A Reflection on Nursing in Neurosurgery

对神经外科护理工作的思考

Around the world in many countries, May is “Nurses Month” and May 12, International Nurses Day (Florence Nightingale's birthday). Thinking about this a few months ago led me to think how little we spend in the pages of this journal and others, on the value of nursing in neurosurgery. The cover this month highlights the partnership of nurses and neurosurgeons from years past and the present. My dear friend Dan Leksell shared this image of his father Lars Leksell performing air ventriculography, while his nurse assists with the imaging...

在世界各地的许多国家，五月是“护士月”，5月12日是国际护士日(弗洛伦斯·南丁格尔的生日)。几个月前，考虑到这一点，我想到我们在这本杂志和其他杂志上花在神经外科护理价值上的钱是多么少。本月的封面突出了过去几年和现在的护士和神经外科医生的合作。我亲爱的朋友丹·莱克塞尔分享了这张照片，照片中他的父亲拉尔斯·莱克塞尔正在做空气脑室造影术，而他的护士正在协助进行成像……

REF: Kondziolka D. A Reflection on Nursing in Neurosurgery. Neurosurgery. 2023;92(5):893. doi:10.1227/neu.0000000000002419 PMID: 37067281

Internal Ventricular Cerebrospinal Fluid Shunt for Adult Hydrocephalus: A Systematic Review and Meta-Analysis of the Infection Rate

成人脑积水脑室内脑脊液分流术的系统评价及感染率的Meta分析

This study is to determine the IVCSFS overall IR in the adult population and search for associated factors. IVCSF is a procedure that every neurosurgeon should be well trained to perform. However, the complication rate remains high, with an estimated overall IR of 4.75%. The IR is especially elevated for hydrocephalic patients who require IVCSFS after intracranial hemorrhage. However, decades of surgical advances may have succeeded in reducing IR over the past 32 years.

本研究旨在确定成人人群中IVCSFS的总体IR，并寻找相关因素。IVCSF是每一位神经外科医生都应该接受过良好培训的程序。然而，并发症的发生率仍然很高，估计总体IR为4.75%。对于颅内出血后需要IVCSFS的脑积水患者，IR尤其升高。然而，在过去的32年里，几十年的外科进步可能成功地减少了IR。

REF: Ramasy Razafindratovo RM, Migliavaca CB, Chevret S, Champeaux-Depond C. Internal Ventricular Cerebrospinal Fluid Shunt for Adult Hydrocephalus: A Systematic Review and Meta-Analysis of the Infection Rate. Neurosurgery. 2023;92(5):894-904. doi:10.1227/neu.0000000000002301 PMID: 36700711

Socioeconomic Effects on Lumbar Fusion Outcomes

社会经济对腰椎融合术结果的影响

This study is to determine the influence of SES variables including race, education, net worth, and homeownership on postoperative outcomes. Black race, less than 12th grade education, <$25K net worth, and lack of homeownership were associated with poorer postoperative outcomes and increased costs. Increasing perioperative support for patients with these sociodemographic risk factors may improve postoperative outcomes.

本研究旨在确定包括种族、教育程度、资产净值和住房拥有率在内的SES变量对术后结果的影响。黑人种族、低于12年级的教育程度、净资产低于25K美元、没有住房与较差的术后结果和增加的费用有关。增加对有这些社会人口学危险因素的患者的围手术期支持可能会改善术后结果。

REF: Touponse G, Li G, Rangwalla T, Beach I, Zygourakis C. Socioeconomic Effects on Lumbar Fusion Outcomes. Neurosurgery. 2023;92(5):905-914. doi:10.1227/neu.0000000000002322 PMID: 36606803 PMCID: PMC10158874

Surgical Management in Herpes Simplex Encephalitis: Illustrative Case Report and Systematic Review of the Literature

单纯疱疹病毒性脑炎的外科治疗：病例例举及文献系统回顾

This study is to systematically review cases describing surgery for the treatment of severe HSVE. We also present an illustrative case of anterior temporal lobectomy (ATL) for refractory status epilepticus in a patient with unilateral HSVE. This case demonstrates one clinical context in which surgery can be a useful adjunct. Surgical treatment can be a useful adjunct for treatment of HSVE. There is substantial variability in the timing of surgical decompression in patients with HSVE, which can be necessary up to approximately 3 weeks after illness onset. ATL should be considered for refractory status epilepticus in HSVE with a unilateral seizure focus.

本研究旨在系统地回顾描述重症单纯疱疹病毒感染手术治疗的病例。我们还提出了一例前颞叶切除术(ATL)的难治性癫痫持续状态的单侧单纯疱疹患者。这个病例展示了一个临床背景，在这个背景下，手术可以是一个有用的辅助手段。手术治疗可作为单纯疱疹病毒感染治疗的有效辅助手段。HSVE患者手术减压的时间有很大的差异，发病后大约3周可能需要手术减压。单侧发作灶HSVE的难治性癫痫持续状态应考虑ATL。

REF: Bhave VM, Bernstock JD, Carlson JM, et al. Surgical Management in Herpes Simplex Encephalitis: Illustrative Case Report and Systematic Review of the Literature. Neurosurgery. 2023;92(5):915-933. doi:10.1227/neu.0000000000002334 PMID: 36700784

Stereotactic Radiosurgery for Vestibular Schwannoma in Neurofibromatosis Type 2: An International Multicenter Case Series of Response and Malignant Transformation Risk

立体定向放射外科治疗2型神经纤维瘤病的前庭神经鞘瘤：一项关于反应和恶变风险的国际多中心病例系列

Vestibular schwannomas (VSs) related to neurofibromatosis type 2 (NF2) are challenging tumors. The increasing use of stereotactic radiosurgery (SRS) necessitates further investigations of its role and safety. This study is to evaluate tumor control, freedom from additional treatment (FFAT), serviceable hearing preservation, and radiation-related risks of patients with NF2 after SRS for VS. Although the absolute volumetric tumor progression rate was 48% at 15 years, the rate of FFAT related to VS was 75% at 15 years after SRS. None of the patients with NF2-related VS developed a new radiation-related neoplasm or malignant transformation after SRS.

前庭神经鞘瘤(VSS)与神经纤维瘤病2型(NF2)相关，是具有挑战性的肿瘤。随着立体定向放射外科(SRS)的日益广泛应用，需要对其作用和安全性进行进一步的研究。本研究旨在评估NF2患者经SRS治疗VS后的肿瘤控制、免于额外治疗(FFAT)、可用听力保护和放射相关风险。虽然15年时肿瘤的绝对体积进展率为48%，但在SRS后15年，与VS相关的FFAT的发生率为75%。NF2相关的VS患者无一例在SRS后发生新的放射相关肿瘤或恶变。

REF: Bin-Alamer O, Faramand A, Alarifi NA, et al. Stereotactic Radiosurgery for Vestibular Schwannoma in Neurofibromatosis Type 2: An International Multicenter Case Series of Response and Malignant Transformation Risk. Neurosurgery. 2023;92(5):934-944. doi:10.1227/neu.0000000000002436 PMID: 36861994 PMCID: PMC10079356

Effects of Neuroanatomic Structural Distances on Pituitary Function After Stereotactic Radiosurgery: A Multicenter Study

立体定向放射外科术后神经解剖结构距离对垂体功能影响的多中心研究

This study is to investigate the relationship between neuroanatomic structure distances from the radiation target and anterior pituitary function preservation after SRS through multicenter study. Achieving a distance between the center of the pituitary stalk and the tumor margin isodose ≥3.95 mm predicted anterior pituitary function preservation. For smaller treatment volumes <2.34 mL, the optimal distance was ≥2.95 mm. This may be modifiable during trans-sphenoidal resection to preserve pituitary function.

本研究旨在通过多中心研究探讨SRS术后神经解剖结构与放射靶区距离与垂体前叶功能保护的关系。垂体柄中心到肿瘤边缘的距离达到等剂量≥3.95 mm预示着垂体前叶功能的保留。对于较小的处理量<2.34mL，最佳距离为≥2.95 mm。在经蝶窦切除术中，这一点可能是可改变的，以保护垂体功能。

REF: Ironside N, Chen CJ, Xu Z, et al. Effects of Neuroanatomic Structural Distances on Pituitary Function After Stereotactic Radiosurgery: A Multicenter Study. Neurosurgery. 2023;92(5):1035-1042. doi:10.1227/neu.0000000000002347 PMID: 36700741

Vertebral Bone Quality Score Independently Predicts Proximal Junctional Kyphosis and/or Failure After Adult Spinal Deformity Surgery

脊柱骨质量评分独立预测成人脊柱畸形手术后近端关节后凸和/或失败

This study is to investigate the utility of the VBQ score in predicting PJK and/or PJF (PJF/PJK) after ASD correction. In patients undergoing ASD correction, higher VBQ was independently associated with PJK/PJF occurrence. Measurement of VBQ score on preoperative MRI may be a useful adjunct to ASD surgery planning.

本研究旨在探讨VBQ评分在预测房间隔缺损矫正后PJK和/或PJF(PJF/PJK)中的作用。在接受ASD矫正的患者中，较高的VBQ与PJK/PJF的发生独立相关。术前MRI上VBQ评分的测量可能是ASD手术计划的有用辅助。

REF: Kuo CC, Soliman MAR, Aguirre AO, et al. Vertebral Bone Quality Score Independently Predicts Proximal Junctional Kyphosis and/or Failure After Adult Spinal Deformity Surgery. Neurosurgery. 2023;92(5):945-954. doi:10.1227/neu.0000000000002291 PMID: 36700747

The Effect of Preoperative Symptom Duration on Patient-Reported Outcomes After Anterior Cervical Discectomy and Fusion in Nonmyelopathic Patients: Analyses From the Michigan Spine Surgery Improvement Collaborative (MSSIC)

术前症状持续时间对非脊髓病患者颈椎前路髓核摘除融合术后患者报告结果的影响：来自密歇根脊柱手术改进协作组(MSSIC)的分析

The effect of preoperative symptom duration (PSD) on patient-reported outcomes (PROs) in anterior cervical discectomy and fusion (ACDF) for radiculopathy is unclear. This study is to determine whether PSD is a predictor for PRO after ACDF for radiculopathy. Preoperative symptom duration greater than 1 year in patients who underwent ACDF for radiculopathy was associated with worse odds of achieving MCID for multiple PROs.

神经根病行颈椎前路髓核摘除融合术(ACDF)中，术前症状持续时间(PSD)对患者报告预后(PRO)的影响尚不清楚。本研究旨在确定PSD是否是神经根病ACDF术后PRO的预测因子。接受ACDF治疗的神经根病患者的术前症状持续时间超过1年与多个专业患者获得MCID的几率较低相关。

REF: Lawless MH, Tong D, Claus CF, et al. The Effect of Preoperative Symptom Duration on Patient-Reported Outcomes After Anterior Cervical Discectomy and Fusion in Nonmyelopathic Patients: Analyses From the Michigan Spine Surgery Improvement Collaborative (MSSIC). Neurosurgery. 2023;92(5):955-962. doi:10.1227/neu.0000000000002295 PMID: 36524819

Postoperative Gravity Line-Hip Axis Offset as a Substantial Risk Factor for Mechanical Failure After Adult Spinal Deformity Correction Surgery

术后重力线-髋轴偏移是成人脊柱畸形矫正术后机械失败的重要危险因素

This study is to assess postoperative GL-hip axis (GL-HA) offset as a critical risk factor for MF after ASD correction surgery. Postoperative GL-HA offset is a substantial risk factor for MF after ASD surgery. Surgical correction of ASD with a GL-HA offset greater than 5 cm is significantly related to MF. The GL should be located near the HA after ASD surgery.

本研究旨在评估术后GL-髋轴偏移量(GL-HA)作为ASD矫正术后MF的关键危险因素。术后GL-HA偏移量是ASD术后MF的重要危险因素。GL-HA偏移量大于5 cm的ASD的手术矫正与MF显著相关。房间隔缺损术后GL应放置在HA附近。

REF: An S, Hyun SJ, Lee JK, Yang SH, Kim KJ. Postoperative Gravity Line-Hip Axis Offset as a Substantial Risk Factor for Mechanical Failure After Adult Spinal Deformity Correction Surgery. Neurosurgery. 2023;92(5):998-1005. doi:10.1227/neu.0000000000002309 PMID: 36700742