Brain & spine最新文献

{"title":"Perioperative neuropsychological assessment reveals dynamic changes in neurocognitive function following brain tumor surgery","authors":"Pranjali Ektare ,&nbsp;Neha Pai ,&nbsp;Kanchi Jain ,&nbsp;Pallavi Rane ,&nbsp;Vikas Kumar Singh ,&nbsp;Prakash M. Shetty ,&nbsp;Aliasgar V. Moiyadi","doi":"10.1016/j.bas.2025.105907","DOIUrl":"10.1016/j.bas.2025.105907","url":null,"abstract":"<div><h3>Introduction</h3><div>Research has shown that patients with primary brain tumours have baseline neurocognitive deficits.</div></div><div><h3>Research question</h3><div>In the present study, we sought to explore the impact of surgical intervention as it is not adequately understood.</div></div><div><h3>Materials and methods</h3><div>Patients with intra-axial tumours undergoing surgery were perioperatively evaluated using a comprehensive neuropsychological battery on domains of Attention and Executive Function, memory, Language, Visuomotor Speed and Visuospatial ability. Assessments were done at baseline and post-operatively around 1 month after the surgery before starting any adjuvant treatment (n = 66).</div></div><div><h3>Results</h3><div>Excluding memory, all domains showed an increased number of patients with severe deficits post-operatively, though the percentage of patients with overall severe deficits decreased. Memory domain was thought to have the most improvement while visuomotor speed had the highest worsening. Patients who underwent craniotomies under general anaesthesia had significant worsening in the memory domain and had an overall trend for worsening across all domains post-op in comparison to those who underwent awake craniotomies. Visuomotor speed was affected by subtotal resection. Tumour lateralisation to the right influenced performance in the visuospatial domain.</div></div><div><h3>Conclusion</h3><div>There is significant neurocognitive dysfunction in patients with PBTs in the perioperative period with many dynamic changes in the post-operative performance as compared to the baseline. Awake craniotomy can mitigate some of this decline. Detailed cognitive assessments serially performed over the course of treatment is essential to unearth the evolving changes in neurocognition and customise interventions.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105907"},"PeriodicalIF":2.5,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791706","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}

{"title":"Multidimensional burden of low back pain: A prospective cross sectional study of patient-reported outcomes and sociodemographic factors at a tertiary neurosurgical center","authors":"Pavlina Lenga ,&nbsp;Robin Fleige ,&nbsp;Max Christian Blumenstock ,&nbsp;Matthias Ganzinger ,&nbsp;Sebastian Ille ,&nbsp;Martin Dugas ,&nbsp;Sandro M. Krieg","doi":"10.1016/j.bas.2025.105905","DOIUrl":"10.1016/j.bas.2025.105905","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Low back pain (LBP) significantly impacts patients’ physical function, mental health, &lt;strong&gt;&lt;em&gt;erectile dysfunction (ED) in males&lt;/em&gt;&lt;/strong&gt;, and occupational status. However, comprehensive prospective assessments of these interrelated dimensions in specialized neurosurgical outpatient settings remain sparse.&lt;/div&gt;&lt;div&gt;Research Question: This study aimed to prospectively evaluate functional disability, depression, erectile dysfunction (ED), occupational impairment, and their associations with demographic and lifestyle factors among patients presenting to a neurosurgical outpatient clinic.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;Between February and June 2025, we prospectively enrolled 247 consecutive patients (mean age 60.4 ± 16.0 years, 53.8 % male) presenting to the neurosurgical outpatient clinic at Heidelberg University Hospital with degenerative lumbar spine disorders, of whom 110 (44.5 %) subsequently underwent decompression surgery. Patients completed validated patient-reported outcome measures (PROMs), including pain intensity (Numeric Rating Scale [NRS]), functional disability (Oswestry Disability Index [ODI]), depression (PHQ-9), and erectile dysfunction (IIEF-5). Correlation analyses and regression models assessed associations among these outcomes and relevant demographic and lifestyle variables.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Patients reported high pain intensity (NRS 7.0 ± 2.2), severe functional disability (ODI 57.4 ± 16.5; 82.2 % severely disabled or worse), frequent moderate-to-severe depressive symptoms (42.2 %), and prevalent erectile dysfunction among males (55 %). Multivariate analyses identified depression severity (PHQ-9; B = 1.30, p &lt; 0.001), older age (B = 0.20, p = 0.045), and surgery (B = 6.13, p = 0.049) as significant predictors of greater disability. Erectile dysfunction severity in males was independently associated with higher disability (B = −0.18, p = 0.002) and older age (B = −0.32, p &lt; 0.001). Undergoing surgery was significantly predicted by higher baseline disability (ODI; OR = 1.04, p = 0.032) and private insurance (OR = 22.39, p &lt; 0.001). Among working-age patients (≤65 years, n = 142), occupational disability was notably high, with 39.4 % currently work-disabled and an additional 15.5 % having experienced disability within the past year.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion and conclusions&lt;/h3&gt;&lt;div&gt;This prospective study highlights the significant multidimensional burden of low back pain among neurosurgical outpatients, characterized by substantial functional disability, high prevalence of depression, frequent erectile dysfunction, and marked occupational impairment. Our results underscore the critical need for routine psychological screening, proactive sexual health assessment, and targeted occupational rehabilitation within specialized neurosurgical care pathways. Implementing these comprehensive approaches may improve patient outcomes, support retu","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105905"},"PeriodicalIF":2.5,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791707","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}

{"title":"Chronic subdural hematoma management with MMA embolization ± surgery: Pre-existing statin therapy did not reduce recurrence","authors":"Fee Christiane Keil ,&nbsp;Emma Becke ,&nbsp;Rejane Golbach ,&nbsp;Angelo Ippolito ,&nbsp;Fatma Kilinc ,&nbsp;Jürgen Konczalla ,&nbsp;Maximillian Rauch ,&nbsp;Marcus Czabanka ,&nbsp;Elke Hattingen ,&nbsp;Katharina J. Wenger","doi":"10.1016/j.bas.2025.105892","DOIUrl":"10.1016/j.bas.2025.105892","url":null,"abstract":"<div><h3>Introduction</h3><div>Adjunctive therapies such as statins have been proposed to reduce recurrence rates in chronic subdural hematoma (CSDH).</div></div><div><h3>Research question</h3><div>Does pre-existing statin therapy influence CSDH recurrence after middle meningeal artery embolization (MMAE), with or without surgical evacuation?</div></div><div><h3>Material and methods</h3><div>We retrospectively analyzed all patients who underwent MMAE for CSDH between January 2020 and October 2021 at a university hospital with a neurovascular focus. Indications were: salvage after recurrence without additional surgical drainage, first-line MMAE in patients at high surgical risk, adjunct after surgical drainage, and salvage after recurrence with additional drainage. Statin exposure referred to statins documented before MMAE and not discontinued during follow-up.</div><div>Data included clinical variables, adjunctive statin and CT-based hematoma characteristics.</div><div>Clinical therapy failure required radiological recurrence plus new neurological symptoms. Analyses were descriptive and exploratory.</div></div><div><h3>Results</h3><div>A total of 47 CSDHs in 38 patients (9 bilateral) were treated. Clinical failures occurred in 3/47 (6.4 %) overall, by indication: 2/13 (15.4 %) salvage-without-drainage, 1/15 (6.7 %) first-line MMAE, 0/6 (0 %) adjunct-after-drainage, 0/13 (0 %) salvage-with-drainage.</div><div>Statins were administered in a subset of patients. The overall recurrence rate was 6.4 %. No significant association was found between statin exposure (18/47, 38.3 % and recurrence.</div><div>One patient died from contrast-induced anaphylaxis prior to embolization; no intraprocedural device related complications were recorded.</div></div><div><h3>Conclusion</h3><div>In this cohort, statin use was not associated with reduced recurrence after MMAE. Combined surgery plus MMAE showed no observed recurrences, whereas events occurred after MMAE alone. Given the small sample these results are exploratory and require prospective confirmation.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105892"},"PeriodicalIF":2.5,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791708","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}

{"title":"SPINE20 recommendations 2025: Sustainable spine care for all","authors":"Adriaan J. Vlok ,&nbsp;Koji Tamai ,&nbsp;Suhail S. Alassiri ,&nbsp;Thomas R. Blattert ,&nbsp;Marco A. Campello ,&nbsp;Robert N. Dunn ,&nbsp;Komal Kamra ,&nbsp;Kazuya Kitamura ,&nbsp;Lisa C. Roberts ,&nbsp;Carlo Ruosi ,&nbsp;Francois D.V. Theron ,&nbsp;Carlos Tucci ,&nbsp;Ratko Yurac ,&nbsp;Bridget Bromfield ,&nbsp;Mufudzi Chihambakwe ,&nbsp;Quinette A. Louw ,&nbsp;Danella Lubbe ,&nbsp;Almero Oosthuizen ,&nbsp;André Bussières ,&nbsp;Harvinder S. Chhabra ,&nbsp;Sami AlEissa","doi":"10.1016/j.bas.2025.105886","DOIUrl":"10.1016/j.bas.2025.105886","url":null,"abstract":"<div><div>Spine disorders remain a leading cause of disability worldwide, affecting over 900 million people and creating profound social and economic burden. In response, SPINE20, a global alliance of 38 professional societies, presents its 2025 policy recommendations under the theme “Sustainable Spine Care for All”.</div><div>Main recommendation; SPINE20 recommends G20 countries to implement sustainable evidence-based spine care models drawing on successful global programs considering particularly registries, incentivized health targets and public-private partnerships.</div><div>Focused on “Public health”; SPINE20 recommends G20 countries to integrate spine health into public health and primary care health policies by addressing the prevention and management of both communicable and non-communicable diseases, and strengthening public–private partnerships to achieve sustainable spine care.</div><div>Focused on “Occupational Health &amp; Safety Policy”; SPINE20 recommends that G20 countries implement evidence-informed, work-focused interventions that address employee and workforce factors early, to reduce the social and economic impact of work loss and increase employability for people with spine disorders.</div><div>Focused on “Capacity Building”; SPINE20 recommends that G20 countries prioritize building capacity in spinal cord injury care by adopting evidence-based interventions such as the global initiatives supported by World Health Organization (WHO) in low- and middle-income countries and aligned with the WHO Rehabilitation 2030 Call to Action.</div><div>This paper serves as a summary of the recommendations. The complete set of SPINE20 2025 Recommendations, which is available in SPINE20 official web-site (<span><span>https://spine20.net</span><svg><path></path></svg></span>), was officially presented to Provincial Minister of Health and Wellness, Western Cape Government, during the SPINE20 Summit 2025. An official communication from the Western Cape Ministry of Health and Wellness subsequently confirmed formal acknowledgment of receipt of the recommendations.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105886"},"PeriodicalIF":2.5,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791705","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}

{"title":"Comparative analysis of the pedicle screw accuracy, screw revision and loosening rate and radiation exposure of robotic-guided (RG), intraoperative computed tomography (iCT)-navigation guided, and fluoroscopy guided placement technique","authors":"Mirza Pojskić ,&nbsp;Miriam Bopp ,&nbsp;Omar Alwakaa ,&nbsp;Christopher Nimsky ,&nbsp;Benjamin Saß","doi":"10.1016/j.bas.2025.105899","DOIUrl":"10.1016/j.bas.2025.105899","url":null,"abstract":"<div><h3>Objective</h3><div>This retrospective single-center study aimed to compare the accuracy and revision rates of pedicle screw (PS) placement using robot-guided (RG), intraoperative CT-navigated (iCT-nav), and fluoroscopy-guided (FG) techniques. Additionally, screw loosening and overall revision rates were assessed across all three methods.</div></div><div><h3>Methods</h3><div>Data from 237 consecutive patients who underwent PS placement using iCT-nav, FG, or RG were analyzed. Each PS was evaluated in intraoperative or postoperative CT and classified using the Gertzbein-Robbins Scale (GRS). Follow-up CT to assess fusion and screw loosening was performed at a median of 8 months (IQR = 5–17).</div></div><div><h3>Results</h3><div>A total of 1352 PS were placed: 444 with RG, 667 with FG, and 241 with iCT-nav. RG showed the highest rate of GRS A screws (91.7 %) compared to iCT-nav (86.2 %) and FG (80.5 %). The iCT-nav group had the lowest revision rate due to loosening (p &lt; 0.001), while the FG group showed the highest revision rates due to misplacement (p &lt; 0.001) and loosening (p = 0.001). Radiation exposure (effective dose, ED) was significantly lower in the iCT group compared to the FG group.</div></div><div><h3>Conclusion</h3><div>RG PS placement demonstrates superior accuracy compared to iCT-nav and FG. Furthermore, intraoperative CT imaging significantly reduces total radiation exposure for patients.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105899"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712254","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}

{"title":"Bioimpedance in neurosurgery for tumor margin delineation","authors":"Jakub Petrzelka ,&nbsp;Martin Rozanek ,&nbsp;Martin Cerny ,&nbsp;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 &lt; 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":"2025-12-03","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}

{"title":"Location-specific outcomes and complications of endoscopic transorbital approaches: A systematic review with novel anatomical grouping.","authors":"Sophia C Lam, Jason Y S Cheung, Ben C F Ng, Hunter K L Yuen, Calvin H K Mak","doi":"10.1016/j.bas.2025.105895","DOIUrl":"10.1016/j.bas.2025.105895","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic transorbital approach (ETOA) is gaining recognition due to lower complication rates and better cosmetic outcomes. Nonetheless, there is no clear anatomical grouping system for lesions that ETOA can address, and location-specific complication rates are still lacking.</p><p><strong>Research question: </strong>This systematic review provides an anatomical grouping system for ETOA and analyse the location-specific surgical risks and outcomes.</p><p><strong>Material and methods: </strong>Based on the PRISMA guideline, articles with keywords \"Endoscopic\" and \"Transorbital\" were searched and analysed. The cases included are regrouped based on four anatomical locations (I - orbital, II - cavernous sinus, III - extradural, IV - intradural), and outcomes are studied respectively.</p><p><strong>Results: </strong>Data from 28 published articles with 382 patients were identified. There were 113 orbital lesions, 58 cavernous lesions, 18 extradural lesions, and 150 intradural lesions. There was significant post-operative visual acuity improvement in Groups I (70.6 %), II (56.3 %), and IV (63.3 %). Proptosis shows notable improvement rates across all groups, particularly in Groups II (95.7 %) and IV (87.0 %). There was an observed difference in the rate of CSF leak depending on the location of the lesion: 0 % in both Group I and II versus 11.8 % in Group III and 3.4 % in Group IV (<i>p=0.005)</i>.</p><p><strong>Discussion and conclusion: </strong>This systematic review proposed an anatomical grouping system to analyse location-specific outcomes for ETOA. Our findings highlighted the significance of this new classification for anatomy-based risk assessment. Future, larger-scale, and multicenter research will generate more data, allowing for further stratification of outcomes based on specific pathology subtypes.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"105895"},"PeriodicalIF":2.5,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12731732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications associated with anterior cervical spine surgery: A systematic review of literature","authors":"Katsikas Athanasios ,&nbsp;Georgountzos Georgios ,&nbsp;Stamatopoulou Aikaterina ,&nbsp;Gkalonakis Ioannis ,&nbsp;Tsitsopoulos Parmenion ,&nbsp;Paleologos Theofilos ,&nbsp;Barkas Konstantinos","doi":"10.1016/j.bas.2025.105897","DOIUrl":"10.1016/j.bas.2025.105897","url":null,"abstract":"<div><h3>Introduction</h3><div>Anterior cervical spine surgery has become a widely accepted approach for treating various cervical spine pathologies.</div></div><div><h3>Research question</h3><div>This systematic review aimed to evaluate the frequency, etiology and outcomes of complications associated with anterior cervical spine surgery.</div></div><div><h3>Material/methods</h3><div>A comprehensive literature search was conducted using multiple databases (CINAHL Plus, MEDLINE, PubMed, Scopus, and EMBASE) for peer-reviewed articles published in English from January 1st, 1989 to December 31st, 2024. Studies involving adult patients undergoing anterior cervical spine surgery were included. The quality of evidence was assessed using the Newcastle Ottawa Scale.</div></div><div><h3>Results</h3><div>Dysphagia emerged as the most common complication, with rates varying widely (2.3 %–87.5 %) depending on timing of assessment and methodology. Other significant complications included adjacent segment disease with the range varying from 0.4 % to 32 %, recurrent laryngeal nerve palsy (0.1 %–9 %), infection (0.39 %–8.5 %), pseudarthrosis (0.25 %–31 %), esophageal perforation (0.1 %–0.45 %), vertebral artery injury (0.3 %–7.7 %), Horner's syndrome (0.06 %–0.45 %), graft failure (2.7 %–35.5 %), CSF leak (0 %–1 %), postoperative hematoma (0.21 %–7 %) and deteriorating or new neurological deficits (0.37 % −3.3). Multilevel disease, revision surgery and OPLL were associated with higher complication rate. Surgeon's experience and higher case volume were consistently correlated with lower complication rates.</div></div><div><h3>Discussion &amp; conclusion</h3><div>While anterior cervical spine surgery is generally safe and effective, it carries risks of various complications ranging from common but typically self-limiting to rare but potentially severe. Μinimizing these complications depends on thorough preoperative planning, careful patient selection, and proper surgical technique.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105897"},"PeriodicalIF":2.5,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739275","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}

{"title":"A new hernia blocking system prevents lumbar disc herniation recurrence and disc degeneration: 2 years results of a multicentric clinical investigation","authors":"Ignasi Català ,&nbsp;Héctor Roldán ,&nbsp;Carlos Fernández-Carballal ,&nbsp;Carlos Domínguez-Alonso ,&nbsp;Luís Álvarez-Galovich ,&nbsp;Óscar Godino","doi":"10.1016/j.bas.2025.105898","DOIUrl":"10.1016/j.bas.2025.105898","url":null,"abstract":"<div><h3>Introduction</h3><div>Recurrent lumbar disc herniation (rLDH) is a common complication of limited discectomy for patients with large annular defects. This manuscript presents the first long-term experience with a new hernia blocking system (HBS) that aims to reduce rLDH.</div></div><div><h3>Research question</h3><div>Whether a new HBS, implanted after a limited discectomy, prevents rLDH.</div></div><div><h3>Material and methods</h3><div>Thirty patients with a postero-lateral disc herniation between L4 and S1 and large annular defects, who underwent a limited discectomy and were treated with a new HBS (DISC care, NEOS Surgery S.L.), were included in the study. Patients were clinically evaluated with patient questionnaires (VAS Pain and Oswestry Disability Index – ODI) and neurological examinations and radiologically evaluated with MR, CT scan and X-Rays before surgery to assess preoperative status and at 6 weeks, 6, 12 and 24 months after surgery to assess their progression.</div></div><div><h3>Results</h3><div>No symptomatic rLDH was detected during the 24-months follow-up. Additionally, disc height was largely preserved, and no disc degeneration was observed in the studied patients. All patients had a significant reduction in leg pain (&gt;2 points in the NRS) and 84.6 % improved &gt;15 points in the ODI. The implantation of the HBS was not associated with segmental instability, vertebral body fractures, heterotopic ossification or spontaneous fusion. No product-related serious adverse events nor secondary surgical interventions occurred.</div></div><div><h3>Discussion and conclusions</h3><div>The implantation of this new HBS is an easy and safe procedure that prevents long-term rLDH.</div></div><div><h3>Clinicaltrials.gov</h3><div><span><span>NCT04188236</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"6 ","pages":"Article 105898"},"PeriodicalIF":2.5,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739327","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}

{"title":"Global prevalence and incidence of chronic subdural hematoma: A systematic review.","authors":"Azra Dziho, Abdullah Al Awadhi, Caterina Mollica, Emily Richards, Rohan Sanghera, Alex Fleet, Angela Huttner, Karl Schaller, Simone Grannò, Aria Nouri","doi":"10.1016/j.bas.2025.105893","DOIUrl":"10.1016/j.bas.2025.105893","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic subdural hematoma (cSDH) is one of the most common conditions in neurosurgery. However, its epidemiology remains poorly investigated.</p><p><strong>Research question: </strong>To systematically evaluate all available evidence on the global prevalence and incidence of cSDH from 1970 to 2022.</p><p><strong>Methods: </strong>A systematic review according to PRISMA guidelines using PubMed, Cochrane, and EMBASE was conducted on articles from 1970 to 2022. Studies reporting regional-to-national incidence or prevalence were included. Studies were graded based on quality of evidence.</p><p><strong>Results: </strong>6253 articles were identified, 18 meeting inclusion criteria. Seven articles reported surgical incidence and 11 provided incidence based on imaging or clinical findings. Six additional articles were evaluated for demographic data. No study discussing prevalence was found. 18 reported incidence from 12 countries in five continents. The lowest incidence was found in Brazil (3.39/100,000/year), and the highest in the USA at 39.1/100,000. Incidence increases with age and may be up to three times higher among patients over 80. It also appears to increase over time, probably with improved diagnostics. In most studies, incidence was higher in men. The most common aetiology was trauma and falls. Other contributing factors were chronic alcohol abuse, anticoagulation, and violence. Several articles did not report any cause.</p><p><strong>Discussions and conclusions: </strong>Epidemiological data remain sparse, with limited incidence data and no prevalence data. The level of evidence remains medium to low with regional differences in methodology, suggesting the need for standardisation. Incidence has increased over time in all regions, particularly amongst older patients. This trend will likely continue with an ageing population.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"105893"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12720100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}