Awake Craniotomy for Eloquent Brain Arteriovenous Malformations: A Systematic Review and Individual Patient Data Meta-Analysis

清醒开颅手术治疗功能区脑动静脉畸形: 系统综述和个体患者数据的Meta分析

Arteriovenous malformations (AVMs) pose a risk of neurologic deterioration, particularly when located in eloquent areas. While awake surgery is well-established for treating low-grade gliomas near eloquent areas, its efficacy for AVMs is less conclusively reported. AC for eloquent AVMs showed promising results. A significant rate of postoperative neurological deficits was found, which was reduced at follow-up. A small mean length of hospitalization was also found. These results suggest that AC for AVMs should be considered in eloquent lesion cases.

动静脉畸形 (avm) 存在神经系统恶化的风险，尤其是位于功能区区域时。虽然清醒手术已被广泛用于治疗功能区区域附近的低级别神经胶质瘤，但其对avm的疗效尚无定论。功能区avm的AC显示出令人鼓舞的结果。发现术后神经功能缺损的发生率很高，在随访时有所降低。还发现平均住院时间短。这些结果表明，在功能区病变病例中应考虑对avm进行AC。

REF: Semione G, de Oliveira Almeida G, Lepine HL, et al. Awake Craniotomy for Eloquent Brain Arteriovenous Malformations: A Systematic Review and Individual Patient Data Meta-Analysis. World Neurosurg. 2025;195:123609. doi:10.1016/j.wneu.2024.123609 PMID: 39725290

Treatment Strategies for Intermediate Spinal Instability Neoplastic Score Patients: A Systematic Review

中度脊柱不稳肿瘤评分患者的治疗策略: 一项系统综述

The Spinal Instability Neoplastic Score (SINS) is used in determining instability in patients with spinal metastases. Intermediate scores of 7 to 12 suggest possible instability, but there are no clear guidelines to address patients with these scores. Complication rates after surgery versus radiotherapy in the intermediate SINS category are similar, but the complication types differ. Patients in the 10-12 SINS subgroup, due to larger lytic area and higher probability of vertebral body fracture, could benefit from stabilization before radiotherapy.

脊柱不稳定性肿瘤评分 (SINS) 用于确定脊柱转移瘤患者的不稳定性。7到12的中间评分表明可能的不稳定性，但是没有明确的指南来解决具有这些评分的患者。中间SINS类别中手术后与放疗后的并发症发生率相似，但并发症类型不同。10-12 SINS亚组的患者由于较大的溶解面积和较高的椎体骨折概率，可以从放疗前的稳定中受益。

REF: Okai BK, Quiceno E, Soliman MAR, et al. Treatment Strategies for Intermediate Spinal Instability Neoplastic Score Patients: A Systematic Review. World Neurosurg. 2025;195:123627. doi:10.1016/j.wneu.2024.123627 PMID: 39742915

The Role of Neuropsychology in the Management of Spinal Cord Injury: A Comprehensive Literature Review

神经心理学在脊髓损伤管理中的作用: 综合文献综述

Spinal cord injury (SCI) poses a complex set of physiological, psychological, and cognitive challenges that significantly affect an individual's quality of life. Analysis of longitudinal studies reveals that cognitive changes following SCI are often underestimated yet significantly impact patient's ability to adapt to their new circumstances. However, the role of neuropsychology in SCI management and rehabilitation is yet to be elucidated. This article offers an in-depth review of the role of neuropsychology in understanding and addressing the cognitive, emotional, and behavioral outcomes of SCI. Additionally, we delve into the emotional and psychological consequences of SCI, which can include increased stress, depression, anxiety, and potential changes in personality and social functioning. Neuropsychological assessment tools are highlighted as essential for diagnosing and monitoring these psychological shifts, aiding in the creation of personalized rehabilitation interventions. We also explore the role of neuroplasticity in cognitive rehabilitation post-SCI, emphasizing the potential of targeted cognitive training to alleviate cognitive deficits and improve adaptive functioning. The article further investigates the interplay between physical and cognitive recovery, underscoring the reciprocal relationship between motor function and cognitive improvement. In conclusion, this review emphasizes the crucial role of neuropsychology in understanding the multifaceted impact of SCI. By enhancing our comprehension of the intricate connections among neural integrity, cognitive function, and psychological well-being, neuropsychology provides valuable insights for developing holistic rehabilitation strategies that address both the cognitive and emotional challenges faced by individuals with SCI. As neurorehabilitation continues to advance, integrating neuropsychological principles offers promise for improving the overall recovery and quality of life for those affected by spinal cord injury.

脊髓损伤 (SCI) 带来了一系列复杂的生理，心理和认知挑战，这些挑战会严重影响个人的生活质量。对纵向研究的分析表明，SCI后的认知变化通常被低估，但会显着影响患者适应新环境的能力。然而，神经心理学在SCI管理和康复中的作用尚未阐明。本文对神经心理学在理解和解决SCI的认知，情感和行为结果中的作用进行了深入的回顾。此外，我们深入研究了SCI的情感和心理后果，其中可能包括压力增加，抑郁，焦虑以及人格和社会功能的潜在变化。强调神经心理学评估工具对于诊断和监测这些心理变化至关重要，有助于创建个性化的康复干预措施。我们还探讨了神经可塑性在SCI后认知康复中的作用，强调了针对性认知训练减轻认知缺陷和改善适应性功能的潜力。本文进一步研究了身体和认知恢复之间的相互作用，强调了运动功能和认知改善之间的相互关系。总之，这篇综述强调了神经心理学在理解SCI的多方面影响中的关键作用。通过增强我们对神经完整性，认知功能和心理健康之间复杂联系的理解，神经心理学为开发整体康复策略提供了有价值的见解，这些策略可以解决SCI患者面临的认知和情感挑战。随着神经康复的不断发展，整合神经心理学原理为改善脊髓损伤患者的整体康复和生活质量提供了希望。

REF: Halalmeh DR, Salama HZ, Alnajjar YA, et al. The Role of Neuropsychology in the Management of Spinal Cord Injury: A Comprehensive Literature Review. World Neurosurg. 2025;195:123679. doi:10.1016/j.wneu.2025.123679 PMID: 39805397

Accuracy, Effectiveness, and Safety of Robot-Assisted Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for Treatment of Drug-Resistant Epilepsy: A Systematic Review and Meta-Analysis

机器人辅助磁共振成像引导下激光间质热疗法治疗耐药性癫痫的准确性、有效性和安全性的系统综述和Meta分析

Robotic-assisted laser interstitial thermal therapy (LITT) is a minimally invasive method for ablating seizure foci and has gained prominence in epilepsy treatment. The use of robotic guidance in these procedures can minimize errors in probe placement, potentially leading to better clinical outcomes. In this meta-analysis, we assessed the accuracy, safety, and effectiveness of robot-assisted LITT for drug-resistant epilepsy. Robot-assisted LITT offers high precision, positive seizure outcomes, and minimal complications, comparable to nonrobotic methods, and is suitable for treating drug-resistant epilepsy with multiple lesions.

机器人辅助激光间质热疗法 (LITT) 是一种消融癫痫发作灶的微创方法，在癫痫治疗中已得到重视。在这些程序中使用机器人引导可以最小化探针放置的误差，潜在地导致更好的临床结果。在这项荟萃分析中，我们评估了机器人辅助LITT治疗耐药性癫痫的准确性，安全性和有效性。与非机器人方法相比，机器人辅助的LITT具有高精度，积极的癫痫发作结果和最小的并发症，适用于治疗多病灶的耐药性癫痫。

REF: Soltani Khaboushan A, Afrooghe A, Ahmadi E, et al. Accuracy, Effectiveness, and Safety of Robot-Assisted Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for Treatment of Drug-Resistant Epilepsy: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;195:123640. doi:10.1016/j.wneu.2024.123640 PMID: 39827953

Meta-Analysis of the Clinical Efficacy and Safety of Unilateral Biportal Endoscopic Lumbar Interbody Fusion versus Endoscopic Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases

单侧双孔镜下腰椎椎间融合术与内镜下腰椎椎间融合术治疗腰椎退行性疾病临床疗效及安全性的Meta分析

To compare the efficacy and safety of unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF) and endoscopic lumbar interbody fusion (Endo-LIF) in the treatment of lumbar degenerative diseases. Postoperative pain and safety were comparable between the two endoscopic procedures.The UBE-LIF procedure was shorter, whereas the Endo-LIF had less TBL and a shorter recovery time.

比较单侧双孔内窥镜腰椎间融合术 (ube-lif) 和内窥镜腰椎间融合术 (endo-lif) 治疗腰椎退行性疾病的疗效和安全性。两种内窥镜手术的术后疼痛和安全性相当。ube-lif手术时间较短，而endo-lif手术的TBL较少，恢复时间较短。

REF: Li X, Qu Y, Zhou L, Zhou Y, Peng B, Duo J. Meta-Analysis of the Clinical Efficacy and Safety of Unilateral Biportal Endoscopic Lumbar Interbody Fusion versus Endoscopic Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases. World Neurosurg. 2025;195:123662. doi:10.1016/j.wneu.2025.123662 PMID: 39798788

Vertebral Augmentation plus Pedicle Screw Fixation versus Vertebral Augmentation Alone in the Treatment of Osteoporotic Thoracolumbar Fractures: A Meta-Analysis

椎体强化加椎弓根螺钉内固定与单纯椎体强化治疗骨质疏松性胸腰椎骨折的Meta分析

This meta-analysis was conducted to compare the efficacy and safety of vertebral augmentation (VA) plus pedicle screw fixation (PSF) with VA for treating osteoporotic thoracolumbar fractures (OTLFs). PSF + VA was superior to VA for the VAS score, ODI, Cobb angle, AVH, and complications, especially in the long-term follow-up. However, more operation time, blood loss, and length of stay were the disadvantages for PSF + VA.

本meta分析旨在比较椎体强化 (VA) 加椎弓根螺钉内固定 (PSF) 与VA治疗骨质疏松性胸腰椎骨折 (OTLFs) 的疗效和安全性。PSF VA在VAS评分、ODI、Cobb角、AVH及并发症方面均优于VA，尤其是在长期随访中。然而，更多的手术时间，失血和住院时间是PSF VA的缺点。

REF: Yan W, Song H, Cao W, Ma D, Sun M. Vertebral Augmentation plus Pedicle Screw Fixation versus Vertebral Augmentation Alone in the Treatment of Osteoporotic Thoracolumbar Fractures: A Meta-Analysis. World Neurosurg. 2025;195:123688. doi:10.1016/j.wneu.2025.123688 PMID: 39827956

Balancing the Scalpel and the Heart: A Neurosurgeon's Guide to Empathy

平衡手术刀和心脏: 神经外科医生的移情指南

Empathy is a basic core human characteristic, the foundation for social relationships and interpersonal attachment. In medicine, particularly in neurosurgery, empathy goes beyond the concept of clinical neutrality and emerges as a guiding philosophy to form patient-centered care. Neurosurgical patients, who are often handling complex, life-changing pathologies, benefit greatly from empathetic reassurances that diminish their anxiety and establish a more robust patient-clinician connection. However, constructs of modern healthcare that undermine empathy include the very high value placed on time, oppressive workloads, inadequate staffing, and performance-driven cultures that can reduce compassion to nothing more than a secondary concern. The evidence underscores that empathy helps to improve patient satisfaction, treatment adherence, and development of strong therapeutic alliances. An empathic practice also helps the clinician in being protective against burnout, building emotional resilience, and the induction of reflection in self-assessment-all beneficial for his or her mental health. Indeed, another obvious and serious decrease in empathy has been detected with the increasing years of training in trainees and practitioners, as well as in clinical environments. The institutions need to have adequate staffing, the best flow processes, and empathetic leadership from the front, really prioritizing emotional well-being. Teaching empathy in medical school and during residency is critical, so our future physicians understand its importance. Empathy is further consolidated by ongoing professional training in communication skills and emotional intelligence and self-care strategies. Neurosurgery, as a high-demand and tough surgical discipline, can benefit the most from a culture of empathy.

移情是人类的基本核心特征，是社会关系和人际依恋的基础。在医学中，特别是在神经外科中，同理心超越了临床中立的概念，并成为形成以患者为中心的护理的指导思想。神经外科患者通常会处理复杂的，改变生活的病理，他们可以从移情的保证中受益匪浅，从而减少他们的焦虑并建立更强大的患者与临床医生的联系。然而，破坏同理心的现代医疗保健结构包括对时间的高度重视，压迫性的工作量，人员配备不足以及绩效驱动的文化，这些文化可以将同情心减少到次要问题。证据强调，同理心有助于提高患者满意度，治疗依从性和发展强大的治疗联盟。移情实践还有助于临床医生防止倦怠，建立情绪弹性，并在自我评估中诱导反思-所有这些都有利于他或她的精神卫生。实际上，随着对受训者和从业者以及临床环境的培训年限的增加，已经发现了同理心的另一个明显和严重的下降。这些机构需要有足够的人员配备，最好的流程，以及来自前线的善解人意的领导，真正优先考虑情绪健康。在医学院和住院期间教授同理心至关重要，因此我们未来的医生了解其重要性。通过不断进行的沟通技巧，情商和自我保健策略的专业培训，进一步巩固了同理心。神经外科作为一门高要求和艰难的外科学科，可以从移情文化中受益最大。

REF: Khan MM, Ali A, Elbadway M, et al. Balancing the Scalpel and the Heart: A Neurosurgeon's Guide to Empathy. World Neurosurg. 2025;195:123703. doi:10.1016/j.wneu.2025.123703 PMID: 39855547

Robotic Systems in Spinal Surgery: A Review of Accuracy, Radiation Exposure, Hospital Readmission Rate, Cost, and Adverse Events

脊柱手术中的机器人系统: 准确性，辐射暴露，再入院率，成本和不良事件的回顾

Recent advances within the last decade have allowed robotics to become commonplace in the operating room. In the field of neurosurgery, robotics assist surgeons in pedicle screw placement and vertebral fusion procedures. The purpose of this review is to look at currently used spinal robots available in the market and compare their overall accuracy, cost, radiation exposure, general adverse events, and hospital readmission rates. This review summarizes the findings comparing the individual robotic systems and their comparison to freehand surgery. As robotics become more popular in clinical practice, additional research is needed to assist hospitals and surgeons in making an informed decision about implementing robotics in spinal surgery.

过去十年的最新进展使机器人技术在手术室中变得司空见惯。在神经外科领域，机器人技术协助外科医生进行椎弓根螺钉放置和椎骨融合手术。这篇综述的目的是研究市场上目前使用的脊柱机器人，并比较它们的总体准确性，成本，辐射暴露，一般不良事件和再入院率。这篇综述总结了比较各个机器人系统及其与徒手手术的比较的发现。随着机器人技术在临床实践中越来越受欢迎，需要进行更多的研究来协助医院和外科医生做出有关在脊柱手术中实施机器人技术的明智决定。

REF: Haik NV, Burgess AE, Talbot NC, et al. Robotic Systems in Spinal Surgery: A Review of Accuracy, Radiation Exposure, Hospital Readmission Rate, Cost, and Adverse Events. World Neurosurg. 2025;195:123721. doi:10.1016/j.wneu.2025.123721 PMID: 39864806

Spinal Metastasis Secondary to Salivary Gland Malignancy: Systematic Review of the Literature with an Illustrative Case Report

继发于唾液腺恶性肿瘤的脊柱转移: 文献系统综述与说明性病例报告

Spinal metastasis from salivary gland malignancies is a rare clinical entity with only several reports in the literature. There is no clear guidance for its optimal management. Spinal metastasis from salivary gland malignancies necessitates a comprehensive and multidisciplinary treatment approach due to the complex nature and variability in presentation. Long-term follow-up is essential for early detection and management of spinal metastases given the extended latency period observed in many cases. The potential for metastasis is not solely dependent on tumor grade, emphasizing the need for ongoing vigilance in all patients with salivary gland malignancies.

唾液腺恶性肿瘤的脊柱转移是一种罕见的临床实体，文献中只有几篇报道。对其优化管理没有明确的指导。由于唾液腺恶性肿瘤的复杂性和表现的可变性，因此需要采用综合，多学科的治疗方法。鉴于在许多情况下观察到的潜伏期延长，长期随访对于早期发现和管理脊柱转移至关重要。转移的可能性不仅仅取决于肿瘤的分级，强调需要对所有患有唾液腺恶性肿瘤的患者保持警惕。

REF: Ameen D, Gujjari KS, Chen BY, Toomey F, Kam J, Sher I. Spinal Metastasis Secondary to Salivary Gland Malignancy: Systematic Review of the Literature with an Illustrative Case Report. World Neurosurg. 2025;195:123715. doi:10.1016/j.wneu.2025.123715 PMID: 39889960