Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion with an Expandable Cage for the Treatment of Degenerative Lumbar Spinal Stenosis with Instability

经皮内镜下椎间孔入路腰椎椎间融合术联合可扩张椎间融合器治疗伴有不稳的退变性腰椎管狭窄症

To evaluate the safety and efficacy of percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) with an expandable cage for the treatment of single-level degenerative lumbar spinal stenosis (LSS) with instability. For patients with single-level LSS with instability, PE-TLIF with an expandable cage under conscious sedation and local anesthesia potentially represents an effective method for treating degenerative LSS with instability.

评估使用可扩张椎间融合器的经皮内镜下经椎间孔腰椎椎间融合术（PE - TLIF）治疗单节段退变性腰椎管狭窄症（LSS）伴不稳的安全性和有效性。对于单节段LSS伴不稳的患者，在清醒镇静和局部麻醉下使用可扩张椎间融合器的PE - TLIF有可能是治疗退变性LSS伴不稳的一种有效方法。

REF: Cheng X, Chen Q, Chen B, Tang J. Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion with an Expandable Cage for the Treatment of Degenerative Lumbar Spinal Stenosis with Instability. World Neurosurg. 2025;197:123876. doi:10.1016/j.wneu.2025.123876 PMID: 40058629

Neuroprotective Effects of Halofuginone in Rat's Sciatic Nerve Injury

卤夫酮对大鼠坐骨神经损伤的神经保护作用

The object of the present study was to investigate the neuroprotective effects of halofuginone-with its antifibrotic and anti-inflammatory effects-on peripheral nerve injuries frequently encountered in daily life, at the functional, pathological, and cellular levels through the use of electron microscopy. Halofuginone has peripheral nerve protective effects on a rat peripheral nerve injury model.

本研究的目的是通过电子显微镜，从功能、病理和细胞水平研究具有抗纤维化和抗炎作用的卤夫酮对日常生活中常见的周围神经损伤的神经保护作用。卤夫酮对大鼠周围神经损伤模型具有周围神经保护作用。

REF: Şahin Ö, Taşcıoğlu T, Fırat A, Sürücü HS, Çaydere M, Cemil DB. Neuroprotective Effects of Halofuginone in Rat's Sciatic Nerve Injury. World Neurosurg. 2025;197:123877. doi:10.1016/j.wneu.2025.123877 PMID: 40058633

Does Simpson 1 Resection of Spinal Meningiomas Lead to Lower Tumor Relapse or Increase of CSF Leaks? A 40-year Single-Center Experience

脊髓脑膜瘤辛普森 1 级切除是否会降低肿瘤复发率或增加脑脊液漏发生率？一项单中心 40 年的经验总结

To evaluate the risk of tumor relapse after Simpson grade 1 resection of spinal meningiomas compared to other Simpson grades. Furthermore, to evaluate incidence of cerebrospinal fluid (CSF) leak after resection of affected dura and use of a patch for dural repair. Gross total resection including the affected dura may reduce the risk of tumor relapse and is not associated with a higher rate of CSF leaks in dorsal spinal meningiomas. Resection of only the inner dural layer is a valid alternative to achieve Simpson 1 resection.

评估脊髓脑膜瘤辛普森1级切除与其他辛普森分级切除相比的肿瘤复发风险。此外，评估切除受累硬脑膜并使用补片进行硬脑膜修复后脑脊液漏的发生率。全切除包括受累硬脑膜可能降低肿瘤复发风险，且对于脊髓背侧脑膜瘤而言，不会增加脑脊液漏的发生率。仅切除硬脑膜内层是实现辛普森1级切除的一种有效替代方法。

REF: Hirschmann D, Hölz M, Kucinska G, Hofbauer M, Herta J, Millesi M. Does Simpson 1 Resection of Spinal Meningiomas Lead to Lower Tumor Relapse or Increase of CSF Leaks? A 40-year Single-Center Experience. World Neurosurg. 2025;197:123857. doi:10.1016/j.wneu.2025.123857 PMID: 40054842

Repeat Microvascular Decompression for Recurrent Trigeminal Neuralgia

复发性三叉神经痛的再次微血管减压术

Trigeminal neuralgia (TN) is described as the most excruciating pain typically involving the face. Microvascular decompression is regarded as the established method of treatment of the condition. We aimed to detect the underlying disease in patients with recurrent TN, to prevent the recurrence rate of the patients and to determine the difficulties encountered during surgery. This study shows that detailed arachnoid dissection and efficient Teflon volume are crucial for the successful treatment of TN. To prevent recurrence, surgical landmarks, anatomic parameters, techniques, and Teflon volume should be planned specifically.

三叉神经痛（TN）被描述为最剧烈的疼痛，通常累及面部。微血管减压术被认为是治疗该病的既定方法。我们的目的是找出复发性三叉神经痛患者的潜在病因，降低患者的复发率，并明确手术中遇到的困难。本研究表明，细致的蛛网膜分离和合适的特氟龙用量对三叉神经痛的成功治疗至关重要。为防止复发，应专门规划手术标志、解剖参数、手术技术和特氟龙用量。

REF: Aydin L, Copur S, Kartum TA, Urgan C, Ozdemir B, Yilmaz A. Repeat Microvascular Decompression for Recurrent Trigeminal Neuralgia. World Neurosurg. 2025;197:123854. doi:10.1016/j.wneu.2025.123854 PMID: 40054848

“Floating Island” Technique: Case Series of a Novel Technique for Surgical Management of Interdigitating Calcified Thoracic Disc Herniations

“浮岛”技术：一种用于手术治疗交错钙化胸椎间盘突出症的新技术病例系列

The objective of this study was to describe the use of a novel approach, the "floating island" technique, to surgically address calcified thoracic disc herniation (cTDH) that interdigitates with adjacent dura and to report clinical and radiographic outcomes of patients. The floating island technique offers a promising option for the surgical management of interdigitating cTDH, demonstrating excellent immediate radiographic and long-term clinical outcomes. Further studies are needed to validate these findings and determine the technique's generalizability.

本研究的目的是描述一种新型方法——“浮岛”技术在手术治疗与相邻硬脑膜交错的钙化性胸椎间盘突出症（cTDH）中的应用，并报告患者的临床和影像学结果。“浮岛”技术为交错型 cTDH 的手术治疗提供了一种有前景的选择，显示出优异的即时影像学和长期临床效果。需要进一步的研究来验证这些发现并确定该技术的可推广性。

REF: Alan N, O'Neill LK, Farber SH, et al. "Floating Island" Technique: Case Series of a Novel Technique for Surgical Management of Interdigitating Calcified Thoracic Disc Herniations. World Neurosurg. 2025;197:123861. doi:10.1016/j.wneu.2025.123861 PMID: 40058634

Extended Resection of Cavernous Sinus Medial Wall Improves Remission Rates in Somatotroph Pituitary Neuroendocrine Tumors: A Strategy to Inspect Anatomical Interface

海绵窦内侧壁扩大切除可提高生长激素细胞型垂体神经内分泌肿瘤的缓解率：一种检查解剖界面的策略

Somatotroph pituitary neuroendocrine tumors (PitNETs) represent one of the most prevalent functional pituitary adenoma subtypes. Achieving biochemical remission has been established as the primary determinant for improving quality of life in affected patients. Nevertheless, current clinical outcomes demonstrate suboptimal remission rates in cases of invasive somatotroph PitNETs, predominantly attributable to cavernous sinus invasion and postoperative residual lesions. Our retrospective cohort study reveals that intraoperative identification of occult tumor invasion combined with extended resection of the medial wall of the cavernous sinus (MWCS) significantly enhances biochemical control rates. The purpose of this study was to investigate the therapeutic efficacy of extended resection of the cavernous sinus medial wall and summarize the current application status of this surgical strategy on somatotroph PitNETs. In somatotroph PitNETs, intraoperative identification of occult invasion combined with extended resection of MWCS significantly improved biochemical remission rates, particularly in Knosp grade 3-4 subgroups. And this selective approach maintained a surgically validated safety profile without increasing overall surgical morbidity. However, MWCS resection should be judiciously avoided in lesions with intact pseudocapsular integrity or circumscribed by a normal pituitary gland.

生长激素细胞型垂体神经内分泌肿瘤（PitNETs）是最常见的功能性垂体腺瘤亚型之一。实现生化缓解已被确立为改善患者生活质量的主要决定因素。然而，目前的临床结果显示，侵袭性生长激素细胞型PitNETs的缓解率不理想，这主要归因于海绵窦侵袭和术后残留病灶。我们的回顾性队列研究表明，术中识别隐匿性肿瘤侵袭并联合扩大切除海绵窦内侧壁（MWCS）可显著提高生化控制率。本研究旨在探讨扩大切除海绵窦内侧壁的治疗效果，并总结该手术策略在生长激素细胞型PitNETs中的当前应用情况。在生长激素细胞型PitNETs中，术中识别隐匿性侵袭并联合扩大切除MWCS可显著提高生化缓解率，尤其是在克诺斯（Knosp）分级为3 - 4级的亚组中。并且这种选择性手术方法在不增加总体手术发病率的情况下，保证了手术安全性。然而，对于假包膜完整或被正常垂体组织包绕的病变，应谨慎避免切除MWCS。

REF: Tian L, Liu M, Luo M, et al. Extended Resection of Cavernous Sinus Medial Wall Improves Remission Rates in Somatotroph Pituitary Neuroendocrine Tumors: A Strategy to Inspect Anatomical Interface. World Neurosurg. 2025;197:123883. doi:10.1016/j.wneu.2025.123883 PMID: 40064350

Causal Associations of Brain Imaging-Derived Phenotypes and Intracranial Aneurysm: A Bidirectional Mendelian Randomization Study

脑影像学衍生表型与颅内动脉瘤的因果关联：一项双向孟德尔随机化研究

Intracranial aneurysms (IAs) represent a significant and potentially fatal category of cerebrovascular disorders that pose serious health risks. Observational studies have indicated a potential link between brain imaging-derived phenotypes (IDPs) and various IAs. Nonetheless, the nature of these relationships remains ambiguous. The findings indicate that these IDPs play a crucial role in the etiology of these IAs and highlight the importance of understanding the mechanisms through which they exert their effects.

颅内动脉瘤（IAs）是一类严重且可能致命的脑血管疾病，会对健康构成严重威胁。观察性研究表明，大脑影像衍生表型（IDPs）与各类颅内动脉瘤之间可能存在关联。然而，这些关联的本质仍不明确。研究结果显示，这些影像衍生表型在颅内动脉瘤的病因学中起着关键作用，并强调了理解其作用机制的重要性。

REF: Wu X, Wan X, Tang Y, et al. Causal Associations of Brain Imaging-Derived Phenotypes and Intracranial Aneurysm: A Bidirectional Mendelian Randomization Study. World Neurosurg. 2025;197:123881. doi:10.1016/j.wneu.2025.123881 PMID: 40058632

Safety and Feasibility of Transabdominal Muscle Action Potential Monitoring in Lateral Lumbar Surgery

侧路腰椎手术中经腹肌肉动作电位监测的安全性和可行性

Neuromonitoring has improved since its advent in the 20th century, but technological innovations can potentially become furthermore specific and perform advanced analyses to prevent nerve injury. TMAP during lumbar spine surgery is feasible and safe for patients being treated for lumbar degenerative disease, while avoiding some of the drawbacks of transcranial motor evoked potentials. Additional studies are needed to assess clinical correlation between TMAP monitoring and patient outcome.

自神经监测技术在20世纪问世以来已有改进，但技术创新有可能进一步实现精准化，并开展高级分析以预防神经损伤。腰椎手术中的经皮电刺激运动诱发电位（TMAP）对于接受腰椎退行性疾病治疗的患者而言是可行且安全的，同时还能避免经颅运动诱发电位的一些缺点。需要开展更多研究来评估TMAP监测与患者预后之间的临床相关性。

REF: Khajavi K, Youssef J, Eastlack RK, Balzer JR, Niznik G, Smith W. Safety and Feasibility of Transabdominal Muscle Action Potential Monitoring in Lateral Lumbar Surgery. World Neurosurg. 2025;197:123878. doi:10.1016/j.wneu.2025.123878 PMID: 40058639

Morphometric Evaluation of Posterior Fossa in Patients Operated Due to Chiari Malformation Type 2

因2型Chiari畸形接受手术治疗患者后颅窝的形态计量学评估

Chiari malformation type 2 (CMII) is a herniation of anatomical structures of the posterior fossa due to myelomeningocele (MMC), the most common neural tube defect. Most patients with MMC exhibit radiologic signs of CMII. The study aimed to evaluate radiological parameters of the posterior fossa in patients undergoing surgery for CMII, with the goal of establishing structural indications for surgical treatment to prevent clinical manifestations and life-threatening symptoms. The depth of the tonsillar herniation may not be the most viable finding influencing operative indication due to its dependency on the length of the McRae line. A small amount of CSF at the level of foramen magnum also should not necessarily be considered an early sign of syringomyelia. Ventriculoperitoneal shunt implantation seems not to influence the depth of tonsillar herniation.

2型Chiari畸形（CMII）是因脊髓脊膜膨出（MMC）（最常见的神经管缺陷）导致的后颅窝解剖结构疝出。大多数脊髓脊膜膨出患者有CMII的影像学表现。本研究旨在评估接受CMII手术治疗患者的后颅窝影像学参数，以期为手术治疗确立结构性指征，从而预防临床表现和危及生命的症状。由于扁桃体疝深度依赖于McRae线的长度，它可能并非影响手术指征的最可靠指标。枕骨大孔水平脑脊液少量存在也不一定应被视为脊髓空洞症的早期征象。脑室腹腔分流术植入似乎并不影响扁桃体疝的深度。

REF: Milczarek O, Kuzaj J, Bębenek A, et al. Morphometric Evaluation of Posterior Fossa in Patients Operated Due to Chiari Malformation Type 2. World Neurosurg. 2025;197:123853. doi:10.1016/j.wneu.2025.123853 PMID: 40054844