World neurosurgery最新文献_第9页

The Case for Completely Abolishing Non-compete Agreements in Healthcare. 完全废除医疗行业竞业禁止协议的理由。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-02-14 DOI: 10.1016/j.wneu.2026.124885

Kathleen S Botterbush, Tobias A Mattei

引用次数: 0

Association Between C-Reactive Protein-Triglyceride-Glucose Index and Outcomes After Endovascular Thrombectomy in Patients with Acute Ischemic Stroke. 急性缺血性卒中患者血管内取栓后c反应蛋白-甘油三酯葡萄糖指数与预后的关系

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-02-14 DOI: 10.1016/j.wneu.2026.124871

Shuyang Zhou, Heng Ni, Hongfei Sang, Keqin Liu, Yongji Zhou, Xin Gu, Biao Chen, Junchao Zhang, Yijia Jin, Jinglong Gong, Congguo Yin

Objective: This study aimed to examine the relationship between the C-reactive protein-triglyceride-glucose index (CTI) and clinical outcomes in patients with acute stroke caused by large vessel occlusion in the anterior circulation following endovascular thrombectomy (EVT).

Methods: This retrospective study included patients who underwent EVT between January 1, 2020, and December 31, 2023. The CTI was computed using the following formula: 0.412 × Ln (C-reactive protein [mg/L]) + Ln (triglyceride [mg/dL] × fasting plasma glucose [mg/dL])/2. Based on the optimal cutoff value determined through receiver operating characteristic curve analysis, patients were categorized into low-CTI and high-CTI groups. The primary functional outcome was a favorable functional status at 90 days, defined as a modified Rankin Scale of 0-2. The relationship between CTI and clinical outcomes after EVT was assessed using univariate and multivariate logistic regression analyses.

Results: Data from 366 patients with acute stroke were analyzed. The univariate analysis revealed that higher CTI levels were associated with unfavorable functional outcomes. The multivariate-adjusted model demonstrated a significant association between CTI levels and clinical functional outcomes (95% confidence interval: 0.29-0.78; P = 0.004). The receiver operating characteristic curve analysis confirmed the ability of CTI to predict poor functional outcomes, with an area under the curve of 0.60.

Conclusions: CTI shows a significant relationship with clinical functional outcomes in patients with acute anterior circulation large vessel occlusion ischemic stroke following EVT.

目的：本研究旨在探讨血管内取栓术（EVT）后前循环大血管闭塞急性卒中患者c反应蛋白-甘油三酯葡萄糖指数（CTI）与临床预后的关系。方法：本回顾性研究纳入了2020年1月1日至2023年12月31日期间接受EVT的患者。CTI计算公式如下：0.412 × Ln (CRP [mg/L]) + Ln (TG [mg/dL] ×空腹血糖（FPG） [mg/dL])/2。根据受试者工作特征（ROC）曲线分析确定的最佳截断值，将患者分为低cti组和高cti组。主要功能终点为90天的良好功能状态，以0-2的修正Rankin量表（mRS）定义。采用单因素和多因素logistic回归分析评估CTI与EVT后临床结果的关系。结果：对366例急性脑卒中患者的资料进行了分析。单变量分析显示，较高的CTI水平与不利的功能结果相关。多变量调整模型显示CTI水平与临床功能结局之间存在显著相关性（95% CI: 0.29-0.78; P = 0.004）。ROC曲线分析证实了CTI预测功能不良预后的能力，曲线下面积（AUC）为0.60。结论：CTI与EVT后急性前循环LVO缺血性脑卒中患者的临床功能预后有显著关系。

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引用次数: 0

3D Reconstruction-Guided Brain Lesion Resection Based on Adjacent Landmarks: Concepts and a Usability Study. 基于相邻地标的三维重建引导脑损伤切除术：概念和可用性研究。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-02-13 DOI: 10.1016/j.wneu.2026.124862

Jin Gong, Chengjie Wan, Manting Li, Zhuang Kang, Tengchao Huang, Chaofeng Liang, Ying Guo

Objective: To evaluate the effect of three dimensional (3D) reconstruction-guided brain lesion resection based on adjacent landmarks.

Methods: Between January 2019 and June 2022, 13 patients with brain lesions underwent 3D reconstruction-guided microsurgery using adjacent landmarks. The study was approved by the Ethics Board of the Third Affiliated Hospital of Sun Yat-sen University. Preoperative planning utilized 3D Slicer for reconstructing and fusing multimodal imaging, with entry points and trajectories localized via adjacent anatomical structures (sulci, gyri, vessels, and nerves). Surgical procedures (positioning, incision, and bone window creation) followed the plan, and lesion resection was guided by 3D virtual models.

Results: All preoperative plans were finalized the day before surgery, with a mean reconstruction and fusion time of less than 2 hours. Intraoperative lesion localization was accurately achieved through 3D reconstruction-assisted visual guidance. Entry points and approaches for deep lesions were guided by adjacent vessels and brain surface morphology, all of which were clearly identified. Postoperative imaging revealed complete resection in all cases except one low-grade glioma in the precentral gyrus. Seven patients had no new neurological deficits, one experienced transient speech impairment, and 2 had limb weakness that resolved during follow-up.

Conclusions: 3D reconstruction-guided resection of brain lesions using adjacent anatomical landmarks reduces procedural costs, optimizes surgical planning, and ensures precise execution. This approach accelerates the learning curve for novice neurosurgeons and enhances the quality and safety of surgery.

目的：评价基于邻近标志的三维重建引导下脑病变切除术的效果。方法：2019年1月至2022年6月，对13例脑病变患者进行了三维重建引导下的邻近地标显微手术。该研究得到了第三附属医院伦理委员会的批准（盲法审查）。术前规划利用3D切片器重建和融合多模态成像，通过邻近解剖结构（脑沟、脑回、血管、神经）定位进入点和轨迹。手术（定位、切口、骨窗创建）按照计划进行，病变切除由3D虚拟模型指导。结果：所有术前计划均于术前1天完成，平均重建融合时间小于2小时。术中病灶通过三维重建辅助视觉引导准确定位。深部病变的进入点和入路由邻近血管和脑表面形态引导，清晰识别。术后影像显示除一例中央前回低级别胶质瘤外，所有病例均完全切除。7名患者没有新的神经功能缺陷，1名患者出现短暂性语言障碍，2名患者出现肢体无力，在随访期间消退。结论：三维重建引导下利用邻近解剖标志切除脑病变可降低手术成本，优化手术计划，确保精确执行。这种方法加快了神经外科新手的学习曲线，提高了手术的质量和安全性。

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引用次数: 0

Advancing White Matter Knowledge in Neurosurgical Training: Validation and Educational Impact of a Novel 3-Dimensional–Printed Simulator 在神经外科训练中推进白质知识：新型3d打印模拟器的验证和教育影响。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-02-01 Epub Date: 2026-01-02 DOI: 10.1016/j.wneu.2025.124778

Grazia Menna , Dora Riva , Carlotta Ranalli , Salvatore Marino , Renata Martinelli , Alessandro Olivi , Francesco Doglietto , Giannantonio Spena , Federico Nicolosi , Giuseppe Maria Della Pepa

Background

A comprehensive understanding of white matter anatomy is essential for neurosurgical education and surgical planning. Traditional educational tools, including cadaveric dissection, 2-dimensional atlases, and histological preparations, while valuable, have inherent limitations in representing the spatial complexity of white matter architecture. Although microsurgical dissection remains the gold standard, no study to date has specifically evaluated the use of 3-dimensional (3D)–printed simulators focused on white matter tract anatomy as a preparatory learning tool.

Methods

The study involved 17 residents in different years of the neurosurgery residency at Università Cattolica del Sacro Cuore through a structured training program including theoretical sessions, practical dissections using the simulator, and pretraining and post-training assessments. Quantitative improvements were analyzed by comparing knowledge and clinical reasoning scores before and after training.

Results

The simulator was perceived as highly realistic and educationally valuable: 81% of participants rated its anatomical accuracy as high or very high. Residents demonstrated significant improvements in clinical reasoning (P = 0.002) and overall test performance (P = 0.005) after training. Specific gains included improved identification of critical white matter tracts at risk during common surgical approaches, enhanced selection of safer trajectories, and better anticipation of intraoperative mapping strategies. The simulator was consistently described as user-friendly and effective in integrating 3D spatial anatomy into surgical decision-making.

Conclusions

This study highlights the utility of 3D-printed simulators in neurosurgical training, offering an accessible platform for learning white matter anatomy. While not a replacement for cadaveric dissections, these simulators provide a complementary tool for early-stage education, bridging the gap between theoretical knowledge and practical application.

背景：全面了解白质解剖学对神经外科教育和手术计划至关重要。传统的教育工具，包括尸体解剖、二维地图集和组织学准备，虽然有价值，但在表现白质建筑的空间复杂性方面存在固有的局限性。尽管显微外科解剖仍然是金标准，但迄今为止还没有研究专门评估将专注于白质束解剖的3d打印模拟器作为预备学习工具的使用。方法：对天主教圣心大学17名不同年限的神经外科住院医师进行结构化的培训，包括理论课程、使用模拟器的实际解剖以及培训前和培训后的评估。通过比较训练前后的知识和临床推理得分来定量分析改进情况。结果：模拟器被认为是高度现实和教育价值：81%的参与者认为其解剖精度高或非常高。住院医师在临床推理（p = 0.002）和整体测试表现（p = 0.005）方面表现出显著改善。具体的进展包括在普通手术入路中对危险的关键白质束的识别改进，更安全轨迹的选择增强，以及更好地预测术中绘图策略。该模拟器一直被描述为用户友好和有效地将三维空间解剖整合到手术决策中。结论：本研究强调了3d打印模拟器在神经外科训练中的应用，为学习白质解剖学提供了一个可访问的平台。虽然不能代替尸体解剖，但这些模拟器为早期教育提供了补充工具，弥合了理论知识和实际应用之间的差距。

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引用次数: 0

Polymethylmethacrylate Versus Autologous Bone Flap Reconstruction After Retrosigmoid Vestibular Schwannoma Surgery: Impact on Wound Healing and Patient Satisfaction 乙状窦后前庭神经鞘瘤术后，聚甲基丙烯酸甲酯与自体骨瓣重建：对伤口愈合和患者满意度的影响。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-02-01 Epub Date: 2025-12-26 DOI: 10.1016/j.wneu.2025.124760

Farjad Khalaveh, Silvan Busch, Mehmet-Salih Yildirim, Julia Shawarba, Matthias Tomschik, Johannes Herta, Christian Matula, Karl Roessler

Objective

Retrosigmoid repair techniques vary widely between and within institutions, complicating comparisons of patient satisfaction and complications. This study aimed to analyze patients' satisfaction with the skin flap healing process and associated symptoms, such as pain, hypoesthesia, dysesthesia, pressure, and tension, as well as to assess wound healing complications, and to evaluate both clinical and esthetic results using polymethylmethacrylate (PMMA) or autologous bone coverage following vestibular schwannoma surgery.

Methods

A retrospective analysis was conducted in 157 consecutive patients (median age 54 years, interquartile range 40–62, 91 female) who underwent retrosigmoid vestibular schwannoma resection between 2019 and 2023. Clinical factors related to wound healing and skull defect coverage complications were assessed in 110 of 157 patients.

Results

PMMA was used in 94 patients (60%) and autologous bone in 63 (40%). Complications that needed an in-hospital treatment occurred in 7 of 157 (4%) patients, including 1 wound infection and four subgaleal cerebrospinal fluid collections. Wound healing disorders were significantly more common in patients with autologous bone (19% vs. 4%, P = 0.02). Using PMMA was independently associated with lower chances of wound healing disorders in a multivariate logistic regression (odds ratio 0.20, 95% confidence interval 0.04–0.87, P = 0.032). No significant differences were found between the two groups in terms of retroauricular pain, dysesthesia, hypoesthesia, pressure, tension, swelling, headache, esthetic appearance, or overall satisfaction.

Conclusions

While patient satisfaction did not differ between reconstruction methods, PMMA for bone defect coverage in vestibular schwannoma surgery may have the potential to reduce wound healing disorders compared with autologous bone.

目的：乙状窦后修复技术在不同机构之间和内部差异很大，使患者满意度和并发症的比较复杂化。本研究旨在分析患者对皮瓣愈合过程的满意度和相关症状，如疼痛、感觉减退、感觉不良、压力和紧张，以及评估伤口愈合并发症，并评估前庭神经鞘瘤手术后使用聚甲基丙烯酸甲酯（PMMA）或自体骨覆盖的临床和美学结果。方法：回顾性分析2019年至2023年间接受乙状结肠后前庭神经鞘瘤切除术的157例患者（中位年龄54岁，IQR 40-62岁，91例女性）。对110/157例患者进行伤口愈合和颅骨缺损并发症相关的临床因素评估。结果：PMMA移植94例（60%），自体骨移植63例（40%）。157例患者中有7例（4%）出现了需要住院治疗的并发症，包括1例伤口感染和4例galeal下脑脊液（CSF）收集。伤口愈合障碍在自体骨患者中更为常见（19% vs. 4%, p=0.02）。在多因素logistic回归中，使用PMMA与较低的伤口愈合障碍发生率独立相关（OR 0.20, 95%-CI 0.04-0.87, p = 0.032）。两组患者在耳后疼痛、感觉不良、感觉减退、压力、紧张、肿胀、头痛、审美外观或总体满意度方面均无显著差异。结论：虽然不同重建方法的患者满意度没有差异，但与自体骨相比，PMMA用于前庭神经鞘瘤手术中骨缺损覆盖可能具有减少伤口愈合障碍的潜力。

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引用次数: 0

On the Question of Prognosis in Cystic Gliomas 关于囊性胶质瘤的预后问题。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-02-01 Epub Date: 2025-12-11 DOI: 10.1016/j.wneu.2025.124714

Allan J. Drapkin

引用次数: 0

Biportal Endoscopic Technique versus Open Microdiscectomy for Recurrent Lumbar Disc Herniation: A Retrospective Comparative Study 双门静脉内窥镜技术与开放式显微椎间盘切除术治疗复发性腰椎间盘突出症：回顾性比较研究。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-02-01 Epub Date: 2025-12-31 DOI: 10.1016/j.wneu.2025.124777

Mehmet İlker Özer , Oğuz Kağan Demirtaş , Göktuğ Ülkü , Mehmet Can Ezgü

Objective

Recurrent lumbar disc herniation (RLDH) is defined as herniation occurring at the same disc level following a primary discectomy after a pain-free period of more than 6 months. Repeated open lumbar microdiscectomy (OLM) is frequently advised for RLDH if instability is absent, but scar tissue complicates these surgeries, increasing the risk of dural tears and nerve damage. The biportal endoscopic (BE) technique, a minimally invasive approach, offers potential advantages in managing these challenges.

Methods

This retrospective review included patients who underwent BE or OLM surgery between January 2020 and July 2023. Only patients with prior surgery at the same level and side were included. Demographic data, preoperative and postoperative pain scores, Oswestry Disability Index scores, MacNab scores, and postoperative complications were analyzed. Statistical analyses were performed, with significance set at P < 0.05.

Results

Eighty-two patients were included: 51 underwent OLM and 31 underwent BE. There were no significant differences between groups regarding gender, side, and level of pathology. Both groups showed significant improvement in visual analog scale and Oswestry Disability Index scores postoperatively. The BE group experienced less early postoperative back pain (P = 0.025) and a shorter hospital stay (21 vs. 36 hours, P = 0.0001). However, the OLM group had lower postoperative leg pain (P = 0.003). Complication rates were similar between groups, with no significant differences in recurrence or MacNab scores.

Conclusions

The BE technique for RLDH offers comparable outcomes to OLM, with advantages in reduced early postoperative back pain and shorter hospital stays. The high magnification and dynamic handling of the BE technique make it a viable alternative for revision surgeries. Further studies with larger sample sizes and longer follow-up periods are needed to validate these findings.

背景和目的：复发性腰椎间盘突出症（RLDH）被定义为原发性腰椎间盘切除术后无疼痛期超过6个月后在同一腰椎间盘水平发生的突出。如果RLDH不存在不稳定性，通常建议重复开放式腰椎微椎间盘切除术（OLM），但瘢痕组织使这些手术复杂化，增加硬脑膜撕裂和神经损伤的风险。双门静脉内窥镜（BE）技术是一种微创方法，在应对这些挑战方面具有潜在的优势。方法：本回顾性研究纳入了2020年1月至2023年7月期间接受BE或OLM手术的患者。仅包括在同一水平和一侧进行过手术的患者。分析人口统计学资料、术前和术后疼痛评分、ODI评分、MacNab评分和术后并发症。进行统计学分析，结果具有显著性：纳入82例患者：51例行OLM， 31例行BE。在性别、侧面和病理水平方面，组间无显著差异。两组术后VAS、ODI评分均有明显改善。BE组术后早期背部疼痛较少（p=0.025），住院时间较短（21小时对36小时，p=0.0001）。然而，OLM组术后腿部疼痛较低（p=0.003）。两组间并发症发生率相似，复发率和MacNab评分无显著差异。结论：BE技术治疗RLDH的效果与OLM相当，在减少术后早期背部疼痛和缩短住院时间方面具有优势。BE技术的高放大倍率和动态处理使其成为翻修手术的可行选择。进一步的研究需要更大的样本量和更长的随访期来验证这些发现。

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引用次数: 0

Bipolar Remodeling Aneurysmorrhaphy and Bookend Clip Reconstruction of Complex Middle Cerebral Artery Aneurysm: 2-Dimensinal Operative Video and Technical Nuances 复杂大脑中动脉瘤的双极重塑动脉瘤吻合和Bookend夹重建：二维手术影像和技术差异。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-02-01 Epub Date: 2025-12-11 DOI: 10.1016/j.wneu.2025.124710

Ahmed Sabra , Caryn J. Ha , Arevik Abramyan , Priyank Khandelwal , James K. Liu

We present the case of a 57-year-old female patient who presented with a large, unruptured complex left middle cerebral artery (MCA) aneurysm with a wide neck and incorporation of M2 vessels. Microsurgical clipping was chosen due to the aneurysm's morphology, location, and rupture risk, with endovascular options deemed less favorable. A left pterional craniotomy was performed, and the aneurysm was reconstructed using bipolar remodeling aneurysmorrhaphy and multiple clip constructs, including the suction pull-through technique (use of the microsuction to manipulate the dome through the clip blades), and bookend clips for dog ear reconstruction. The operative video highlights critical steps such as wide Sylvian fissure splitting, freeing the aneurysm dome from frontal lobe adhesions, achieving proximal and distal control, and reshaping the aneurysm dome under temporary occlusion. Post-clipping indocyanine green, fluorescein, and catheter angiography confirmed excellent bifurcation reconstruction with complete aneurysm obliteration and preserved MCA circulation. Postoperatively, the patient was neurologically intact and was discharged on postoperative day 5. This case underscores the value of tailored clip reconstruction for complex MCA aneurysms using advanced techniques, such as suction pull-through and meticulous bipolar reshaping. Microsurgical clipping remains the first-line approach for large, complex MCA aneurysms, offering high occlusion rates and durability despite inherent risks. The patient consented to the procedure and to the publication of her images. Institutional review board approval was deemed unnecessary due to the retrospective case report nature of this work. This video provides an in-depth review of surgical nuances to optimize outcomes in these challenging cases.

我们报告一位57岁的女性，她表现为一个大的，未破裂的复杂左MCA动脉瘤，颈部宽，并合并M2血管。考虑到动脉瘤的形态、位置和破裂风险，我们选择了显微手术夹闭，而血管内手术被认为不太有利。行左侧翼点开颅术，采用双极重塑动脉瘤吻合和多个夹装置重建动脉瘤，包括抽吸拉通技术（使用微吸通过夹叶片操纵穹窿）和书端夹用于犬耳重建。手术视频强调了关键步骤，如宽Sylvian裂缝分裂，从额叶粘连中释放动脉瘤穹窿，实现近端和远端控制，以及在临时闭塞下重塑动脉瘤穹窿。夹闭后的ICG，荧光素和导管血管造影证实了良好的分岔重建，动脉瘤完全闭塞，MCA循环保存完好。术后患者神经功能完整，于术后第5天出院。本病例强调了采用先进技术，如“抽吸拉通”和细致的“双极重塑”，对复杂MCA动脉瘤进行量身定制的夹重建的价值。显微外科夹持术仍然是治疗大型复杂MCA动脉瘤的一线方法，尽管存在固有风险，但它具有较高的闭塞率和耐久性。病人同意手术并同意公布她的照片。由于这项工作的回顾性病例报告性质，机构审查委员会的批准被认为是不必要的。本视频提供了一个深入的回顾手术的细微差别，以优化这些具有挑战性的情况下的结果。

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引用次数: 0

Acute Radiculopathy After Anterior Cervical Discectomy and Fusion of Cervical Spondylotic Radiculopathy with Cervical Kyphosis: Causes and Prevention 颈椎病型神经根病伴颈椎后凸的ACDF后急性神经根病：原因及预防。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-02-01 Epub Date: 2025-12-29 DOI: 10.1016/j.wneu.2025.124767

Fan He , Zong-xian Feng , Pei-ming Sang , Shi-rong Gu , Bin-hui Chen

Background

This study was performed to investigate the incidence and clinical features of acute radiculopathy after anterior cervical discectomy and fusion (ACDF) in patients of cervical spondylotic radiculopathy (CSR) combined with cervical kyphosis, to analyze the causes, and to identify preventive measures.

Methods

We analyzed 39 ACDF patients, stratified into three kyphosis groups (n = 29) and a lordotic control group (n = 10). Kyphosis Group-1 (n = 8) had acute radiculopathy with SAP displacement; Group-2 (n = 13) had displacement without radiculopathy; Group-3 (n = 8) had neither. Analyz ed parameters included C2-C7 Cobb angle (CL), Fusion Cobb angle (FCA), foraminal dimensions (D:the diameter of foramen;H:the distance from SAP to apex of foramen;L:the distance of SAP displacement), disc space height (DSH), and clinical outcomes.

Results

Compared to controls, the kyphosis groups exhibited larger CL and FCA corrections. Postoperative improvements in D, H, and L were superior in Kyphosis Group-1 and Kyphosis Group-2 over both Kyphosis Group-3 and Control group, with Kyphosis Group-1 showing greater changes in D and L than Kyphosis Group-2.The post-ACDF increase in DSH was higher in kyphosis groups and decreased sequentially from Kyphosis Group-1 to Kyphosis Group-3. A moderate positive correlation was found between the increase in DSH and L (r = 0.43, P = 0.005).Facet joint over-distraction was exclusive to Kyphosis Groups-1 and Kyphosis Groups-2, with a markedly higher incidence in Kyphosis Group-1 (5/8 vs. 2/13).

Conclusions

Excessive intervertebral distraction during ACDF can cause acute radiculopathy. This leads to vertebral rotation and SAP displacement, resulting in iatrogenic foraminal stenosis. Selecting a properly sized cage is a key preventive measure.

本研究旨在探讨神经根型颈椎病（CSR）合并颈椎后凸患者行颈椎前路椎间盘切除术融合（ACDF）后急性神经根病的发生率及临床特点，分析其原因，并探讨预防措施。方法将39例ACDF患者分为3个后凸组（n = 29）和前凸对照组（n = 10）。后凸组1 （n = 8）有急性神经根病伴SAP移位；组2 （n = 13）有移位，无神经根病变；第三组（n = 8）两者均无。分析参数包括C2-C7 Cobb角（CL）、融合Cobb角（FCA）、椎间孔尺寸（D：椎间孔直径；H：椎间孔距椎间孔尖距离；L：椎间孔位移距离）、椎间盘间隙高度（DSH）和临床结果。结果与对照组相比，后凸组有更大的CL和FCA矫正。后凸组1和后凸组2的术后D、H和L的改善优于后凸组3和对照组，后凸组1的D和L的变化大于后凸组2。后凸组DSH在acdf后升高较高，从后凸1组到后凸3组依次下降。DSH升高与L呈中度正相关（r = 0.43, P = 0.005）。小关节过度牵张是后凸组-1和后凸组-2独有的，后凸组-1的发病率明显更高（5/8比2/13）。结论ACDF时过度的椎间牵张可引起急性神经根病。这导致椎体旋转和SAP移位，导致医源性椎间孔狭窄。选择一个大小合适的笼子是关键的预防措施。

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引用次数: 0

Editor's Choices 编辑器的选择

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2026-02-01 Epub Date: 2026-03-07 DOI: 10.1016/S1878-8750(26)00071-9

引用次数: 0