World Neurosurgery: X最新文献

The maternal-fetal trade-off in pregnancy-associated meningioma management: A systematic review and meta-analysis 妊娠相关脑膜瘤治疗的母胎权衡：系统回顾和荟萃分析

IF 2 Q1 Medicine

World Neurosurgery: X

Pub Date : 2026-01-24 DOI: 10.1016/j.wnsx.2026.100571

Agung Budi Sutiono, Yulius Hermanto

The management of pregnancy-associated meningioma (PAM) necessitates a critical balance between preserving maternal neurological function and ensuring fetal safety. This study aims to systematically evaluate the maternal and fetal outcomes associated with different management strategies for PAM by synthesizing the available evidence. This systematic review and meta-analysis quantitatively synthesize evidence from 5 studies (144 patients) from January 1, 2010, to December 31, 2024, to evaluate trade-offs between maternal and fetal outcomes across three management pathways: antepartum surgery, planned early postpartum surgery (≤7 days post-delivery), and deferred surgery/conservative management. Maternal neurological recovery was similarly high across all groups (89 %, 90 %, and 86 %, respectively). However, a clear gradient in fetal risk was observed: preterm delivery (<37 weeks) occurred in 38 % (95 % CI: 30–46 %) of the antepartum surgery group, 15 % (95 % CI: 9–23 %) of the planned early postpartum group, and 10 % (95 % CI: 5–17 %) of the deferred management group. The risk ratio for preterm delivery was 3.2 (95 % CI: 2.0–5.1) for antepartum versus combined postpartum pathways. Vaginal delivery was most common in the deferred group (66 %) and planned early postpartum group (60 %). In conclusion, these findings support a risk-stratified approach: antepartum surgery remains effective for neurologically declining mothers but carries the highest fetal risk, while planned early postpartum intervention offers a middle-ground, and deferred management is safest for the fetus in stable patients. Clinical decision-making should be individualized and guided primarily by maternal neurological status within a multidisciplinary framework.

妊娠相关脑膜瘤（PAM）的治疗需要在保护母体神经功能和确保胎儿安全之间取得关键的平衡。本研究旨在通过综合现有证据，系统地评估PAM不同管理策略与母胎结局的关系。本系统综述和荟萃分析定量地综合了2010年1月1日至2024年12月31日期间5项研究（144例患者）的证据，以评估三种治疗途径（产前手术、计划中的产后早期手术（分娩后≤7天）和推迟手术/保守治疗）对孕产妇和胎儿结局的权衡。在所有组中，产妇的神经系统恢复同样高（分别为89%、90%和86%）。然而，观察到胎儿风险的明显梯度：早产（37周）发生在38% （95% CI: 30 - 46%）的产前手术组，15% （95% CI: 9 - 23%）的计划产后早期组，10% （95% CI: 5 - 17%）的延迟管理组。产前与产后联合路径早产的风险比为3.2 （95% CI: 2.0-5.1）。阴道分娩在推迟分娩组（66%）和计划产后早期分娩组（60%）中最为常见。总之，这些发现支持风险分层方法：产前手术对神经功能下降的母亲仍然有效，但对胎儿的风险最高，而计划的产后早期干预提供了一个中间立场，对稳定患者的胎儿延迟处理是最安全的。临床决策应个性化，并在多学科框架内主要以产妇神经系统状况为指导。

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引用次数: 0

Japanese post-marketing database study of PulseRider-assisted coil embolization for wide-neck bifurcation aneurysm pulserider辅助线圈栓塞治疗宽颈分叉动脉瘤的日本上市后数据库研究

IF 2 Q1 Medicine

World Neurosurgery: X

Pub Date : 2026-01-01 DOI: 10.1016/j.wnsx.2025.100561

Nobuyuki Sakai , Shigeru Miyachi , Yuji Matsumaru , Shinya Kohyama , Shigeki Kobayashi , Chiaki Sakai , Tomoji Takigawa , Hiroaki Neki , Atsuko Honda , Yoichiro Kawamura , Aiko Fujiki , Kumiko Yagi , Yukie Horikoshi , Patrick A. Brouwer

Background

Coil embolization of wide-neck bifurcation aneurysms poses risks such as coil migration into the parent artery. The PulseRider, designed to reshape the aneurysmal neck at bifurcation points, provides support at the aneurysm neck while safeguarding daughter branches during coil embolization. We performed a post-marketing database study of the PulseRider in Japanese patients with wide-neck bifurcation aneurysms.

Methods

We analyzed the first 70 consecutive cases in which the PulseRider was used from the time of its launch in Japan. Data were extracted from the Japanese Society of Neuroendovascular Therapy Database.

Results

The safety analysis group comprised 77 patients (78 lesions), and the efficacy analysis group comprised 63 patients (excluding those in whom the PulseRider was ultimately not implanted, in whom it was used for parent vessels outside the 2.7- to 4.5-mm diameter range, and in whom it was used on recently ruptured intracranial aneurysms). The rate of adequate occlusion, defined as Raymond–Roy occlusion classification (RR class) I + II, was 44.4 % immediately postoperatively, 88.6 % at 180 days, and 85.4 % at 1 year. In the safety analysis group, the RR class of most lesions improved from immediately postoperatively to postoperative day 180. Adverse events included two cases of intracerebral hemorrhage, four cases of subarachnoid hemorrhage, six cases of cerebral infarction, one case of basilar artery occlusion, and one case of aspiration pneumonia. Most patients with modified Rankin scale scores of 0–2 showed little change postoperatively.

Conclusions

PulseRider-assisted coiling for wide-neck bifurcation aneurysms was effective and safe.

背景：对宽颈分岔动脉瘤进行线圈栓塞会带来诸如线圈迁移到母动脉的风险。PulseRider用于在分叉点重塑动脉瘤颈部，在动脉瘤颈部提供支撑，同时在线圈栓塞期间保护子分支。我们对PulseRider在日本宽颈分岔动脉瘤患者中的应用进行了上市后数据库研究。方法对PulseRider在日本上市以来连续使用的前70例病例进行分析。数据来自日本神经血管内治疗学会数据库。结果安全性分析组包括77例患者（78个病变），疗效分析组包括63例患者（不包括最终未植入PulseRider的患者，用于2.7- 4.5 mm外的母血管，以及用于近期破裂的颅内动脉瘤的患者）。适当的咬合率，定义为Raymond-Roy咬合分类（RR类）I + II，术后立即为44.4%，180天为88.6%，1年为85.4%。在安全性分析组中，大多数病变的RR级别从术后立即到术后180天有所改善。不良事件包括脑出血2例，蛛网膜下腔出血4例，脑梗死6例，基底动脉闭塞1例，吸入性肺炎1例。大多数患者的改良Rankin评分为0-2分，术后变化不大。结论spulseride辅助行宽颈分岔动脉瘤卷取术是安全有效的。

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引用次数: 0

Early postoperative changes predict long-term cervical kyphosis after laminoplasty: A retrospective radiographic study 椎板成形术后早期术后改变预测长期颈椎后凸：回顾性影像学研究

IF 2 Q1 Medicine

World Neurosurgery: X

Pub Date : 2026-01-01 DOI: 10.1016/j.wnsx.2026.100567

Noriaki Sako, Masashi Miyazaki, Tetsutaro Abe, Nobuhiro Kaku

Objective

Postoperative loss of cervical lordosis is a common outcome following laminoplasty, with kyphotic changes often appearing shortly after surgery. We hypothesized that radiographic findings as early as one week postoperatively could help predict long-term kyphotic progression. To explore this, we analyzed associations between preoperative and postoperative radiographic parameters up to one year following surgery.

Methods

This retrospective study included 113 patients who underwent cervical laminoplasty for compressive myelopathy. Collected preoperative data included age, number of operated levels, C2–7 Cobb angle, C2–7 cervical sagittal vertical axis (cSVA), T1 slope, and modified Japanese Orthopaedic Association (mJOA) score. Radiographic evaluations were conducted preoperatively and at 1 week, 1 month, 6 months, and 1 year postoperatively. Changes in alignment (ΔC2–7 and ΔcSVA) were calculated at both 1 week and 1 year. Patients were grouped based on kyphotic progression, and intergroup comparisons of radiographic changes were made.

Results

ΔC2–7 at 1 week strongly correlated with ΔC2–7 at 1 year (r = 0.522, p < 0.0001), and a similar correlation was found for ΔcSVA (r = 0.541, p < 0.0001). The progression group exhibited a greater early decrease in C2–7 Cobb angle (−8.65°) and a larger increase in cSVA at 1 week postoperatively compared to the non-progression group.

Conclusion

Patients exhibiting early postoperative kyphotic changes within the first week after laminoplasty are more likely to develop significant kyphosis by one year. Early imaging may serve as a valuable indicator of long-term sagittal alignment outcomes.

目的颈椎前凸消失是椎板成形术后的常见结果，术后常出现后凸改变。我们假设早在术后一周的x线检查结果可以帮助预测长期后凸进展。为了探讨这一点，我们分析了手术后一年术前和术后放射学参数之间的关系。方法回顾性研究113例颈椎椎板成形术治疗压缩性脊髓病的患者。术前收集的资料包括年龄、手术节段数、C2-7 Cobb角、C2-7颈椎矢状垂直轴（cSVA）、T1斜率、修正日本骨科协会（mJOA）评分。术前、术后1周、1个月、6个月、1年进行影像学评价。在第1周和第1年计算对齐变化（ΔC2-7和ΔcSVA）。根据后凸进展情况对患者进行分组，并对组间影像学变化进行比较。1周时的ResultsΔC2-7与1年时的ΔC2-7强相关（r = 0.522, p < 0.0001）， ΔcSVA也有类似的相关性（r = 0.541, p < 0.0001）。与非进展组相比，进展组在术后1周时表现出更大的C2-7 Cobb角下降（- 8.65°）和更大的cSVA增加。结论椎板成形术后1周内出现早期后凸改变的患者在术后1年内发生明显后凸的可能性较大。早期成像可以作为长期矢状位对齐结果的有价值的指标。

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引用次数: 0

‘Ligation only’ treatment in traumatic superficial temporal artery pseudoaneurysm: A case report and systematic review of the literature 外伤性颞浅动脉假性动脉瘤的“仅结扎”治疗：1例报告及文献系统回顾

IF 2 Q1 Medicine

World Neurosurgery: X

Pub Date : 2026-01-01 DOI: 10.1016/j.wnsx.2026.100569

Çağrı Canbolat , Majid Ismayilzade

Purpose

Pseudoaneurysms of the superficial temporal artery (STA) are uncommon masses that present as a painless, pulsatile, progressively growing lump following blunt trauma. Although surgical resection is the preferred treatment method there is no comparative data in the literature. The aim of this review study was to compare the preferred treatment strategies for managing trauma-induced STA pseudoaneurysms, by performing a comprehensive review of related literature.

Materials and methods

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was performed in PubMed by typing [superficial temporal artery pseudoaneurysm] OR [STA pseudoaneurysm]. The following data were recorded for each study: the number of trauma-induced pseudoaneurysm cases, the time elapsed between trauma and hospital admission, the management method, any complications experienced, and recurrences.

Results

A total of 145 patients with trauma-related superficial temporal artery pseudoaneurysms were found in 102 studies. The longest time period between the trauma and hospital admission was 8 years, the shortest 1 day, and the mean 77.2 days. Direct surgical resection was preferred in the first stage for 102 patients. Embolization methods were performed in 21 patients. Five cases were successfully managed by surgical ligation only, including the case reported in this study.

Conclusion

Surgical resection is an extensive procedure that can lead to anesthesia- and surgery-related complications, and most patients with STA pseudoaneurysms are elderly and have comorbidities. Therefore, surgical ligation may be the preferred treatment strategy for the early management of post-traumatic STA pseudoaneurysms.

目的：颞浅动脉（STA）的假性动脉瘤是一种罕见的肿块，在钝性创伤后表现为无痛、搏动、进行性生长的肿块。虽然手术切除是首选的治疗方法，但文献中没有比较数据。本综述研究的目的是通过对相关文献的全面回顾，比较创伤性STA假性动脉瘤的首选治疗策略。材料和方法本系统评价按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。在PubMed中输入[浅颞动脉假性动脉瘤]或[STA假性动脉瘤]进行搜索。记录每项研究的以下数据：创伤性假性动脉瘤病例的数量，创伤至住院的时间，处理方法，任何并发症和复发。结果102例研究共发现创伤性颞浅动脉假性动脉瘤145例。创伤至住院时间最长8年，最短1天，平均77.2天。102例患者首期首选直接手术切除。21例患者采用栓塞方法。包括本研究报告的病例在内，有5例仅通过手术结扎成功。结论手术切除是一个广泛的过程，可导致麻醉和手术相关并发症，大多数STA假性动脉瘤患者为老年人并有合并症。因此，手术结扎可能是创伤后STA假性动脉瘤早期治疗的首选治疗策略。

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引用次数: 0

A descriptive analysis of endoscope-assisted endonasal, transorbital, and transcanal transpetrosal approaches to the pons 内窥镜辅助下经鼻、经眶、经鼻、经颅入路进入脑桥的描述性分析

IF 2 Q1 Medicine

World Neurosurgery: X

Pub Date : 2026-01-01 DOI: 10.1016/j.wnsx.2026.100566

Bon-Jour Lin , Hao-Yuan Hung , Kuan-Yin Tseng , Dueng-Yuan Hueng , Yuan-Hao Chen , Da-Tong Ju , Hsin-I Ma , Ming-Ying Liu , Hong-Jaan Wang

Introduction

This study sough to determine the anatomical extents of anterior petrosectomy and corresponding exposure of the pons afforded by endoscopic endonasal, transorbital, and transcanal transpetrosal approaches.

Methods

Anatomical dissections were performed in five human cadaveric heads. The expanded endoscopic endonasal transclival approach (EEA), endoscopic transorbital transpetrosal approach (ETOA), and endoscopic transcanal transpetrosal approach (ETCA) were executed consecutively in each cadaveric head. After that, the extents of anterior petrosectomy and surgical exposure of the pons were compared among the three approaches.

Results

For each endoscopic transpetrosal approach, the petrous segment of the internal carotid artery (petrous ICA) constituted the major limitation of anterior petrosectomy.

Because the petrous apex drilling was restricted superiorly and laterally by the paraclival segment of the ICA and the horizontal portion of the petrous ICA near the foramen lacerum, the EEA provided inferior anterior petrosectomy with exposure of the pons positioned medially to the inferior petrous sinus. The horizontal portion of the petrous ICA formed the inferior delimitation of superior anterior petrosectomy, and the ETOA predominately revealed the supratrigeminal zone of the pons. Otherwise, the vertical portion of the petrous ICA composed the anterior boundary of fully anterior petrosectomy, and the ETCA mainly disclosed the peritrigeminal zone of the pons.

Conclusion

The EEA, ETOA, and ETCA offer optimum visualization for different compartments of the pons. These three endoscopic transpetrosal approaches provide alternative means of access to safe entry zones of the pons.

本研究旨在确定经鼻内窥镜、经眶和经鼻经骨入路行前路岩石切除术的解剖范围和相应的脑桥暴露。方法对5具人头颅进行解剖。在每具尸体头部连续行经鼻内经巩膜扩径入路（EEA）、经眶经窦入路（ETOA）和经鼻经窦入路（ETCA）。然后，比较三种入路的前路岩石切除术和脑桥手术暴露程度。结果对于每一个经颅镜入路，颈内动脉的岩段（岩性ICA）构成了前路岩石切除术的主要限制。由于岩尖钻孔在上部和外侧受到ICA的锁骨旁段和靠近撕裂孔的岩尖ICA的水平部分的限制，EEA提供了位于下岩窦内侧的桥桥暴露的下前岩切开术。岩质ICA的水平部分形成了上前岩切开术的下界，ETOA主要显示了桥桥的腹股沟上带。另外，岩质ICA的垂直部分构成了全前路岩石切开术的前界，ETCA主要暴露了脑桥的生殖周区。结论EEA、ETOA和ETCA对脑桥的不同腔室具有较好的可视化效果。这三种经颅镜入路提供了进入桥脑桥安全区域的替代方法。

{"title":"A descriptive analysis of endoscope-assisted endonasal, transorbital, and transcanal transpetrosal approaches to the pons","authors":"Bon-Jour Lin , Hao-Yuan Hung , Kuan-Yin Tseng , Dueng-Yuan Hueng , Yuan-Hao Chen , Da-Tong Ju , Hsin-I Ma , Ming-Ying Liu , Hong-Jaan Wang","doi":"10.1016/j.wnsx.2026.100566","DOIUrl":"10.1016/j.wnsx.2026.100566","url":null,"abstract":"<div><h3>Introduction</h3><div>This study sough to determine the anatomical extents of anterior petrosectomy and corresponding exposure of the pons afforded by endoscopic endonasal, transorbital, and transcanal transpetrosal approaches.</div></div><div><h3>Methods</h3><div>Anatomical dissections were performed in five human cadaveric heads. The expanded endoscopic endonasal transclival approach (EEA), endoscopic transorbital transpetrosal approach (ETOA), and endoscopic transcanal transpetrosal approach (ETCA) were executed consecutively in each cadaveric head. After that, the extents of anterior petrosectomy and surgical exposure of the pons were compared among the three approaches.</div></div><div><h3>Results</h3><div>For each endoscopic transpetrosal approach, the petrous segment of the internal carotid artery (petrous ICA) constituted the major limitation of anterior petrosectomy.</div><div>Because the petrous apex drilling was restricted superiorly and laterally by the paraclival segment of the ICA and the horizontal portion of the petrous ICA near the foramen lacerum, the EEA provided inferior anterior petrosectomy with exposure of the pons positioned medially to the inferior petrous sinus. The horizontal portion of the petrous ICA formed the inferior delimitation of superior anterior petrosectomy, and the ETOA predominately revealed the supratrigeminal zone of the pons. Otherwise, the vertical portion of the petrous ICA composed the anterior boundary of fully anterior petrosectomy, and the ETCA mainly disclosed the peritrigeminal zone of the pons.</div></div><div><h3>Conclusion</h3><div>The EEA, ETOA, and ETCA offer optimum visualization for different compartments of the pons. These three endoscopic transpetrosal approaches provide alternative means of access to safe entry zones of the pons.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100566"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Study on the relationship between CXCL1, CXCL10, and prognosis in hypertensive basal ganglia hemorrhage: A comparative analysis of drainage and non-drainage cohorts 高血压基底神经节出血患者CXCL1、CXCL10与预后关系的研究：引流组与非引流组对比分析

IF 2 Q1 Medicine

World Neurosurgery: X

Pub Date : 2026-01-01 DOI: 10.1016/j.wnsx.2025.100564

Xiaoqian Yang , Ranran Tang , Zonglei Chong

Objective

To investigate the relationship between serum CXCL1/CXCL10 levels and prognosis in hypertensive basal ganglia hemorrhage (HBGH), comparing patients treated with minimally invasive puncture and drainage (MIPD) to those managed conservatively.

Methods

This observational study enrolled 173 HBGH patients undergoing MIPD (Drainage Group), 50 HBGH patients managed conservatively (Non-Drainage Group), and 121 healthy volunteers (Control Group). Serum levels of CXCL1, CXCL10, and neural injury markers (NSE, GFAP, S100β) were measured via ELISA at admission. Clinical and radiographic data were collected. Functional outcome was assessed at 3 months using the modified Rankin Scale (mRS: 0–2 good, 3–6 poor). Statistical analyses included t-tests, chi-square tests, Pearson correlation, and multivariable logistic regression.

Results

Serum levels of all biomarkers were significantly elevated in both patient groups versus controls (all P < 0.05), with the highest levels in the Drainage Group. Positive correlations existed between chemokines and neural injury markers in both cohorts (all P < 0.05). In the Drainage Group, poor prognosis was associated with older age, higher LDL, larger hematoma volume, lower 24-h clearance rate, more frequent urokinase flushes, and elevated CXCL1/CXCL10 in univariate analysis. Multivariable analysis confirmed these as independent risk factors (all P < 0.05).

Conclusions

Elevated serum CXCL1 and CXCL10 are associated with neural injury and independently predict poor prognosis in severe HBGH requiring surgical drainage. Their prognostic value, alongside key clinical factors, aids in early risk stratification.

目的探讨高血压基底神经节出血（HBGH）患者血清CXCL1/CXCL10水平与预后的关系，比较微创穿刺引流（MIPD）治疗与保守治疗的差异。方法观察性研究纳入173例HBGH患者行MIPD（引流组），50例HBGH患者行保守治疗（非引流组），121例健康志愿者（对照组）。入院时采用ELISA检测血清CXCL1、CXCL10和神经损伤标志物（NSE、GFAP、S100β）水平。收集临床和影像学资料。3个月时使用改良Rankin量表评估功能结局（mRS: 0-2好，3 - 6差）。统计分析包括t检验、卡方检验、Pearson相关和多变量logistic回归。结果两组患者血清中所有生物标志物水平均显著高于对照组（P < 0.05），以引流组最高。趋化因子与神经损伤标志物在两个队列中均存在正相关（均P <； 0.05）。单因素分析显示，引流组预后不良与年龄较大、低密度脂蛋白较高、血肿体积较大、24小时清除率较低、尿激酶冲红频率较高、CXCL1/CXCL10升高有关。多变量分析证实这些是独立的危险因素（均P <； 0.05）。结论血清CXCL1和CXCL10升高与神经损伤有关，并可独立预测需要手术引流的严重HBGH患者预后不良。它们的预后价值，以及关键的临床因素，有助于早期风险分层。

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引用次数: 0

Full-endoscopic posterior cervical foraminotomy: Case-series and technical nuances 全内窥镜颈椎后椎间孔切开术：病例系列和技术上的细微差别

IF 2 Q1 Medicine

World Neurosurgery: X

Pub Date : 2026-01-01 DOI: 10.1016/j.wnsx.2025.100559

Sameer Nazeeruddin, Jean-Yves Fournier, Alexandre Simonin

Background

Full-endoscopic posterior cervical foraminotomy (FEPCF) is the most minimally invasive procedure that allows to decompress a nerve root in the cervical spine from a posterior approach. We present to the best of our knowledge the first case-series of FEPCF in Switzerland and detail technical nuances including O-arm navigation.The objective of the study is to assess the patients' outcome after this novel procedure.

Methods

We retrospectively analyzed data from a consecutive series of 6 patients who underwent a FEPCF in our institution, from October 2022 to May 2023. Primary outcome was pain reduction evaluated with the Visual Analog Scale (VAS) for neck and arm, as well as Neck Disability Index (NDI) preoperatively and one month postoperatively. Surgical time, length of stay, opioid consumption, complications were also analyzed.

Results

Median pre-operative arm and neck pain (VAS) was 9 and 8.5. One month post-operative arm and neck pain was 2 and 4. Pain reduction was significant for arm pain (mean 7.7 preoperative vs 3.2 postoperative, p = 0.02) but not for neck pain (mean 7.2 preoperative vs 4.2 postoperative, p = 0.14). NDI was 48.4 % ± 7.9 SEM pre-operatively, and 16.4 % ± 8.7 SEM postoperatively, which was highly significant (p = 0.0006). Mean length of stay was 2.3 days in average (avg). Mean surgical time was 126 min avg. Mean total oxycodone consumption during hospital stay was 9.8 mg avg. There was no complication.

Conclusion

Full-endoscopic posterior cervical foraminotomy (FEPCF) was a safe and effective procedure for cervical foraminal stenosis in a small group of patients. O-Arm navigation may be used for localization.

背景：全内窥镜下后颈椎椎间孔切开术（FEPCF）是最微创的手术，可以从后路减压颈椎神经根。据我们所知，我们介绍了瑞士FEPCF的第一个病例系列，并详细介绍了技术上的细微差别，包括o型臂导航。该研究的目的是评估这种新手术后患者的预后。方法回顾性分析2022年10月至2023年5月在我院连续接受FEPCF治疗的6例患者的数据。主要终点是术前和术后1个月用颈部和手臂的视觉模拟评分（VAS）以及颈部残疾指数（NDI）评估疼痛减轻程度。并对手术时间、住院时间、阿片类药物用量、并发症进行分析。结果术前手臂和颈部疼痛（VAS）中位数分别为9和8.5。术后1个月手臂和颈部疼痛分别为2和4。手臂疼痛减轻显著（术前平均7.7比术后平均3.2,p = 0.02），但颈部疼痛减轻不显著（术前平均7.2比术后平均4.2,p = 0.14）。NDI术前为48.4%±7.9 SEM，术后为16.4%±8.7 SEM，差异有高度统计学意义（p = 0.0006）。平均住院时间为2.3天（avg）。平均手术时间为126分钟，住院期间平均总羟考酮消耗量为9.8毫克，无并发症。结论全内窥镜后路颈椎椎间孔切开术（FEPCF）是治疗少数颈椎椎间孔狭窄的一种安全有效的方法。o型臂导航可用于定位。

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引用次数: 0

Current practices in the diagnosis and management of primary spinal cord tumors: A cross-sectional assessment of algorithm utilization in Yaoundé, Cameroon 目前在原发性脊髓肿瘤的诊断和管理的做法：在喀麦隆的雅温德省的算法使用的横断面评估

IF 2 Q1 Medicine

World Neurosurgery: X

Pub Date : 2026-01-01 DOI: 10.1016/j.wnsx.2026.100570

Ghislain Guea Ngbwa, Sandjong Ngoudjou Maxwell, Sandjong Nganso Steve, Ruth Rosine Meka'h Mapenya, Guegang Goujou Emillienne

Background

Primary spinal cord tumors (PSCTs) present diagnostic and management challenges, particularly in low-resource settings. This study assessed current diagnostic and treatment practices, with a specific focus on the use of standardized management algorithms for PSCTs in Yaoundé, Cameroon.

Methods

A cross-sectional analysis was conducted on 67 consecutive patients with newly diagnosed PSCTs in Yaoundé between November 1, 2011, and December 31, 2023. Data collected included demographics (mean age 43.28 ± 9.8 years; 34 % female), clinical parameters (median admission delay 405 days, interquartile range 248–541; 13.4 % insured), tumor histology, and WHO grade. Five predefined management algorithms were used to classify care pathways, incorporating diagnostic imaging, staging, surgical intervention, and chemotherapy. We evaluated completion of the algorithmic care pathway and applied multivariate logistic regression to identify factors associated with adherence.

Results

Tumor histologies were ependymoma (41.2 %), meningioma (23.5 %), plasmacytoma/multiple myeloma (19.6 %), and other types (15.7 %). WHO grade II tumors predominated (76.5 %). Overall, 76.1 % of patients completed the prescribed algorithmic care pathway. In multivariate analysis, strong family support was the strongest predictor of algorithm completion (odds ratio 12.6, 95 % confidence interval 2.45–64.8 for high vs. low support). Age, gender, and insurance status were not significantly associated with completion of care. Given the limited sample size and wide 95 % confidence intervals, these associations should be interpreted as exploratory and hypothesis-generating rather than definitive.

Conclusion

In Yaoundé, Cameroon, PSCT diagnosis and management were characterized by prolonged delays and limited insurance coverage, yet standardized algorithmic care was largely achievable. Importantly, family support substantially influenced algorithm completion. These findings highlight the need to integrate social support mechanisms and improve access to diagnostic and therapeutic resources to optimize PSCT care in low-resource settings.

背景：原发性脊髓肿瘤（psct）的诊断和治疗面临挑战，特别是在资源匮乏的地区。本研究评估了目前的诊断和治疗做法，特别关注喀麦隆yaound地区psct标准化管理算法的使用。方法对2011年11月1日至2023年12月31日在云南省雅温市连续67例新诊断的psct患者进行横断面分析。收集的数据包括人口统计学（平均年龄43.28±9.8岁；女性占34%）、临床参数（中位入院延迟405天，四分位数间距248-541；13.4%参加保险）、肿瘤组织学和WHO分级。使用五种预定义的管理算法对护理路径进行分类，包括诊断成像、分期、手术干预和化疗。我们评估了算法护理路径的完成情况，并应用多变量逻辑回归来确定与依从性相关的因素。结果肿瘤组织学类型为室管膜瘤（41.2%）、脑膜瘤（23.5%）、浆细胞瘤/多发性骨髓瘤（19.6%）和其他类型（15.7%）。WHO II级肿瘤占主导地位（76.5%）。总体而言，76.1%的患者完成了规定的算法护理途径。在多变量分析中，强大的家庭支持是算法完成的最强预测因子（优势比12.6,95%置信区间2.45-64.8，高支持vs低支持）。年龄、性别和保险状况与护理完成无显著相关。考虑到有限的样本量和95%的置信区间，这些关联应该被解释为探索性和假设生成，而不是决定性的。结论在喀麦隆的yaound， PSCT的诊断和管理存在延迟时间长、保险覆盖面有限的特点，但标准化的算法护理在很大程度上是可以实现的。重要的是，家庭支持极大地影响了算法的完成。这些发现强调了整合社会支持机制和改善获得诊断和治疗资源的必要性，以优化低资源环境下的PSCT护理。

{"title":"Current practices in the diagnosis and management of primary spinal cord tumors: A cross-sectional assessment of algorithm utilization in Yaoundé, Cameroon","authors":"Ghislain Guea Ngbwa, Sandjong Ngoudjou Maxwell, Sandjong Nganso Steve, Ruth Rosine Meka'h Mapenya, Guegang Goujou Emillienne","doi":"10.1016/j.wnsx.2026.100570","DOIUrl":"10.1016/j.wnsx.2026.100570","url":null,"abstract":"<div><h3>Background</h3><div>Primary spinal cord tumors (PSCTs) present diagnostic and management challenges, particularly in low-resource settings. This study assessed current diagnostic and treatment practices, with a specific focus on the use of standardized management algorithms for PSCTs in Yaoundé, Cameroon.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis was conducted on 67 consecutive patients with newly diagnosed PSCTs in Yaoundé between November 1, 2011, and December 31, 2023. Data collected included demographics (mean age 43.28 ± 9.8 years; 34 % female), clinical parameters (median admission delay 405 days, interquartile range 248–541; 13.4 % insured), tumor histology, and WHO grade. Five predefined management algorithms were used to classify care pathways, incorporating diagnostic imaging, staging, surgical intervention, and chemotherapy. We evaluated completion of the algorithmic care pathway and applied multivariate logistic regression to identify factors associated with adherence.</div></div><div><h3>Results</h3><div>Tumor histologies were ependymoma (41.2 %), meningioma (23.5 %), plasmacytoma/multiple myeloma (19.6 %), and other types (15.7 %). WHO grade II tumors predominated (76.5 %). Overall, 76.1 % of patients completed the prescribed algorithmic care pathway. In multivariate analysis, strong family support was the strongest predictor of algorithm completion (odds ratio 12.6, 95 % confidence interval 2.45–64.8 for high vs. low support). Age, gender, and insurance status were not significantly associated with completion of care. Given the limited sample size and wide 95 % confidence intervals, these associations should be interpreted as exploratory and hypothesis-generating rather than definitive.</div></div><div><h3>Conclusion</h3><div>In Yaoundé, Cameroon, PSCT diagnosis and management were characterized by prolonged delays and limited insurance coverage, yet standardized algorithmic care was largely achievable. Importantly, family support substantially influenced algorithm completion. These findings highlight the need to integrate social support mechanisms and improve access to diagnostic and therapeutic resources to optimize PSCT care in low-resource settings.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100570"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preoperative MRI-based vertebral bone quality (VBQ) scores assessment in patients with severe scoliosis 重度脊柱侧凸患者术前mri椎体骨质量（VBQ）评分评估

IF 2 Q1 Medicine

World Neurosurgery: X

Pub Date : 2026-01-01 DOI: 10.1016/j.wnsx.2025.100565

Deng Zhao , Zhong Zhang , Linbo Jiang , Lin Li , Lei Chu , Zhengkai Zhao

Object

To evaluate the correlation between vertebral bone quality (VBQ) scores and quantitative computer tomography (QCT) based bone mineral density BMD in patients with severe scoliosis, and the correlation between spinal BMD and severity of deformity.

Method

We selected patients with severe scoliosis from January 2022 to December 2023 in our hospital. Spinal parameters including main Cobb angle, kyphosis, apical vertebrae evaluated. The BMD was evaluated by QCT technique and VBQ scores was also evaluated. The correlation between the VBQ score and QCT was analyzed. A multivariate logistic regression model was used to analyse factors independently related to osteoporosis.

Results

68 patients were evaluated in this study. The overall mean age was 21.7 ± 7.9 years. The mean Cobb angle was 135 ± 20°, and the mean angle of kyphosis was 125 ± 41°. There was a total of 16 (23.5 %) patients with osteoporosis according to QCT. The statistically differences in QCT and VBQ-score were found between Non-osteoporosis group and osteoporosis group. Although the mean age, Cobb angle degree, and kyphosis degree in osteoporosis group were greater than in Non-osteoporosis group, but there were no statistically differences. The VBQ was significantly related with QCT. The model revealed that the VBQ-score could independently associated with osteoporosis in patients with severe scoliosis.

Conclusion

The overall prevalence of osteoporosis in severe scoliosis was 23.5 %. The VBQ-scores had a moderate to strong negative linear correlation with QCT-based BMD. The VBQ scores had a moderate diagnostic ability to verify patients with or without osteoporotic BMD in severe scoliosis.

目的评价重度脊柱侧凸患者椎体骨质量（VBQ）评分与基于定量计算机断层扫描（QCT）的骨密度骨密度（BMD）的相关性，以及脊柱骨密度与畸形严重程度的相关性。方法选择2022年1月~ 2023年12月我院收治的重度脊柱侧凸患者。脊柱参数包括主Cobb角、后凸、椎尖。采用QCT技术评估骨密度，同时评估VBQ评分。分析VBQ评分与QCT的相关性。采用多元logistic回归模型分析与骨质疏松症相关的独立因素。结果本研究共纳入68例患者。总平均年龄21.7±7.9岁。平均Cobb角为135±20°，平均后凸角为125±41°。QCT结果显示，骨质疏松患者共16例（23.5%）。骨质疏松组与非骨质疏松组在QCT和vbq评分上有统计学差异。骨质疏松组患者的平均年龄、Cobb角度、后凸度均大于非骨质疏松组，但差异无统计学意义。VBQ与QCT有显著相关。该模型显示，vbq评分与重度脊柱侧凸患者骨质疏松具有独立相关性。结论重度脊柱侧凸患者骨质疏松总体患病率为23.5%。vbq得分与基于qct的骨密度呈中等至强烈的负线性相关。在重度脊柱侧凸中，VBQ评分具有中等的诊断能力，可证实患者是否存在骨质疏松性骨密度。

{"title":"Preoperative MRI-based vertebral bone quality (VBQ) scores assessment in patients with severe scoliosis","authors":"Deng Zhao , Zhong Zhang , Linbo Jiang , Lin Li , Lei Chu , Zhengkai Zhao","doi":"10.1016/j.wnsx.2025.100565","DOIUrl":"10.1016/j.wnsx.2025.100565","url":null,"abstract":"<div><h3>Object</h3><div>To evaluate the correlation between vertebral bone quality (VBQ) scores and quantitative computer tomography (QCT) based bone mineral density BMD in patients with severe scoliosis, and the correlation between spinal BMD and severity of deformity.</div></div><div><h3>Method</h3><div>We selected patients with severe scoliosis from January 2022 to December 2023 in our hospital. Spinal parameters including main Cobb angle, kyphosis, apical vertebrae evaluated. The BMD was evaluated by QCT technique and VBQ scores was also evaluated. The correlation between the VBQ score and QCT was analyzed. A multivariate logistic regression model was used to analyse factors independently related to osteoporosis.</div></div><div><h3>Results</h3><div>68 patients were evaluated in this study. The overall mean age was 21.7 ± 7.9 years. The mean Cobb angle was 135 ± 20°, and the mean angle of kyphosis was 125 ± 41°. There was a total of 16 (23.5 %) patients with osteoporosis according to QCT. The statistically differences in QCT and VBQ-score were found between Non-osteoporosis group and osteoporosis group. Although the mean age, Cobb angle degree, and kyphosis degree in osteoporosis group were greater than in Non-osteoporosis group, but there were no statistically differences. The VBQ was significantly related with QCT. The model revealed that the VBQ-score could independently associated with osteoporosis in patients with severe scoliosis.</div></div><div><h3>Conclusion</h3><div>The overall prevalence of osteoporosis in severe scoliosis was 23.5 %. The VBQ-scores had a moderate to strong negative linear correlation with QCT-based BMD. The VBQ scores had a moderate diagnostic ability to verify patients with or without osteoporotic BMD in severe scoliosis.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100565"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Demographic, clinical, and social data predictive of 1-month mortality post-aneurysmal subarachnoid hemorrhage 预测动脉瘤性蛛网膜下腔出血后1个月死亡率的人口学、临床和社会数据

IF 2 Q1 Medicine

World Neurosurgery: X

Pub Date : 2026-01-01 DOI: 10.1016/j.wnsx.2025.100563

Ansley Grimes Stanfill , Xueyuan Cao , Patrick Devlin , Lucas Elijovich , Adam Arthur , Kayla M. Wynja , Drew Prescott , Brandon Baughman

Introduction

Attempts to develop a multidimensional predictive model for outcomes after aneurysmal subarachnoid hemorrhage have largely failed. Other demographic, clinical, and social information may enhance the predictive value of clinical scales for the prognostication of outcomes. This study investigates other factors that may also be influential for 1-month mortality.

Materials and methods

An existing quality control database was interrogated for ICD-9/10 codes of 430/I60. Missing data were handled by multiple imputations with predictive mean method. The probability of mortality at 1-month was regressed on each predictor variables with results pooled to estimate regression coefficients; a multivariable model was constructed by a backward model selection procedure.

Results

The 1286 subjects averaged 53 years old, were 51.5 % Caucasian and 71.2 % female. Mortality rate was 13.7 % at 1 month. Of the 24 factors interrogated, 10 were significantly (p < 0.05) associated with death (age; race; marital status; employment status; cardiac history; diabetes; treatment method; Glasgow Coma Scale score [GCS]; modified Fisher Group score [mFGS]; Hunt Hess Grade). The final model had four predictors: age (OR 1.08; p < 0.0001), employment status (OR 0.29; p = 0.0051), treatment method (OR 13.11; p = 0.0007), and Hunt Hess Grade (OR 2.45; p < 0.0001).

Conclusion

Our model, constructed from a fairly large and diverse sample, demonstrates that the inclusion of additional demographic, clinical, and social variables improves predictive power beyond that offered by traditional clinical grading scales. Future work should examine the utility of this or a similar model for prediction of morbidity and long-term functional outcomes.

为动脉瘤性蛛网膜下腔出血的预后建立多维预测模型的尝试在很大程度上失败了。其他人口统计、临床和社会信息可能增强临床量表对预后预测的预测价值。本研究调查了其他可能影响1个月死亡率的因素。材料和方法在现有的质量控制数据库中查询430/I60的ICD-9/10编码。用预测均值法对缺失数据进行多次插值处理。对每个预测变量进行1个月的死亡率概率回归，并将结果汇总以估计回归系数；采用逆向模型选择方法建立了多变量模型。结果1286例患者平均年龄53岁，白种人51.5%，女性71.2%。1个月死亡率为13.7%。在调查的24个因素中，有10个因素（年龄、种族、婚姻状况、就业状况、心脏病史、糖尿病、治疗方法、格拉斯哥昏迷量表评分（GCS）、改良Fisher Group评分（mFGS）、Hunt Hess评分）与死亡显著相关（p < 0.05）。最终模型有四个预测因子：年龄（OR 1.08; p < 0.0001）、就业状况（OR 0.29; p = 0.0051）、治疗方法（OR 13.11; p = 0.0007）和Hunt Hess评分（OR 2.45; p < 0.0001）。我们的模型建立在一个相当大的和多样化的样本上，表明包含额外的人口统计、临床和社会变量比传统的临床分级量表提供的预测能力更好。未来的工作应该检查这种或类似的模型在预测发病率和长期功能结果方面的效用。

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引用次数: 0