Delayed Screw Migration Following Anterior Cervical Discectomy and Fusion

前路颈部椎间盘切除术和融合术后延迟螺钉移位

To identify the clinical and surgical characteristics and treatment options of patients suffering delayed (>1 month) screw back-out after anterior cervical discectomy and fusion (ACDF). The risk of screw back-out is low, but it can be a devastating complication. The majority of reported cases developed pharyngoesophageal injury and dysphagia. Surgery is often required to remove the hardware and repair any damage to the esophagus or hypopharynx, and may require prolonged antibiotics and NPO. Rarely, patients may be asymptomatic and treated conservatively; but in 7 patients in this series in whom back-out was initially managed conservatively there was worsening back-out or injury that occurred an average of 29 months later.

探讨前路颈部椎间盘切除融合术 (ACDF) 后延迟 (>1个月) 螺钉退出的临床和手术特点及治疗选择。螺钉退出的风险很低，但它可能是一个毁灭性的并发症。大多数报告的病例发展为咽食管损伤和吞咽困难。通常需要手术来移除硬件并修复食道或下咽的任何损伤，并且可能需要长时间的抗生素和NPO。极少数情况下，患者可能无症状并接受保守治疗; 但是在该系列中，最初采用保守治疗的7例患者中，平均29个月后出现了恶化的退出或损伤。

REF: Carr MT, Steinberger J, Houten JK. Delayed Screw Migration Following Anterior Cervical Discectomy and Fusion. World Neurosurg. Published online December 31, 2024. doi:10.1016/j.wneu.2024.12.014 PMID: 39647522

Does Adjuvant Radiotherapy Enhance Survival in Intracranial Solitary Fibrous Tumor Patients?

辅助放疗能提高颅内孤立性纤维瘤患者的生存率吗？

Intracranial solitary fibrous tumor is a rare central nervous system tumor that lacks a reliable prognostic clinical model. Uncertainty persists regarding the treatment outcomes of surgery and adjuvant radiotherapy (ART). To address this, we investigated the efficacy of ART and applied machine learning (ML) to develop accurate prognostic models. Although ART did not lead to a substantial decrease in cancer-specific deaths, it did improve overall survival. This underscores the broader health benefits of ART, including effective management of comorbid conditions. Caution is advised when interpreting these survival benefits because of potential confounding factors in patient health and treatment management. Our web tool and ML models aid in clinical decision-making.

颅内孤立性纤维瘤是一种罕见的中枢神经系统肿瘤，缺乏可靠的预后临床模型。手术和辅助放疗 (ART) 的治疗结果仍存在不确定性。为了解决这个问题，我们研究了ART的功效，并应用机器学习 (ML) 来开发准确的预后模型。尽管ART并未导致癌症特异性死亡的大幅减少，但它确实提高了总生存期。这强调了ART的更广泛的健康益处，包括对合并症的有效管理。由于患者健康和治疗管理中潜在的混杂因素，因此在解释这些生存益处时建议谨慎。我们的web工具和ML模型有助于临床决策。

REF: Alshwayyat S, Kamal H, Alshwayyat TA, Alshwayyat M, Alkhatib M, Erjan A. Does Adjuvant Radiotherapy Enhance Survival in Intracranial Solitary Fibrous Tumor Patients?. World Neurosurg. Published online December 31, 2024. doi:10.1016/j.wneu.2024.12.004 PMID: 39647524

Optimized Bifrontal Craniotomy: Reducing Risks and Boosting Surgical Results

优化双额开颅手术: 降低风险并提高手术效果

Bifrontal craniotomy is one of the most common surgical approaches for dealing with anterior skull base lesions. However, this procedure occasionally presents complications like anosmia, cerebrospinal fluid (CSF) leakage, infection, and cosmetic problems. Although previous reports suggested various solutions, there remains a need to further refine the procedure to ensure better outcomes. In this paper, we introduce our revised method and examine the clinical results. Through diligent practices and attention to minute details, such as gentle manipulations to preserve the olfactory nerve, reliable procedures for frontal sinus closure, and maximum attention to esthetic results, surgical techniques can be refined and developed to the level of highly skilled expertise with low rate of complications.

双额开颅手术是治疗前颅底病变最常见的手术方法之一。但是，此过程有时会出现并发症，例如嗅觉丧失，脑脊液 (CSF) 泄漏，感染和美容问题。尽管以前的报告提出了各种解决方案，但仍需要进一步完善程序以确保更好的结果。在本文中，我们介绍了我们的修订方法并检查了临床结果。通过勤奋的实践和对细微细节的关注，例如保持嗅觉神经的轻柔操作，可靠的额窦闭合程序以及对美学结果的最大关注，可以完善和发展手术技术，使其达到高技能的专业水平，并发症发生率低。

REF: Fukuda N, Yoshioka H, Ogiwara M, et al. Optimized Bifrontal Craniotomy: Reducing Risks and Boosting Surgical Results. World Neurosurg. Published online December 30, 2024. doi:10.1016/j.wneu.2024.12.020 PMID: 39662622

Correlation Between Coagulation Parameters and Dense Fibrin Band Configuration in Tough Intracerebral Hematoma in Anticoagulated Patients

抗凝患者顽固性脑内血肿凝血参数与致密纤维蛋白带构型的相关性

Patients receiving anticoagulation therapy develop intracerebral hematomas, which are difficult to evacuate during endoscopic surgery. Insufficient thrombin activation results in the gradual conversion of fibrinogen to fibrin, forming dense fibrin bands (FBs) that harden the hematoma. We aimed to investigate the factors contributing to hematoma hardness. Tough hematomas were histologically characterized by high FB density. Preoperative PT-INR and APTT may predict the presence of tough hematomas.

接受抗凝治疗的患者会出现脑内血肿，在内窥镜手术中很难清除。凝血酶激活不足会导致纤维蛋白原逐渐转化为纤维蛋白，形成致密的纤维蛋白带 (FBs)，使血肿变硬。我们的目的是调查影响血肿硬度的因素。坚韧的血肿在组织学上具有高FB密度的特征。术前pt-inr和APTT可预测顽固性血肿的存在。

REF: Nomura S, Sadahiro H, Inoue T, et al. Correlation Between Coagulation Parameters and Dense Fibrin Band Configuration in Tough Intracerebral Hematoma in Anticoagulated Patients. World Neurosurg. Published online December 29, 2024. doi:10.1016/j.wneu.2024.123565 PMID: 39675666

Noninvasive Skin Autofluorescence of Advanced Glycation End Products in Patients with Degenerative Cervical Myelopathy

退行性颈部脊髓病患者晚期糖基化终末产物的无创性皮肤自体荧光

To clarify the association between skin autofluorescence of advanced glycation end products (AGEs) and clinical outcomes and pain in patients with degenerative cervical myelopathy (DCM). Noninvasive skin autofluorescence of AGEs may be a useful biomarker for pain symptoms in the lower limbs in patients with DCM.

探讨晚期糖基化终末产物 (AGEs) 皮肤自身荧光与退行性颈部脊髓病 (DCM) 患者临床结局及疼痛的关系。AGEs的非侵入性皮肤自发荧光可能是DCM患者下肢疼痛症状的有用生物标志物。

REF: Doi T, Inoue T, Sugaya J, et al. Noninvasive Skin Autofluorescence of Advanced Glycation End Products in Patients with Degenerative Cervical Myelopathy. World Neurosurg. Published online December 28, 2024. doi:10.1016/j.wneu.2024.12.015 PMID: 39653077

Establishing Indicative Neurofilament Gradients Based on Severity of Spinal Cord Injury

根据脊髓损伤的严重程度建立指示性神经丝梯度

Acute traumatic spinal cord injury (SCI) results in a lifelong condition without any standardized biomarker or corresponding interventions. The objective of this study was to correlate changes in fluid biomarkers with the severity of SCI. A negative correlation was observed between biomarkers and functional outcome scores with statistical significance for the 100 kdyn injury. As such, this study demonstrates the potential usefulness of these biomarkers in SCI, especially with regards to impact severity. Futures studies may be conducted at various impact forces to establish a biomarker gradient based on severity of injury.

急性创伤性脊髓损伤 (SCI) 导致终身疾病，没有任何标准化的生物标志物或相应的干预措施。这项研究的目的是将流体生物标志物的变化与SCI的严重程度相关联。在生物标志物和功能结果评分之间观察到负相关，对于100 kdyn损伤具有统计学意义。因此，这项研究证明了这些生物标志物在SCI中的潜在有用性，特别是在影响严重程度方面。可以在各种冲击力下进行期货研究，以基于损伤的严重程度建立生物标志物梯度。

REF: Rabon W, Rode M, Taylor T, et al. Establishing Indicative Neurofilament Gradients based on Severity of Spinal Cord Injury. World Neurosurg. Published online November 27, 2024. doi:10.1016/j.wneu.2024.11.098 PMID: 39613089

Concomitant Diffuse Idiopathic Skeletal Hyperostosis and Cervical Ossification of the Posterior Longitudinal Ligament: A U.S. Database Study of Clinical Prevalence, Surgical Intervention, Patient Characteristics, and Postoperative Complications

伴发弥漫性特发性骨肥厚和颈部后纵韧带骨化: 一项关于临床患病率、手术干预、患者特征和术后并发症的美国数据库研究

Concomitant diffuse idiopathic skeletal hyperostosis (DISH) and cervical ossification of the posterior longitudinal ligament (cOPLL) are primarily investigated in radiographic studies of East Asian populations. This study aimed to determine clinical prevalence of concomitant DISH/cOPLL in a large U.S. sample and to compare characteristics and complications in cOPLL patients with and without concomitant DISH who were surgically treated. Clinical prevalence of DISH in patients with cOPLL in the United States is low; however, cOPLL patients with concomitant DISH underwent surgery more frequently than those without. Despite higher comorbidity burden, cOPLL patients with DISH may have similar short-term postsurgical risk to cOPLL patients without DISH. However, higher nonprocedural neurologic injury in cOPLL patients with DISH may indicate insidious or delayed disease sequelae.

在东亚人群的影像学研究中，主要研究了伴随的弥漫性特发性骨骼肥大 (DISH) 和后纵韧带 (cOPLL) 的颈部骨化。本研究旨在确定美国大样本中伴随DISH/cOPLL的临床患病率，并比较接受手术治疗的cOPLL患者的特征和并发症。在美国，患有cOPLL的患者中DISH的临床患病率较低; 然而，伴随DISH的cOPLL患者比没有DISH的患者接受手术的频率更高。尽管合并症负担较高，但患有DISH的cOPLL患者可能与没有DISH的cOPLL患者具有相似的短期术后风险。然而，患有DISH的cOPLL患者较高的非程序性神经系统损伤可能表明存在隐匿或延迟的疾病后遗症。

REF: Litvak AL, Zhang DM, Seidel H, et al. Concomitant Diffuse Idiopathic Skeletal Hyperostosis and Cervical Ossification of the Posterior Longitudinal Ligament: A U.S. Database Study of Clinical Prevalence, Surgical Intervention, Patient Characteristics, and Postoperative Complications. World Neurosurg. Published online December 11, 2024. doi:10.1016/j.wneu.2024.11.089 PMID: 39603457

Role of Statins in the Clinical and Radiologic Outcomes of Patients with Unruptured Intracranial Aneurysm Undergoing Microsurgery or Endovascular Treatment: A Systematic Review and Meta-Analysis

他汀类药物在接受显微手术或血管内治疗的未破裂颅内动脉瘤患者的临床和影像学结局中的作用: 系统综述和荟萃分析

The impact of statin pretreatment on outcomes for patients undergoing endovascular treatment of intracranial aneurysms remains uncertain. We aimed to conduct a systematic review and meta-analysis evaluating the efficacy and safety of statins in this population. Statin pretreatment may decrease the risk of hemorrhagic complications and in-stent stenosis after endovascular aneurysm therapy but does not improve angiographic occlusion. An increased hazard of ischemic events was found. Further data are needed to validate these findings and clarify the role of statins in patients with aneurysms undergoing endovascular procedures.

他汀类药物预处理对颅内动脉瘤血管内治疗患者预后的影响仍不确定。我们的目的是进行系统综述和荟萃分析，评估他汀类药物在该人群中的疗效和安全性。他汀类药物预处理可降低血管内动脉瘤治疗后出血并发症和支架内狭窄的风险，但不能改善血管造影闭塞。发现缺血事件的风险增加。需要进一步的数据来验证这些发现，并阐明他汀类药物在接受血管内手术的动脉瘤患者中的作用。

REF: Habibi MA, Naseri Alavi SA, Mirjnani MS, et al. Role of Statins in the Clinical and Radiologic Outcomes of Patients with Unruptured Intracranial Aneurysm Undergoing Microsurgery or Endovascular Treatment: A Systematic Review and Meta-Analysis. World Neurosurg. Published online December 11, 2024. doi:10.1016/j.wneu.2024.11.080 PMID: 39603459