patients were identified within this cohort and their data analyzed, including demographics and treatment history. Postoperative pain was subjectively measured during follow-up visits. Descriptive statistics were compiled, and a one-way analysis of variance test was used to measure the mean postoperative pain levels.

Results

Fifty-one patients were included in our cohort with a median age of 83 (interquartile range 81–85). Over one-half (n = 27, 53%) of patients had concurrent back and leg pain. There was no statistically significant differences in regard to location of presenting pain and improvement of pain. Moreover, there was no statistically significant difference in trial improvement with postoperative pain outcomes in our cohort. Two (4%) patients suffered postoperative infections, and two (4%) had device removal. There were no neurologic deficits nor mortality.

Conclusions

Paddle lead SCS may be performed safely in octogenarians with no obvious increase in complications or less efficacy and should not be precluded in these patients with chronic pain and may have a favorable risk/benefit profile compared to more invasive spinal surgeries.

脊髓刺激（SCS）是一种治疗慢性疼痛的外科技术，涉及经皮或桨状引线进入脊髓硬膜外以治疗疼痛。由于需要去骨（椎板切开术/椎板切除术），桨导联SCS是一种更具侵入性的手术，因此可能不太常用于老年患者。方法回顾性分析2019年1月1日至2024年7月1日由一名外科医生植入的所有桨铅脊髓刺激器的数据库。在这个队列中确定了80多岁的患者，并分析了他们的数据，包括人口统计学和治疗史。术后疼痛在随访时主观测量。编制描述性统计，采用单因素方差分析检验测量术后平均疼痛水平。结果51例患者纳入我们的队列，中位年龄为83岁（四分位数范围为81-85）。超过一半（n = 27,53 %）的患者同时有背部和腿部疼痛。在出现疼痛的部位和疼痛的改善方面没有统计学上的显著差异。此外，在我们的队列中，试验改善与术后疼痛结局没有统计学上的显著差异。2例（4%）患者发生术后感染，2例（4%）患者切除了器械。无神经功能缺损，无死亡。结论spaddle - lead SCS在80多岁老人中可以安全进行，没有明显的并发症增加或疗效降低，不应排除在这些慢性疼痛患者中，与更具侵入性的脊柱手术相比，可能具有更好的风险/收益。

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引用次数: 0

The Continuing Legacy of M. Gazi Yaşargil and the Microneurosurgery Laboratory at Yeditepe University School of Medicine Gazi yaargil和Yeditepe大学医学院微神经外科实验室的持续遗产。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-01-01 DOI: 10.1016/j.wneu.2025.124668

Aysu İyigün Kabakcı , Abuzer Güngör , Sima Cebecik Çakır , Gökberk Erol , Kemal Kantarcı , Semih Fidan , Uğur Türe

Background

The importance of cadaver studies has been evident throughout history. Herophilus, as the first in human history to perform systemic dissections of the human body, was born in Chalcedon, where the Yeditepe University Microneurosurgery Laboratory was established to perpetuate Professor Yaşargil's esteemed legacy. This article aims to showcase the historical background and the workflow of the laboratory to highlight its contributions to microneurosurgery.

Methods

The archives of the Department of Neurosurgery at Yeditepe University were analyzed from August 2005 to July 2025. Historical background of the establishment of the microneurosurgery laboratory was explained in conjunction with the İstanbul Yaşargil Microneurosurgery Courses. Four parts of the laboratory were defined. The achievements of the laboratory and the fellow training curriculum were clarified in detail.

Results

The department of neurosurgery at Yeditepe University was constructed by the senior author (U.T.) on August 26, 2005, and then the microneurosurgery laboratory was constructed within the department on May 30, 2008. After its creation, the idea of the İstanbul Yaşargil Microneurosurgery Courses emerged through collaboration with Professor Yaşargil and the senior author (U.T.). To date, fellows and observers have authored more than 100 publications with the department.

Conclusions

Under the visionary leadership of Professor Yaşargil, the Yeditepe University Microneurosurgery Laboratory has significantly impacted the field of neurosurgery, preparing the next generation to lead and innovate. We respectfully and gratefully dedicate this work to his memory.

背景：纵观历史，尸体研究的重要性是显而易见的。Herophilus，作为人类历史上第一个进行人体系统解剖的人，出生在Chalcedon， Yeditepe大学显微神经外科实验室成立，以延续ya argil教授的尊敬遗产。本文旨在展示该实验室的历史背景和工作流程，以突出其对微神经外科的贡献。方法：对2005年8月至2025年7月叶地特佩大学神经外科的档案资料进行分析。结合İstanbul yaargil微神经外科课程，解释了微神经外科实验室建立的历史背景。定义了实验室的四个部分。详细阐述了实验所取得的成果和研究员培训课程。结果：由资深作者（UT）于2005年8月26日建立了叶迪特佩大学神经外科，2008年5月30日在该科内建立了显微神经外科实验室。在创建之后，İstanbul ya argil微神经外科课程的想法通过与ya argil教授和资深作者（UT）的合作而出现。迄今为止，研究员和观察员已经与该部门合作撰写了一百多篇出版物。结论：在yyaargil教授富有远见的领导下，Yeditepe大学微神经外科实验室对神经外科领域产生了重大影响，为下一代的领导和创新做好了准备。我们怀着敬意和感激之情，以这部作品来纪念他。

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