Traumatic brain injuries (TBI) and stroke are major causes of morbidity and mortality in both developing and developed countries. The complex and heterogeneous pathophysiology of TBI and cerebral ischemia‐reperfusion injury (CIRI), in addition to the blood‐brain barrier (BBB) resistance, is a major barrier to the advancement of diagnostics and therapeutics. Clinical data showed that the severity of TBI and stroke is positively correlated with the number of neutrophils in peripheral blood and brain injury sites. Furthermore, neutrophil extracellular traps (NETs) released by neutrophils correlate with worse TBI and stroke outcomes by impairing revascularization and vascular remodeling. Therefore, targeting neutrophils to deliver NETs inhibitors to brain injury sites and reduce the formation of NETs can be an optimal strategy for TBI and stroke therapy. Herein, the study designs and synthesizes a reactive oxygen species (ROS)‐responsive neutrophil‐targeting delivery system loaded with peptidyl arginine deiminase 4 (PAD4) inhibitor, GSK484, to prevent the formation of NETs in brain injury sites, which significantly inhibited neuroinflammation and improved neurological deficits, and improved the survival rate of TBI and CIRI. This strategy may provide a groundwork for the development of targeted theranostics of TBI and stroke.

Objective: Spinal schwannomas are the most common intradural extramedullary tumors, and their complete removal is recommended to avoid tumor recurrence. Although laminoplasty provides a sufficient window for tumor resection, this approach may increase tissue trauma and cause postoperative instability compared with unilateral hemilaminectomy. This study aimed to compare the efficacy and clinical outcomes of the two approaches.Materials and methods: We included 100 consecutive patients who underwent unilateral hemilaminectomy or laminoplasty for resection of spinal schwannomas between January 2015 and February 2023. The patients' baseline characteristics, including sex, age, tumor location, percentage of tumor occupying the intradural space, operative time, postoperative length of hospital stay, intraoperative bleeding volume, visual analog scale score, and neurologic results, were retrospectively analyzed.Results: Hemilaminectomy patients who underwent unilateral hemilaminectomy had smaller intraoperative bleeding (p = 0.020) volume, shorter operative time (p = 0.012), and shorter postoperative length of hospital stay (p = 0.044). The mean VAS scores at the last follow-up were similar between the two groups (p = 0.658). Although the postoperative McCormick and Karnofsky Performance scores were not significantly different between the laminoplasty and unilateral hemilaminectomy groups (p = 0.687 and p = 0.649, respectively), there was a statistically significant improvement based on postoperative neurological results compared to preoperative neurological results for both groups. The incidence of postoperative complications was 5% and 11.7% in the unilateral hemilaminectomy and laminoplasty groups, respectively (p = 0.308).Conclusions: For spinal schwannoma resection, unilateral hemilaminectomy has more advantages than laminoplasty, including a shorter postoperative hospital stay, faster procedure, and less intraoperative blood loss while achieving the same desired result.

Cerebral ischemia–reperfusion injury (CIRI) represents a major contributing factor to adverse outcomes following ischemic stroke (IS), posing signifi

This study introduces and evaluates a modified four-zone classification of the posterior lumbar spinal canal, assessing its anatomical basis and clinical utility in guiding microchannel surgery. Current minimally invasive lumbar procedures rely predominantly on fluoroscopic imaging of bony landmarks for localization, often neglecting the consistent anatomical boundaries provided by the ligamentum flavum for surgical orientation and trajectory planning. Anatomical measurements were performed on six fresh-frozen human cadaveric spines to define key parameters of the ligamentum flavum and their spatial relationships with adjacent structures. A retrospective clinical analysis compared 223 patients undergoing microchannel surgery: 103 patients in the conventional localization group (Group A) and 120 patients in the modified four-zone classification group (Group B). Outcomes assessed included fluoroscopy time, microchannel tilt angle, estimated blood loss, operative duration, length of hospital stay, VAS scores, ODI, and Modified MacNab criteria. Anatomically, the interligamentum flavum space measured 12.3 ± 1.8 mm on the left and 11.9 ± 1.9 mm on the right, with the S-point located approximately midway between the ligamentum flavum boundaries. Clinically, Group B demonstrated significant reductions in fluoroscopy time (4.4 ± 1.4 vs. 5.7 ± 1.7 min, p < 0.01), microchannel tilt angle (7.8 ± 2.7° vs. 10.1 ± 3.6°, p < 0.01), blood loss (44.7 ± 12.7 vs. 58.5 ± 13.5 ml, p < 0.01), operative time (69.4 ± 22.5 vs. 81.4 ± 27.1 min, p < 0.01), along with less early postoperative incision pain and length of hospital stay (p < 0.01). While long-term improvements in back pain VAS and ODI scores were similar between groups, Group B demonstrated superior outcomes in both leg pain VAS scores (final score: 0.5 ± 0.6 vs. 1.8 ± 0.8, p < 0.01) and patient satisfaction (Modified MacNab Excellent/Good rate: 85.8% vs. 75.7%, p = 0.03).The modified four-zone classification offers an anatomically reliable framework for posterior lumbar microchannel surgery, enabling precise anatomical targeting, reducing radiation exposure, and improving both perioperative and long-term functional outcomes, This approach may facilitate the standardization and enhancement of procedural precision.