Measurement of Resource Utilization in Spine Healthcare for Elective Spine Surgery Patients: A Systematic Review

择期脊柱手术患者脊柱医疗保健资源利用情况的测量：一项系统评价

This study aimed to characterize the metrics used to report Resource Utilization in Spine Healthcare (RUSH) for spine surgery patients in the United States. Spine surgery lacks consensus on the metrics used to report RUSH. While there are numerous metrics are used, there are no standardized guidelines to help researchers select these measures consistently across studies. Establishing a standardized set of RUSH metrics will enhance the ability to compare findings across studies, assess their validity, and correlate them with patient outcomes.

本研究旨在确定用于报告美国脊柱手术患者脊柱医疗资源利用情况（RUSH）的指标特征。脊柱手术在报告RUSH的指标方面缺乏共识。虽然使用了众多指标，但没有标准化指南来帮助研究人员在各项研究中一致地选择这些指标。建立一套标准化的RUSH指标将提高跨研究比较研究结果、评估其有效性并将其与患者预后相关联的能力。

REF: Rosenthal ME, Haffke WG, Sanghvi P, et al. Measurement of Resource Utilization in Spine Healthcare for Elective Spine Surgery Patients: A Systematic Review. World Neurosurg. 2026;209:124876. doi:10.1016/j.wneu.2026.124876 PMID: 41713778

A Systematic Review With Meta-analysis of the Mastoid Emissary Foramen: Implications for Posterior Cranial Fossa Surgery

乳突导血管孔的系统评价与Meta分析：对后颅窝手术的意义

The mastoid emissary foramen (MEF), transmitting the mastoid emissary vein, is a key anatomical structure encountered during posterior cranial fossa and cerebellopontine angle approaches. Injury to this variable venous pathway may result in significant hemorrhage. However, published data regarding the prevalence and morphology of the MEF remain inconsistent. The MEF is a common but highly variable anatomical structure. Awareness of its prevalence and morphology is essential for neurosurgical planning, emphasizing the importance of high-resolution preoperative imaging to minimize vascular complications during posterior cranial fossa approaches.

乳突导血管孔（MEF）传导乳突导静脉，是后颅窝和小脑脑桥角入路中会遇到的关键解剖结构。损伤这一变异的静脉通路可能导致严重出血。然而，已发表的关于乳突导血管孔发生率和形态的资料仍存在不一致。乳突导血管孔是一种常见但变异很大的解剖结构。了解其发生率和形态对于神经外科手术规划至关重要，这凸显了高分辨率术前影像检查对于减少后颅窝入路手术中血管并发症的重要性。

REF: Alzir I, Triantafyllou G, Luzzi S, et al. A Systematic Review With Meta-analysis of the Mastoid Emissary Foramen: Implications for Posterior Cranial Fossa Surgery. World Neurosurg. 2026;209:124895. doi:10.1016/j.wneu.2026.124895 PMID: 41794395

Cerebrospinal Fluid Shunting in Hydrocephalus Secondary to Leptomeningeal Metastases: A Systematic Review and Meta-Analysis of Functional Outcomes, Symptom Improvement, and Complications

软脑膜转移继发脑积水的脑脊液分流术：功能结局、症状改善和并发症的系统评价与荟萃分析

Leptomeningeal metastasis (LMM) frequently leads to hydrocephalus due to impaired cerebrospinal fluid (CSF) flow, resulting in elevated intracranial pressure and debilitating neurological symptoms. CSF shunting including ventriculoperitoneal, lumboperitoneal, and other diversion procedures is widely used as a palliative strategy, yet current evidence remains fragmented, with limited quantitative synthesis of functional outcomes, symptom reversibility, survival, and complications. This systematic review and meta-analysis aimed to evaluate the clinical outcomes and safety profile of CSF shunting for hydrocephalus secondary to LMM. Pooled results showed that CSF shunting provides meaningful symptomatic and functional improvement for patients with LMM-associated hydrocephalus, although survival remains limited and complication rates are substantial.

软脑膜转移（LMM）常因脑脊液（CSF）循环障碍导致脑积水，进而引起颅内压升高和严重的神经系统症状。脑脊液分流术，包括脑室腹腔分流、腰大池腹腔分流及其他引流手术，被广泛用作姑息治疗策略，但目前相关证据较为零散，关于功能结局、症状可逆性、生存率及并发症的定量综合分析有限。本系统评价和荟萃分析旨在评估脑脊液分流术治疗LMM继发脑积水的临床结局和安全性。汇总结果显示，尽管生存期仍然有限且并发症发生率较高，但脑脊液分流术可为LMM相关性脑积水患者带来有意义的症状和功能改善。

REF: Alomari O, Uslu I, Kılıç D, et al. Cerebrospinal Fluid Shunting in Hydrocephalus Secondary to Leptomeningeal Metastases: A Systematic Review and Meta-Analysis of Functional Outcomes, Symptom Improvement, and Complications. World Neurosurg. 2026;209:124901. doi:10.1016/j.wneu.2026.124901 PMID: 41796675

Endoscopic Trans-Costovertebral Approach to Thoracic Discectomy for Central Calcified Disc Herniations: A Technical Note

经内镜经肋椎入路治疗中央型钙化椎间盘突出症的胸椎椎间盘切除术：技术要点

Thoracic disc herniations are rare but can cause severe myelopathy, particularly when centrally located and calcified. Their ventral position and limited operative corridor make surgical management challenging. The endoscopic trans-costovertebral approach offers an effective minimally invasive corridor for the resection of large, centrally located, calcified thoracic disc herniation when careful technique is applied. Critical factors include selecting an entry point at least 10 cm off midline and referencing the dorsal rib border for trajectory planning. Swimmer's arm positioning can lateralize the scapula when needed, though the approach may be limited to very thin patients. Superficial lateral facet docking is the first step. Foraminoplasty should then be performed under endoscopic visualization, establishing key anatomical landmarks including the rib head and neck and identifying the rib anatomy by tracing back from the foramen/disc space.

胸椎间盘突出症较为罕见，但可导致严重的脊髓病，尤其是当突出位于中央且伴有钙化时。其腹侧位置和有限的手术通道使得手术治疗颇具挑战性。当采用精细的技术时，内镜下经肋横突入路为切除大型、位于中央且钙化的胸椎间盘突出提供了一种有效的微创通道。关键因素包括选择距离中线至少10厘米的入点，并以肋骨背侧缘为参考进行路径规划。必要时，采用游泳者手臂体位可使肩胛骨外移，不过该入路可能仅适用于非常瘦的患者。第一步是进行浅层外侧小关节对接。然后应在内镜直视下进行椎间孔成形术，确定关键的解剖标志，包括肋骨头和肋颈，并通过从椎间孔/椎间盘间隙回溯来识别肋骨解剖结构。

REF: Mambelli D, Demand A, Kankam SB, Huang M. Endoscopic Trans-Costovertebral Approach to Thoracic Discectomy for Central Calcified Disc Herniations: A Technical Note. World Neurosurg. 2026;209:124872. doi:10.1016/j.wneu.2026.124872 PMID: 41707890

A Protocol to Preserve the Dural Safety Margin During Simultaneous Hybrid Lumbar Unilateral Biportal Endoscopy and Cervical Laminoplasty

同时进行混合式腰椎单侧双孔内镜手术与颈椎椎板成形术时保留硬脑膜安全边界的方案

Simultaneous single-stage decompression for tandem spinal stenosis is increasingly favored to reduce recovery time. The "hybrid" approach combines open cervical laminoplasty with lumbar unilateral biportal endoscopy (UBE). However, UBE requires continuous saline irrigation, which creates hydrostatic pressure capable of increasing intracranial pressure via the subarachnoid space. We hypothesized this transmitted pressure impacts the exposed cervical dura during simultaneous surgery, posing an iatrogenic risk. Simultaneous hybrid surgery makes the cervical dura susceptible to injury due to hydraulic coupling. Hydrostatic pressure from lumbar irrigation causes cervical dural bulging, increasing iatrogenic durotomy risk. Surgeons must coordinate to pause lumbar irrigation during critical cervical manipulation to ensure dural relaxation.

对于串联性脊柱狭窄，同期单阶段减压术越来越受到青睐，以缩短恢复时间。“混合”手术方法将开放性颈椎椎板成形术与腰椎单侧双通道内镜（UBE）相结合。然而，UBE 需要持续的生理盐水冲洗，这会产生静水压力，该压力能够通过蛛网膜下腔升高颅内压。我们假设这种传递的压力会在同期手术期间对暴露的颈椎硬脑膜产生影响，带来医源性风险。同期混合手术由于液压耦合作用使颈椎硬脑膜容易受到损伤。腰椎冲洗产生的静水压力会导致颈椎硬脑膜膨出，增加医源性硬脑膜切开的风险。外科医生必须相互配合，在进行关键的颈椎操作时暂停腰椎冲洗，以确保硬脑膜松弛。

REF: Tam K, Li HY, Lo HK, Kam WL. A Protocol to Preserve the Dural Safety Margin During Simultaneous Hybrid Lumbar Unilateral Biportal Endoscopy and Cervical Laminoplasty. World Neurosurg. 2026;209:124877. doi:10.1016/j.wneu.2026.124877 PMID: 41722774

Fluoroscopic Myelography-Guided Lumboperitoneal Shunt Placement to Reduce the Risk of Spinal Subdural–Extra-Arachnoid Catheter Misplacement: A Technical Note

透视下脊髓造影引导腰大池 - 腹腔分流术以降低脊髓硬膜下 - 蛛网膜外导管误置风险：技术说明

Lumboperitoneal (LP) shunting is an established treatment for idiopathic normal pressure hydrocephalus (iNPH). However, lumbar catheter misplacement into the spinal subdural-extra-arachnoid space (SSES) can cause shunt malfunction. We describe a fluoroscopy-assisted LP shunt placement technique combined with limited intraoperative spinal myelography to facilitate catheter placement accuracy. In this series, fluoroscopy-assisted LP shunt placement with limited intraoperative spinal myelography allowed real-time confirmation of subarachnoid catheter positioning. This technique appears technically feasible and may help prevent SSES-related malfunction by reducing the risk of catheter misplacement during LP shunt surgery.

腰腹腔（LP）分流术是特发性正常压力脑积水（iNPH）的一种既定治疗方法。然而，腰导管误置入脊髓硬膜下 - 蛛网膜外间隙（SSES）会导致分流装置故障。我们介绍一种在透视辅助下结合有限术中脊髓造影的 LP 分流管置入技术，以提高导管置入的准确性。在本系列中，透视辅助下结合有限术中脊髓造影的 LP 分流管置入术可实时确认导管在蛛网膜下腔的位置。该技术在技术上似乎可行，且通过降低 LP 分流手术中导管误置的风险，有助于预防与 SSES 相关的分流装置故障。

REF: Tanaka T, Suehiro E, Hue AT, et al. Fluoroscopic Myelography-Guided Lumboperitoneal Shunt Placement to Reduce the Risk of Spinal Subdural-Extra-Arachnoid Catheter Misplacement: A Technical Note. World Neurosurg. 2026;209:124897. doi:10.1016/j.wneu.2026.124897 PMID: 41796676

The Patapata Articulating Dissector for Endoscopic Neurosurgery: Improving Precision and Expanding Surgical Access

用于神经内镜手术的帕塔帕塔关节式解剖器：提高手术精度并拓展手术操作空间

Endoscopic neurosurgery enables minimally invasive access to deep-seated lesions. However, surgical manipulation is restricted by the limited maneuverability of straight instruments within narrow corridors. To address these limitations, we developed a clinically applicable articulating dissector that enables multidirectional distal-tip motion without requiring shaft movement. This newly developed articulating dissector expands the operable range and improves maneuverability in endoscopic neurosurgery by enabling controlled distal tip motion without the need for shaft manipulation. It represents a practical advancement in minimally invasive neurosurgical instrumentation.

内镜神经外科手术可实现对深部病灶的微创操作。然而，直型器械在狭窄通道内的操作灵活性有限，限制了手术操作。为解决这些局限，我们研发了一种临床适用的可关节式解剖器，该解剖器可实现远端尖端多向运动，且无需移动器械杆。这种新研发的可关节式解剖器通过实现无需器械杆操作的可控远端尖端运动，扩大了内镜神经外科手术的可操作范围并提高了操作灵活性。它代表了微创神经外科器械的一项实用性进展。

REF: Takeuchi K, Nagata Y, Iwami K, et al. The Patapata Articulating Dissector for Endoscopic Neurosurgery: Improving Precision and Expanding Surgical Access. World Neurosurg. 2026;209:124917. doi:10.1016/j.wneu.2026.124917 PMID: 41812794

Central Laminectomy Contralateral Lumbar Decompression for Lumbar Degenerative Disease using Unilateral Biportal Endoscopy: A Technical Note and Preliminary Clinical Results

单侧双镜联合中央椎板切除术对侧腰椎减压治疗腰椎退行性疾病：技术说明与初步临床结果

Minimally invasive spine surgery can minimize damage to normal anatomical structures. Unilateral Biportal Endoscopic (UBE) surgery is being increasingly adopted as a minimally invasive technique. In this study, we performed a novel surgical technique named Central Laminectomy Contralateral Lumbar Decompression with Unilateral Biportal Endoscopy (CLCD-UBE) as a minimally invasive surgery for Lumbar Degenerative Disease. The purpose of this study is to present the CLCD technique of UBE and to analyze the clinical results. CLCD-UBE demonstrated safe and effective contralateral spinal canal/foraminal decompression and discectomy. CLCD-UBE technique may represent an alternative minimally invasive surgery for the treatment of LDD.

脊柱微创手术可以将对正常解剖结构的损伤降至最低。单侧双孔内镜（UBE）手术作为一种微创手术技术正越来越多地被采用。在本研究中，我们实施了一种名为单侧双孔内镜下中央椎板切除对侧腰椎减压术（CLCD - UBE）的新型手术技术，将其作为腰椎退行性疾病的微创手术方法。本研究的目的是介绍UBE的CLCD技术并分析临床结果。CLCD - UBE显示出安全有效的对侧椎管/椎间孔减压和椎间盘切除术效果。CLCD - UBE技术可能是治疗腰椎退行性疾病的另一种微创手术选择。

REF: Zhang H, An F, Yang D, Zhu M, Zhang W, Xu W. Central Laminectomy Contralateral Lumbar Decompression for Lumbar Degenerative Disease using Unilateral Biportal Endoscopy: A Technical Note and Preliminary Clinical Results. World Neurosurg. 2026;209:124925. doi:10.1016/j.wneu.2026.124925 PMID: 41862154

Bilateral Hippocampal High-Grade Glioma: An Exceptional Rare Entity

双侧海马高级别胶质瘤：一种极其罕见的病症

We report a 60-year-old woman who presented with a 1-month history of progressive cognitive decline and was found to have bilateral enhancing lesions involving both hippocampi. Histopathological examination confirmed the diagnosis of high-grade glioma. High-grade gliomas arising specifically within the bilateral hippocampi are exceedingly rare and may mimic encephalitic processes, with only a single case previously reported in the literature. Nevertheless, this entity should be considered in the differential diagnosis of bilateral hippocampal lesions.

我们报告了一名60岁女性患者，她有1个月的进行性认知功能减退病史，检查发现双侧海马区有强化病灶。组织病理学检查确诊为高级别胶质瘤。双侧海马区特异性发生的高级别胶质瘤极为罕见，可能会与脑炎过程相混淆，此前文献中仅报道过1例。然而，在双侧海马区病变的鉴别诊断中应考虑到这种情况。

REF: Yindeedej V, Phairintr P, Rukskul P. Bilateral Hippocampal High-Grade Glioma: An Exceptional Rare Entity. World Neurosurg. 2026;209:124896. doi:10.1016/j.wneu.2026.124896 PMID: 41796677