En Bloc Spondylectomy versus Separation Surgery for Spinal Metastases: A Systematic Review and Meta-Analysis

整块脊椎切除术与分离手术治疗脊柱转移瘤的系统评价和荟萃分析

Two main surgical techniques to treat spinal metastases are available: 1) en bloc spondylectomy, involving complete resection of the affected vertebrae, and 2) separation surgery with partial debulking followed by stereotactic body therapy (SBRT). Comparative outcomes between these approaches have not been well studied. Outcomes are comparable between en bloc spondylectomy and separation surgery with SBRT for spinal metastases, but en bloc techniques lead to a higher complication rate. Additional rigorous comparative effectiveness research is needed to refine patient selection criteria for these invasive procedures.

目前有两种主要的手术技术可用于治疗脊柱转移瘤：1）整块脊椎切除术，即切除受影响的椎体；2）分离手术联合部分肿瘤减瘤术，随后进行立体定向体部放疗（SBRT）。这两种方法的对比效果尚未得到充分研究。对于脊柱转移瘤，整块脊椎切除术和分离手术联合SBRT的治疗效果相当，但整块切除技术的并发症发生率更高。需要开展更多严格的对比有效性研究，以完善这些侵入性手术的患者选择标准。

REF: AlMekkawi AK, Bhojane A, Edelbach B, et al. En Bloc Spondylectomy versus Separation Surgery for Spinal Metastases: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;200:124129. doi:10.1016/j.wneu.2025.124129 PMID: 40449839

Risk Factors for Delayed Facial Palsy Following Microvascular Decompression in Hemifacial Spasm: A Systematic Review and Meta-Analysis

面肌痉挛微血管减压术后迟发性面瘫的危险因素：系统评价与Meta分析

Delayed facial palsy (DFP) remains a significant postoperative complication following microvascular decompression (MVD) for hemifacial spasm. However, the underlying mechanisms of DFP remain unclear. This study aimed to determine the incidence, duration, and latency of DFP onset following MVD. A secondary objective was to identify risk factors associated with DFP in this context. DFP is a relatively common complication after MVD, and facial nerve indentation, prolonged disease duration, and the presence of multiple offending vessels significantly increase DFP risk.

延迟性面瘫（DFP）仍然是面肌痉挛微血管减压术（MVD）后一种严重的术后并发症。然而，DFP的潜在机制仍不清楚。本研究旨在确定MVD后DFP发作的发生率、持续时间和潜伏期。第二个目标是确定在此情况下与DFP相关的危险因素。DFP是MVD后较为常见的并发症，面神经受压、疾病持续时间延长以及存在多条责任血管会显著增加DFP的发生风险。

REF: Liu X, Li X, Hou Z, et al. Risk Factors for Delayed Facial Palsy Following Microvascular Decompression in Hemifacial Spasm: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;200:124144. doi:10.1016/j.wneu.2025.124144 PMID: 40480542

Knowledge Mapping of Intracranial Artery Dissection: A Bibliometric Analysis (2014–2024)

颅内动脉夹层知识图谱：一项文献计量分析（2014 - 2024）

Intracranial artery dissection (IAD) is a rare but serious vascular disease predominantly affecting young and middle-aged individuals. This condition is marked by a high incidence and significant disability rate. The increasing number of affected patients underscores the growing attention that the pathogenesis and treatment of IAD are receiving from scholars worldwide. However, there is currently no bibliometric analysis available in this research domain. This study aims to provide a comprehensive overview of the knowledge structure and research hotspots of IAD through the use of bibliometrics. This is the first bibliometric study that comprehensively summarizes the research trends in the field of intracranial artery dissection. We identified recent research frontiers and hot topics, providing a reference for researchers focusing on this field.

颅内动脉夹层（IAD）是一种罕见但严重的血管疾病，主要影响中青年人群。该疾病发病率较高且致残率显著。受影响患者数量的增加凸显了全球学者对颅内动脉夹层发病机制和治疗的关注度日益提高。然而，目前该研究领域尚无文献计量学分析。本研究旨在通过文献计量学方法全面概述颅内动脉夹层的知识结构和研究热点。这是第一项全面总结颅内动脉夹层领域研究趋势的文献计量学研究。我们确定了近期的研究前沿和热点话题，为专注于该领域的研究人员提供参考。

REF: Wang Y, Pan W, Peng Y, Zhu S. Knowledge Mapping of Intracranial Artery Dissection: A Bibliometric Analysis (2014-2024). World Neurosurg. 2025;200:124172. doi:10.1016/j.wneu.2025.124172 PMID: 40513818

Surgical Strategies in Basal Ganglia Gliomas: A Systematic Review of Resection Extent, Mortality, and Neurological Recovery

基底神经节胶质瘤的手术策略：关于切除范围、死亡率和神经功能恢复的系统评价

Basal ganglia gliomas are challenging for the neurosurgeon owing to their depth and the risk of permanent neurologic impairment. Several treatment modalities are reported, including resection, biopsy, and adjunct treatment. This review evaluates the surgical outcomes in basal ganglia gliomas through a comprehensive analysis of neurological improvement, recurrence, mortality, and complication rates, stratified by tumor characteristics and resection extent. This is the first meta-analysis to quantitatively stratify surgical outcomes in basal ganglia gliomas by tumor grade, location, and resection extent. Subtotal resection may offer a safer alternative to gross total resection in functionally critical areas. These findings support a paradigm shift toward individualized surgical planning that balances resection with functional preservation, especially in deep-seated gliomas.

由于基底神经节胶质瘤位置较深，且存在导致永久性神经功能损伤的风险，神经外科医生处理这类肿瘤颇具挑战。目前有多种治疗方式见诸报道，包括切除、活检及辅助治疗。本综述通过全面分析神经功能改善情况、复发率、死亡率和并发症发生率，按肿瘤特征和切除范围进行分层，评估了基底神经节胶质瘤的手术效果。这是首次通过肿瘤分级、位置和切除范围对基底神经节胶质瘤手术效果进行定量分层的荟萃分析。在功能关键区域，次全切除相较于全切除可能是一种更安全的选择。这些研究结果支持向个体化手术规划的范式转变，即在切除肿瘤的同时兼顾功能保留，尤其是对于深部胶质瘤。

REF: K Al-Shalchy A, H Al-Taie R, Algabri MH, H Ali Al-Khafaji N, Loulida H, Ismail M. Surgical Strategies in Basal Ganglia Gliomas: A Systematic Review of Resection Extent, Mortality, and Neurological Recovery. World Neurosurg. 2025;200:124174. doi:10.1016/j.wneu.2025.124174 PMID: 40513817

Trigeminal Schwannoma Resection: A Systematic Review Functional Outcomes with Endoscopic and Microscopic Approaches

三叉神经鞘瘤切除术：内镜与显微镜入路功能结局的系统评价

Trigeminal schwannomas are uncommon, benign neoplasms originating from the trigeminal nerve and frequently necessitate surgical management to alleviate symptoms and preserve neurological function. This systematic review aims to evaluate and compare the functional outcomes and adverse events of endoscopic versus microscopic surgical resection techniques. These findings provide valuable insights for neurosurgeons to select optimal surgical strategies for trigeminal schwannoma management.

三叉神经鞘瘤是一种罕见的良性肿瘤，起源于三叉神经，通常需要手术治疗以缓解症状并保留神经功能。本系统评价旨在评估并比较内镜手术与显微手术切除技术的功能结局和不良事件。这些研究结果为神经外科医生选择治疗三叉神经鞘瘤的最佳手术策略提供了有价值的参考。

REF: Muhsen AA, Muhsen BA. Trigeminal Schwannoma Resection: A Systematic Review Functional Outcomes with Endoscopic and Microscopic Approaches. World Neurosurg. 2025;200:124162. doi:10.1016/j.wneu.2025.124162 PMID: 40523426

The Dual Roles of Autophagy in Pituitary Adenomas: Current Research Status

自噬在垂体腺瘤中的双重作用：当前研究现状

Pituitary adenomas (PAs) are tumors originating from the anterior lobe of the pituitary gland. Although most are benign, some may exhibit invasive behavior. While surgical treatment is effective in controlling most PAs, it carries inherent risks of complications, some of which may be severe. Consequently, managing PAs remains a significant clinical challenge. Autophagy, a cellular recycling process, plays a pivotal role in tumor biology and is frequently activated in response to stimuli such as nutrient deprivation, hypoxia, or mitochondrial dysfunction. Autophagy's role in tumors is complex, exhibiting both tumor-promoting and tumor-suppressing effects, which are context-dependent and vary across different stages of development. Recent studies on autophagy in PAs have gained considerable attention. This article describes the process of autophagy and its main signaling pathways, summarizes the research progress of autophagy in PAs, analyzes the potential therapeutic potential of targeting autophagy in PAs, and provides new directions for the treatment of PAs.

垂体腺瘤（PAs）是起源于垂体前叶的肿瘤。虽然大多数为良性，但有些可能表现出侵袭性。虽然手术治疗对控制大多数垂体腺瘤有效，但它存在固有的并发症风险，其中一些可能很严重。因此，垂体腺瘤的管理仍然是一项重大的临床挑战。自噬是一种细胞自我更新过程，在肿瘤生物学中起着关键作用，并且常在营养缺乏、缺氧或线粒体功能障碍等刺激下被激活。自噬在肿瘤中的作用很复杂，既有促进肿瘤的作用，也有抑制肿瘤的作用，这取决于具体情况，并会随着肿瘤发展的不同阶段而变化。最近关于垂体腺瘤自噬的研究受到了相当多的关注。本文介绍了自噬的过程及其主要信号通路，总结了垂体腺瘤自噬的研究进展，分析了靶向自噬在垂体腺瘤中的潜在治疗潜力，并为垂体腺瘤的治疗提供了新方向。

REF: Fu X, Li H, Yu T, et al. The Dual Roles of Autophagy in Pituitary Adenomas: Current Research Status. World Neurosurg. 2025;200:124231. doi:10.1016/j.wneu.2025.124231 PMID: 40615035

Predictors of Dura-Brain Neoangiogenesis After Combined Revascularization for Patients with Symptomatic Atherosclerotic Cerebral Artery Occlusion: A Multivariate Regression Analysis

症状性动脉粥样硬化性脑动脉闭塞患者联合血管重建术后硬脑膜 - 脑新生血管形成的预测因素：一项多变量回归分析

To investigate the independent predictors of dura-brain neoangiogenesis (DBN) after superficial temporal artery-to-middle cerebral artery bypass combined with dural inversion in patients with symptomatic atherosclerotic cerebral arterial occlusion (SACAO). Old age and diabetes status were independent predictors of poor DBN after combined revascularization in SACAO patients. Good DBN was associated with a lower recurrence rate of stroke and better neurological status.

探讨有症状性动脉粥样硬化性脑动脉闭塞（SACAO）患者行颞浅动脉-大脑中动脉搭桥联合硬脑膜翻转术后硬脑膜-脑新生血管形成（DBN）的独立预测因素。高龄和糖尿病状态是SACAO患者联合血管重建术后DBN不良的独立预测因素。良好的DBN与较低的卒中复发率和较好的神经功能状态相关。

REF: Ling C, Mo N, Zhang B, et al. Predictors of Dura-Brain Neoangiogenesis After Combined Revascularization for Patients with Symptomatic Atherosclerotic Cerebral Artery Occlusion: A Multivariate Regression Analysis. World Neurosurg. 2025;200:124105. doi:10.1016/j.wneu.2025.124105 PMID: 40409595

Drainage versus Nondrainage for Thoracolumbar Spine Surgery: An Evidence Synthesis

胸腰椎手术引流与不引流：一项证据综合分析

Drainage tube placement during posterior thoracolumbar spine surgery is common, yet debated due to conflicting evidence on complication risks. This study compares the safety and efficacy of drainage use versus nonuse. The utilization of drainage tubes in posterior thoracolumbar spine surgery does not show significant associations with SSI, reoperation rates, length of hospital stay, or clinical effectiveness. However, their use is associated with an increased frequency of postoperative blood transfusions. In single-segment operations, drainage tube placement demonstrates correlations with a lower occurrence of PEH, reduced probability of postoperative fever, and fewer dressing changes.

胸腰椎后路脊柱手术中放置引流管很常见，但由于在并发症风险方面存在相互矛盾的证据，这一做法仍存在争议。本研究比较了使用引流管与不使用引流管的安全性和有效性。胸腰椎后路脊柱手术中使用引流管与手术部位感染、再次手术率、住院时长或临床疗效并无显著关联。然而，使用引流管与术后输血频率增加有关。在单节段手术中，放置引流管与硬膜外血肿发生率降低、术后发热概率降低以及换药次数减少相关。

REF: Liu S, Zhou J. Drainage versus Nondrainage for Thoracolumbar Spine Surgery: An Evidence Synthesis. World Neurosurg. 2025;200:124111. doi:10.1016/j.wneu.2025.124111 PMID: 40412531

BOOTStrap-SCI: Beyond One Option of Treatment for Spinal Trauma and Spinal Cord Injury: Consensus-Based Stratified Protocols for Intensive Care and Surgical Management

BOOTStrap - SCI：脊柱创伤和脊髓损伤的多治疗选择：基于共识的重症监护和手术管理分层方案

Spinal trauma (STx), with or without spinal cord injury (SCI), represents a significant global health burden, particularly in low- and middle-income countries (LMICs). International guidelines often assume the availability of resources for intensive care and surgical management, limiting their applicability in resource-constrained settings. A resource-adapted approach may improve management in these contexts. This study aimed to develop resource-tiered protocols for the intensive care and surgical management of STx and SCI, addressing LMIC-specific challenges with clinical evidence and expert-based practices. The proposed protocols may bridge gaps in STx and SCI care in LMICs by providing adaptable frameworks for resource-limited contexts. The consensus-driven approach can foster protocolized care delivery in LMICs, emphasizing feasibility and local adaptability. Future efforts should focus on validating these protocols in clinical practice.

脊柱创伤（STx），无论是否伴有脊髓损伤（SCI），都是一项重大的全球健康负担，在低收入和中等收入国家（LMICs）尤为如此。国际指南通常假定具备进行重症监护和手术治疗的资源，这限制了它们在资源有限环境中的适用性。采用适应资源状况的方法或许能改善这些情况下的治疗。本研究旨在制定针对STx和SCI的重症监护与手术治疗的分资源层级方案，结合临床证据和基于专家经验的做法，应对低收入和中等收入国家特有的挑战。所提出的方案可为资源有限的环境提供可调整的框架，从而弥补低收入和中等收入国家在STx和SCI治疗方面的差距。以达成共识为导向的方法可推动低收入和中等收入国家实现规范化的医疗服务，强调方案的可行性和本地适应性。未来应着重在临床实践中验证这些方案。

REF: Marchesini N, Dange RM, Demetriades AK, et al. BOOTStrap-SCI: Beyond One Option of Treatment for Spinal Trauma and Spinal Cord Injury: Consensus-Based Stratified Protocols for Intensive Care and Surgical Management. World Neurosurg. 2025;200:124099. doi:10.1016/j.wneu.2025.124099 PMID: 40383265