World neurosurgery · 2026
Pedicle Involvement Is Associated with Preoperative Neurological Deficit in Metastatic Spinal Cord Compression: A Single-Institution Cohort Study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lin Wei-Hsiag, Li Cheng-Yu, Huang Sheng-Han, Wang Hong-Kai, Chen Bo-An, Lin Tzu-Chin, Chen Kuan-Hung, Kang Yan-Po, Lin Shin-Nan, Li Ying-Ching, Lu Yu-Jen
Аннотация
OBJECTIVE: To evaluate whether pedicle involvement - tumor invasion of Weinstein-Boriani-Biagini (WBB) zones 3, 4, 9, or 10 - is associated with preoperative neurological deficit in metastatic spinal cord compression (MSCC), and to compare early recovery between surgical approaches in this subgroup.
METHODS: Thirty-nine patients with high-grade epidural spinal cord compression (ESCC grade ≥ 2) treated at a single tertiary center in Taiwan between September 2021 and December 2025 were reviewed retrospectively. The primary outcome was the American Spinal Injury Association motor score (AMS). Interobserver reliability was quantified by Cohen's kappa. Multiple linear regression was supported by variance inflation factors, bootstrap validation, and a prespecified incremental comparison against conventional radiographic measures. Early recovery (ΔAMS) was compared between corpectomy and laminectomy.
RESULTS: Twenty-five patients (64%) had pedicle involvement and lower preoperative AMS (55 ± 17 vs. 83 ± 15, p < 0.001). Interobserver κ was 0.62. Pedicle involvement was the only independent correlate (β = -23.645, p < 0.001; n = 35; all variance inflation factors < 1.4). Adding it to conventional measures raised R2 from 0.049 to 0.440 (ΔR2 = 0.391, p < 0.001). Corpectomy showed greater early ΔAMS than laminectomy (median 14.5 vs. 4.5, p = 0.042) but longer operative time and greater blood loss; complication (47% vs. 17%) and 30-day mortality (16% vs. 0%) differences were non-significant but underpowered.
CONCLUSIONS: In our practice, pedicle involvement was independently associated with lower preoperative AMS and added explanatory value beyond conventional radiographic measures. The surgical comparison was small, underpowered, and exploratory.
METHODS: Thirty-nine patients with high-grade epidural spinal cord compression (ESCC grade ≥ 2) treated at a single tertiary center in Taiwan between September 2021 and December 2025 were reviewed retrospectively. The primary outcome was the American Spinal Injury Association motor score (AMS). Interobserver reliability was quantified by Cohen's kappa. Multiple linear regression was supported by variance inflation factors, bootstrap validation, and a prespecified incremental comparison against conventional radiographic measures. Early recovery (ΔAMS) was compared between corpectomy and laminectomy.
RESULTS: Twenty-five patients (64%) had pedicle involvement and lower preoperative AMS (55 ± 17 vs. 83 ± 15, p < 0.001). Interobserver κ was 0.62. Pedicle involvement was the only independent correlate (β = -23.645, p < 0.001; n = 35; all variance inflation factors < 1.4). Adding it to conventional measures raised R2 from 0.049 to 0.440 (ΔR2 = 0.391, p < 0.001). Corpectomy showed greater early ΔAMS than laminectomy (median 14.5 vs. 4.5, p = 0.042) but longer operative time and greater blood loss; complication (47% vs. 17%) and 30-day mortality (16% vs. 0%) differences were non-significant but underpowered.
CONCLUSIONS: In our practice, pedicle involvement was independently associated with lower preoperative AMS and added explanatory value beyond conventional radiographic measures. The surgical comparison was small, underpowered, and exploratory.