Clinical Effect of Ventricular Entry During Resection of Isocitrate Dehydrogenase-Wildtype Glioblastoma: A Multi-Institutional Analysis

异柠檬酸脱氢酶-野生型胶质母细胞瘤切除术中心室进入的临床效果: 多机构分析

Glioblastomas contacting the subventricular zone (SVZ) are associated with poor prognosis, and the impact of ventricular entry (VE) during resection remains controversial. Since glioblastomas with SVZ involvement often require VE, both SVZ involvement and VE are confounding factors. This study aimed to evaluate the effect of VE during glioblastoma resection by comparing patients with and without SVZ involvement. VE during glioblastoma resection does not impact complications or nonlocal recurrence. Surgeons may safely perform VE during resection of both SVZ and non-SVZ glioblastomas without adverse effects.

接触脑室下区 (SVZ) 的胶质母细胞瘤与预后不良有关，切除过程中心室进入 (VE) 的影响仍存在争议。由于SVZ受累的胶质母细胞瘤通常需要VE，因此SVZ受累和VE都是混杂因素。这项研究旨在通过比较有和没有SVZ参与的患者来评估VE在胶质母细胞瘤切除术中的作用。胶质母细胞瘤切除术中的VE不会影响并发症或非局部复发。外科医生可以在SVZ和非SVZ胶质母细胞瘤的切除过程中安全地进行VE，而不会产生不良影响。

REF: Shimoda Y, Shibahara I, Kanamori M, et al. Clinical Effect of Ventricular Entry During Resection of Isocitrate Dehydrogenase-Wildtype Glioblastoma: A Multi-Institutional Analysis. World Neurosurg. 2025;195:123643. doi:10.1016/j.wneu.2024.123643 PMID: 39793731

Use of the Neutrophil-to-Lymphocyte Ratio Improves the Accuracy of Outcome Prediction in Patients with Acute Traumatic Subdural Hematoma Undergoing Surgical Treatment

使用中性粒细胞与淋巴细胞比率可提高接受手术治疗的急性外伤性硬膜下血肿患者预后预测的准确性

Traumatic brain injury is a major cause of disability and mortality worldwide. Acute traumatic subdural hematoma (TSDH) accounts for a large proportion of all traumatic brain injury cases. However, factors to predict postoperative prognosis in patients with acute TSDH are limited. Recently, it has been reported that inflammatory markers increase the accuracy of prognosis in various diseases. The neutrophil-to-lymphocyte ratio (NLR) is a marker for inflammation, which is easy to test, inexpensive, and can be performed quickly. However, the prognostic value of NLR in patients with acute TSDH remains controversial. This study therefore aimed to assess the predictive value of the admission and postoperative NLR in patients with acute TSDH who underwent surgical treatment. Initial NLR was not strongly associated with 1-month mortality in patients with acute TSDH who underwent surgery. However, the postoperative 48-hour NLR was associated with 1-month mortality.

创伤性脑损伤是全世界残疾和死亡的主要原因。急性外伤性硬膜下血肿 (TSDH) 占所有创伤性脑损伤病例的很大比例。然而，预测急性TSDH患者术后预后的因素有限。最近，已经报道炎性标志物增加了各种疾病的预后的准确性。中性粒细胞与淋巴细胞比率 (NLR) 是炎症的标志物，易于测试，廉价且可以快速进行。然而，NLR在急性TSDH患者中的预后价值仍存在争议。因此，本研究旨在评估接受手术治疗的急性TSDH患者入院和术后NLR的预测价值。初始NLR与接受手术的急性TSDH患者的1个月死亡率没有强相关性。然而，术后48小时NLR与1个月死亡率相关。

REF: Hong SP, Woo JB, Kim HY. Use of the Neutrophil-to-Lymphocyte Ratio Improves the Accuracy of Outcome Prediction in Patients with Acute Traumatic Subdural Hematoma Undergoing Surgical Treatment. World Neurosurg. 2025;195:123642. doi:10.1016/j.wneu.2024.123642 PMID: 39755151

Mapping Theme Trends and Recognizing Hot Spots in Acute Spinal Cord Injury: A Bibliometric Analysis

绘制急性脊髓损伤的主题趋势和识别热点: 文献计量学分析

Acute spinal cord injury causes severe motor and sensory dysfunction, significantly burdening individuals and society. This study uses bibliometric analysis to identify research trends and key areas, providing insights for future advancements in treatment. Our study reveals substantial growth in acute spinal cord injury research over the past 2 decades, emphasizing leading countries, researchers, institutions, and journals. Animal models remain pivotal in drug development for basic medicine and neuroscience. Consensus has been reached among experts regarding the timing of surgical intervention, while artificial intelligence and multidisciplinary approaches are emerging as promising avenues for comprehensive treatment. Additionally, ongoing research into spinal cord injury pathophysiology provides essential guidance for pharmacological and surgical treatments.

急性脊髓损伤会导致严重的运动和感觉功能障碍，给个人和社会带来沉重负担。本研究使用文献计量分析来确定研究趋势和关键领域，为未来治疗的进步提供见解。我们的研究揭示了在过去的20年中，急性脊髓损伤研究的大幅增长，强调了领先的国家，研究人员，机构和期刊。动物模型在基础医学和神经科学的药物开发中仍然至关重要。专家们已经就手术干预的时机达成了共识，而人工智能和多学科方法正在成为全面治疗的有希望的途径。此外，正在进行的脊髓损伤病理生理学研究为药物和手术治疗提供了必要的指导。

REF: Ma W, Guo R, Hu W. Mapping Theme Trends and Recognizing Hot Spots in Acute Spinal Cord Injury: A Bibliometric Analysis. World Neurosurg. 2025;195:123648. doi:10.1016/j.wneu.2024.123648 PMID: 39778628

Understanding Chinese Early-Career Neurosurgeons' Professional Identity Construction as Clinician-Researchers

理解中国早期职业神经外科医生作为临床研究人员的职业认同建构

Medical professionals with both M.D. and Ph.D. degrees are increasingly expected to balance roles as clinicians and researchers, a trend particularly prevalent in China. However, little is known about how early-career Chinese neurosurgeons navigate these dual responsibilities. This study sheds light on the complexities of professional identity construction among early-career Chinese neurosurgeons. Implications for international neurosurgeons include the need for tailored mentoring and institutional support. Limitations include the small sample size and regional focus. Future research could explore cross-cultural comparisons to further understand clinician-researcher identities.

拥有医学博士学位和博士学位的医学专业人士越来越被期望平衡临床医生和研究人员的角色，这一趋势在中国尤为普遍。然而，对于早期职业的中国神经外科医生如何应对这些双重责任知之甚少。这项研究揭示了中国早期神经外科医生职业认同建构的复杂性。对国际神经外科医生的影响包括需要量身定制的指导和机构支持。局限性包括样本量小和区域重点。未来的研究可以探索跨文化比较，以进一步了解临床医生-研究人员的身份。

REF: Zhang YW, Li AW. Understanding Chinese Early-Career Neurosurgeons' Professional Identity Construction as Clinician-Researchers. World Neurosurg. 2025;195:123645. doi:10.1016/j.wneu.2024.123645 PMID: 39756543

Presurgical Embolization of Meningiomas: Analysis of Safety and Efficacy in a Mexican National Center and Proposal for a Classification of Preoperative Embolization of Meningiomas Based on Embolic Agent Penetration

脑膜瘤的术前栓塞: 墨西哥国家中心的安全性和有效性分析以及基于栓塞剂渗透的脑膜瘤术前栓塞分类的建议

Meningiomas are the most common primary central nervous system tumors, often requiring surgical resection. Presurgical embolization (PSE) is used to reduce intraoperative bleeding, although its effectiveness varies. This study evaluates the safety and efficacy of PSE using ethyl-vinyl alcohol (EVOH) in meningioma surgeries. PSE using EVOH significantly decreases surgical bleeding and time in meningioma resections without associated complications. The proposed PSE grading system (Preoperative Embolization of Meningiomas, Mexican Classification) may enhance the predictability of intraoperative bleeding control. While we acknowledge the relatively small sample size of 48 cases, we believe this study serves as a foundation to encourage the inclusion of more patients and collaboration with additional centers, aiming to further validate and standardize the classification.

脑膜瘤是最常见的原发性中枢神经系统肿瘤，通常需要手术切除。术前栓塞 (PSE) 用于减少术中出血，尽管其效果各不相同。这项研究评估了在脑膜瘤手术中使用乙基乙烯醇 (EVOH) 进行PSE的安全性和有效性。使用EVOH的PSE显着减少了脑膜瘤切除术中的手术出血和时间，而没有相关的并发症。拟议的PSE分级系统 (脑膜瘤术前栓塞，墨西哥分类) 可能会增强术中出血控制的可预测性。虽然我们承认48例病例的样本量相对较小，但我们相信这项研究是鼓励纳入更多患者并与其他中心合作的基础，旨在进一步验证和标准化分类。

REF: de Jesús Gutiérrez-Baños J, Castillo-Rangel C, Ivan Rodriguez-Pereira M, et al. Presurgical Embolization of Meningiomas: Analysis of Safety and Efficacy in a Mexican National Center and Proposal for a Classification of Preoperative Embolization of Meningiomas Based on Embolic Agent Penetration. World Neurosurg. 2025;195:123663. doi:10.1016/j.wneu.2025.123663 PMID: 39800159

Hyponatremia Incidence After Subarachnoid Hemorrhage and Association with Outcomes: Systematic Review and Meta-Analysis

蛛网膜下腔出血后低钠血症发生率及其与预后的关系: 系统综述和荟萃分析

Hyponatremia after aneurysmal subarachnoid hemorrhage (aSAH) is common; however, the incidence, and association with vasospasm, morbidity, and mortality, has yet to be defined. We aimed to identify incidence of hyponatremia after aSAH, and quantify its association with measurable outcomes. Hyponatremia is common in aSAH, may increase the likelihood of vasospasm, but in isolation does not appear to affect overall outcomes. Managing hyponatremia effectively should be a priority for treating clinicians.

动脉瘤性蛛网膜下腔出血 (aSAH) 后的低钠血症很常见; 然而，其发生率以及与血管痉挛，发病率和死亡率的关系尚未确定。我们旨在确定aSAH后低钠血症的发生率，并量化其与可测量结果的相关性。低钠血症在aSAH中很常见，可能会增加血管痉挛的可能性，但在隔离中似乎不会影响总体结果。有效管理低钠血症应该是治疗临床医生的优先事项。

REF: Gillespie CS, Mihaela-Vasilica A, Dhaliwal J, et al. Hyponatremia Incidence After Subarachnoid Hemorrhage and Association with Outcomes: Systematic Review and Meta-Analysis. World Neurosurg. 2025;195:123616. doi:10.1016/j.wneu.2024.123616 PMID: 39732459

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 regard 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. 2025;195:123515. 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. 2025;195:123506. doi:10.1016/j.wneu.2024.11.089 PMID: 39603457

Conventional Radiotherapy Timing and Wound Complication Avoidance After Surgery for Metastatic Spine Disease. A LatAm Modified Delphi Study

转移性脊柱疾病手术后常规放疗时机和伤口并发症的避免。LatAm改进的Delphi研究

Combining surgery and radiotherapy is the gold standard in treating spinal metastasis when spinal stabilization or surgical decompression is required. Determining the optimal timing for radiotherapy postsurgery is crucial to balance treatment efficacy minimizing wound complications. The study aimed to identify consensus and nonconsensus areas among Latin American spinal surgeons regarding the use, timing, risks, and surgical approach to conventional external beam radiotherapy (cEBRT) following spinal surgery for metastases, specifically focusing on the risk of radiotherapy-related wound complications. We report strong agreements among the experts on important issues such as waiting times and risk factors for cEBRT. The findings underscore the significance of considering factors such as, spinal levels, surgical approaches, and sutures when making clinical decisions.

当需要脊柱稳定或手术减压时，手术和放疗相结合是治疗脊柱转移的金标准。确定术后放疗的最佳时机对于平衡治疗效果，最大程度地减少伤口并发症至关重要。该研究旨在确定拉丁美洲脊柱外科医生在脊柱转移手术后常规外照射放疗 (cEBRT) 的使用、时机、风险和手术方法方面的共识和非共识领域，特别是关注放疗相关伤口并发症的风险。我们报告了专家之间在重要问题上的强烈共识，例如cEBRT的等待时间和风险因素。研究结果强调了在做出临床决策时考虑诸如脊柱水平，手术方法和缝合线等因素的重要性。

REF: Landriel F, White K, Padilla Lichtenberger F, et al. Conventional Radiotherapy Timing and Wound Complication Avoidance After Surgery for Metastatic Spine Disease. A LatAm Modified Delphi Study. World Neurosurg. 2025;195:123575. doi:10.1016/j.wneu.2024.123575 PMID: 39681260