Efficacy and Safety of Dual Microcatheter Interventional Embolization for Intracranial Aneurysms: A Systematic Review and Meta-Analysis

双微导管介入栓塞治疗颅内动脉瘤的有效性和安全性：系统评价与Meta分析

To comprehensively evaluate the clinical effectiveness and safety of dual microcatheter (DMC) embolization for intracranial aneurysms (IAs) through a single-group rate meta-analysis and provide evidence-based medical evidence for clinical decision-making. DMC embolization appears to be an effective and safe treatment option for IAs. However, due to the significant heterogeneity among them, more high-quality, large-scale, and prospective studies are required in the future.

通过单组率Meta分析全面评价双微导管（DMC）栓塞治疗颅内动脉瘤（IAs）的临床有效性和安全性，为临床决策提供循证医学依据。DMC栓塞似乎是一种有效且安全的IAs治疗选择。然而，由于研究间存在显著的异质性，未来需要开展更多高质量、大规模的前瞻性研究。

REF: Feng W, Tang S, Shang D, et al. Efficacy and Safety of Dual Microcatheter Interventional Embolization for Intracranial Aneurysms: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;204:124517. doi:10.1016/j.wneu.2025.124517 PMID: 41076241

Evaluating Sensory Restoration Following Surgical Intervention for Tethered Cord Syndrome: A Scoping Review and Illustrative Cases

脊髓拴系综合征手术干预后感觉功能恢复的评估：一项范围综述及案例展示

Tethered cord syndrome (TCS) is characterized by the caudal anchoring of the spinal cord, causing restricted movement and tension, leading to neurologic, urologic, musculoskeletal, and gastrointestinal symptoms. Neuropathic sensory loss in the lower extremities is prevalent, increasing infection risk and, in severe cases, resulting in amputation. The potential for sensory recovery following surgical intervention in TCS has not been thoroughly documented. This study reviews existing literature and presents 2 illustrative cases of sensory recovery following surgical intervention in TCS patients with severe neuropathic sensory loss leading to amputation. Sensory loss in TCS can lead to sequelae as severe as amputations from repeated wound infections. Surgical intervention may play a role in preventing and treating sensory loss in TCS patients. Further investigation into the mechanisms of sensory loss in TCS is needed.

脊髓栓系综合征（TCS）的特征是脊髓尾部被固定，导致脊髓活动受限并产生张力，进而引发神经、泌尿、肌肉骨骼和胃肠道症状。下肢神经性感觉丧失很常见，这会增加感染风险，在严重情况下会导致截肢。TCS患者手术干预后感觉功能恢复的可能性尚未得到充分记录。本研究回顾了现有文献，并介绍了2例TCS患者的典型病例，这些患者因严重的神经性感觉丧失而截肢，术后感觉功能得到了恢复。TCS导致的感觉丧失可能会引发严重的后遗症，如反复伤口感染导致的截肢。手术干预可能在预防和治疗TCS患者的感觉丧失方面发挥作用。有必要进一步研究TCS感觉丧失的机制。

REF: Albdewi MJ, McVeigh L, Guley N, Joshi RS, Muraszko KM, Kazemi N. Evaluating Sensory Restoration Following Surgical Intervention for Tethered Cord Syndrome: A Scoping Review and Illustrative Cases. World Neurosurg. 2025;204:124525. doi:10.1016/j.wneu.2025.124525 PMID: 41077184

Comparison of Anterior and Posterior Surgical Approaches for Cervical Ossification of the Posterior Longitudinal Ligament Stratified by Spinal Levels: A Systematic Review and Meta-Analysis

按脊髓节段分层的颈椎后纵韧带骨化症前路与后路手术入路比较：系统评价与Meta分析

To compare the outcomes of anterior and posterior surgical approaches for treating cervical ossification of the posterior longitudinal ligament across multiple spinal levels, including 1-2 spinal levels, ≥ 3 levels, or studies that operated on both spinal levels, called mixed spinal levels. LAMP significantly preserved cervical range of motion. LAMP and laminectomy with fusion reduced dysphagia but increased C5 palsy. The anterior approach improved alignment and function, but the mJOA score and recovery rate were not clinically meaningful. Patient-specific characteristics should be taken into account when selecting the surgical approach.

比较前路和后路手术方式治疗多节段颈椎后纵韧带骨化症的效果，多节段包括1 - 2个椎体节段、≥3个椎体节段，或对两种节段均进行手术的研究（称为混合节段）。侧块关节间减压植骨融合术（LAMP）能显著保留颈椎活动度。LAMP和椎板切除融合术可减少吞咽困难，但会增加C5神经根麻痹的发生。前路手术可改善颈椎排列和功能，但日本骨科协会（mJOA）评分及恢复率并无临床意义。选择手术方式时应考虑患者的个体特征。

REF: Alizadeh SD, Khosravi S, Farahbakhsh F, et al. Comparison of Anterior and Posterior Surgical Approaches for Cervical Ossification of the Posterior Longitudinal Ligament Stratified by Spinal Levels: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;204:124528. doi:10.1016/j.wneu.2025.124528 PMID: 41072914

Halo, Collar, Anterior, or Posterior Fusion? Comparative Outcomes in Typical and Atypical Hangman's Fractures: A Systematic Review of Fusion Rate and Complication Profile

halo（头环背心）、颈托、前路融合还是后路融合？典型与非典型绞刑者骨折的对比结果：融合率和并发症情况的系统评价

Hangman's fracture, a traumatic spondylolisthesis of the C2 vertebra, represents a significant challenge in cervical spine management because of its complex anatomy and biomechanical considerations. Management strategies range from nonsurgical immobilization (rigid collar, halo vest) to surgical stabilization (anterior cervical discectomy and fusion [ACDF], posterior fusion, or combination of both anterior and posterior approaches). This systematic review evaluates fusion rates and complication profiles associated with collar, halo, ACDF, and posterior fusion in typical and atypical Hangman's fractures. Although fusion is achievable with all approaches, failure rates exist particularly in posterior fusion for atypical Hangman's fractures. Complication patterns also vary between anterior and posterior techniques. No single method is universally superior; treatment should be tailored to fracture type, patient factors, and surgeon expertise. Prospective multicenter trials are needed to refine surgical indications and long-term outcomes.

绞刑者骨折，即第二颈椎（C2）的创伤性椎体滑脱，由于其解剖结构复杂和生物力学因素的考量，在颈椎处理方面是一项重大挑战。治疗策略包括非手术固定（刚性颈托、 halo 背心）到手术稳定（前路颈椎间盘切除融合术 [ACDF]、后路融合术，或前后路联合手术）。本系统评价评估了在典型和非典型绞刑者骨折中，使用颈托、halo 背心、ACDF 和后路融合术的融合率及并发症情况。虽然所有方法都有可能实现融合，但在非典型绞刑者骨折的后路融合术中，尤其存在失败率。前路和后路技术的并发症模式也有所不同。没有一种方法在所有情况下都更优；治疗应根据骨折类型、患者因素和外科医生的专业技能进行个体化选择。需要开展前瞻性多中心试验来完善手术指征和评估长期疗效。

REF: Elias C, Daoud A, Nasser Z, Daoud R, Elias E. Halo, Collar, Anterior, or Posterior Fusion? Comparative Outcomes in Typical and Atypical Hangman's Fractures: A Systematic Review of Fusion Rate and Complication Profile. World Neurosurg. 2025;204:124530. doi:10.1016/j.wneu.2025.124530 PMID: 41067692

Early Mobilization in Chronic Subdural Hematoma: A Systematic Review and Meta-Analysis

慢性硬膜下血肿的早期活动：系统评价与荟萃分析

There is variation in timing of postoperative mobilization in patients with chronic subdural hematoma (cSDH). Some studies suggest that early postoperative mobilization may reduce complications, without increase in recurrence. This review aims to evaluate whether timing of postoperative mobilization impacts such outcomes. EM decreases complications after cSDH, but is not associated with higher risk of recurrence. Additional prospective studies are required to further characterize this potential association, with greater sample size and clear outcome definitions.

慢性硬膜下血肿（cSDH）患者术后活动时间存在差异。一些研究表明，术后早期活动可能减少并发症，且不会增加复发率。本综述旨在评估术后活动时间是否会影响这些结局。早期活动可减少cSDH术后并发症，但与更高的复发风险无关。需要开展更多前瞻性研究，以更大样本量和明确的结局定义来进一步阐明这种潜在关联。

REF: AlDallal U, Veremu M, O'Leary S, et al. Early Mobilization in Chronic Subdural Hematoma: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;204:124546. doi:10.1016/j.wneu.2025.124546 PMID: 41077180

Hormonal Influences on Cognitive Function in Pituitary Neuroendocrine Tumors

垂体神经内分泌肿瘤中激素对认知功能的影响

Pituitary neuroendocrine tumors (PitNETs) represent prevalent central nervous system neoplasms frequently associated with endocrine disturbances and cognitive dysfunction. Cognitive function encompasses the brain's sophisticated capacity to acquire, process, and analyze external information. When severe cognitive impairment develops in these patients, it imposes substantial burdens on individuals, families, and society. This impairment may arise from various etiological factors, including tumor mass effect. Distinct from other common central nervous system tumors, PitNETs, owing to their unique anatomical position within the sella, often do not produce significant mass effects on adjacent brain parenchyma. Consequently, hormonal dysregulation is frequently posited as the primary mediator of cognitive dysfunction in these patients. This article comprehensively reviews the associations between various hormones and cognitive function in PitNET patients, briefly elucidates potential underlying mechanisms, and discusses cognitive outcomes following therapeutic intervention. It aims to provide a theoretical framework to guide future research in neuroendocrinology.

垂体神经内分泌肿瘤（PitNETs）是常见的中枢神经系统肿瘤，常与内分泌紊乱和认知功能障碍相关。认知功能是指大脑获取、处理和分析外部信息的复杂能力。当这些患者出现严重的认知障碍时，会给患者本人、家庭和社会带来沉重负担。这种障碍可能由多种病因引起，包括肿瘤占位效应。与其他常见的中枢神经系统肿瘤不同，由于垂体神经内分泌肿瘤独特的解剖位置（位于蝶鞍内），通常不会对邻近脑实质产生明显的占位效应。因此，激素失调常被认为是这些患者认知功能障碍的主要原因。本文全面综述了垂体神经内分泌肿瘤患者各种激素与认知功能之间的关联，简要阐述了潜在的作用机制，并探讨了治疗干预后的认知结局。旨在为神经内分泌学领域的未来研究提供理论框架。

REF: Ku J, Li H, Bao J, Dai X, Wang B. Hormonal Influences on Cognitive Function in Pituitary Neuroendocrine Tumors. World Neurosurg. 2025;204:124548. doi:10.1016/j.wneu.2025.124548 PMID: 41072910

Anatomical Prevalence and Surgical Implications of the Ossified Pterygospinous and Pterygoalar Ligaments: A Systematic Review with Meta-Analysis

翼棘韧带和翼突颧突韧带骨化的解剖学患病率及其手术意义：一项系统评价与荟萃分析

The infratemporal fossa houses critical neurovascular structures and is frequently accessed in skull base and craniofacial surgery. Ossification of the pterygospinous (PSL) and pterygoalar (PAL) ligaments-forming the pterygospinous (PSB) and pterygoalar (PAB) bars represents a clinically crucial ossified (morphological) variant that may alter surgical access and predispose to nerve entrapment. The ossification of the PSL and PAL represents a relatively common morphological variation with significant implications for skull base and trigeminal interventions. These ossified structures may impede cannulation of the foramen ovale, alter local anatomical relationships, and contribute to trigeminal or lingual nerve entrapment, which could lead to unsuccessful or complicated procedures. Routine preoperative imaging using computed tomography or cone beam computed tomography should be considered when approaching the foramen ovale to identify these variants. Additional anatomical and clinical research is warranted to optimize surgical strategies and enhance patient safety in cases involving PSB and PAB.

颞下窝容纳着重要的神经血管结构，在颅底和颅面外科手术中常需对其进行操作。翼棘韧带（PSL）和翼蝶韧带（PAL）骨化形成翼棘骨桥（PSB）和翼蝶骨桥（PAB），这是一种临床上至关重要的骨化（形态学）变异，可能会改变手术入路，并易导致神经卡压。PSL和PAL骨化是一种相对常见的形态学变异，对颅底和三叉神经相关手术具有重要意义。这些骨化结构可能会阻碍卵圆孔置管，改变局部解剖关系，并导致三叉神经或舌神经卡压，从而导致手术失败或出现并发症。在进行卵圆孔相关手术时，应常规考虑术前采用计算机断层扫描或锥形束计算机断层扫描进行影像学检查，以识别这些变异。有必要开展更多的解剖学和临床研究，以优化涉及PSB和PAB病例的手术策略，提高患者的安全性。

REF: Piagkou M, Gondorf D, Triantafyllou G, et al. Anatomical Prevalence and Surgical Implications of the Ossified Pterygospinous and Pterygoalar Ligaments: A Systematic Review with Meta-Analysis. World Neurosurg. 2025;204:124549. doi:10.1016/j.wneu.2025.124549 PMID: 41067691

Current Applications and Technical Considerations of Indocyanine Green During Endonasal Endoscopic Approaches for Resection of Pituitary Region Tumors: A Systematic Review

经鼻内镜下切除垂体区域肿瘤术中吲哚菁绿的当前应用及技术考量：系统评价

Endoscopic endonasal approaches (EEAs) are now common practice to treat sellar and parasellar tumors. Indocyanine green (ICG) is a fluorescent dye with multiple novel applications during endonasal approaches. This systematic review assesses the role of ICG in enhancing tumor resection, predicting postoperative visual outcomes, and reducing endocrinological complications. ICG enhances the visualization of critical structures in the sellar region, which has aided in achieving safe maximal gross total resection. Emerging uses include real-time monitoring of optic chiasm perfusion and pituitary blood flow, possibly helping prevent postoperative visual and endocrinological deficits.

鼻内镜入路（EEAs）目前已成为治疗鞍区及鞍旁肿瘤的常用方法。吲哚菁绿（ICG）是一种荧光染料，在鼻内镜入路手术中有多种新的应用。本系统评价评估了ICG在提高肿瘤切除率、预测术后视力结局以及减少内分泌并发症方面的作用。ICG可增强鞍区重要结构的可视性，有助于实现安全的最大程度全切除肿瘤。其新兴应用包括实时监测视交叉灌注和垂体血流，可能有助于预防术后视力和内分泌功能障碍。

REF: Quintana D, Liu J, Segura A, Chen X, Goldschmidt E. Current Applications and Technical Considerations of Indocyanine Green During Endonasal Endoscopic Approaches for Resection of Pituitary Region Tumors: A Systematic Review. World Neurosurg. 2025;204:124550. doi:10.1016/j.wneu.2025.124550 PMID: 41077183

Clinical Outcomes After Spine Surgery for Patients with Potentially Unstable Metastatic Spinal Disease (Spine Instability Neoplastic Score 7–12): A Systematic Review

潜在不稳定转移性脊柱疾病患者（脊柱不稳定肿瘤评分7 - 12分）脊柱手术后的临床结局：一项系统评价

While the surgical management of metastatic spinal disease has wide consensus for "stable" (Spine Instability Neoplastic Score [SINS] 0-6) and "unstable" (SINS 13-18) disease, there is limited consensus regarding spine surgery for patients with "potentially unstable" (SINS 7-12) metastatic disease. We examined the clinical outcomes for these patients after spine surgery. Patients with potentially unstable metastatic spinal disease (SINS 7-12) treated with surgery have varying survival rates and outcomes in comparison to radiation. Up to 25% of patients with SINS 7-12 may fail nonoperative treatments. SINS 7-12 represents heterogeneous grouping of spine instability, with possible subgroups within SINS 7-12.

虽然对于“稳定型”（脊柱肿瘤不稳定评分 [SINS] 0 - 6 分）和“不稳定型”（SINS 13 - 18 分）脊柱转移性疾病的手术治疗已达成广泛共识，但对于“潜在不稳定型”（SINS 7 - 12 分）脊柱转移性疾病患者的手术治疗，共识有限。我们对这些患者接受脊柱手术后的临床结局进行了研究。与放疗相比，接受手术治疗的潜在不稳定型脊柱转移性疾病（SINS 7 - 12 分）患者的生存率和预后各不相同。高达 25% 的 SINS 7 - 12 分患者可能非手术治疗失败。SINS 7 - 12 分代表了脊柱不稳定的异质性分组，SINS 7 - 12 分范围内可能存在不同亚组。

REF: Baumann AN, Talaski GM, Anaspure OS, et al. Clinical Outcomes After Spine Surgery for Patients with Potentially Unstable Metastatic Spinal Disease (Spine Instability Neoplastic Score 7-12): A Systematic Review. World Neurosurg. 2025;204:124552. doi:10.1016/j.wneu.2025.124552 PMID: 41072915