Brain & spine最新文献

Frameless robotic stereotactic brain biopsy workflow with CT-MRI fusion and CT-to-fluoroscopy registration: Step-by-step technical note and early experience 无框机器人立体定向脑活检工作流程与CT-MRI融合和ct -透视登记：一步一步的技术说明和早期经验

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2026.105940

Mario Taravilla-Loma, Víctor Rodríguez-Domínguez , Catalina Vivancos Sánchez, María Luisa Gandía-González, Alberto Isla Guerrero

Introduction

Stereotactic brain biopsy is a widely used procedure for the histopathological and molecular diagnosis of different types of brain lesions. While frame-based techniques remain highly accurate, frameless neuronavigation and robotic platforms have progressively streamlined workflow and standardization. Practical, reproducible registration strategies are key to facilitate safe implementation across centers.

Research question

We describe a frameless, robot-assisted stereotactic brain biopsy workflow based on preoperative CT-MRI fusion and intraoperative fiducial-free CT-to-fluoroscopy registration, and report technical considerations for reproducible adoption.

Material and methods

A robot-assisted brain biopsy was performed on a patient with a right frontal butterfly-shaped lesion, based on CT-MRI fusion and CT-to-fluoroscopy “Merge Images” registration. We detail the step-by-step workflow, including the registration strategy, technical advantages and disadvantages, and our initial experience with this protocol.

Results

CT-to-fluoroscopy registration provided reliable intraoperative anatomical correlation and was integrated into the routine setup without intraoperative CT or cone-beam CT. In the index case (and in our early experience), tissue sampling provided a conclusive histomolecular diagnosis, with procedure times consistent with routine stereotactic biopsy practice and no major procedure-related complications.

Discussion and conclusion

This technical note outlines a reproducible, step-by-step workflow for robot-assisted stereotactic brain biopsy based on CT-MRI fusion and CT-to-fluoroscopy registration, supported by a standardized operating-room setup. We highlight the practical checkpoints that keep the procedure reliable in routine use, particularly strict fusion verification and uninterrupted optical tracking. Further experience and larger series are warranted to refine its role alongside established stereotactic techniques.

立体定向脑活检是一种广泛应用于不同类型脑病变的组织病理学和分子诊断的方法。虽然基于框架的技术仍然高度精确，但无框架神经导航和机器人平台逐渐简化了工作流程和标准化。实用的、可重复的注册策略是促进跨中心安全实施的关键。研究问题：我们描述了一种基于术前CT-MRI融合和术中无基准ct -透视登记的无框架机器人辅助立体定向脑活检工作流程，并报告了可重复采用的技术考虑。材料和方法基于CT-MRI融合和ct -透视“合并图像”配准，对右额叶蝴蝶状病变患者进行了机器人辅助脑活检。我们详细介绍了一步一步的工作流程，包括注册策略、技术优点和缺点，以及我们使用该协议的初步经验。结果CT-透视配准提供了可靠的术中解剖相关性，可纳入常规设置，无需术中CT或锥束CT。在索引病例（以及我们的早期经验）中，组织取样提供了结论性的组织分子诊断，手术时间与常规立体定向活检实践一致，没有主要的手术相关并发症。本技术说明概述了基于CT-MRI融合和ct -透视登记的机器人辅助立体定向脑活检的可重复的、逐步的工作流程，并支持标准化的手术室设置。我们强调了在日常使用中保持程序可靠的实际检查点，特别是严格的融合验证和不间断的光学跟踪。进一步的经验和更大的系列保证完善其作用与建立立体定向技术。

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引用次数: 0

Swiss national spinal implant registry SIRIS Spine: methods and first results 瑞士国家脊柱植入注册中心SIRIS脊柱：方法和初步结果

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2026.105928

Thorsten Jentzsch , David Bellut , Ralph T. Schär , Daniel Haschtmann , Emin Aghayev

Introduction

Spine registries are important for advancing the field to provide evidence for clinical and health policy decision-making.

Research question

The objective is to introduce the Swiss Implant Registry "SIRIS Spine" as one of the world's first mandatory nationwide spinal implant registries for selected spinal surgeries.

Material and methods

SIRIS Spine is governed by the SIRIS Foundation, Switzerland. EUROSPINE is commissioned to operate the registry. Collected patient data includes demographic, clinical, and implant information and may additionally include electronic patient-reported outcome measures. Inclusion criteria are growing stepwise.

Results

Between the years 2021–2023, 12,815 surgeries for 11,789 patients from 91 hospitals were registered. This includes 75,522 implants from 40 manufactures. Reoperations and revisions were registered in 6.9 %. The most frequent pathology was degenerative disease (61.6 %), followed by osteoporotic fractures (12.4 %), and non-degenerative spondylolisthesis (5.4 %). The mean age was 66.8 (standard deviation (SD) 13.7) years. Women (58.7 %) were slightly more frequently included than men. Almost half of the surgeries were preceded by one or several prior surgeries at the same or adjacent segment (49.6 %), after excluding 1′367 patients with missing information.

Discussion and conclusion

The SIRIS Spine registry has successfully captured initial data from the involved Swiss hospitals. Involvement of all key stakeholders including specialist societies has proven to be important and a clear success factor. The primary challenge identified was the complexity of inclusion criteria, which has impeded data validation. Future efforts will focus on simplifying criteria, rigorously validating data completeness and accuracy, and leveraging data for quality improvement and comparative analyses.

脊柱登记对于推进该领域为临床和卫生政策决策提供证据具有重要意义。研究问题：目的是将瑞士植入物注册中心“SIRIS Spine”作为世界上第一个强制性的全国性脊柱植入物注册中心之一，用于选定的脊柱手术。材料和方法SIRIS Spine由瑞士SIRIS基金会管理。EUROSPINE被委托运营该登记处。收集的患者数据包括人口统计、临床和植入信息，还可能包括电子患者报告的结果测量。纳入标准正在逐步提高。结果2021-2023年共登记91家医院11,789例患者12,815例手术。这包括来自40家制造商的75,522个植入物。再手术和改头换面占6.9%。最常见的病理是退行性疾病（61.6%），其次是骨质疏松性骨折（12.4%）和非退行性脊柱滑脱（5.4%）。平均年龄66.8岁（标准差13.7）。女性（58.7%）被纳入的频率略高于男性。在排除1 367例信息缺失患者后，几乎有一半（49.6%）手术前在同一节段或相邻节段进行过一次或多次手术。讨论与结论SIRIS脊柱登记系统已经成功地从相关瑞士医院获取了初步数据。包括专业协会在内的所有关键利益相关者的参与已被证明是重要的，也是一个明显的成功因素。确定的主要挑战是纳入标准的复杂性，这阻碍了数据验证。未来的努力将集中于简化标准，严格验证数据的完整性和准确性，以及利用数据进行质量改进和比较分析。

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引用次数: 0

Changes in quality of life and work status after surgical management of meralgia paresthetica– an observational cohort study 手术治疗痛觉异常后生活质量和工作状态的变化——一项观察性队列研究

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2025.105916

S. Baruchi , B. Schönberg , J. Reinsch , J. Alsolivany , A. Zdunczyk , N.F. Dengler

Purpose

Surgical management of meralgia paresthetica (MP) is effective in reducing pain. This study aims to analyze changes in health-related quality of life (HRQoL) and work status after surgical management of MP.

Methods

The institutional database was screened for surgically treated MP cases between January 1, 2010 and December 31, 2022. Patients were followed up by a standardized questionnaire (EQ-5D-5L) and interview.

Results

The final analysis included 24 patients at a median age of 51 years (interquartile range [IQR] 40–57). Comorbidities were present in 92 % of patients. At a median time of follow-up of 25 months (IQR 11–57) after surgery, 83 % of patients reported a benefit, independent of comorbidities or individual work-status. Pre-surgical pain (on a numeric scale from 1 to 10) improved from 8 (IQR 6–9) to 4 (IQR 1–7; p < 0.001). Preoperatively, HRQoL (on a visual scale from 0 to 100) was rated at a median of 50 (IQR 30–75) and improved to a median of 70 (IQR 35–89; p = 0.004). Improvements in HRQoL were more pronounced among patients without comorbidity. A dimension specific EQ-5D-5L analysis for mobility/self-care/usual activities/pain/anxiety showed improvements from 3/1/3/4/2 pre-operatively to 2/1/2/3/2 at follow-up.

Although most patients that had been part of the active workforce showed a benefit from surgery, 25 % of them did not return to work.

Conclusion

The majority of MP patients showed improvement in MP specific symptoms. HRQoL after surgery only improved among patients without depression, obesity and/or cardiovascular comorbidities as well as in non-retired subjects. However, a substantial number of patients did not return to work.

目的：手术治疗感觉异常痛（MP）是减轻疼痛的有效方法。本研究旨在分析MP手术治疗后健康相关生活质量（HRQoL）和工作状态的变化。方法筛选2010年1月1日至2022年12月31日期间手术治疗的MP病例。随访采用标准化问卷（EQ-5D-5L）和访谈。结果最终分析纳入24例患者，中位年龄51岁（四分位数间距[IQR] 40-57）。92%的患者存在合并症。在术后25个月的中位随访时间（IQR 11-57）中，83%的患者报告获益，与合并症或个人工作状态无关。术前疼痛（数值范围从1到10）从8 （IQR 6-9）改善到4 （IQR 1 - 7; p < 0.001）。术前HRQoL（视觉评分从0到100）的中位数为50 (IQR 30-75)，中位数为70 （IQR 35-89; p = 0.004）。在无合并症的患者中，HRQoL的改善更为明显。一项针对行动能力/自我护理/日常活动/疼痛/焦虑的EQ-5D-5L维度分析显示，从术前的3/1/3/4/2到随访时的2/1/2/3/2有所改善。虽然大多数曾是活跃劳动力的患者从手术中受益，但其中25%的人没有重返工作岗位。结论大多数MP患者的特异性症状均有改善。术后HRQoL仅在无抑郁、肥胖和/或心血管合并症的患者以及未退休的受试者中有所改善。然而，相当数量的病人没有重返工作岗位。

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引用次数: 0

Assessing cervical intervertebral disc height on MRI and X-ray versus CT; a single center retrospective cohort study MRI、x线与CT对比评估颈椎间盘高度单中心回顾性队列研究

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2026.105927

Esther van Santbrink , Toon Boselie , Valérie Schuermans , Nykle Krijgsveld , Rob de Bie , Anouk Smeets , Henk van Santbrink

Introduction

Cervical intervertebral disc height is often used to score cervical degenerative disc disease (CDDD) and can also aid in pre-operative surgical planning. For this purpose, MRI and X-ray imaging are routinely used. However, the reliability and agreement with computed tomography (CT), the gold standard for linear measurements, remain unknown.

Research question

To assess the reliability and agreement of intervertebral disc height measurements between MRI, X-ray, and CT.

Material and methods

Data was collected from all patients that received an MRI, X-ray, and CT within a timeframe of 6 months at Zuyderland Medical Center (ZMC) between 2014 and 2024. Mid, anterior, and posterior cervical intervertebral disc heights were measured from C2-C3 to C6-C7 in all three imaging modalities. 120 patients were included. The intraclass correlation coefficient (ICC) was calculated for the inter- and intraobserver reliability. A linear mixed model with Bonferroni correction was used to compare outcomes.

Results

ICCs ranged from moderate to excellent for X-ray. ICCs ranged from good to excellent for MRI and CT after sensitivity analysis for equal slice selection. Mean difference in disc height was .1 mm (p = 0.163) between MRI and X-ray, 1.3 mm (p < 0.001) between MRI and CT, and 1.3 mm (p < 0.001) between X-ray and CT.

Discussion and conclusion

MRI and X-ray exhibit a systematic bias in the measurement of cervical intervertebral disc height when compared to CT. CT should be considered for the assessment of disc height. The mid-disc measurement is recommended to ensure high reliability.

颈椎椎间盘高度常用于颈椎退行性椎间盘疾病（CDDD）的评分，也有助于术前手术计划。为此，常规使用核磁共振成像和x射线成像。然而，其可靠性和与线性测量的金标准计算机断层扫描（CT）的一致性仍然未知。研究问题：评估MRI、x线和CT间椎间盘高度测量的可靠性和一致性。材料和方法数据收集自2014年至2024年间在Zuyderland Medical Center （ZMC）接受MRI、x射线和CT检查的所有患者，时间为6个月。在所有三种成像方式下测量从C2-C3到C6-C7的中、前、后颈椎间盘高度。纳入120例患者。用类内相关系数（ICC）计算观察者之间和观察者内部的信度。采用Bonferroni校正的线性混合模型比较结果。结果iccs的x线表现为中等至优良。在对等层选择进行敏感性分析后，ICCs在MRI和CT上的表现从良好到优异。椎间盘高度的平均差异为。MRI与x线之间相差1 mm (p = 0.163)， MRI与CT之间相差1.3 mm (p < 0.001)， x线与CT之间相差1.3 mm （p < 0.001）。讨论和结论与CT相比，mri和x线在测量颈椎间盘高度时表现出系统性的偏差。应考虑CT评估椎间盘高度。为保证高可靠性，建议采用盘中部测量。

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引用次数: 0

Perioperative disease activity and metabolic optimization in spinal Paget's disease 脊柱佩吉特病围手术期疾病活动性和代谢优化

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2026.105938

Audai Abudayeh, Iakiv Fishchenko

引用次数: 0

Assisted full-endoscopic spine surgery for lumbar spinal stenosis: Technical note and learning curve 腰椎管狭窄的辅助全内窥镜脊柱手术：技术说明和学习曲线

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2026.105935

Koichiro Ono , Daisuke Fukuhara , Yuka Yamami , Yushi Yamaguchi , Kazuma Miura , Yuki Kasuga , Kaichi Sato , Satoshi Takamoto , Naoya Takabayshi , Hiroshi Kawaguchi , Makoto Hirao

Introduction

Lumbar spinal stenosis (LSS) causes disabling back and radicular pain. Full-endoscopic spine surgery offers minimally invasive decompression, but uniportal and biportal approaches have limitations. Assisted full-endoscopic spine surgery (AFESS) combines the advantages of both techniques to enhance decompression while preserving facet joints.

Research question

Can AFESS provide effective decompression with high facet preservation for LSS, and what is the learning curve for this technique?

Material and methods

We retrospectively reviewed 33 patients with single-level LSS treated with AFESS, divided into initial (20 cases) and advanced (13 cases) phases. Outcomes assessed at a minimum 6-month follow-up included operative time, facet joint preservation ratio, complications, and visual analog scale (VAS) scores for back and leg pain.

Results

Operative time decreased significantly from the initial to the advanced phase (mean 99 vs 72 min; p < 0.01). Facet joints were more preserved in the advanced phase (76.2 % vs 68.9 %, p < 0.05). In the initial and advanced phases, mean lumbar VAS improved from 4.2 to 1.1 cm and 2.8 to 0.2 cm, respectively. Radicular VAS improved from 7.7 to 0.8 cm (initial) and 6.9 to 0.9 cm (advanced) (p < 0.01 for all). Two patients (6 %) experienced minor complications in the initial phase, with no permanent deficits.

Discussion and conclusion

AFESS is safe and effective, achieving adequate decompression with high facet preservation and significant pain relief in LSS patients. By integrating uniportal and biportal endoscopic approaches, AFESS overcomes limitations of each. The well-defined learning curve suggests it can be efficiently incorporated into clinical practice with minimal complications.

腰椎管狭窄症（LSS）会导致背部和神经根性疼痛。全内窥镜脊柱手术提供了微创减压，但单门和双门入路有局限性。辅助全内窥镜脊柱手术（AFESS）结合了两种技术的优点，以加强减压，同时保留小关节。研究问题：AFESS能否为LSS提供有效的减压和高关节面保护？这项技术的学习曲线是什么？材料和方法我们回顾性分析了33例接受AFESS治疗的单级LSS患者，分为初期（20例）和晚期（13例）。在至少6个月的随访中评估的结果包括手术时间、小关节保存率、并发症和背部和腿部疼痛的视觉模拟评分（VAS）。结果手术时间从初期到晚期明显缩短（平均99 vs 72 min； p < 0.01）。关节突关节在晚期保存较多（76.2% vs 68.9%, p < 0.05）。在初始和晚期，平均腰椎VAS分别从4.2到1.1 cm和2.8到0.2 cm改善。神经根性VAS从7.7 ~ 0.8 cm（初始）和6.9 ~ 0.9 cm（晚期）改善（p < 0.01）。2例患者（6%）在初始阶段出现轻微并发症，没有永久性缺陷。讨论与结论在LSS患者中，afess是安全有效的，可以实现充分的减压，高度保留关节突，显著缓解疼痛。通过整合单门静脉和双门静脉内镜入路，AFESS克服了各自的局限性。明确的学习曲线表明，它可以有效地纳入临床实践，并发症最少。

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引用次数: 0

Temporal muscle measurements as predictor for outcome in a cohort of IDH-wildtype glioblastoma patients 颞肌测量作为idh野生型胶质母细胞瘤患者队列预后的预测因子

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2025.105914

H. Pinson , C. De Rudder , L. De Backer , A. Van Sinay , T. Boterberg , G. Hallaert

Background

Temporal muscle thickness has been suggested as an independent prognostic marker for glioblastoma patient outcome. Various cohort studies show however conflicting results. This study therefore aims to reevaluate the prognostic value of different types of temporal muscle measurements in glioblastoma patients.

Methods

A retrospective cohort study was performed including 137 patients diagnosed with IDH-wildtype glioblastoma. Temporal muscle thickness (TMT) and volume (TMV) were measured on preoperative MR-imaging. Next, these measurements were used in a multivariate Cox survival analysis to identify their possible prognostic value. These results were compared to the literature after systematic review of the Medline database.

Results

TMT has a moderate to strong linear correlation with total muscle volume (Pearson r = 0.6; P < 0.001). Glioblastoma patients “at risk for sarcopenia” show similar outcome compared to controls (median overall survival time: 13 months vs 11 months; P = 0.775). In a covariate Cox regression model, none of the temporal muscle measurements (TMT, TMV or sex-specific cut-off points) showed prognostic value for outcome in glioblastoma patients.

Conclusion

Temporal muscle measurements show no independent relation to clinical outcome in IDH-wildtype glioblastoma patients. There seems adequate linear correlation of temporal muscle thickness and overall muscle volume. The literature on temporal muscle measurements lacks methodological consistency and should be interpreted with caution.

背景颞肌厚度已被认为是胶质母细胞瘤患者预后的独立预后指标。然而，各种队列研究显示出相互矛盾的结果。因此，本研究旨在重新评估不同类型颞肌测量在胶质母细胞瘤患者中的预后价值。方法对137例idh野生型胶质母细胞瘤患者进行回顾性队列研究。术前mri测量颞肌厚度（TMT）和体积（TMV）。接下来，将这些测量结果用于多变量Cox生存分析，以确定其可能的预后价值。这些结果在Medline数据库的系统回顾后与文献进行了比较。结果stmt与总肌肉体积呈中等至强线性相关（Pearson r = 0.6; P < 0.001）。与对照组相比，“有肌肉减少风险”的胶质母细胞瘤患者表现出相似的结果（中位总生存时间：13个月vs 11个月；P = 0.775）。在协变量Cox回归模型中，颞肌测量（TMT、TMV或性别特异性截断点）均未显示出胶质母细胞瘤患者预后的价值。结论颞肌测量与idh野生型胶质母细胞瘤患者的临床预后无独立关系。颞肌厚度和整体肌肉体积似乎有足够的线性相关性。关于颞肌测量的文献缺乏方法学上的一致性，应谨慎解释。

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引用次数: 0

Cortical structural variations and scoliosis risk: insights from a large-scale Mendelian randomization analysis 皮质结构变异和脊柱侧凸风险：来自大规模孟德尔随机化分析的见解

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2026.105936

Hanjun Ma , Ju Liao , Mingxuan Liu , Zonglong He , Qi Wei , Qunqiang Luo

Introduction

Scoliosis is a complex condition that may be influenced by neurobiological factors, including brain structure.

Research question

Does a causal relationship exist between brain structure and scoliosis, and if so, which brain structural imaging-derived phenotypes (IDPs) are implicated?

Material and methods

We conducted a bidirectional Mendelian randomization (MR) analysis to evaluate potential causal relationships between brain structural IDPs and scoliosis. Instrumental variables were selected from genome-wide association studies, and causal estimates were derived primarily using inverse variance weighted (IVW) analysis, complemented by other sensitivity analyses.

Results

In the forward MR analysis, 27 brain structural IDPs showed positive associations with scoliosis risk, whereas 37 showed negative associations. Notably, increased grey matter volume in the left middle frontal gyrus (MFG) showed the strongest association (IDP code: IDP_T1_FAST_ROIs_L_mid_front_gyrus; IVW OR = 2.238, 95 % CI: 1.534–3.264, P = 2.911 × 10⁻⁵; P_FDR = 0.049), and it remained significant after FDR correction. In the reverse MR analysis, scoliosis was associated with 55 brain structural traits, but none remained significant after FDR correction.

Discussion and conclusion

These findings provide evidence supporting a potential causal role of specific brain structures in scoliosis susceptibility, particularly the left MFG, a region associated with postural control. Further studies are needed to replicate these associations and clarify their clinical relevance.

脊柱侧凸是一种复杂的疾病，可能受到包括脑结构在内的神经生物学因素的影响。研究问题：脑结构和脊柱侧凸之间是否存在因果关系？如果存在因果关系，哪些脑结构成像衍生表型（IDPs）与之相关？材料和方法我们进行了双向孟德尔随机化（MR）分析，以评估脑结构性IDPs与脊柱侧凸之间的潜在因果关系。工具变量从全基因组关联研究中选择，因果估计主要使用逆方差加权（IVW）分析，辅以其他敏感性分析。结果在正向MR分析中，27例脑结构IDPs与脊柱侧凸风险呈正相关，37例与脊柱侧凸风险负相关。值得注意的是，左侧额叶中回（MFG）灰质体积增加表现出最强的相关性（IDP代码：IDP_T1_FAST_ROIs_L_mid_front_gyrus； IVW OR = 2.238, 95% CI: 1.534 ~ 3.264, P = 2.911 × 10−5;P_FDR = 0.049）， FDR校正后仍具有显著性。在反向MR分析中，脊柱侧凸与55个脑结构特征相关，但在FDR校正后没有一个保持显著性。讨论和结论这些发现提供了证据，支持特定大脑结构在脊柱侧凸易感性中的潜在因果作用，特别是与姿势控制相关的左侧MFG区域。需要进一步的研究来重复这些关联并阐明其临床相关性。

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引用次数: 0

Surgical selection and outcomes: Unilateral hemilaminectomy vs. total laminectomy for spinal tumors 手术选择和结果：单侧半椎板切除术与全椎板切除术治疗脊柱肿瘤

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2026.105944

Almir Džurlić , Bekir Rovčanin , Džan Ahmed Jesenković , Azra Grebo , Lamija Terzić , Adi Ahmetspahić , Edin Hajdarpašić , Mirza Pojskić , Ibrahim Omerhodžić

Introduction

Spinal tumor surgery mandates complete removal with preserved neurological function and stability. Total Laminectomy (TL) provides access but risks complications (pain, deformity) from extensive tissue removal. The safer, tissue-sparing Unilateral Hemilaminectomy (UHL) is limited by concerns about complete resection via its narrower corridor.

Research question

This study was comparing the clinical and radiological characteristic between unilateral TL and total laminectomy UHL and they clinical outcomes and complications.

Material and methods

This was a retrospective cohort study comparing UHL and TL for intradural/extradural spinal tumors. We analyzed consecutive patients operated between January 2018 and December 2024, excluding those with confounding factors. Surgical approach was selected based on tumor location and intraoperative needs. Data on patient demographics, pre/postoperative neurological status, surgical parameters, and tumor characteristics were collected. Primary outcomes were postoperative neurological status and complications rate. Statistical analysis compared variables between groups using appropriate tests, with significance at p = 0.05.

Results

Baseline characteristics were similar between groups, and the overall postoperative complication rate was low (6.3 %) and comparable. The postoperative KPS score between UHL and TL showed improvement, without significant difference between them. Both approaches yielded significant improvements in functional status and neurological recovery from preoperative baselines.

Discussion and conclusion

Our findings indicate that the tissue-sparing UHL approach can achieve similar functional outcomes and complication rates as TL for similarly sized tumors. This supports UHL as a safe and effective option, although the final surgical approach must remain individualized based on specific tumor complexity and radiological findings.

脊柱肿瘤手术要求完全切除并保留神经功能和稳定性。全椎板切除术（TL）提供了手术途径，但存在大面积组织切除带来的并发症（疼痛、畸形）的风险。更安全、保留组织的单侧半椎板切除术（UHL）由于其狭窄的通道不能完全切除而受到限制。研究问题本研究比较单侧TL和全椎板切除术UHL的临床和影像学特点及其临床结局和并发症。材料和方法这是一项回顾性队列研究，比较UHL和TL治疗硬膜内/硬膜外脊柱肿瘤。我们分析了2018年1月至2024年12月期间连续手术的患者，排除了混杂因素。根据肿瘤位置和术中需要选择手术入路。收集患者人口统计学、术前/术后神经状态、手术参数和肿瘤特征的数据。主要结果是术后神经系统状况和并发症发生率。统计学分析采用适当的检验比较组间变量，p = 0.05为显著性。结果两组患者基线特征相似，总体术后并发症发生率低（6.3%），具有可比性。UHL与TL术后KPS评分均有改善，两者无显著差异。两种方法均能显著改善患者的功能状态和术前基线的神经恢复。讨论和结论我们的研究结果表明，对于类似大小的肿瘤，保留组织的UHL入路可以获得与TL相似的功能结果和并发症发生率。这支持UHL作为一种安全有效的选择，尽管最终的手术方法必须根据特定的肿瘤复杂性和放射学发现保持个体化。

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引用次数: 0

Implementation of 3D printing technology for complex spine revision cases that require multilevel anterior spinal support: Over 5-year experience in six cases and costs assessment 在复杂脊柱翻修病例中实施3D打印技术，需要多水平脊柱前路支持：超过5年的6例经验和成本评估

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2026.105929

J. Magré , M.S. Ramselaar , K. Willemsen , H. Weinans , T.P.C. Schlösser , M.C. Kruyt

Introduction

The anterior column of the spine is crucial for stability. In a dystrophic spine, the loss of multisegmental anterior spinal support can have devastating consequences. Since posterior instrumentation alone cannot take over the weight bearing capacity of the anterior column, structural anterior support must be created. Long bone struts are at risk for failure of engraftment and pseudoarthrosis. Patient-specific anterior support using 3D printing technology may be a better solution in these patients.

Research question

Are patient-specific approaches using 3D printing technology a viable treatment option for multilevel anterior spinal support?

Material and methods

Five patients received a custom-made anterior paravertebral titanium spinal strut prosthesis; one patient received a 3D shaped structural allograft. Cost assessment was made based on hours spent and production costs. Clinical outcomes were extracted from the medical records.

Results

All six implantations went uneventful with adequate fit of the prostheses and allograft. The mean surgery time was 219 min, and mean blood loss was 850 ml. No implant subsidence or loosening occurred during follow-up (0.5–8 years). Complications observed were partial bronchial compression in one patient and a postoperative infection in another. The first cases were most costly due to the hours spent on design and regulatory compliance. These costs declined for subsequent cases.

Discussion and conclusion

Custom-made prostheses appear to be a viable treatment option for multi-level anterior spinal support. No implant failure was observed up to 8 years postoperative. Close collaboration between an in-house 3D lab and the surgical team was essential for implementing custom-made prosthesis in clinical care.

脊柱前柱对脊柱的稳定性至关重要。在营养不良的脊柱中，多节段脊柱前支撑的丧失可能会造成毁灭性的后果。由于单纯后路内固定不能取代前柱的承重能力，因此必须建立结构性的前路支撑。长骨支柱有植入失败和假关节的危险。在这些患者中，使用3D打印技术的患者特异性前路支持可能是更好的解决方案。研究问题：针对患者使用3D打印技术进行多节段脊柱前路支持是否可行？材料与方法5例患者采用定制的椎旁前路钛脊柱支撑假体；一名患者接受了3D形状的同种异体结构移植。成本评估是根据花费的小时数和生产成本进行的。从医疗记录中提取临床结果。结果6例移植均顺利进行，假体与同种异体移植吻合良好。平均手术时间219 min，平均失血量850 ml，随访0.5 ~ 8年无种植体下沉、松动。观察到的并发症是1例患者部分支气管受压，另1例患者术后感染。由于在设计和法规遵从性上花费的时间，第一个案例的成本最高。这些费用在随后的案件中有所下降。讨论与结论定制假体似乎是一种可行的治疗选择，多段前路脊柱支持。术后8年未见种植体失败。内部3D实验室和外科团队之间的密切合作对于在临床护理中实施定制假体至关重要。

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