Brain & spine最新文献_第2页

Exoscope-assisted spine surgery: Insights from orthopedic and neurosurgical teams through a survey 外窥镜辅助脊柱手术：通过调查从骨科和神经外科团队的见解。

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 Epub Date: 2026-02-13 DOI: 10.1016/j.bas.2026.105974

Rossella Rispoli , Simona Legrenzi , Pietro Domenico Giorgi , Barbara Cappelletto

Introduction

Spine surgery requires precise visualization to ensure safety in anatomically complex regions. Traditional microscopes, though effective, have ergonomic and communication limitations. High-definition three-dimensional (3D) exoscopes address these challenges by providing superior image quality, depth perception, ergonomics, collaboration, and teaching opportunities, while supporting minimally invasive techniques. This study reports the experience of two Italian centers adopting the exoscope as a primary visualization tool, integrating surgeons’ and staff perspectives through structured questionnaires.

Methods

This retrospective, observational, dual-center study evaluated spinal procedures performed with the exoscope between January 2022 and June 2025 at two Italian institutions. Procedures included cervical, thoracic, and lumbar surgeries performed through anterior, posterior, and lateral approaches, and encompassed intradural and extradural pathologies. Clinical experience was complemented by two structured questionnaires, one for surgeons and one for non-surgeon team members, addressing image quality and visualization, ergonomics and fatigue, intraoperative communication and workflow, learning curve and implementation, and educational value.

Results

A total of 880 spinal procedures were performed. Surgeons reported excellent visualization, illumination, magnification, depth perception, and ergonomics, with reduced fatigue and improved workflow. Competency was typically achieved within three cases. Non-surgeons confirmed improved image quality, intraoperative communication, awareness of surgical actions, and educational engagement. Both groups consistently endorsed the exoscope as a transformative surgical and teaching tool.

Conclusions

The exoscope enhances visualization and ergonomics while fostering collaboration and education in the operating room. It offers significant advantages over traditional microscopes, improving precision, efficiency, and training across diverse spinal procedures, and represents a valuable tool for routine clinical practice.

脊柱手术需要精确的可视化，以确保解剖复杂区域的安全。传统的显微镜虽然有效，但有人体工程学和通讯方面的限制。高清三维（3D）外窥镜通过提供卓越的图像质量、深度感知、人体工程学、协作和教学机会，同时支持微创技术，解决了这些挑战。本研究报告了两家意大利中心采用外窥镜作为主要可视化工具的经验，通过结构化问卷整合了外科医生和工作人员的观点。方法：这项回顾性、观察性、双中心研究评估了2022年1月至2025年6月在意大利两家机构使用外窥镜进行的脊柱手术。手术包括通过前路、后路和外侧入路进行的颈椎、胸椎和腰椎手术，包括硬膜内和硬膜外病理。临床经验通过两份结构化问卷进行补充，一份用于外科医生，一份用于非外科医生团队成员，涉及图像质量和可视化，人体工程学和疲劳，术中沟通和工作流程，学习曲线和实施，以及教育价值。结果：共进行880例脊柱手术。外科医生报告了出色的可视化、照明、放大、深度感知和人体工程学，减少了疲劳，改善了工作流程。胜任能力通常在三个案例中获得。非外科医生证实图像质量、术中沟通、手术操作意识和教育参与得到改善。这两个团体一致认为外窥镜是一种变革性的手术和教学工具。结论：外窥镜增强了可视化和人体工程学，同时促进了手术室的协作和教育。与传统显微镜相比，它具有显著的优势，提高了精度、效率和各种脊柱手术的培训，是常规临床实践的宝贵工具。

{"title":"Exoscope-assisted spine surgery: Insights from orthopedic and neurosurgical teams through a survey","authors":"Rossella Rispoli , Simona Legrenzi , Pietro Domenico Giorgi , Barbara Cappelletto","doi":"10.1016/j.bas.2026.105974","DOIUrl":"10.1016/j.bas.2026.105974","url":null,"abstract":"<div><h3>Introduction</h3><div>Spine surgery requires precise visualization to ensure safety in anatomically complex regions. Traditional microscopes, though effective, have ergonomic and communication limitations. High-definition three-dimensional (3D) exoscopes address these challenges by providing superior image quality, depth perception, ergonomics, collaboration, and teaching opportunities, while supporting minimally invasive techniques. This study reports the experience of two Italian centers adopting the exoscope as a primary visualization tool, integrating surgeons’ and staff perspectives through structured questionnaires.</div></div><div><h3>Methods</h3><div>This retrospective, observational, dual-center study evaluated spinal procedures performed with the exoscope between January 2022 and June 2025 at two Italian institutions. Procedures included cervical, thoracic, and lumbar surgeries performed through anterior, posterior, and lateral approaches, and encompassed intradural and extradural pathologies. Clinical experience was complemented by two structured questionnaires, one for surgeons and one for non-surgeon team members, addressing image quality and visualization, ergonomics and fatigue, intraoperative communication and workflow, learning curve and implementation, and educational value.</div></div><div><h3>Results</h3><div>A total of 880 spinal procedures were performed. Surgeons reported excellent visualization, illumination, magnification, depth perception, and ergonomics, with reduced fatigue and improved workflow. Competency was typically achieved within three cases. Non-surgeons confirmed improved image quality, intraoperative communication, awareness of surgical actions, and educational engagement. Both groups consistently endorsed the exoscope as a transformative surgical and teaching tool.</div></div><div><h3>Conclusions</h3><div>The exoscope enhances visualization and ergonomics while fostering collaboration and education in the operating room. It offers significant advantages over traditional microscopes, improving precision, efficiency, and training across diverse spinal procedures, and represents a valuable tool for routine clinical practice.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105974"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349851","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

Neurosurgical and neuro-oncological outcomes of confirmatory brain biopsies in patients with glioblastoma: a real-life monocentric experience 胶质母细胞瘤患者确证性脑活检的神经外科和神经肿瘤学结果：真实的单中心经验。

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 Epub Date: 2026-02-13 DOI: 10.1016/j.bas.2026.105966

Andrea Di Cristofori , Davide Ferlito , Francesca Graziano , Andrea Trezza , Chiara Benedetta Rui , Tommaso Calloni , Gaia Chiarello , Giovanni Stefanoni , Chiara Julita , Giovanni Palumbo , Stefania Galimberti , Giorgio Carrabba , Carlo Giussani

Introduction

Glioblastoma (GB) is an uncurable tumor with poor prognosis despite resection plus adjuvant cares. When unresectable, even in case of a clear radiological imaging, guidelines require a formal histological diagnosis to confirm the diagnosis of GB.

Research question

This study aims to assess the post-surgical complications and neuro-oncological outcomes of patients undergoing a confirmatory brain biopsy for diagnosing GB.

Materials and methods

We considered 125 adult patients who underwent stereotactic biopsy between January 2018 and December 2023 at the Neurosurgery Department of IRCCS San Gerardo dei Tintori. Among them, 74 patients with radiological diagnosis of GB underwent a purely confirmatory biopsy. The clinical history of each patient was evaluated from the onset of symptoms through subsequent neuro-oncological treatments. We evaluated the patients' clinical conditions at the time of biopsy and upon discharge, the radiological characteristics of the tumor, the histopathological diagnosis, biopsy-related complications, access to oncological treatments along with associated complications and neurological-functional outcomes.

Results

Unmethylated MGMT status, KPS≤70, tumor proximity to the internal capsule and absence of motor hemisyndrome at symptoms onset emerged as possible risk factors. Biopsied GB patients had an 11% complication rate and exhibited a dismal short-term prognosis, with a median survival of 4.7 months. Furthermore, about 40% of patients did not access subsequent treatment.

Discussion and conclusions

Brain biopsy is still a minor procedure with not a negligible rate of complications. When performed as a purely confirmatory procedure, a great deal of patients does not access oncological treatments.

胶质母细胞瘤（GB）是一种无法治愈的肿瘤，尽管进行了手术和辅助治疗，但预后很差。当无法切除时，即使有清晰的放射学成像，指南也要求进行正式的组织学诊断以确认GB的诊断。研究问题：本研究旨在评估行确证性脑活检诊断GB的患者术后并发症和神经肿瘤预后。材料和方法：我们纳入了2018年1月至2023年12月在IRCCS San Gerardo dei Tintori神经外科接受立体定向活检的125名成年患者。其中影像学诊断为GB的74例患者行单纯确认性活检。每位患者的临床病史从症状开始到随后的神经肿瘤治疗进行评估。我们评估了患者在活检时和出院时的临床状况，肿瘤的放射学特征，组织病理学诊断，活检相关并发症，肿瘤治疗的可及性以及相关并发症和神经功能结果。结果：MGMT未甲基化状态、KPS≤70、肿瘤靠近内囊、症状发作时无运动半球综合征是可能的危险因素。活检后的GB患者并发症发生率为11%，短期预后不佳，中位生存期为4.7个月。此外，约40%的患者没有获得后续治疗。讨论与结论：脑活检仍然是一个小手术，并发症的发生率不容忽视。当作为一个纯粹的确认程序进行时，大量患者无法获得肿瘤治疗。

{"title":"Neurosurgical and neuro-oncological outcomes of confirmatory brain biopsies in patients with glioblastoma: a real-life monocentric experience","authors":"Andrea Di Cristofori , Davide Ferlito , Francesca Graziano , Andrea Trezza , Chiara Benedetta Rui , Tommaso Calloni , Gaia Chiarello , Giovanni Stefanoni , Chiara Julita , Giovanni Palumbo , Stefania Galimberti , Giorgio Carrabba , Carlo Giussani","doi":"10.1016/j.bas.2026.105966","DOIUrl":"10.1016/j.bas.2026.105966","url":null,"abstract":"<div><h3>Introduction</h3><div>Glioblastoma (GB) is an uncurable tumor with poor prognosis despite resection <em>plus</em> adjuvant cares. When unresectable, even in case of a clear radiological imaging, guidelines require a formal histological diagnosis to confirm the diagnosis of GB.</div></div><div><h3>Research question</h3><div>This study aims to assess the post-surgical complications and neuro-oncological outcomes of patients undergoing a confirmatory brain biopsy for diagnosing GB.</div></div><div><h3>Materials and methods</h3><div>We considered 125 adult patients who underwent stereotactic biopsy between January 2018 and December 2023 at the Neurosurgery Department of IRCCS San Gerardo dei Tintori. Among them, 74 patients with radiological diagnosis of GB underwent a purely confirmatory biopsy. The clinical history of each patient was evaluated from the onset of symptoms through subsequent neuro-oncological treatments. We evaluated the patients' clinical conditions at the time of biopsy and upon discharge, the radiological characteristics of the tumor, the histopathological diagnosis, biopsy-related complications, access to oncological treatments along with associated complications and neurological-functional outcomes.</div></div><div><h3>Results</h3><div>Unmethylated MGMT status, KPS≤70, tumor proximity to the internal capsule and absence of motor hemisyndrome at symptoms onset emerged as possible risk factors. Biopsied GB patients had an 11% complication rate and exhibited a dismal short-term prognosis, with a median survival of 4.7 months. Furthermore, about 40% of patients did not access subsequent treatment.</div></div><div><h3>Discussion and conclusions</h3><div>Brain biopsy is still a minor procedure with not a negligible rate of complications. When performed as a purely confirmatory procedure, a great deal of patients does not access oncological treatments.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105966"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349872","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

The effect of postoperative rehabilitation on outcomes in patients with degenerative cervical myelopathy (DCM): A systematic review 术后康复对退行性颈椎病（DCM）患者预后的影响：一项系统综述

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 Epub Date: 2026-02-02 DOI: 10.1016/j.bas.2026.105956

Chanelle Montpetit , Adam Kobaisi , Justin M. Lantz , Rohil V. Chauhan , David B. Anderson , Maryse Fortin

Introduction

Degenerative cervical myelopathy (DCM) is the leading cause of adult spinal cord dysfunction, often requiring surgery. However, the role of postoperative rehabilitation in optimizing patient outcomes remains unclear.

Research question

What are the effects of postoperative rehabilitation on clinical outcomes following DCM surgery?

Material and methods

This systematic review was registered with PROSPERO (CRD42024582484). PubMed, Scopus, and Web of Science were searched through September 2025. Eligible studies included randomized controlled trials (RCTs), and other research on rehabilitation interventions for postoperative outcomes (e.g., function, pain, neurological recovery) in patients undergoing DCM surgery. Studies without confirmed DCM, non-peer-reviewed articles, or lacking a rehabilitation protocol were excluded. Risk of bias was assessed using the RoB 2 and ROBINS-I. Descriptive summaries were conducted, categorizing studies into active, passive, and mixed interventions. The evidence quality was rated using the GRADE approach.

Results

Ten studies with a total of 766 patients were included, made up of 5 RCTs and 5 cohort studies. Seven studies had high risk of bias, and three had moderate risk of bias. Mixed rehabilitation interventions combining physical, behavioral, and psychosocial strategies yielded the most consistent improvements in neurological function, quality of life, and self-efficacy. Intervention timing ranged from a few days postoperatively to 6 months. A meta-analysis was not performed due to study heterogeneity.

Discussion and Conclusion

Postoperative rehabilitation for DCM shows promise, particularly with multimodal, goal-oriented, and patient-centered approaches. However, evidence is limited by the high risk of bias, poor methodological detail and lack of standardization.

退行性颈脊髓病（DCM）是成人脊髓功能障碍的主要原因，通常需要手术治疗。然而，术后康复在优化患者预后中的作用尚不清楚。研究问题：DCM术后康复对临床结果的影响是什么？材料和方法本系统综述已在普洛斯彼罗注册（CRD42024582484）。PubMed、Scopus和Web of Science的检索截止到2025年9月。符合条件的研究包括随机对照试验（RCTs），以及其他关于DCM手术患者术后结局（如功能、疼痛、神经恢复）康复干预的研究。未证实DCM的研究、未经同行评议的文章或缺乏康复方案的研究被排除。使用rob2和ROBINS-I评估偏倚风险。进行描述性总结，将研究分为主动、被动和混合干预。使用GRADE方法对证据质量进行评分。结果纳入10项研究，共766例患者，包括5项rct和5项队列研究。7项研究有高偏倚风险，3项研究有中等偏倚风险。结合身体、行为和社会心理策略的混合康复干预在神经功能、生活质量和自我效能方面产生了最一致的改善。干预时间从术后几天到6个月不等。由于研究异质性，未进行meta分析。讨论与结论DCM的术后康复表现出良好的前景，特别是采用多模式、目标导向和以患者为中心的方法。然而，证据受到高偏倚风险、方法细节不足和缺乏标准化的限制。

{"title":"The effect of postoperative rehabilitation on outcomes in patients with degenerative cervical myelopathy (DCM): A systematic review","authors":"Chanelle Montpetit , Adam Kobaisi , Justin M. Lantz , Rohil V. Chauhan , David B. Anderson , Maryse Fortin","doi":"10.1016/j.bas.2026.105956","DOIUrl":"10.1016/j.bas.2026.105956","url":null,"abstract":"<div><h3>Introduction</h3><div>Degenerative cervical myelopathy (DCM) is the leading cause of adult spinal cord dysfunction, often requiring surgery. However, the role of postoperative rehabilitation in optimizing patient outcomes remains unclear.</div></div><div><h3>Research question</h3><div>What are the effects of postoperative rehabilitation on clinical outcomes following DCM surgery?</div></div><div><h3>Material and methods</h3><div>This systematic review was registered with PROSPERO (CRD42024582484). PubMed, Scopus, and Web of Science were searched through September 2025. Eligible studies included randomized controlled trials (RCTs), and other research on rehabilitation interventions for postoperative outcomes (e.g., function, pain, neurological recovery) in patients undergoing DCM surgery. Studies without confirmed DCM, non-peer-reviewed articles, or lacking a rehabilitation protocol were excluded. Risk of bias was assessed using the RoB 2 and ROBINS-I. Descriptive summaries were conducted, categorizing studies into active, passive, and mixed interventions. The evidence quality was rated using the GRADE approach.</div></div><div><h3>Results</h3><div>Ten studies with a total of 766 patients were included, made up of 5 RCTs and 5 cohort studies. Seven studies had high risk of bias, and three had moderate risk of bias. Mixed rehabilitation interventions combining physical, behavioral, and psychosocial strategies yielded the most consistent improvements in neurological function, quality of life, and self-efficacy. Intervention timing ranged from a few days postoperatively to 6 months. A meta-analysis was not performed due to study heterogeneity.</div></div><div><h3>Discussion and Conclusion</h3><div>Postoperative rehabilitation for DCM shows promise, particularly with multimodal, goal-oriented, and patient-centered approaches. However, evidence is limited by the high risk of bias, poor methodological detail and lack of standardization.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105956"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187884","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

Extradural hematoma management: A case-control study with historical controls reassessing the 'zero mortality' goal 硬膜外血肿处理：一项病例对照研究，历史对照重新评估“零死亡率”目标

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.1016/j.bas.2026.105963

N. Marchesini , L. Rossi , E. Saiu , G. Pinna , F. Sala

Introduction

Extradural hematoma (EDH) remains a significant cause of mortality following traumatic brain injury (TBI), although fatality rates have declined. This study examines whether improvements in a regional trauma and neurosurgical care system over four decades have enabled the achievement of the long-standing goal of “zero mortality” in surgically treated EDH.

Research question

Has the evolution of a regional trauma and neurosurgical care system over four decades reduced mortality and moved towards the ‘zero mortality’ goal in surgically treated extradural hematomas?

Materials and methods

We retrospectively reviewed all patients who underwent surgery for EDH at our institution between 2011 and 2021. Demographic, clinical, and radiological data were collected and compared in a case-control design with a historical cohort treated at the same center in the early 1980s, when the “zero mortality” concept was first proposed.

Results

Among 85 contemporary cases, most patients were aged 41–61 years (previously 11–20), and falls were the leading cause of injury (55% vs. 50% due to road traffic accidents; p = 0.007). Direct presentations increased (65% vs. 33%; p < 0.001), and 96% arrived within 6 h (vs. 65%; p < 0.001). Surgery within 6 h occurred in 68% of cases. Referred patients experienced significantly longer delays. Craniotomy was performed in 94% of cases. In-hospital mortality was 2.4% (vs. 4.7%).

Discussion and conclusions

Although system-wide improvements have reduced mortality, the “zero mortality” target remains unmet. Delays in referral and triage continue to pose challenges, particularly in complex or rapidly evolving cases.

尽管死亡率有所下降，但硬膜外血肿（EDH）仍然是外伤性脑损伤（TBI）后死亡的一个重要原因。本研究探讨了四十年来区域创伤和神经外科护理系统的改进是否能够实现手术治疗EDH的“零死亡率”这一长期目标。区域创伤和神经外科护理系统在过去40年的发展是否降低了手术治疗硬膜外血肿的死亡率并朝着“零死亡率”的目标迈进？材料和方法我们回顾性分析了2011年至2021年在我院接受EDH手术的所有患者。收集了人口统计学、临床和放射学数据，并与20世纪80年代初在同一中心接受治疗的历史队列进行了病例对照设计，当时“零死亡率”概念首次提出。结果85例患者中，年龄以41 ~ 61岁（原11 ~ 20岁）居多，跌倒是致伤的主要原因（55%对50%，p = 0.007）。直接就诊增加了（65% vs. 33%; p < 0.001）， 96%的患者在6小时内就诊（vs. 65%; p < 0.001）。68%的病例在6小时内手术。转诊患者的延迟时间明显更长。94%的病例行开颅手术。住院死亡率为2.4% （vs. 4.7%）。讨论和结论尽管全系统的改进降低了死亡率，但“零死亡率”的目标仍未实现。转诊和分诊方面的延误继续构成挑战，特别是在复杂或迅速发展的病例中。

{"title":"Extradural hematoma management: A case-control study with historical controls reassessing the 'zero mortality' goal","authors":"N. Marchesini , L. Rossi , E. Saiu , G. Pinna , F. Sala","doi":"10.1016/j.bas.2026.105963","DOIUrl":"10.1016/j.bas.2026.105963","url":null,"abstract":"<div><h3>Introduction</h3><div>Extradural hematoma (EDH) remains a significant cause of mortality following traumatic brain injury (TBI), although fatality rates have declined. This study examines whether improvements in a regional trauma and neurosurgical care system over four decades have enabled the achievement of the long-standing goal of “zero mortality” in surgically treated EDH.</div></div><div><h3>Research question</h3><div>Has the evolution of a regional trauma and neurosurgical care system over four decades reduced mortality and moved towards the ‘zero mortality’ goal in surgically treated extradural hematomas?</div></div><div><h3>Materials and methods</h3><div>We retrospectively reviewed all patients who underwent surgery for EDH at our institution between 2011 and 2021. Demographic, clinical, and radiological data were collected and compared in a case-control design with a historical cohort treated at the same center in the early 1980s, when the “zero mortality” concept was first proposed.</div></div><div><h3>Results</h3><div>Among 85 contemporary cases, most patients were aged 41–61 years (previously 11–20), and falls were the leading cause of injury (55% vs. 50% due to road traffic accidents; p = 0.007). Direct presentations increased (65% vs. 33%; p < 0.001), and 96% arrived within 6 h (vs. 65%; p < 0.001). Surgery within 6 h occurred in 68% of cases. Referred patients experienced significantly longer delays. Craniotomy was performed in 94% of cases. In-hospital mortality was 2.4% (vs. 4.7%).</div></div><div><h3>Discussion and conclusions</h3><div>Although system-wide improvements have reduced mortality, the “zero mortality” target remains unmet. Delays in referral and triage continue to pose challenges, particularly in complex or rapidly evolving cases.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105963"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187883","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

Evaluating clinical characteristics and neuroimaging indications of paediatric traumatic brain injury patients using Scandinavian paediatric traumatic brain injury guidelines in Southwest Finland 应用芬兰西南部斯堪的纳维亚儿科创伤性脑损伤指南评估儿科创伤性脑损伤患者的临床特征和神经影像学指征

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 Epub Date: 2026-02-12 DOI: 10.1016/j.bas.2026.105969

Nina Erkinjuntti , Jussi P. Posti , Tuire Lähdesmäki

Introduction

Neuroimaging of paediatric head injuries has increased during the past decades.

Research question

To describe clinical features and neuroimaging outcomes of the retrospective cohort, and to assess the alignment of neuroimaging decisions for paediatric head injuries with the Scandinavian guidelines for the management of mild and moderate head trauma in children (SCN16 guideline) in a tertiary care setting.

Materials and methods

Patients <16 years with head injury and neuroimaging were identified through diagnostic registry search at Turku University Hospital (2010–2016), Finland. Medical records were reviewed for data collection. The SCN subgroup included patients assessed within 24 h and with a Glasgow Coma Scale (GCS) of 13–15.

Results

Of the 637 patients (58% male, mean age 9.3 years), traumatic intracranial pathologies were found in 9% (n = 55) on CT and 13% (n = 85) on MRI; 3% (n = 16) underwent neurosurgery. Most skull fractures (82%, n = 31) co-occurred with intracranial findings. Between 2010 and 2016, CT use increased from 37 to 70 and MRI from 20 to 93, while traumatic abnormalities remained stable or decreased. 512 patients were included in the SCN subgroup (59% male, mean age 9.4). Acute neuroimaging was performed in 75%; 91% fulfilled the SCN16 neuroimaging criteria. Two (0.4%) of 163 discharged patients required neurosurgery, and 14 (3%) had traumatic pathology on later neuroimaging.

Discussion and conclusions

In this cohort, neuroimaging indications during 2010–2016 largely aligned with the SCN16 guidelines. Clinical features, neuroimaging utilization, and neurosurgical intervention rates were generally consistent with previous literature.

在过去的几十年里，儿科头部损伤的神经影像学研究有所增加。研究问题：描述回顾性队列的临床特征和神经影像学结果，并评估小儿头部损伤的神经影像学决策与斯堪的纳维亚三级医疗机构轻度和中度儿童头部创伤管理指南（SCN16指南）的一致性。材料和方法在芬兰图尔库大学医院（2010-2016）通过诊断登记检索确定16岁的头部损伤和神经影像学患者。审查了医疗记录以收集数据。SCN亚组包括24小时内评估的患者，格拉斯哥昏迷评分（GCS）为13-15。结果637例患者中（58%为男性，平均年龄9.3岁），CT表现为外伤性颅内病变占9%（55例），MRI表现为13%（85例）；3% （n = 16）接受了神经外科手术。大多数颅骨骨折（82%,n = 31）与颅内病变同时发生。2010年至2016年，CT使用次数从37次增加到70次，MRI使用次数从20次增加到93次，而创伤性异常保持稳定或减少。512例患者被纳入SCN亚组（59%为男性，平均年龄9.4岁）。75%的患者进行了急性神经影像学检查；91%符合SCN16神经影像学标准。163例出院患者中有2例（0.4%）需要神经外科手术，14例（3%）在后来的神经影像学检查中有创伤性病理。讨论与结论：在该队列中，2010-2016年的神经影像学适应症与SCN16指南基本一致。临床特征、神经影像学应用和神经外科干预率与以往文献基本一致。

{"title":"Evaluating clinical characteristics and neuroimaging indications of paediatric traumatic brain injury patients using Scandinavian paediatric traumatic brain injury guidelines in Southwest Finland","authors":"Nina Erkinjuntti , Jussi P. Posti , Tuire Lähdesmäki","doi":"10.1016/j.bas.2026.105969","DOIUrl":"10.1016/j.bas.2026.105969","url":null,"abstract":"<div><h3>Introduction</h3><div>Neuroimaging of paediatric head injuries has increased during the past decades.</div></div><div><h3>Research question</h3><div>To describe clinical features and neuroimaging outcomes of the retrospective cohort, and to assess the alignment of neuroimaging decisions for paediatric head injuries with the Scandinavian guidelines for the management of mild and moderate head trauma in children (SCN16 guideline) in a tertiary care setting.</div></div><div><h3>Materials and methods</h3><div>Patients <16 years with head injury and neuroimaging were identified through diagnostic registry search at Turku University Hospital (2010–2016), Finland. Medical records were reviewed for data collection. The SCN subgroup included patients assessed within 24 h and with a Glasgow Coma Scale (GCS) of 13–15.</div></div><div><h3>Results</h3><div>Of the 637 patients (58% male, mean age 9.3 years), traumatic intracranial pathologies were found in 9% (n = 55) on CT and 13% (n = 85) on MRI; 3% (n = 16) underwent neurosurgery. Most skull fractures (82%, n = 31) co-occurred with intracranial findings. Between 2010 and 2016, CT use increased from 37 to 70 and MRI from 20 to 93, while traumatic abnormalities remained stable or decreased. 512 patients were included in the SCN subgroup (59% male, mean age 9.4). Acute neuroimaging was performed in 75%; 91% fulfilled the SCN16 neuroimaging criteria. Two (0.4%) of 163 discharged patients required neurosurgery, and 14 (3%) had traumatic pathology on later neuroimaging.</div></div><div><h3>Discussion and conclusions</h3><div>In this cohort, neuroimaging indications during 2010–2016 largely aligned with the SCN16 guidelines. Clinical features, neuroimaging utilization, and neurosurgical intervention rates were generally consistent with previous literature.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105969"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188007","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

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 Epub Date: 2026-01-07 DOI: 10.1016/j.bas.2026.105938

Audai Abudayeh, Iakiv Fishchenko

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 Epub Date: 2025-12-23 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。

{"title":"Changes in quality of life and work status after surgical management of meralgia paresthetica– an observational cohort study","authors":"S. Baruchi , B. Schönberg , J. Reinsch , J. Alsolivany , A. Zdunczyk , N.F. Dengler","doi":"10.1016/j.bas.2025.105916","DOIUrl":"10.1016/j.bas.2025.105916","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div><div>Although most patients that had been part of the active workforce showed a benefit from surgery, 25 % of them did not return to work.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105916"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926852","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

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 Epub Date: 2026-01-08 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。

{"title":"Assessing cervical intervertebral disc height on MRI and X-ray versus CT; a single center retrospective cohort study","authors":"Esther van Santbrink , Toon Boselie , Valérie Schuermans , Nykle Krijgsveld , Rob de Bie , Anouk Smeets , Henk van Santbrink","doi":"10.1016/j.bas.2026.105927","DOIUrl":"10.1016/j.bas.2026.105927","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Research question</h3><div>To assess the reliability and agreement of intervertebral disc height measurements between MRI, X-ray, and CT.</div></div><div><h3>Material and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Discussion and conclusion</h3><div>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.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105927"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926851","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

Bioimpedance in neurosurgery for tumor margin delineation 生物阻抗在神经外科肿瘤边缘划定中的应用

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 Epub Date: 2025-12-03 DOI: 10.1016/j.bas.2025.105894

Jakub Petrzelka , Martin Rozanek , Martin Cerny , David Netuka

Introduction

The electrical properties of brain tissue, shaped by cellular composition, fluid content, and ion distribution, create measurable impedance differences that can be exploited intraoperatively [1–7]. Bioimpedance has emerged as a promising adjunct for guiding resection in gliomas and other brain lesions, offering real-time information beyond microscopic views, fluorescence, or MRI imaging.

Research question

This review synthesizes current evidence to assess whether bioimpedance can reliably delineate tumor margins in neurosurgery, evaluating differences between normal and pathological tissue and its potential for routine use.

Material and methods

We reviewed key studies (2014–2024) on bioimpedance in brain tissue, focusing on in vivo measurements, systematic analyses, and oncology applications, selected from PubMed and Scopus for relevance to intraoperative margin identification. Keywords included bioimpedance, brain tumor margins, glioma surgery, intraoperative monitoring, and neurosurgery. Two recent reviews by Georgiannakis et al. (2024) and Abboud et al. (2022) were included to provide up to date insights.

Results

Recent studies confirm tumor tissue shows distinct resistivity compared with surrounding white and gray matter [1–3, 5, 8]. For example, Abboud et al. (2022) reported white matter at 13.3 ± 1.7 Ω m, peritumoral edema at 8.5 ± 1.6 Ω m, low-grade gliomas at 6.4 ± 1.3 Ω m, and high-grade gliomas at 5.0 ± 1.0 Ω m (enhancing) or 3.9 ± 1.1 Ω m (necrotic; p < 0.001). Though absolute values vary, differences between physiological white/gray matter and tumor remain consistently significant.

Discussion and conclusion

Methodological heterogeneity and lack of standardization prevent routine clinical application. Standardized protocols and larger-scale validation are needed to facilitate bioimpedance's role in decisions about the radicality of resection.

脑组织的电特性受细胞组成、流体含量和离子分布的影响，产生可测量的阻抗差异，可在术中利用[1-7]。生物阻抗已成为指导胶质瘤和其他脑病变切除的一种有前途的辅助手段，它提供了超越显微镜视图、荧光或MRI成像的实时信息。研究问题：本综述综合了目前的证据，以评估生物阻抗是否可以可靠地描绘神经外科肿瘤边缘，评估正常和病理组织之间的差异及其常规应用的潜力。材料和方法我们回顾了2014-2024年关于脑组织生物阻抗的关键研究，重点是体内测量、系统分析和肿瘤学应用，这些研究选择自PubMed和Scopus，与术中边缘识别相关。关键词：生物阻抗，脑肿瘤边缘，胶质瘤手术，术中监测，神经外科。包括Georgiannakis et al.（2024）和Abboud et al.（2022）最近的两篇综述，以提供最新的见解。最近的研究证实，肿瘤组织与周围的白质和灰质相比具有明显的电阻率[1 - 3,5,8]。例如，Abboud等人（2022）报道白质为13.3±1.7 Ω m，瘤周水肿为8.5±1.6 Ω m，低级别胶质瘤为6.4±1.3 Ω m，高级别胶质瘤为5.0±1.0 Ω m（增强）或3.9±1.1 Ω m（坏死；p < 0.001）。虽然绝对值不同，但生理白质/灰质和肿瘤之间的差异仍然是显著的。讨论与结论方法学的异质性和缺乏标准化阻碍了临床常规应用。标准化的方案和更大规模的验证是必要的，以促进生物阻抗在决定切除的根治性方面的作用。

{"title":"Bioimpedance in neurosurgery for tumor margin delineation","authors":"Jakub Petrzelka , Martin Rozanek , Martin Cerny , David Netuka","doi":"10.1016/j.bas.2025.105894","DOIUrl":"10.1016/j.bas.2025.105894","url":null,"abstract":"<div><h3>Introduction</h3><div>The electrical properties of brain tissue, shaped by cellular composition, fluid content, and ion distribution, create measurable impedance differences that can be exploited intraoperatively [1–7]. Bioimpedance has emerged as a promising adjunct for guiding resection in gliomas and other brain lesions, offering real-time information beyond microscopic views, fluorescence, or MRI imaging.</div></div><div><h3>Research question</h3><div>This review synthesizes current evidence to assess whether bioimpedance can reliably delineate tumor margins in neurosurgery, evaluating differences between normal and pathological tissue and its potential for routine use.</div></div><div><h3>Material and methods</h3><div>We reviewed key studies (2014–2024) on bioimpedance in brain tissue, focusing on in vivo measurements, systematic analyses, and oncology applications, selected from PubMed and Scopus for relevance to intraoperative margin identification. Keywords included bioimpedance, brain tumor margins, glioma surgery, intraoperative monitoring, and neurosurgery. Two recent reviews by Georgiannakis et al. (2024) and Abboud et al. (2022) were included to provide up to date insights.</div></div><div><h3>Results</h3><div>Recent studies confirm tumor tissue shows distinct resistivity compared with surrounding white and gray matter [1–3, 5, 8]. For example, Abboud et al. (2022) reported white matter at 13.3 ± 1.7 Ω m, peritumoral edema at 8.5 ± 1.6 Ω m, low-grade gliomas at 6.4 ± 1.3 Ω m, and high-grade gliomas at 5.0 ± 1.0 Ω m (enhancing) or 3.9 ± 1.1 Ω m (necrotic; p < 0.001). Though absolute values vary, differences between physiological white/gray matter and tumor remain consistently significant.</div></div><div><h3>Discussion and conclusion</h3><div>Methodological heterogeneity and lack of standardization prevent routine clinical application. Standardized protocols and larger-scale validation are needed to facilitate bioimpedance's role in decisions about the radicality of resection.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105894"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712256","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

The mFI-11 frailty index as a predictor of surgical outcomes in elderly patients with brain metastases mFI-11衰弱指数作为老年脑转移患者手术预后的预测指标

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 Epub Date: 2025-12-15 DOI: 10.1016/j.bas.2025.105912

Stefanie Quach , Roland Coras , Florian Weissinger , Matthias Simon , Tunc Faik Ersoy

Introduction

The vulnerability towards disease but also treatment in elderly patients has been referred to as frailty and can be measured using frailty indices, which assess functional health and comorbidities. Frailty has been shown to correlate with survival and functional outcomes in brain tumor patients.

Research question

Does frailty, assessed by the 11-item modified Frailty Index (mFI-11), provide useful prognostic information in elderly patients undergoing brain metastasis surgery?

Material and methods

A retrospective analysis of 139 patients aged ≥60 years who underwent brain metastasis resection (2015–2019) was conducted. Frailty was assessed using the mFI-11.

Results

Increasing frailty correlated with poorer median overall survival (mFI 0: 13.8 months [95 %-CI: 8.7–18.9] vs. mFI 1–2l: 8.7 [5.8–11.6] vs. mFI≥3: 2.8 [0.9–4.6], p = 0.001) and functional outcome (postoperative KPS 80–100 %, mFI 0: 27/36 [75.0 %] vs. mFI 1–2: 44/64 [68.8 %] vs. mFI≥3: 13/38 [34.2 %], p < 0.001). Age was less prognostic. In the multivariate analyses, mFI-11 and age were not independently predictive, while KPS was. Frailty was not associated with major complications.

Discussion

While frailty correlates with outcome, functional health rather than comorbidities and age is prognostic. The mFI-11's predictive ability may be largely due to its inclusion of a functional health assessment.

Conclusion

Functional health (KPS) is a much stronger predictor of survival and functional outcome in the elderly than the presence of comorbidities and age, i.e. age per se and comorbidities without impact on the patient's functional health status (i.e. well-treated) should not deter from surgery. Frailty is not a predictor of complications.

老年患者对疾病和治疗的脆弱性被称为脆弱性，可以使用脆弱性指数来衡量，脆弱性指数评估功能健康和合并症。虚弱已被证明与脑肿瘤患者的生存和功能预后相关。由11项修正的衰弱指数（mFI-11）评估的衰弱是否能为老年脑转移手术患者提供有用的预后信息？材料与方法对2015-2019年139例年龄≥60岁行脑转移切除术的患者进行回顾性分析。使用mFI-11评估虚弱程度。结果衰弱加重与较差的中位总生存期（mFI 0: 13.8个月[95% -CI: 8.7 - 18.9] vs. mFI 1 - 21: 8.7 [5.8-11.6] vs. mFI≥3:2.8 [0.9-4.6],p = 0.001）和功能结局（术后KPS 80 - 100%， mFI 0: 27/36 [75.0%] vs. mFI 1-2: 44/64 [68.8%] vs. mFI≥3:13 /38 [34.2%],p < 0.001）相关。年龄对预后的影响较小。在多变量分析中，mFI-11和年龄不能独立预测，而KPS可以。虚弱与主要并发症无关。虽然虚弱与预后相关，但功能健康而不是合并症和年龄是预后因素。mFI-11的预测能力可能主要是由于它包含了功能健康评估。结论功能健康（KPS）比合并症和年龄更能预测老年人的生存和功能结局，即年龄本身和合并症不影响患者的功能健康状态（即治疗良好）不应阻止手术。虚弱并不是并发症的前兆。

{"title":"The mFI-11 frailty index as a predictor of surgical outcomes in elderly patients with brain metastases","authors":"Stefanie Quach , Roland Coras , Florian Weissinger , Matthias Simon , Tunc Faik Ersoy","doi":"10.1016/j.bas.2025.105912","DOIUrl":"10.1016/j.bas.2025.105912","url":null,"abstract":"<div><h3>Introduction</h3><div>The vulnerability towards disease but also treatment in elderly patients has been referred to as frailty and can be measured using frailty indices, which assess functional health and comorbidities. Frailty has been shown to correlate with survival and functional outcomes in brain tumor patients.</div></div><div><h3>Research question</h3><div>Does frailty, assessed by the 11-item modified Frailty Index (mFI-11), provide useful prognostic information in elderly patients undergoing brain metastasis surgery?</div></div><div><h3>Material and methods</h3><div>A retrospective analysis of 139 patients aged ≥60 years who underwent brain metastasis resection (2015–2019) was conducted. Frailty was assessed using the mFI-11.</div></div><div><h3>Results</h3><div>Increasing frailty correlated with poorer median overall survival (mFI 0: 13.8 months [95 %-CI: 8.7–18.9] vs. mFI 1–2l: 8.7 [5.8–11.6] vs. mFI≥3: 2.8 [0.9–4.6], p = 0.001) and functional outcome (postoperative KPS 80–100 %, mFI 0: 27/36 [75.0 %] vs. mFI 1–2: 44/64 [68.8 %] vs. mFI≥3: 13/38 [34.2 %], p < 0.001). Age was less prognostic. In the multivariate analyses, mFI-11 and age were not independently predictive, while KPS was. Frailty was not associated with major complications.</div></div><div><h3>Discussion</h3><div>While frailty correlates with outcome, functional health rather than comorbidities and age is prognostic. The mFI-11's predictive ability may be largely due to its inclusion of a functional health assessment.</div></div><div><h3>Conclusion</h3><div>Functional health (KPS) is a much stronger predictor of survival and functional outcome in the elderly than the presence of comorbidities and age, i.e. age per se and comorbidities without impact on the patient's functional health status (i.e. well-treated) should not deter from surgery. Frailty is not a predictor of complications.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105912"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791704","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