Evidence map›Paper›PMID 41077980›Full record

ArticleNeurospine2025

Posterolateral Sulcus Approach for Intramedullary Hemorrhage Associated With Cavernous Malformation of High Cervical Spine: Operative Technique and Outcomes.

Yoshiki Fujikawa, Hideki Kashiwagi, Masao Fukumura, Ryokichi Yagi, Ryo Hiramatsu, Masahiro Kameda, Naosuke Nonoguchi, Motomasa Furuse, Shinji Kawabata, Toshihiro Takami and 1 more

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In one paragraph

Article in Neurospine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yoshiki FujikawaDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Hideki KashiwagiDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Masao FukumuraDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Ryokichi YagiDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Ryo HiramatsuDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Masahiro KamedaDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Naosuke NonoguchiDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Motomasa FuruseDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Shinji KawabataDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Toshihiro TakamiDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Masahiko WanibuchiDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveIntramedullary hemorrhage (IH) associated with cavernous malformation (CM) of the high cervical spine remains a significant challenge for neurosurgeons. This study aimed to evaluate the efficacy and safety of the posterolateral sulcus (PLS) approach in managing these complex cases.

methodsThis single-center retrospective study included 58 cases of spinal intramedullary tumors treated surgically over the past 4 years. The PLS approach on the side of the IH was applied for the removal of CM. Neurological function was assessed using the modified McCormick functional scale (MMCS) before surgery, one week after surgery, and at the most recent follow-up.

resultsSix patients with IH associated with CM above the C3 level were identified from the database. The mean age was 31.2 years, and 4 of the 6 patients were female. Symptom duration prior to surgery ranged from 0 to 48 months. Total removal of the CM was achieved in all 6 cases without any serious adverse events including respiratory complications. The average follow-up duration was 21.7 months. The mean MMCS score was 3.0 before surgery, maintained at 2.5 in the early postoperative period, and improved further to 2.2 at the most recent follow-up. One patient of ventral-type CM experienced recurrent hemorrhage at the same level 30 months after the initial surgery. This patient subsequently underwent a second surgery using the anterolateral sulcus approach, which was well tolerated.

conclusionThe PLS approach enables safe removal of CM even in the high cervical spine. However, ventral-type CMs remain a major surgical concern.

Indexed as

Cavernous malformationCervical cordDorsal root entry zoneIntramedullary hemorrhageMyelotomyPosterolateral sulcus

Identifiers

PMID41077980
PMCPMC12518911

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