SpineForge Planner: Free and Open-Source Software for Spinal Alignment Analysis and Surgical Planning

脊柱锻造规划器：用于脊柱对齐分析和手术规划的免费开源软件

Precise measurement of sagittal spinopelvic parameters is fundamental to modern spine surgery planning, with established correlations to surgical outcomes. However, platforms such as Surgimap (Nemaris Inc.) have discontinued new-user registration, thereby restricting global access. Manual measurement introduces inefficiency and variability, while existing alternatives lack comprehensive functionality or remain closed-source. This study aimed to develop and validate SpineForge Planner, a free, open-source software for sagittal spinopelvic alignment analysis and surgical planning, addressing this critical accessibility gap. SpineForge Planner demonstrates measurement reliability that is noninferior to established commercial platforms and provides surgical planning capabilities within a permanently free, open-source framework. This software addresses the accessibility gap in sagittal alignment assessment, enabling universal access to precise measurement tools essential for modern spine surgery planning and outcomes optimization.

精确测量矢状面脊柱骨盆参数是现代脊柱手术规划的基础，且已证实其与手术结果相关。然而，像Surgimap（Nemaris公司）这样的平台已停止新用户注册，从而限制了全球用户的使用。手动测量效率低下且存在差异，而现有的替代方案要么功能不全面，要么仍为闭源软件。本研究旨在开发并验证SpineForge Planner，这是一款免费的开源软件，用于矢状面脊柱骨盆对齐分析和手术规划，以解决这一关键的可及性问题。SpineForge Planner的测量可靠性不逊于现有的商业平台，并在永久免费的开源框架内提供手术规划功能。该软件解决了矢状面对齐评估的可及性问题，使全球用户都能使用对现代脊柱手术规划和优化手术结果至关重要的精确测量工具。

REF: Akbulut BB. SpineForge Planner: Free and Open-Source Software for Spinal Alignment Analysis and Surgical Planning. Oper Neurosurg. Published online May 27, 2026. doi:10.1227/ons.0000000000002079 PMID: 42200626

Prospective Dysphagia and Dysphonia Assessment After the Simplified Retropharyngeal Approach for Anterior Cervical Surgery

前路颈椎手术简化咽后入路术后前瞻性吞咽困难和发声困难评估

Anterior access to the axial and upper subaxial cervical spine is anatomically constrained by the pharyngolaryngeal complex and adjacent neurovascular structures, and postoperative dysphagia/dysphonia remains clinically relevant after anterior approaches. The aim of this study was to prospectively quantify and explore predictors of patient-reported dysphagia and dysphonia after anterior cervical surgery performed through the Simplified Retropharyngeal (SR) approach. The SR approach was associated with frequent but transient patient-reported swallowing and voice symptoms, attributable to postoperative discomfort rather than true dysphagia, with complete recovery by the last follow-up. No functional impairment was detected on DOSS assessment. Larger controlled studies incorporating instrumental functional assessments are needed.

轴向和上亚轴颈椎前路入路在解剖学上受到咽喉复合体和相邻神经血管结构的限制，前路手术后吞咽困难/发声困难在临床上仍是需要关注的问题。本研究的目的是前瞻性地量化并探索通过简化咽后（SR）入路进行颈椎前路手术后患者自述的吞咽困难和发声困难的预测因素。SR入路与患者频繁但短暂的吞咽和发声症状相关，这些症状归因于术后不适而非真正的吞咽困难，到最后一次随访时可完全恢复。吞咽困难严重程度量表（DOSS）评估未发现功能障碍。需要开展更大规模的纳入仪器功能评估的对照研究。

REF: De Bonis P, Moldovan RA, Bortolotti S, et al. Prospective Dysphagia and Dysphonia Assessment After the Simplified Retropharyngeal Approach for Anterior Cervical Surgery. Oper Neurosurg. Published online May 27, 2026. doi:10.1227/ons.0000000000002062 PMID: 42200633

Improved Outcomes With Temporalis Resuspension During Cranioplasty for Craniofacial Reconstruction After Decompressive Hemicraniectomy

去骨瓣减压术后颅面重建颅骨成形术中颞肌悬吊改善预后

Temporal hollowing is a well-documented and common phenomenon after decompressive hemicraniectomy and arises from the loss of temporalis muscle bulk due to muscle elevation, absence of underlying bone, and other alterations in soft tissue dynamics postsurgery. Temporalis muscle resuspension is a promising technique to minimize hollowing, and we present our technique for muscle resuspension during cranioplasty to minimize cosmetic and functional concerns. In our cohort, the Rostock scores, evaluating cosmetic appearance, were better in the group in which we deployed our temporalis resuspension technique. By preserving the integrity of the temporalis muscle and resuspending it to the underlying cranial implant, we believe that this approach minimizes temporal hollowing and improves patient satisfaction and overall outcomes.

去骨瓣减压术后颞部凹陷是一种有充分记载且常见的现象，它是由于颞肌上抬、下方骨质缺失以及术后软组织动力学的其他改变导致颞肌体积减小而引起的。颞肌悬吊术是一种有望减少凹陷的技术，我们介绍了在颅骨修补术中进行颞肌悬吊的技术，以减少美容和功能方面的担忧。在我们的研究队列中，评估美容外观的罗斯托克评分在采用我们的颞肌悬吊技术的组中更好。我们认为，通过保留颞肌的完整性并将其悬吊至下方的颅骨植入物上，这种方法可以最大程度减少颞部凹陷，提高患者满意度和总体治疗效果。

REF: Vij R, Stegamat N, Tabla Cendra D, et al. Improved Outcomes With Temporalis Resuspension During Cranioplasty for Craniofacial Reconstruction After Decompressive Hemicraniectomy. Oper Neurosurg. Published online May 27, 2026. doi:10.1227/ons.0000000000002078 PMID: 42200645

Efficacy and Safety of Regenerative Peripheral Nerve Interface: A Retrospective Study on Amputees With Bone and Soft Tissue Tumor

再生周围神经接口的有效性和安全性：一项针对骨与软组织肿瘤截肢患者的回顾性研究

Bone and soft tissue tumors are significant causes of limb amputation. Regenerative peripheral nerve interface (RPNI) is an effective method for preventing neuroma formation in residual nerves. However, the efficacy and safety of RPNI in patients undergoing amputation due to bone and soft tissue tumors require further investigation. In patients undergoing amputation for bone and soft tissue tumors, RPNI significantly reduces the incidence and severity of postoperative pain without increasing the risk of tumor recurrence and metastasis.

骨与软组织肿瘤是导致肢体截肢的重要原因。再生性周围神经接口（RPNI）是预防残端神经形成神经瘤的有效方法。然而，RPNI在因骨与软组织肿瘤而接受截肢手术的患者中的有效性和安全性尚需进一步研究。在因骨与软组织肿瘤接受截肢手术的患者中，RPNI可显著降低术后疼痛的发生率和严重程度，且不会增加肿瘤复发和转移的风险。

REF: Lin Z, Chen Y, Zang H, Wang C, Li G. Efficacy and Safety of Regenerative Peripheral Nerve Interface: A Retrospective Study on Amputees With Bone and Soft Tissue Tumor. Oper Neurosurg. Published online May 21, 2026. doi:10.1227/ons.0000000000002053 PMID: 42165571

Surgical Versus Endovascular Treatment of Middle Cerebral Artery Aneurysms: A Single-Center Retrospective Cohort Study Emphasizing Complex Lesions

大脑中动脉动脉瘤的手术治疗与血管内治疗：一项强调复杂病变的单中心回顾性队列研究

Middle cerebral artery aneurysms, especially those with complex morphology, present significant treatment challenges and are commonly managed with either microsurgical treatment (MT) or endovascular treatment (EVT). This study compares clinical and angiographic outcomes for MT and EVT in a single-center retrospective cohort, with particular attention to aneurysm complexity. Both treatment modalities yielded excellent overall outcomes; however, aneurysm complexity strongly influenced treatment selection and outcomes. MT ensured durable aneurysm exclusion and lower retreatment rates, offering particular benefit for complex aneurysms, including blister-like or dissecting subtypes. An individualized, anatomy-based strategy remains essential: MT should be prioritized when managing complex lesions, while EVT remains valuable for appropriately selected simple aneurysms.

大脑中动脉动脉瘤，尤其是那些形态复杂的动脉瘤，在治疗上颇具挑战，通常采用显微外科治疗（MT）或血管内治疗（EVT）。本研究在单中心回顾性队列中比较了MT和EVT的临床及血管造影结果，特别关注了动脉瘤的复杂性。两种治疗方式总体效果都很好；然而，动脉瘤的复杂性对治疗选择和结果有很大影响。MT能确保持久地排除动脉瘤，降低再治疗率，对包括水泡样或夹层亚型在内的复杂动脉瘤尤其有益。基于解剖结构的个体化治疗策略仍然至关重要：处理复杂病变时应优先选择MT，而EVT对适当选择的简单动脉瘤仍有价值。

REF: Serikkanov Y, Sulaimanov U, Erginoglu U, et al. Surgical Versus Endovascular Treatment of Middle Cerebral Artery Aneurysms: A Single-Center Retrospective Cohort Study Emphasizing Complex Lesions. Oper Neurosurg. Published online May 21, 2026. doi:10.1227/ons.0000000000002074 PMID: 42165609

The Contralateral Transfalcine Approach: An Anatomic Study Quantifying Its Superior and Lateral Limits of Exposure

对侧经大脑镰入路：一项量化其暴露范围上界和外侧界的解剖学研究

Contralateral transfalcine approaches are widely used for interhemispheric/mesial cortical pathologies, even those extending beyond 2 cm lateral from the midline. Nevertheless, the superior limit of contralateral exposure through this approach is not defined. This anatomic study aims to characterize the maximal superior and lateral limits of contralateral exposure using a contralateral transfalcine approach. Using the contralateral transfalcine approach, the superior limit of contralateral exposure progressively decreases more posteriorly along the interhemispheric corridor-ranging from 4.8 mm inferior to the cortex in the anterior-third to 12.6 mm inferior to the cortex in the posterior-third. The contralateral optimal view of exposure increases deeper along the interhemispheric corridor.

对侧经大脑镰入路广泛用于治疗半球间/内侧皮质病变，即使是那些距离中线外侧超过2厘米的病变。然而，通过该入路进行对侧显露的上限尚未明确。这项解剖学研究旨在确定使用对侧经大脑镰入路进行对侧显露的最大上界和外侧界。采用对侧经大脑镰入路时，对侧显露的上界沿着半球间通道向后逐渐降低，从前三分之一处皮质下方4.8毫米到后三分之一处皮质下方12.6毫米。沿着半球间通道深入，对侧的最佳显露视野会增大。

REF: Alexander AY, Graepel S, Peris-Celda M, Lanzino G. The Contralateral Transfalcine Approach: An Anatomic Study Quantifying Its Superior and Lateral Limits of Exposure. Oper Neurosurg. Published online May 21, 2026. doi:10.1227/ons.0000000000002057 PMID: 42165614

Proximal Junctional Kyphosis Prevention in Adult Spinal Deformity Surgery: A Technical Review of Tethering and Adjunctive Strategies

成人脊柱畸形手术中近端交界性后凸的预防：系索技术及辅助策略的技术综述

Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) remain significant complications after long-segment posterior fusion for adult spinal deformity. Preventive strategies-including tethering, vertebral cement augmentation (VCA), hooks, trajectory modifications, and alignment optimization-have been proposed, but comparative evidence remains heterogeneous. The objective of this narrative review is to synthesize current biomechanical and clinical evidence, prioritize clinically meaningful end points (revision and PJF), and differentiate them from purely radiographic PJK. Tethering is an effective adjunct-not a stand-alone solution-best used within a multimodal strategy (bone health, frailty, and age-adjusted alignment), with selective application of hooks or VCA based on failure mode risk. Standardized, prospective multicenter studies are necessary to determine long-term durability and comparative effectiveness.

近端交界性后凸（PJK）和近端交界性失败（PJF）仍然是成人脊柱畸形长节段后路融合术后的重大并发症。已经提出了预防策略，包括系绳固定、椎体骨水泥强化（VCA）、钩棒系统、轨迹调整和力线优化，但相关比较证据参差不齐。本叙述性综述的目的是综合当前的生物力学和临床证据，确定具有临床意义的终点（翻修和PJF）的优先级，并将其与单纯影像学表现的PJK区分开来。系绳固定是一种有效的辅助手段，而非独立解决方案，最好在多模式策略（骨骼健康、身体虚弱状况和年龄调整后的力线）中使用，并根据失败模式风险选择性应用钩棒系统或VCA。需要开展标准化的前瞻性多中心研究来确定其长期耐久性和相对有效性。

REF: Tahmasebpour P, Jankowski PP, Liang J, et al. Proximal Junctional Kyphosis Prevention in Adult Spinal Deformity Surgery: A Technical Review of Tethering and Adjunctive Strategies. Oper Neurosurg. Published online May 21, 2026. doi:10.1227/ons.0000000000002072 PMID: 42165582

Magnetic Resonance Venography–Based Anterior Interhemispheric Transcallosal-Transforaminal Approach to Colloid Cysts of the Third Ventricle

基于磁共振静脉成像的前半球间经胼胝体 - 经室间孔入路治疗第三脑室胶样囊肿

This study highlights the significance of magnetic resonance (MR) venography in guiding surgical planning for the anterior interhemispheric transcallosal-transforaminal (AITT) approach to colloid cysts of the third ventricle. A comprehensive MR venography-guided AITT approach is essential for the craniotomy and selecting the ventricular access side, ensuring less traumatic and complete resection of colloid cysts while minimizing the risk of complications. This strategy consistently yielded good patient outcomes, no recurrences, and a rapid return to educational or professional activities.

本研究强调了磁共振（MR）静脉成像在指导经前半球间胼胝体 - 经室间孔（AITT）入路切除第三脑室胶样囊肿手术规划中的重要性。全面的MR静脉成像引导的AITT入路对于开颅手术和选择脑室入路侧至关重要，可确保以较小创伤完整切除胶样囊肿，同时将并发症风险降至最低。该策略始终能使患者获得良好的治疗效果，无复发情况，且患者能快速恢复学习或工作。

REF: Luzzi S, Güngör A, Ülgen M, et al. Magnetic Resonance Venography-Based Anterior Interhemispheric Transcallosal-Transforaminal Approach to Colloid Cysts of the Third Ventricle. Oper Neurosurg. Published online May 21, 2026. doi:10.1227/ons.0000000000002061 PMID: 42165593

Integration of the Zeiss QEVO® Inspection Tool in a Commercial Retractor System for Bimanual Angled View Tumor Resections: Technical Note With Case Illustration

蔡司QEVO®检查工具集成于商用牵开器系统用于双手斜视角肿瘤切除术：附病例说明的技术报告

The QEVO® microinspection tool integrated into the ZEISS KINEVO® platform provides high-quality angled visualization and is increasingly used to inspect microscopic blind spots during neurosurgical tumor resections. However, effective integration of the QEVO® tool into the standard neurosurgical bimanual workflow remains challenging in delicate environments, as no commercially available device can securely position the tool to enable undisturbed bimanual dissection under angulated endoscopic vision. This report describes a practical and reproducible technique for stable hands-free fixation of the QEVO® inspection tool using a commercially available retractor system, enabling bimanual microsurgical dissection under angled endoscopic visualization. This approach addresses limitations of angled view-assisted microsurgery with the QEVO® tool, offering enhanced control in demanding procedures and enabling higher surgical radicality with reduced operative risk.

集成于蔡司 KINEVO® 平台的 QEVO® 显微检查工具可提供高质量的斜角可视化效果，且在神经外科肿瘤切除术中越来越多地用于检查微观盲区。然而，在精细的手术环境中，将 QEVO® 工具有效融入标准神经外科双手操作流程仍具有挑战性，因为目前尚无市售设备能牢固固定该工具，以实现在斜角内镜视野下不受干扰的双手解剖操作。本报告介绍了一种实用且可重复的技术，即使用市售的牵开器系统对 QEVO® 检查工具进行稳定的免手持固定，从而实现在斜角内镜可视化下的双手显微外科解剖操作。这种方法解决了使用 QEVO® 工具进行斜角视野辅助显微手术的局限性，在复杂手术中提供了更好的操作控制，能够在降低手术风险的同时提高手术的彻底性。

REF: Souei Z, Goloshchapova K, Zipfel J, Schuhmann MU. Integration of the Zeiss QEVO® Inspection Tool in a Commercial Retractor System for Bimanual Angled View Tumor Resections: Technical Note With Case Illustration. Oper Neurosurg. Published online May 21, 2026. doi:10.1227/ons.0000000000002066 PMID: 42165615