Early Voice and Swallowing Disturbance Incidence and Risk Factors After Revision Anterior Cervical Discectomy and Fusion Using a Multidisciplinary Surgical Approach: A Retrospective Cohort Evaluation of a Prospective Database

使用多学科手术方法进行颈椎前路椎间盘切除术和融合术后早期嗓音和吞咽障碍的发生率和危险因素: 前瞻性数据库的回顾性队列评估

Dysphagia and vocal cord palsy (VCP) are common otolaryngological complications after revision anterior cervical discectomy and fusion (rACDF) procedures. Our objective was to determine the early incidence and risk factors of VCP and dysphagia after rACDF using a 2-team approach. VCP is more likely to occur in long-segment rACDF but is often temporary. Clinically relevant and functional rates of dysphagia approach 37% and 45%, respectively, at 2 weeks postoperatively after rACDF.

吞咽困难和声带麻痹 (VCP) 是修订前路颈椎间盘切除和融合 (rACDF) 手术后常见的耳鼻喉科并发症。我们的目标是使用两组方法确定rACDF后VCP和吞咽困难的早期发生率和危险因素。VCP更可能发生在长段rACDF中，但通常是暂时的。rACDF术后2周，吞咽困难的临床相关和功能发生率分别达到37% 和45%。

REF: Laskay NMB, Yang LC, Estevez-Ordonez D, et al. Early Voice and Swallowing Disturbance Incidence and Risk Factors After Revision Anterior Cervical Discectomy and Fusion Using a Multidisciplinary Surgical Approach: A Retrospective Cohort Evaluation of a Prospective Database. Neurosurgery. 2024;94(3):444-453. doi:10.1227/neu.0000000000002704 PMID: 37830799

Long-Term Results After Surgery for Degenerative Cervical Myelopathy

退行性脊髓型颈椎病手术后的长期结果

Degenerative cervical myelopathy (DCM) is a frequent cause of spinal cord dysfunction, and surgical treatment is considered safe and effective. Long-term results after surgery are limited. This study investigated long-term clinical outcomes through data from the Norwegian registry for spine surgery. Long-term follow-up of patients undergoing surgery for DCM demonstrates persistence of statistically significant and clinically meaningful improvement across a wide range of PROMs.

退行性颈椎病 (DCM) 是脊髓功能障碍的常见原因，手术治疗被认为是安全有效的。手术后的长期结果是有限的。这项研究通过挪威脊柱外科注册中心的数据调查了长期临床结果。接受DCM手术的患者的长期随访表明，在广泛的prom中，统计学上显着且临床上有意义的改善持续存在。

REF: Johansen TO, Holmberg ST, Danielsen E, et al. Long-Term Results After Surgery for Degenerative Cervical Myelopathy. Neurosurgery. 2024;94(3):454-460. doi:10.1227/neu.0000000000002712 PMID: 37823669 PMCID: PMC10846761

Cervical Vertebral Bone Quality Score Independently Predicts Distal Junctional Kyphosis After Posterior Cervical Fusion

颈椎骨质量评分可独立预测颈椎后路融合术后远端交界性后凸

Posterior cervical fusion is the surgery of choice when fusing long segments of the cervical spine. However, because of the limited presence of this pathology, there is a paucity of data in the literature about the postoperative complications of distal junctional kyphosis (DJK). We aimed to identify and report potential associations between the preoperative cervical vertebral bone quality (C-VBQ) score and the occurrence of DJK after posterior cervical fusion. We found that the C-VBQ score was an independent predictive factor of DJK after posterior cervical fusion.

颈椎后路融合术是融合颈椎长段的首选手术。然而，由于这种病理的存在有限，文献中关于远端交界性后凸畸形 (DJK) 的术后并发症的数据很少。我们旨在确定和报告术前颈椎骨质量 (c-vbq) 评分与颈椎后路融合术后DJK发生之间的潜在关联。我们发现，c-vbq评分是颈椎后路融合术后DJK的独立预测因素。

REF: Aguirre AO, Soliman MAR, Kuo CC, et al. Cervical Vertebral Bone Quality Score Independently Predicts Distal Junctional Kyphosis After Posterior Cervical Fusion. Neurosurgery. 2024;94(3):461-469. doi:10.1227/neu.0000000000002714 PMID: 37823666

A New Treatment Strategy for Spinal Metastasis: The “Systemic Conditions, Effectiveness of Systemic Treatment, Neurology, and Oncology” Decision Framework System

脊柱转移瘤的新治疗策略: “系统状况，系统治疗的有效性，神经病学和肿瘤学” 决策框架系统

Treating metastatic spinal tumors poses a significant challenge because there are currently no universally applied guidelines for managing spinal metastases. This study aims to propose a new decision framework for the 12-point epidural spinal cord compression grading system to treat patients with metastatic spinal tumors and investigate its clinical effectiveness in a multicenter analysis. The SENO decision framework is a promising approach for treating patients with metastatic spinal tumors.

治疗转移性脊柱肿瘤是一项重大挑战，因为目前尚无普遍应用的脊柱转移治疗指南。这项研究旨在为12点硬膜外脊髓压迫分级系统提出一种新的决策框架，以治疗转移性脊柱肿瘤患者，并在多中心分析中研究其临床有效性。SENO决策框架是治疗转移性脊柱肿瘤患者的一种有前途的方法。

REF: Cao X, Jiang W, Zhang B, et al. A New Treatment Strategy for Spinal Metastasis: The "Systemic Conditions, Effectiveness of Systemic Treatment, Neurology, and Oncology" Decision Framework System. Neurosurgery. 2024;94(3):584-596. doi:10.1227/neu.0000000000002709 PMID: 37800928

Comparative Effectiveness of Early Neurosurgical Intervention in Civilian Penetrating Brain Injury Management

早期神经外科干预在平民穿透性颅脑损伤管理中的疗效比较

To compare the outcomes of early vs no-neurosurgical intervention in civilians with penetrating brain injury (PBI). Management including early neurosurgical intervention is associated with decreased mortality and increased ICU LOS in matched cohorts of PBI.

比较早期与非神经外科手术干预对穿透性脑损伤 (PBI) 平民的治疗效果。在匹配的PBI队列中，包括早期神经外科干预在内的管理与死亡率降低和ICU LOS增加相关。

REF: Mansour A, Powla PP, Fakhri F, et al. Comparative Effectiveness of Early Neurosurgical Intervention in Civilian Penetrating Brain Injury Management. Neurosurgery. 2024;94(3):470-477. doi:10.1227/neu.0000000000002725 PMID: 37847039

Toward Optimized and Cost-Efficient Protocols for Inferior Petrosal Sinus Sampling in the Diagnosis of Cushing Disease

在库欣病的诊断中寻求优化和具有成本效益的岩下窦采样方案

Conventional protocols for inferior petrosal sinus sampling (IPSS) during the workup of hypercortisolemia require adrenocorticotrophic hormone (ACTH) measurement at multiple time points with corticotropic-releasing hormone (CRH) used as a stimulator. Modernized evidence-based protocols must also reflect the increased utilization of desmopressin (DDAVP) for ACTH stimulation as the manufacturing shortage of traditionally used CRH continues. We model the diagnostic accuracy and potential economic savings of DDAVP utilization and reduced time point sampling. DDAVP is a cost-efficient and effective alternative to CRH during IPSS. Our results encourage prospective evaluation of potentially fewer sampling time points in the interest of time and cost efficiency balanced with preserved accuracy.

在皮质醇过多症检查期间，下岩下窦采样 (IPSS) 的常规方案需要在多个时间点测量促肾上腺皮质激素 (ACTH)，并使用促肾上腺皮质激素释放激素 (CRH) 作为刺激剂。随着传统使用的CRH的制造短缺，现代化的基于证据的协议还必须反映出去氨加压素 (DDAVP) 用于ACTH刺激的增加。我们对DDAVP利用率和减少时间点采样的诊断准确性和潜在的经济节省进行了建模。在IPSS期间，DDAVP是CRH的一种经济高效且有效的替代方案。我们的结果鼓励对潜在的较少采样时间点进行前瞻性评估，以兼顾时间和成本效率与保留的准确性。

REF: Abdallah HM, Gersey ZC, Plute T, et al. Toward Optimized and Cost-Efficient Protocols for Inferior Petrosal Sinus Sampling in the Diagnosis of Cushing Disease. Neurosurgery. 2024;94(3):508-514. doi:10.1227/neu.0000000000002669 PMID: 37706685

Visual Morbidity in Patients With Ophthalmic Segment Aneurysms Treated With Flow Diverters: A Dual-Center Experience

用血流导向装置治疗的眼段动脉瘤患者的视觉发病率: 双中心经验

Flow diverter (FD) treatment for aneurysms of the ophthalmic segment of the internal carotid artery (ICA) may raise concerns about visual morbidity related to coverage of the ophthalmic artery by the device. Our objective was to evaluate clinical and angiographic outcomes associated with FD treatment of these aneurysms, with particular emphasis on visual morbidity. In our experience, flow diversion for ICA ophthalmic segment aneurysms resulted in low rates of visual morbidity, which was mostly transient in occurrence.

颈内动脉 (ICA) 眼段动脉瘤的血流导向装置 (FD) 治疗可能会引起与设备覆盖眼动脉有关的视觉发病率的担忧。我们的目标是评估与这些动脉瘤的FD治疗相关的临床和血管造影结果，特别强调视觉发病率。根据我们的经验，对ICA眼段动脉瘤的血流导向导致视觉发病率低，这主要是短暂的。

REF: Levy BR, Monteiro A, Raygor KP, et al. Visual Morbidity in Patients With Ophthalmic Segment Aneurysms Treated With Flow Diverters: A Dual-Center Experience. Neurosurgery. 2024;94(3):538-544. doi:10.1227/neu.0000000000002694 PMID: 37721433

Revisiting the WFNS Score: Native Computed Tomography Imaging Improves Identification of Patients With “False Poor Grade” Aneurysmal Subarachnoid Hemorrhage

重新评估WFNS评分: 原生计算机断层扫描成像可改善 “假不良分级” 动脉瘤蛛网膜下腔出血患者的识别

In patients suffering from aneurysmal subarachnoid hemorrhage (aSAH), the optimal time to determine the World Federation of Neurosurgical Societies (WFNS) score remains controversial because of possible confounding factors. Goals of this study were (1) to analyze the most sensitive timepoint to determine the WFNS score in patients with aSAH and (2) to evaluate the impact of initial native computed tomography (CT) imaging on reducing the mismatch of "false poor grade" patients. The initial WFNS score may misclassify a subgroup of patients with aSAH as poor grade, which can be avoided by later determination of the WFNS score, at days 3-4 losing its usefulness. Alternatively, the initial WFNS score can be improved in its predictive value, especially in poor-grade patients, using criteria from the initial native CT imaging, such as the Hijdra, LeRoux, and Subarachnoid Hemorrhage Early Brain Edema score, combined in the ICT WFNS score with even higher predictive power.

在患有动脉瘤性蛛网膜下腔出血 (aSAH) 的患者中，由于可能的混杂因素，确定世界神经外科学会联合会 (WFNS) 评分的最佳时间仍然存在争议。这项研究的目标是 (1) 分析最敏感的时间点，以确定aSAH患者的WFNS评分，以及 (2) 评估初始计算机断层扫描 (CT) 成像对减少 “假不良” 不匹配的影响分级 ”患者。最初的WFNS评分可能将aSAH患者亚组错误分类为不良等级，这可以通过随后确定WFNS评分来避免，在第3-4天失去其有用性。或者，可以使用来自初始原生CT成像的标准，例如Hijdra，LeRoux和蛛网膜下腔出血早期脑水肿评分，结合具有更高预测能力的ICT WFNS评分，提高初始WFNS评分的预测价值，尤其是在不良等级患者中。

REF: Hofmann BB, Fischer I, Neyazi M, et al. Revisiting the WFNS Score: Native Computed Tomography Imaging Improves Identification of Patients With "False Poor Grade" Aneurysmal Subarachnoid Hemorrhage. Neurosurgery. 2024;94(3):515-523. doi:10.1227/neu.0000000000002715 PMID: 37823661

Gender Differences in Procedural Clinical Complications and Outcomes of Intracranial Aneurysms: Analysis of the Stroke Thrombectomy and Aneurysm Registry

颅内动脉瘤的手术临床并发症和预后的性别差异: 卒中血栓切除术和动脉瘤注册登记研究的分析

Some studies have shown that female patients had a poorer prognosis after endovascular treatment for ruptured intracranial aneurysm than male patients. However, data have been sparse regarding differences in the periprocedural and perioperative complication rate with ruptured and unruptured intracranial aneurysms. This large multicenter registry of patients undergoing intracranial aneurysm treatment found that female patients were not at increased risk of perioperative complications.

一些研究表明，女性患者在颅内动脉瘤破裂血管内治疗后的预后比男性患者差。然而，关于破裂和未破裂颅内动脉瘤的围手术期和围手术期并发症发生率差异的数据很少。这个大型的接受颅内动脉瘤治疗的患者的多中心注册表发现，女性患者围手术期并发症的风险没有增加。

REF: Uchida K, Matsukawa H, Sowlat MM, et al. Gender Differences in Procedural Clinical Complications and Outcomes of Intracranial Aneurysms: Analysis of the Stroke Thrombectomy and Aneurysm Registry. Neurosurgery. 2024;94(3):545-551. doi:10.1227/neu.0000000000002695 PMID: 37747370