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World Neurosurgery

2025
2024
2023
2022
2021
2020

本篇文献由机器智能翻译

【Online】2024年8月速览(下)
  • Volatile Sedation in Neurointensive Care Patients After Aneurysmal Subarachnoid Hemorrhage: Effects on Delayed Cerebral Ischemia, Cerebral Vasospasm, and Functional Outcome

    动脉瘤性蛛网膜下腔出血后神经重症监护患者的挥发性镇静: 对迟发性脑缺血,脑血管痉挛和功能结局的影响

    Volatile anesthetics have shown neuroprotective effects in preclinical studies, but clinical data on their use after aneurysmal subarachnoid hemorrhage (aSAH) are limited. This study aimed to analyze whether the use of volatile anesthetics for neurocritical care sedation affects the incidence of delayed cerebral ischemia (DCI), cerebral vasospasm (CVS), DCI-related infarction or functional outcome. Volatile sedation in aSAH patients is not associated with the incidence of DCI, CVS, DCI-related infarction or functional outcome. Although we could not demonstrate neuroprotective effects of volatile anesthetics, our results suggest that volatile sedation after aSAH has no negative effect on patient's outcome.

    挥发性麻醉药在临床前研究中已显示出神经保护作用,但在动脉瘤性蛛网膜下腔出血 (aSAH) 后使用的临床数据有限。本研究旨在分析使用挥发性麻醉药进行神经重症监护镇静是否会影响迟发性脑缺血 (DCI),脑血管痉挛 (CVS),DCI相关梗死或功能结局的发生率。aSAH患者的挥发性镇静与DCI,CVS,DCI相关梗死或功能结局的发生率无关。尽管我们无法证明挥发性麻醉药的神经保护作用,但我们的结果表明,aSAH后的挥发性镇静对患者的预后没有负面影响。

    REF: Küchler J, Schwachenwald B, Matone MV, Tronnier VM, Ditz C. Volatile sedation in neurointensive care patients after aneurysmal subarachnoid hemorrhage: effects on delayed cerebral ischemia, cerebral vasospasm and functional outcome. World Neurosurg. Published online August 23, 2024. doi:10.1016/j.wneu.2024.08.097 PMID: 39182830

  • Surgical Repair of Obstetric Brachial Plexus Injuries: A Case Series and Discussion of the Current Literature

    产科臂丛神经损伤的外科修复: 病例系列和当前文献的讨论

    To assess factors which may influence surgical success following brachial plexus reconstruction for Obstetric Brachial Plexus Injury (OBPI). Brachial plexus reconstruction is an effective treatment modality for patients without spontaneous recovery of upper extremity function following OBPI, although identifying the optimal age-range for surgery remains elusive. Patients with intraoperative findings consistent with a more severe injury may be less likely to benefit from surgery.

    评估可能影响臂丛神经重建术治疗产科臂丛神经损伤 (OBPI) 手术成功的因素。对于OBPI后上肢功能没有自发恢复的患者,臂丛神经重建是一种有效的治疗方式,尽管确定手术的最佳年龄范围仍然难以捉摸。术中发现与更严重损伤一致的患者可能不太可能从手术中受益。

    REF: Taylor JJ, Hoggard CE, Gegg CA. Surgical Repair of Obstetric Brachial Plexus Injuries: A Case Series and Discussion of the Current Literature. World Neurosurg. Published online August 24, 2024. doi:10.1016/j.wneu.2024.08.103 PMID: 39186975

  • Current Status and Trends of Research on Cervical Spondylotic Myelopathy from the Perspective of Bibliometrics

    文献计量学视角下颈部脊髓型颈椎病研究现状与趋势

    This review was performed to analyze the research on cervical spondylotic myelopathy published during the past 25 years, summarize the developments in existing research, and predict future hotspots in the field. The goal is to provide a comprehensive overview and exploration of developments in this research area. This study provides both an overview of the research trajectory in the field of cervical spondylotic myelopathy for scholars interested in this area, as well as offering insights and references for future research directions in the field.

    本文旨在分析近25年来发表的关于颈部脊柱疾病的研究,总结现有研究的进展,并预测该领域的未来热点。目的是对该研究领域的发展进行全面的概述和探索。本研究既为有志于该领域的学者提供了颈部脊柱疾病领域研究的概况,也为该领域未来的研究方向提供了见解和参考。

    REF: Liu S, Wang D, Liu Y, Zeng Z. Current Status and Trends of Research on Cervical Spondylotic Myelopathy from the Perspective of Bibliometrics. World Neurosurg. Published online August 23, 2024. doi:10.1016/j.wneu.2024.08.089 PMID: 39182836

  • Predictors of postoperative persistent low back pain following lumbar fusion in patients older than 75 years: An analysis of a minimum 2-year follow-up

    75岁以上患者腰椎融合术后持续性下腰痛的预测因素: 至少2年随访分析

    This study aimed to evaluate pre- and perioperative predictors associated with persistent low back pain (LBP) following lumbar fusion in patients aged > 75 years. This study showed that a relatively younger age, history of preoperative lumbar decompression, and greater preoperative VAS score for LBP were preoperative predictors of postoperative persistent LBP following lumbar fusion in elderly patients. In contrast, preoperative spinopelvic sagittal parameters were not associated with persistent postoperative LBP. Although lumbar fusion is expected to improve LBP, surgeons should pay attention to age, surgical history, and preoperative back pain intensity.

    这项研究旨在评估年龄> 75岁的患者腰椎融合术后持续性下腰痛 (LBP) 的术前和围手术期预测因素。这项研究表明,年龄相对较小,术前腰椎减压史和术前VAS评分较高的LBP是老年患者腰椎融合术后持续LBP的术前预测因素。相反,术前脊髓骨盆矢状位参数与术后持续LBP无关。尽管腰椎融合术有望改善LBP,但外科医生应注意年龄,手术史和术前背痛强度。

    REF: Suzuki H, Tsujimoto T, Kanayama M, et al. Predictors of postoperative persistent low back pain following lumbar fusion in patients older than 75 years: An analysis of a minimum 2-year follow-up. World Neurosurg. Published online August 24, 2024. doi:10.1016/j.wneu.2024.08.102 PMID: 39186974

  • Patient Reported Physical and Mental Health Outcomes Following Lumbar Spinal Fusion versus Total Hip and Total Knee Replacement

    患者报告了腰椎融合术与全髋关节和全膝关节置换后的身体和精神卫生结果

    Total hip and knee arthroplasty (THA/TKA) are reliable surgical procedures for alleviating pain and optimizing function. Spinal fusion has also been shown to be beneficial, however the comparative benefit of THA/TKA to lumbar spinal fusion is incompletely understood. Spinal fusion, total knee arthroplasty, and total hip arthroplasty all significantly improved PROMs at 1-year follow-up. At baseline, spinal fusion patients had better physical function scores and worse mental health scores compared to joint arthroplasty patients, while spinal fusion resulted in mean smaller gains in patient reported physical function and higher gains in patient reported mental health function compared to arthroplasty.

    全髋膝关节置换术 (THA/TKA) 是减轻疼痛和优化功能的可靠手术方法。脊柱融合术也被证明是有益的,但是THA/TKA与腰椎融合术的相对益处尚不完全清楚。在1年的随访中,脊柱融合,全膝关节置换术和全髋关节置换术均显着改善了PROMs。在基线时,与关节成形术患者相比,脊柱融合患者的身体功能评分更高,精神卫生评分更差,而与关节成形术相比,脊柱融合导致患者报告的身体功能的平均增益更小,而患者报告的精神卫生功能的平均增益更高。

    REF: Daher M, Liu J, Baroudi M, et al. Patient Reported Physical and Mental Health Outcomes Following Lumbar Spinal Fusion versus Total Hip and Total Knee Replacement. World Neurosurg. Published online August 24, 2024. doi:10.1016/j.wneu.2024.08.106 PMID: 39186976

  • Utility of Sodium Fluorescein During Peripheral Nerve Tumor Surgery: A Scoping Review of Indications, Techniques, and Outcomes

    荧光素钠在周围神经肿瘤手术中的效用: 适应症,技术和结果的概况性综述

    The primary treatment for peripheral nerve tumors involves maximal surgical resection while preserving nerve function. Sodium fluorescein shows potential for enhancing the safety and efficacy of nerve tumor surgery. This review evaluates the advantages and limitations of sodium fluorescein in this context. Sodium fluorescein shows promise as assisting tool in nerve tumor surgery by facilitating differentiation between the tumor, parent nerve, and surrounding soft tissue. However, multi-center randomized controlled trials are necessary to determine its effect on extent of resection rates, clinical outcomes, postoperative complication rates, and surgical duration in comparison to current standard of care.

    周围神经肿瘤的主要治疗包括最大程度的手术切除,同时保留神经功能。荧光素钠显示出增强神经肿瘤手术的安全性和有效性的潜力。这篇综述在这种情况下评估了荧光素钠的优点和局限性。荧光素钠通过促进肿瘤,父神经和周围软组织之间的区分,有望作为神经肿瘤手术的辅助工具。然而,多中心随机对照试验是必要的,以确定其对切除率,临床结果,术后并发症发生率和手术持续时间的影响,与目前的护理标准相比。

    REF: Asfour MZ, Venero C Jr, Mo J, et al. Utility of Sodium Fluorescein During Peripheral Nerve Tumor Surgery: A Scoping Review of Indications, Techniques, and Outcomes. World Neurosurg. Published online August 26, 2024. doi:10.1016/j.wneu.2024.08.101 PMID: 39197705

  • Preparing Residents to Navigate Neurosurgical Careers in the 21st Century: Implementation of a Yearlong Enhanced Didactics Curriculum

    为21世纪的神经外科职业生涯做好准备: 实施为期一年的强化教学课程

    Neurosurgery residency, known for its rigorous training, must adapt to evolving healthcare demands. Formal education should now encompass areas like quality improvement and patient safety (QIPS), machine learning, career planning, research infrastructure, grant funding, and socioeconomics. We share our institution's experience with a yearlong enhanced didactics curriculum, complementing our traditional teaching. Organized neurosurgery excels in clinical and technical training for residents but lacks formalized training in crucial nonclinical areas, such as QIPS, machine learning/artificial intelligence, research infrastructure, and socioeconomics. Our formal curriculum focused on these topics, with positive resident engagement and feedback over the first six months. However, continuous longitudinal monitoring is needed to confirm the curriculum's efficacy. This program may guide other neurosurgery departments in enhancing resident education in these areas.

    神经外科住院医师以其严格的培训而闻名,必须适应不断变化的医疗保健需求。正规教育现在应该包括质量改进和患者安全 (qip),机器学习,职业规划,研究基础设施,赠款资金和社会经济学等领域。我们通过为期一年的强化教学课程分享我们机构的经验,补充我们的传统教学。有组织的神经外科在住院医师的临床和技术培训方面表现出色,但在关键的非临床领域缺乏正式培训,例如qip,机器学习/人工智能,研究基础设施和社会经济学。我们的正式课程集中在这些主题上,在前六个月内有积极的居民参与和反馈。但是,需要持续的纵向监控来确认课程的功效。该计划可以指导其他神经外科部门加强这些地区的居民教育。

    REF: Sundar SJ, Whiting BB, Li S, et al. Preparing Residents to Navigate Neurosurgical Careers in the 21st Century: Implementation of a Yearlong Enhanced Didactics Curriculum. World Neurosurg. Published online August 26, 2024. doi:10.1016/j.wneu.2024.08.104 PMID: 39197702

  • Multi-dimensional morphometric and volumetric analysis of the posterior cranial fossa to study type I Chiari Malformation

    后颅窝的多维形态和体积分析以研究I型Chiari畸形

    Chiari malformation type I (CM-1) is a complex disorder in which tonsillar herniation through the foramen magnum manifests with a spectrum of clinical symptoms. This work analyzes morphometric and volumetric characteristics of CM-1 patients. Our findings suggest that the amount of tissue at the foramen magnum correlates with CM-1 patients who underwent decompressive surgery, more so than tonsillar length. Additionally, the combination of neural tissue at foramen magnum, cerebellar & 4th ventricular volumes led to great degree of correlation with syrinx formation. Together, these findings suggest that a global compressive phenomenon within the posterior fossa leads to CM-1 symptomatology and syrinx formation.

    Chiari畸形I型 (CM-1) 是一种复杂的疾病,其中通过大孔的扁桃体疝气表现为一系列临床症状。这项工作分析了CM-1患者的形态和体积特征。我们的发现表明,大孔处的组织数量与接受减压手术的CM-1患者相关,而与扁桃体长度相关。此外,大孔,小脑和第4心室体积的神经组织的组合导致与脊髓空洞形成的高度相关性。总之,这些发现表明后颅窝内的整体压缩现象导致CM-1症状和脊髓空洞形成。

    REF: Chuang YC, Carrasquilla A, Bilgili G, et al. Multi-dimensional morphometric and volumetric analysis of the posterior cranial fossa to study type I Chiari Malformation. World Neurosurg. Published online August 26, 2024. doi:10.1016/j.wneu.2024.08.105 PMID: 39197706

  • Utilization of the Modified Brain Injury Guidelines by neurosurgeons to improve traumatic brain injury patient throughput at a level one trauma center: a retrospective observational study

    神经外科医生利用修改后的脑损伤指南在一级创伤中心提高创伤性脑损伤患者的吞吐量: 一项回顾性观察研究

    The Modified Brain Injury Guidelines (mBIG) were developed to improve care of traumatic brain injury (TBI) patients. The objective of this study was to assess if utilization of the mBIG by neurosurgeons would improve TBI patient throughput at a level one trauma center, particularly for patients meeting mBIG 1 criteria. The mBIG 1 criteria were safe and effective at improving low risk TBI patient throughput at a level one trauma center. Neurosurgical involvement may be beneficial to the mBIG while still facilitating significant resource savings.

    制定了修改后的脑损伤指南 (mBIG),以改善对创伤性脑损伤 (TBI) 患者的护理。这项研究的目的是评估神经外科医生使用mBIG是否会在一级创伤中心提高TBI患者的吞吐量,特别是对于符合mBIG 1标准的患者。mBIG 1标准在改善一级创伤中心的低风险TBI患者吞吐量方面是安全有效的。神经外科手术的参与可能对mBIG有益,同时仍有助于节省大量资源。

    REF: Sweeney JF, Nath K, Field NC, Harland TA, Adamo MA. Utilization of the Modified Brain Injury Guidelines by neurosurgeons to improve traumatic brain injury patient throughput at a level one trauma center: a retrospective observational study. World Neurosurg. Published online August 26, 2024. doi:10.1016/j.wneu.2024.08.098 PMID: 39197704

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