Wanru Duan

Xuanwu hospital | xwhosp · Department of Neurosurgery

Purpose Surgical treatment for atlantoaxial instability in pediatric patients is challenging. We report our experience with posterior intra-articular distraction technique in treating this disorder. Methods This is a retrospective descriptive study which included 15 patients of atlantoaxial instability whose age was less than 16 years at the time...

Objective: Surgical procedures for patients with posttraumatic syringomyelia (PTS) remain controversial. Until now, there have been no effective quantitative evaluation methods to assist in selecting appropriate surgical plans before surgery. Methods: We consecutively enrolled PTS patients (arachnoid lysis group, n = 42; shunting group, n = 14)...

Craniovertebral junction malformation is a congenital malformation located in the foramen magnum and upper cervical spine, including bone and nerve malformation, resulting in motor and sensory disorders, cerebellar and lower cranial nerves, etc. The evaluation methods of clinical symptoms and efficacy of craniovertebral junction malformation are im...

Background: In cases of cervical ossification of the posterior longitudinal ligament (OPLL), when initial anterior or posterior decompression fails to yield satisfactory results, the alternative approach is often chosen for revision surgery. Nevertheless, there is a lack of reported information regarding the treatment and prognosis of patients with...

Pedicle screw placement is a well-established procedure in spine surgeries, and the utilization of robots in spinal surgery has been on the rise. This study aims to investigate the accuracy and screw placement time associated with the use of Mazor X robots in robotic-assisted pedicle screw placement. A retrospective case study was conducted on 12 p...

Study Design Cohort study. Objective The aim of this study was to explore the association between blood spinal cord barrier (BSCB) markers and other factors associated with unfavorable outcome among patients with post-traumatic syringomyelia (PTS) who achieved successful intradural adhesion lysis (IAL). Summary of Background Data Only approximate...

Cranio-cervical junction (CVJ) anomalies encompass a spectrum of bone,soft tissue,and neural structural abnormalities,including basilar invagination,platybasia,atlantoaxial dislocation,tonsillar herniation,and occipito-cervical fusion.Given the frequent coexistence of these anomalies and the intricate anatomical variations involved,precise imaging...

Hypertrophic pachymeningitis (HP) is a relatively rare disease of the central nervous system characterized by local or diffuse fibrous thickening of the dura mater. At present, there is still insufficient research on the pathogenesis and treatment strategies of this disease. We reported a continuous case series of seven patients with idiopathic HP...

Objective: The surgical management of basilar invagination without atlantoaxial dislocation (type B basilar invagination) remains controversial. Hence, we have reported the use of posterior intra-articular C1-2 facet distraction, fixation, and cantilever technique versus foramen magnum decompression in treating type B basilar invagination as well...

Objective: Although cerebrospinal fluid (CSF)-based liquid biopsy was proved to be practical in molecular analysis of intracranial gliomas, liquid biopsy of primary intramedullary astrocytoma was rarely reported. Given the distinct genomic profiles between primary intramedullary glioma and intracranial astrocytoma, whether the feasibility of CSF-b...

Malignant peripheral nerve sheath tumors (MPNSTs) are commonly associated with poor prognosis and are primarily caused by germline mutations in the SMARCB1/INI-1 gene. However, these tumors are rarely found in the spine. This case report presents the case of a 3-year-old boy diagnosed with a lumbosacral dumbbell-shaped epithelioid MPNST, an extreme...

Background: To develop a practical prediction model to predict the risk of deep surgical site infection (SSI) in patients receiving open posterior instrumented thoracolumbar surgery. Methods: Data of 3,419 patients in 4 hospitals from Jan 1, 2012 to Dec 30, 2021 were evaluated. We used clinical knowledge-driven, data-driven and decision tree mod...

Primary spinal cord astrocytoma (SCA) is a rare disease. Knowledge about the molecular profiles of SCAs mostly comes from intracranial glioma; the pattern of genetic alterations of SCAs is not well understood. Herein, we describe genome-sequencing analyses of primary SCAs, aiming to characterize the mutational landscape of primary SCAs. We utilized...

Background: The correlation among syrinx resolution, occipitoaxial sagittal alignment, and surgical outcome in long-term follow-up seems to have not been clarified. Objective: To further explore the relationship between the syrinx resolution and occipitoaxial realignment after posterior reduction and fixation in basilar invagination (BI)-atlanto...

Background: A specific scoring system for syringomyelia is lacking. Our objective was to investigate the value of a novel scoring system (Syringomyelia Outcome Scale of Xuanwu hospital, SOS-XW) in assessing surgical outcomes in the treatment of syringomyelia (SM) associated with Chiari malformation type I (CM I). Methods: A quantitative evaluati...

Objective: We used topology optimization technology to explore the new theory and method of interbody fusion cage design and realized an innovative design of interbody cages. Methods: The lumbar spine of a normal healthy volunteer was scanned to perform reverse modeling. Based on the scan data for the L1-L2 segments of the lumbar spine, a 3D mod...

Objectives: To analyze the prognostic and risk factors related to surgical treatment of central spinal cord syndrome (CSS) and to find out the optimal timing of operative management. Methods: From January 2011 to January 2019, a consecutive series of 128 patients with CSS confirmed by magnetic resonance imaging (MRI) were retrospectively analyze...

Objective: Combined with different configuration types of syringomyelia, to analyze the correlation between syrinx resolution and changes in cervical sagittal alignment following Foramen magnum and Magendie dredging (FMMD) for syringomyelia associated with Chiari I malformation (CM-I), and to further explore the respective relationship with clinic...

Objective: To discuss the surgical strategy for difficult-reducible atlantoaxial dislocation. Methods: Clinical data of 82 patients with difficult-reducible atlantoaxial dislocation underwent surgical treatment in the Department of Neurosurgery, Xuanwu Hospital from January 2018 to February 2019 were retrospectively reviewed. Total of 32 men and 50...

Objectives Chronic pain is primarily treated with pharmaceuticals, but the effects remain unsatisfactory. A promising alternative therapy is peripheral nerve stimulation (PNS), but it has been associated with suboptimal efficacy because its modulation mechanisms are not clear and the current therapies are primarily open loop (ie, manually adjusting...

Objective: The specific association between morphometric characteristics of the syrinx and the prognosis of Chiari malformation type I (CM-I) with syringomyelia following surgical procedure seems to have not been fully elaborated. This study focused on the preoperative clinical and radiologic parameters in CM-I patients with syringomyelia to find...

Background Patients with syringomyelia who present with new neurological symptoms after posterior fossa decompression (PFD) are not uncommon. However, systematic reports on different pathologies are few in the literature. Objective The purpose of this study was to summarize our experience for failed PFD. Methods Between January 2015 and December...

Chordoma is a rare and aggressive bone tumor. An accurate investigation of tumor heterogeneity is necessary for the development of effective therapeutic strategies. This study aims to assess the poorly understood tumor heterogeneity of chordomas and identify potential therapeutic targets. Single-cell RNA sequencing was performed to delineate the tr...

Neural electrode interfaces are essential to the stimulation safety and recording quality of various bioelectronic therapies. The recently proposed hierarchical platinum-iridium (Pt-Ir) electrodes produced by femtosecond lasers have exhibited superior electrochemical performance in vitro, but their in vivo performance is still unclear. In this stud...

Objective: To examine the effect of posterior atlanto-axial intraarticular distraction technique as revision surgery for failed posterior fossa decompression in patients with basilar invagination(BI) and atlanto-axial dislocation(AAD). Methods: The clinical data of 13 cases of AAD accompanied with BI treated at Department of Neurosurgery, Xuanwu Ho...

Spinal extradural meningeal cysts (SEMCs) are rare lesions of the spinal canal. Although closure of the dural defect can achieve satisfactory therapeutic effects, locating the fistula is difficult. This review summarizes the methods for locating the fistula of SEMCs and the distribution and features of fistula sites. This was a non-systematic liter...

Background No prior reports have focused on spinal cord injury (SCI) characteristics or inflammation after destruction of the blood–spinal cord barrier by syringomyelia. This study aimed to determine the differences in syringomyelia-related central SCI between craniocervical junction (CCJ) syringomyelia and post-traumatic syringomyelia (PTS) before...

Chronic pain affects about 100 million adults in the US and is primarily treated with drugs, which can have significant side effects. A promising alternative therapy is electrical peripheral nerve stimulation (PNS) treatment. However, it has been associated with suboptimal efficacy since its modulation mechanisms are unclear, and the current therap...

Pathologies of the lateral masses could lead to bone destruction of the cervical spine. Their treatment includes lesion resection and fixation. However, the resulting bone defect of a lateral mass is often neglected, resulting in difficulty in bone fusion. Therefore, we designed a subaxial lateral mass prosthesis to achieve lateral mass joint fusio...

Background: To investigate the clinical efficacy of percutaneous endoscopic transforaminal discectomy (PETD) in the treatment of upper lumbar disc herniation (LDH). Methods: Twenty-two patients, 14 males and 8 females with ages ranging from 23 to 76 years, who had upper LDH and were treated with PETD from April 2015 to April 2020 in the Departme...

Background The specific association between morphometric characteristics of the syrinx and the prognosis of Chiari malformation type I (CM-I) with syringomyelia following surgical procedure seems to have not been elaborated. This study focused on the preoperative clinical and radiologic parameters in simple CM-I patients with syringomyelia to find...

Objective: This study aimed to investigate the outcome of using three-dimensional (3D)-printed prostheses to reconstruct a cervical lateral mass to maintain cervical stability. Methods: We retrospectively analyzed data of seven patients requiring cervical lateral mass reconstruction using a 3D-printed prosthesis, comprising axial and subaxial la...

Dysphagia is a common complication following anterior cervical spine surgery (ACSS). Although several literatures have reported the potential benefit of local corticosteroid application on dysphagia, its safety and efficacy are still unclear. A systematic review was performed aiming to evaluate the evidence of local corticosteroid application in pr...

BACKGROUND Treatment of severe rigid 360° fused cervical kyphosis (CK) is challenging and often requires a combined approach for ankylosis release, establishment of sagittal balance, and fixation with fusion. OBSERVATIONS Four patients with iatrogenic 360° fused severe rigid CK (Cobb angle ≥40°) were enrolled for this retrospective analysis. All p...

Purpose: To obtain the relevant morphometry of the lateral mass of the subaxial cervical spine (C3-C7) and to design a series of lateral mass prostheses for the posterior reconstruction of the stability of cervical spine. Methods: The computed tomography (CT) scans of healthy volunteers were obtained. RadiAnt DICOM Viewer software (Version 2020....

Objective: This study aimed to illustrate the features of fistula location distribution, surgical strategies, and outcomes in spinal epidural meningeal cysts (SEMCs). Methods: The authors searched and reviewed the medical records for cases of SEMCs. Imaging features, operative reports, and media were reviewed to accurately describe the surgical...

Background No prior reports have focused on spinal cord injury (SCI) characteristics or inflammation after destruction of the blood-spinal cord barrier by syringomyelia. To compare the difference of syringomyelia-related central SCI between craniocervical junction (CCJ) and post-traumatic syringomyelia (PTS) before and after decompression. Methods...

Objective To examine the surgical procedure for and the clinical efficacy of using spinal endoscopy for sacral Tarlov cyst treatment. Methods A retrospective analysis of the general information, clinical symptoms, radiologic examinations, surgical methods, postoperative recovery, and follow-up status of patients with sacral Tarlov cysts who underw...

Neuromodulation treatments for chronic pain are programmed with limited knowledge of how electrical stimulation of nerve fibers affects the dynamic response of pain-processing neurons in the spinal cord and the brain. By modeling these effects with tractable representations, we may be able to improve efficacy of stimulation therapy. However, pain t...

Pain is a protective physiological system essential for survival. However, it can malfunction and create a debilitating disease known as chronic pain (CP), which is primarily treated with drugs that can produce negative side effects (e.g., opioid addiction). Peripheral nerve stimulation (PNS) is a promising alternative therapy; it has fewer negativ...

Introduction: Atlantoaxial dislocation (AAD) is a complicated and challenging deformity with severe morbidities. Irreducible AAD with C1/2 bony fusion requires anterior (transoral or transnasal) odontoidectomy to decompress spinal cord or medulla, which is highly demanding technique that is risky for comorbidities. Here, we report our application o...

Objective: Primary spinal cord H3 K27M-mutant diffuse midline glioma (DMG) is a rare and devastating pathological entity. However, little attention has been paid to this disease. As a result, its clinicoradiological characteristics have yet to be described. The aim of this study was to describe the clinicoradiological characteristics of primary in...

Background: Pathologies of a lateral masses due to trauma, tumors, and surgery, could lead to bone destruction and biomechanical changes of the cervical spine. Their treatment includes lesion resection and internal fixation. However, the resulting bone defect of a lateral mass is often neglected, resulting in difficulty in bone fusion. Therefore, w...

Background The existing classification in Chiari I malformation (CM-I) has limited significance for the selection of surgical methods.Objective The purpose of this study was to investigate the surgery of CM-I with syringomyelia based on the high-resolution MR imaging (HRMRI) findings.Methods Data from 115 patients were collected and retrospectively...

A correction to this paper has been published: https://doi.org/10.1007/s00586-021-06787-3.

Background Occipitalization of the atlas (AO) is among the most common congenital or environmental malformations of the craniovertebral region, the rate of incidence of which ranges from 0.08%-2.76% in the general population. The fundamental pathogenic mechanisms and molecular etiology remain largely unknown.. Results Rare variants were detected i...

Background: Chordoma is a rare and aggressive bone tumor with high recurrence. The intra-tumoral heterogeneity of chordomas is poorly understood, limiting the development of effective therapeutic strategies. Methods: Single-cell RNA sequencing was performed to delineate the transcriptomic landscape of chordomas. Six tumor samples of pathologically...

Objectives The combination of epidural electrical stimulation (EES) and serotonin agonists (5‐HTA) effectively restores rhythmic lower‐limb movements and improves intraspinal hemodynamics after spinal cord injury (SCI). Nonetheless, whether EES + 5‐HTA improves intraspinal metabolism remains unclear. The present study aimed to evaluate the effects...

BACKGROUND The management of atlantoaxial dislocation (AAD) associated with basilar invagination (BI) is challenging, and traditional posterior-only approaches lack the ability to release the anterior soft tissue resulting in unsatisfactory reduction. Furthermore, vertebral artery anomalies and deformed anatomy increase surgical risks. OBJECTIVE T...

The anterior decompression technique, including vertebral body sliding osteotomy1 and anterior controllable antedisplacement fusion (ACAF),2 treats ossified posterior longitudinal ligament (OPLL) without actual excision of the OPLL.3 The fundamental strategy is to separate the mid-portion of the vertebral body along with the OPLL using bilateral an...

PurposePrimary spinal cord glioblastoma (GBM) is a rare and devastating disease. Little attention was ever paid to this rare disease. As a result, the standard treatment protocol and prognostic factors of primary spinal cord GBM were not well established. The aim of this study was to determine the predictors associated with survival in patients wit...

Background Although effective results of many studies support the use of spinal cord stimulation in chronic pain patients, no randomized controlled trial has been undertaken in China to date. CITRIP is a multicenter, prospective, randomized, withdrawal study designed to evaluate the clinical effectiveness and safety of spinal cord stimulation plus...

Objective: This study evaluated the feasibility and efficacy of quantitative reduction and fixation to treat basilar invagination (BI) with atlantoaxial dislocation (AAD). Methods: Posterior occipitocervical angle (POCA), occiput-C2 angle (Oc-C2A), clivusaxial angle (CAA), and C2-7 angle (C2-7A) were considered for quantitative reduction. Twelve...

Background: There is still no consensus on the time period of wearing collar after anterior cervical discectomy and fusion (ACDF). We aim to investigate the optimal time period of wearing protective collar. Methods: We retrospectively reviewed patients with cervical spondylosis who underwent one to two segment ACDF during January 2016 and December...

Objectives The burden of pain after spinal cord injury (SCI), which may occur above, at, or below injury level, is high worldwide. Spinal cord stimulation (SCS) is an important neuromodulation pain therapy, but its efficacy in SCI pain remains unclear. In SCI rats, we tested whether conventional SCS (50 Hz, 80% motor threshold [MoT]) and 1200 Hz, l...

Purpose By summarizing the pathological changes in the intradural region of the craniocervical junction in patients with syringomyelia and the pathophysiological mechanism of cerebrospinal fluid (CSF) circulation obstruction, this article discusses the procedure of foramen magnum and Magendie dredging (FMMD). Methods Clinical data from 50 adult pa...

Transoral odontoidectomy is a traditional technique to treat congenital basilar invagination (BI) associated with atlantoaxial dislocation (AAD). Although posterior surgery has been a trend to treat most cases, there are still cases that need to be treated through a transoral approach. In addition, intraoperative modern image-guided navigation syst...

Congenital atlantoaxial dislocation (AAD) associated with basilar invagination (BI) is a complex congenital malalignment at the craniovertebral junction. The olisthesis, atlantoaxial facet joint arthropathy, and the contraction of the anterior soft tissue make the treatment challenging. Our video demonstrates the surgical technique for posterior in...

Objective To investigate the clinical efficacy of transverse process endoscopic transforaminal discectomy for the treatment of high-iliac-crest L5-S1 lumbar disc herniation. Methods Seventeen patients with high-iliac-crest L5-S1 lumbar disc herniation who were treated with transforaminal endoscopy from April 2016 to January 2019 in the Department...

Study design: A mechanism-based reasoning and case-control study. Objective: To introduce correction target of clivo-axial angle (CXA) in quantitative surgical reduction of basilar invagination (BI). Summary of background data: The exact mechanism of BI with or without atlantoaxial dislocation is still unclear. Sagittal deformity is a key feat...

Object: FMD remains the first-line treatment for CM-I associated with syringomyelia, although consistent approaches are not used. However, there are few reports on a persistent or recurrent syrinx or worsening neurological symptoms after FMD. Methods: We retrospectively reviewed medical records of patients who attended Xuanwu Hospital between Ja...

Acute pain is a common complication after injury of a peripheral nerve but the underlying mechanism is obscure. We established a model of acute neuropathic pain via pulling a pre-implanted suture loop to transect a peripheral nerve in awake rats. The tibial (both muscular and cutaneous), gastrocnemius–soleus (muscular only), and sural nerves (cutan...

Background Although effective results of many studies support the use of spinal cord stimulation in the chronic pain patients, no randomized controlled trial has been undertaken in China to date. CITRIP is a multicenter, prospective, randomized, withdrawal study designed to evaluate the clinical effectiveness and safety of spinal cord stimulation p...

Background: Although effective results of many studies support the use of spinal cord stimulation in the chronic pain patients, no randomized controlled trial has been undertaken in China to date. CITRIP is a multicenter, prospective, randomized, withdrawal study designed to evaluate the clinical effectiveness and safety of spinal cord stimulation...

Background Although effective results of many studies support the use of spinal cord stimulation in the chronic pain patients, no randomized controlled trial has been undertaken in China to date. CITRIP is a multicenter, prospective, randomized, withdrawal study designed to evaluate the clinical effectiveness and safety of spinal cord stimulation p...

Objective: To examine the effect of posterior reduction in atlantoaxial dislocation (AAD) associated with basilar invagination(BI) using Xuanwu occipital-cervical fusion system in single stage. Methods: Thirty-seven AAD accompanied with BI cases treated at Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy and the Second Hospita...

Introduction: Paclitaxel-induced peripheral neuropathy (PIPN) is a common dose-limiting side effect of this cancer treatment drug. Spinal cord stimulation (SCS) has demonstrated efficacy for attenuating some neuropathic pain conditions. Objective: We aim to examine the inhibitory effect of SCS on the development of PIPN pain and changes of gene...

Objective: To assess the value and limitation of cervical traction in the evaluation of the reducibility of atlantoaxial dislocation (AAD) and basilar invagination (BI) using the intraoperative O-arm. Methods: A total of 22 patients with hyperextensive, irreducible AAD were included. The cervical traction test under general anesthesia was perfor...

OBJECTIVE The treatment of atlantoaxial dislocation (AAD) and basilar invagination (BI) is challenging, especially in symptomatic patients with a history of previous surgery. Although seldom reported, posterior revision surgery to revise prior constructs can be advantageous over an anterior or combined approach. The authors describe their experienc...

Opioid use for chronic pain is limited by severe central adverse effects. We examined whether activating mu-opioid receptors (MORs) in the peripheral nervous system attenuates spinal cord injury (SCI) pain-like behavior in mice. We produced a contusive SCI at the T10 vertebral level and examined motor and sensory dysfunction for 6 weeks. At 6 weeks...

Topical irritants such as capsaicin (CAP), peppermint oil (PO), and mustard oil (MO) are effective in relieving inflammatory muscle pain. We investigated the effects of topical irritants in a rat model of inflammatory muscle pain produced by injecting complete Freund’s adjuvant (CFA) into the tibialis anterior muscle. CFA-induced mechanical hyperse...

Objectives: High-frequency spinal cord stimulation (SCS) administered below the sensory threshold (subparesthetic) can inhibit pain, but the mechanisms remain obscure. We examined how different SCS paradigms applied at intensities below the threshold of Aβ-fiber activation (sub-sensory threshold) affect spinal nociceptive transmission in rats afte...

Rodent models of contusion spinal cord injury (SCI) are widely studied for the mechanisms underlying functional deficits after SCI. Yet, how does lesion level affect SCI-induced motor and sensory dysfunctions remains unclear. Using a computer-controlled impactor (Impact One™, Leica) and the same parameters (diameter, 2.0 mm; Speed: 4.0 m/s; Depth:...

Purpose Surgical procedures on atlantoaxial dislocation remain controversial. The aim of this observational retrospective study was to investigate the treatment algorithm of surgical procedures. Methods According to CT and intraoperative evaluation during direct posterior reduction, 135 AAD cases were categorized into three groups: Group I: reduci...

Study design: A mechanism-based reasoning and retrospective cohort study. Objective: To establish a quantitative relationship between the change of clivo-axial angle (CXA) and the change of subaxial cervical lordosis (CL) in correction surgery of atlantoaxial dislocation (AAD). Summary of background data: The evolving understanding of mechanis...

In addition to restoration of bladder, bowel, and motor functions, alleviating the accompanying debilitating pain is equally important for improving the quality of life of patients with spinal cord injury (SCI). Currently, however, the treatment of chronic pain after SCI remains a largely unmet need. Electrical spinal cord stimulation (SCS) has bee...

Purpose: To compare the clinical and radiographic outcomes of irreducible atlantoaxial dislocation (IAAD) treated with posterior fusion after anterior release and direct posterior reduction of the dislocation. Methods: Online databases were searched for articles describing IAAD published from 1999 to 2015. Five studies (105 patients) described t...

The aim of the study is to explore the experiences in diagnosis and treatment of severe neurosurgical patients with pyogenic ventriculitis caused by gram-negative bacteria (G−). Nineteen patients with pyogenic ventriculitis were reviewed for their treatment. The bacterial testing results of cerebrospinal fluid (CSF), the clinical intervention, and...

Background Implantation of deep brain stimulation (DBS) electrodes is a landmark therapy for movement disorders and some mental conditions. Compared to conventional platinum–iridium (Pt–Ir) electrodes, carbon nanotube yarns (CNTY) electrodes have improved stability and interface characteristics with less distortion during high field strength MRI. S...

Some types of peripheral neuropathic pain are associated with damage to myelin rather than to axons of primary sensory neurons. It is extremely important to develop selective demyelination animal models for understanding neuropathic pain caused by demyelination. We induced a rapid-onset and reversible demyelination of peripheral A-fibers and neurop...