Neuroanatomy Education Access by Country Income Level: A Mixed-Methods Analysis

按国家收入水平划分的神经解剖学教育可及性：一项混合方法分析

Neuroanatomy is complex and often perceived as challenging to students and residents. It is important to have an appreciation of neuroanatomy as it directs sound clinical reasoning and may provide inspiration to pursue higher training in a neuroscience related medical specialty. A sample 519 responses to a pre-course questionnaire to a neuroanatomy course was analysed. The questionnaire collected basic demographic variables and opinions regarding the provision of neuroanatomy on a Likert scale. A mixed methods approach was undertaken comparing quantitative and free text responses between respondents from high-income (HIC) and low-middle income countries (LMIC). Participants from HIC (N=383) formed the largest group compared to LMIC (N=136) and most respondents reported being in medical school (N=271, 52%). Multivariable proportional ordinal regression, highlighted greater dissatisfaction with neuroanatomy provision by LMIC trainees (OR=2.34, 95% CI=1.58-3.48, p<0.001). Thematic analysis uncovered four barriers to surgical neuroanatomy education including the need for greater multimodal teaching, a lack of specialist led teaching, systematic barriers and the complexity of neuroanatomy. LMIC trainees were more likely to report a lack of specialist teaching as a barrier (χ2=7.68, p=0.006). HIC and LMIC neuroanatomy provision differs, with a lack of specialist teaching highlighted as a barrier in our survey. Greater focus is required to ensure equitable access to neuroanatomy teaching with international online courses providing a useful bridge between HIC and LMIC neuroanatomy provision.

神经解剖学十分复杂，学生和住院医师通常认为学习起来颇具挑战。了解神经解剖学很重要，因为它有助于合理的临床推理，还可能激发人们在神经科学相关医学专业领域接受更高层次培训的兴趣。研究人员分析了一份神经解剖学课程课前问卷的519份回复样本。该问卷收集了基本的人口统计学变量，并让受访者就神经解剖学课程的设置情况按照李克特量表表达意见。研究采用了混合研究方法，比较了高收入国家（HIC）和中低收入国家（LMIC）受访者的定量和自由文本回复。与中低收入国家的受访者（N = 136）相比，高收入国家的参与者（N = 383）占比最大，且大多数受访者表示自己正在医学院学习（N = 271，52%）。多变量比例序数回归分析显示，中低收入国家的学员对神经解剖学课程设置的满意度更低（优势比 = 2.34，95%置信区间 = 1.58 - 3.48，p < 0.001）。主题分析揭示了神经外科解剖学教育存在的四个障碍，包括需要更多的多模式教学、缺乏专家指导教学、系统性障碍以及神经解剖学本身的复杂性。中低收入国家的学员更有可能将缺乏专家教学列为障碍（卡方值 = 7.68，p = 0.006）。高收入国家和中低收入国家的神经解剖学课程设置存在差异，本次调查凸显了缺乏专家教学是一个障碍。需要更加关注，以确保公平获得神经解剖学教学资源，国际在线课程可以为高收入国家和中低收入国家的神经解剖学教学搭建一座有益的桥梁。

REF: Ramsay DSC, Nicholls BJ, Dixon N, et al. Neuroanatomy Education Access by Country Income Level: A Mixed-Methods Analysis. World Neurosurg. Published online November 27, 2025. doi:10.1016/j.wneu.2025.124683 PMID: 41318088

Exploring Demographic, Clinical, Surgical, and Imaging Features in Relation to CDKN2A/B Status in Meningiomas

探索脑膜瘤中与CDKN2A/B状态相关的人口统计学、临床、手术及影像学特征

Meningiomas are the most common primary intracranial tumors, mostly benign, but some exhibit aggressive behavior. The 2021 WHO classification considers CDKN2A/B homozygous deletion as sufficient for grade 3 designation, highlighting its prognostic significance. It remains unclear whether demographic, clinical, or radiological features can predict deletion status or guide testing. In this cohort, demographic, clinical, or radiological features did not reliably predict CDKN2A/B deletion. Several deletion-positive meningiomas were classified as grade 1 or 2, underscoring the disconnect between morphology and molecular grading. These findings support universal CDKN2A/B testing for accurate WHO classification and risk assessment.

脑膜瘤是最常见的原发性颅内肿瘤，大多为良性，但有些会表现出侵袭性。2021年世界卫生组织（WHO）分类认为，CDKN2A/B纯合缺失足以将肿瘤判定为3级，凸显了其预后意义。目前尚不清楚人口统计学、临床或影像学特征是否能够预测缺失状态或指导检测。在该队列中，人口统计学、临床或影像学特征并不能可靠地预测CDKN2A/B缺失情况。一些呈CDKN2A/B缺失阳性的脑膜瘤被归类为1级或2级，这凸显了形态学分级与分子分级之间的脱节。这些发现支持对CDKN2A/B进行普遍检测，以实现准确的WHO分类和风险评估。

REF: Abofani H, Ben-Moyal O, Cohen ZR, et al. Exploring Demographic, Clinical, Surgical, and Imaging Features in Relation to CDKN2A/B Status in Meningiomas. World Neurosurg. Published online December 2, 2025. doi:10.1016/j.wneu.2025.124699 PMID: 41344397

L-Shaped Zygotomy: A Safe and Versatile Modification of the Zygomatic Approach with Quantitative and Cosmetic Advantages in Skull Base Surgery

L形颧弓切开术：颅底手术中一种安全且灵活的颧弓入路改良方法，具有量化和美容优势

The zygomatic approach provides extensive exposure of the anterior and middle skull base but carries risks of facial nerve injury, cosmetic deformity, and unstable arch reconstruction. We developed a modified L-shaped zygotomy designed to improve safety, reduce flap retraction, and ensure stable cosmetic and reconstructive outcomes, while allowing seamless transition to an orbitozygomatic (OZ) craniotomy when required. The L-shaped zygotomy is a safe and versatile modification of the zygomatic approach. It provides reproducible quantitative advantages in exposure, minimizes flap retraction, ensures stable cosmetic outcomes validated by long-term follow-up, and allows seamless transition to OZ when broader exposure is necessary.

颧弓入路可广泛显露前颅底和中颅底，但存在面神经损伤、美容畸形和颧弓重建不稳定的风险。我们设计了一种改良的L形颧弓截骨术，旨在提高安全性、减少皮瓣牵拉，并确保良好的美容和重建效果，同时在需要时可无缝过渡至眶颧（OZ）开颅术。L形颧弓截骨术是对颧弓入路的一种安全且灵活的改良方法。它在显露方面具有可重复性的量化优势，最大限度减少皮瓣牵拉，通过长期随访证实能确保良好的美容效果，并且在需要更广泛显露时可无缝过渡至OZ开颅术。

REF: Ohgaki F, Murata H, Uchida M, et al. L-Shaped Zygotomy: A Safe and Versatile Modification of the Zygomatic Approach with Quantitative and Cosmetic Advantages in Skull Base Surgery. World Neurosurg. Published online December 1, 2025. doi:10.1016/j.wneu.2025.124701 PMID: 41338383

Percutaneous Full Endoscopic Interlaminar Decompression Combined with Percutaneous Vertebroplasty in Treatment of Thoracic Vertebral Tumors

经皮全内镜椎板间隙减压联合经皮椎体成形术治疗胸椎肿瘤

Separation surgery is a good alternative in the treatment of oncological cases as a minimally invasive procedure. We applied percutaneous full endoscopic interlaminar decompression (PEID) with vertebroplasty in treatment of thoracic tumors in order to avoid the morbidity associated with conventional approaches. In this study, we tried to define a full endoscopic interlaminar separation technique that we applied in combination with vertebroplasty in patients with tumors in the thoracic vertebra levels.

作为一种微创手术，分离手术是肿瘤病例治疗的一种不错选择。为避免传统手术方式带来的并发症，我们采用经皮全内镜椎板间减压术（PEID）联合椎体成形术治疗胸椎肿瘤。在本研究中，我们试图明确一种全内镜椎板间分离技术，即我们在胸椎肿瘤患者中联合椎体成形术应用的该技术。

REF: Çeliker Ö, Kocaoğlu M. PERCUTANEOUS FULL ENDOSCOPIC INTERLAMİNAR DECOMPRESSION COMBINED WITH PERCUTANEOUS VERTEBROPLASTY IN TREATMENT OF THORACIC VERTEBRAL TUMORS. World Neurosurg. Published online December 2, 2025. doi:10.1016/j.wneu.2025.124703 PMID: 41344395

Geographic and Socioeconomic Predictors of Early Follow-Up Loss in Patients Undergoing Pituitary Neuroendocrine Tumors (PitNETs) Resection: A Retrospective Review of 1143 Cases

垂体神经内分泌肿瘤（PitNETs）切除患者早期失访的地理和社会经济预测因素：1143例回顾性研究

Postoperative follow-up after PitNET resection is essential for monitoring tumor recurrence and endocrinological deficits. Despite advances in telehealth, loss to follow-up remains a persistent challenge across neurosurgical patients. This study aims to identify factors to identify patients are at higher risk of being lost to follow-up after surgery. To follow-up after PitNET surgery remains a substantial concern, particularly among younger, uninsured patients and those residing farther from the treating center. These findings highlight the importance of early identification and proactive outreach to high-risk individuals.

垂体神经内分泌肿瘤（PitNET）切除术后的随访对于监测肿瘤复发和内分泌功能缺陷至关重要。尽管远程医疗有所发展，但失访仍然是神经外科患者群体持续面临的一个挑战。本研究旨在确定可识别出术后失访风险较高患者的因素。PitNET手术后的随访仍然是一个重大问题，尤其是对于年轻、未参保的患者以及居住在离治疗中心较远地区的患者而言。这些研究结果凸显了早期识别高风险个体并主动进行沟通联系的重要性。

REF: Quintana D, Ramesh R, Osorio RC, et al. Geographic and Socioeconomic Predictors of Early Follow-Up Loss in Patients Undergoing Pituitary Neuroendocrine Tumors (PitNETs) Resection: A retrospective review of 1143 cases. World Neurosurg. Published online November 24, 2025. doi:10.1016/j.wneu.2025.124643 PMID: 41297625

Sagittal Alignment and Clinical Outcomes After Biportal Endoscopic Transforaminal Lumbar Interbody Fusion Using a Single Expandable Cage: One Year Follow-up

使用单个可扩张椎间融合器的双镜联合经椎间孔腰椎椎间融合术后矢状面排列及临床结局：一年随访

Advancements in expandable cage technology may overcome limitations such as narrow working corridor, continuous irrigation, and endplate injury risk in biportal endoscopic transforaminal lumbar interbody fusion (BE-TLIF). We evaluate sagittal realignment, fusion rates, and clinical outcomes over one year using a single bullet-type expandable cage. BE-TLIF using a single bullet-type expandable cage achieved favorable outcomes at one year, with meaningful sagittal correction and fusion rates, supporting the non-inferiority of this construct in short-segment lumbar fusion.

可扩张椎间融合器技术的进步可能会克服双镜联合内镜下经椎间孔腰椎椎间融合术（BE - TLIF）中工作通道狭窄、持续冲洗以及终板损伤风险等局限性。我们使用单个子弹型可扩张椎间融合器评估了一年的矢状面复位情况、融合率和临床疗效。使用单个子弹型可扩张椎间融合器的 BE - TLIF 在一年时取得了良好的效果，实现了有意义的矢状面矫正和融合率，这支持了该术式在短节段腰椎融合中的非劣效性。

REF: Park SR, Kim N, Kwon JW, et al. Sagittal Alignment and Clinical Outcomes after Biportal Endoscopic Transforaminal Lumbar Interbody Fusion Using a Single Expandable Cage: One year follow-up. World Neurosurg. Published online November 29, 2025. doi:10.1016/j.wneu.2025.124698 PMID: 41325932

Efficacy of Hybrid Sleeve-Assisted Surgery for Spinal Dural Arteriovenous Fistula

混合套管辅助手术治疗脊髓硬脊膜动静脉瘘的疗效

This study aimed to evaluate the efficacy of hybrid surgery combined with the sleeve technique in treating spinal dural arteriovenous fistula (SDAVF). Hybrid sleeve-assisted surgery integrates the advantages of endovascular interventional therapy and microsurgery, reducing late recurrence and surgical trauma. Consequently, this combined approach represents a valuable, clinically translatable therapeutic modality for the management of SDAVF.

本研究旨在评估杂交手术联合 sleeve 技术治疗脊髓硬脊膜动静脉瘘（SDAVF）的疗效。杂交 sleeve 辅助手术整合了血管内介入治疗和显微外科手术的优势，降低了远期复发率和手术创伤。因此，这种联合治疗方法是一种有价值的、可在临床应用的 SDAVF 治疗方式。

REF: Liu H, Liu J, Wang J, et al. Efficacy of Hybrid Sleeve-Assisted Surgery for Spinal Dural Arteriovenous Fistula. World Neurosurg. Published online December 3, 2025. doi:10.1016/j.wneu.2025.124702 PMID: 41349919

Hidden Blood Loss and its Risk Factors in the Treatment of Osteoporotic Vertebral Compression Fractures Using Percutaneous Vertebroplasty: A Multicenter Retrospective Study

经皮椎体成形术治疗骨质疏松性椎体压缩骨折的隐性失血及其危险因素：一项多中心回顾性研究

Percutaneous vertebroplasty (PVP) is widely employed as a minimally invasive procedure for osteoporotic vertebral compression fractures (OVCFs). However, significant perioperative hidden blood loss (HBL) is frequently underestimated. This study aimed to quantify HBL during PVP and to determine its associated risk factors. HBL remains a significant perioperative concern during PVP for OVCF and should not be overlooked, particularly in patients with compromised physical status or multiple vertebral fractures. Recognizing the risk factors for HBL is critical for orthopedic surgeons to optimize perioperative strategies and minimize its impact on patient outcomes.

经皮椎体成形术（PVP）作为一种治疗骨质疏松性椎体压缩骨折（OVCFs）的微创手术被广泛应用。然而，围手术期大量的隐性失血（HBL）常常被低估。本研究旨在量化PVP术中的隐性失血量，并确定其相关危险因素。在PVP治疗OVCF过程中，隐性失血仍是一个重要的围手术期问题，不应被忽视，尤其是对于身体状况不佳或存在多节段椎体骨折的患者。识别隐性失血的危险因素对于骨科医生优化围手术期策略、减少其对患者预后的影响至关重要。

REF: A J, Zhou S, Tian J, et al. Hidden blood loss and its risk factors in the treatment of osteoporotic vertebral compression fractures using percutaneous vertebroplasty: A multicenter retrospective study. World Neurosurg. Published online December 2, 2025. doi:10.1016/j.wneu.2025.124705 PMID: 41344396

The Shifting Landscape of Traumatic Brain Injury After COVID-19: Prelockdown, Lockdown, and Postlockdown Trends: Data from a Referral Center in Colombia

新冠疫情后创伤性脑损伤情况的变化：封控前、封控期间和封控后的趋势——来自哥伦比亚一家转诊中心的数据

The coronavirus disease 2019 (COVID-19) pandemic required widespread lockdowns, which have been shown to influence the incidence and characteristics of traumatic brain injury (TBI) worldwide. However, the specific influence of the pandemic on TBI epidemiology in Latin America, particularly Colombia, remains largely unexplored. TBI characteristics changed not only during the lockdown but also in its aftermath, as post-lockdown patients exhibited distinct features from those in the pre-lockdown cohort.

2019年冠状病毒病（COVID - 19）大流行导致了大范围的封锁措施，已证实这些措施在全球范围内影响了创伤性脑损伤（TBI）的发病率和特征。然而，此次大流行对拉丁美洲，尤其是哥伦比亚的TBI流行病学的具体影响在很大程度上仍未得到探究。TBI的特征不仅在封锁期间发生了变化，在封锁结束后也有所改变，因为封锁后患者表现出与封锁前患者群体不同的特征。

REF: Gomez-Niebles S, Osejo-Arcos V, Vergara-Garcia D, et al. The Shifting Landscape of Traumatic Brain Injury across COVID-19 Pandemic: Trends Before, During, and After Lockdown at a Referral Center in Colombia. World Neurosurg. Published online November 27, 2025. doi:10.1016/j.wneu.2025.124667 PMID: 41318092