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Intelligent neurosurgery: technological convergence, clinical transformation, and future challenges
Journal of Army Medical University 2026, 48(5): 523-529
Published: 15 March 2026
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The development of neurosurgery has now entered a new stage of Intelligent Neurosurgery, driven by artificial intelligence (AI) as its core force. Intelligent Neurosurgery, grounded in modern neurosurgery, integrates cutting-edge technologies such as AI, machine learning, surgical robotics, brain-computer interfaces (BCIs), big data, digital twins, and neuromodulation. Through a human-machine collaborative model, it constructs an intelligent diagnosis and treatment system covering the entire process of “precise preoperative evaluation—intraoperative real-time navigation and assistance—meticulous postoperative management.” Its core technological pillars include deep learning-driven automated image segmentation and molecular subtype prediction, surgical robots achieving submillimeter precision, BCIs establishing direct communication pathways between the brain and external devices, multimodal data fusion integrating clinical, genomic, and imaging information to build predictive models for optimized decision-making, and digital twin and neuromodulation technologies enabling personalized treatment simulation and reversible neural regulation. Clinical applications now extensively cover maximal safe resection of brain tumors, personalized parameter optimization for functional disorders such as Parkinson’s disease and epilepsy, and minimally invasive interventional treatments for cerebrovascular diseases. Furthermore, Intelligent Neurosurgery demonstrates significant value in military medicine for the rapid, intelligent management of traumatic brain injury. However, challenges including data privacy, algorithmic accountability, ethical norms, and uneven technology dissemination remain critical obstacles to its development. The essence of Intelligent Neurosurgery lies in empowering traditional disciplines with cutting-edge technologies to form an intelligent control system, ultimately achieving “patient-centered” precision medicine. Future directions will focus on the evolution of core technologies from assistance towards semi-autonomy, the construction of smart operating rooms and remote collaboration, and the expansion from disease treatment to neural function enhancement. The establishment and promotion of this system will reshape the paradigm of neurosurgical diagnosis and treatment by balancing technological innovation with ethical norms, ultimately delivering preciser, safer, and more efficient medical services to patients worldwide.

Issue
Prognostic factors for glioblastoma: a retrospective single-center analysis of 176 adults
Journal of Army Medical University 2024, 46(17): 2002-2008
Published: 15 September 2024
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Objective

To explore the clinical features, treatment and prognosis of glioblastomas (GBM) in adults.

Methods

A retrospective cohort study was performed on 176 adult GBM patients admitted to our department from January 2015 to December 2021. Chi-square test was used to investigate the clinical differences between isocitrate dehydrogenase (IDH) mutant and wild-type GBM. Kaplan-Meier and Log-Rank tests were employed to plot survival curve and compute the survival analysis. Multivariate Cox regression model was applied to identify the independent prognostic factors.

Results

IDH wild-type GBM account for 89.2% and had significantly differences from the IDH-mutant GBM in terms of age of onset, Karnofsky (KPS) score at admission, symptoms of neurological deficit, and methylation status of O6-methylguanine-DNA-methyltransferase (MGMT) promoter (P<0.05). For the IDH wild-type GBM patients receiving conventional therapy, univariate Cox hazard analysis showed gross total resection, methylation of MGMT promoter, initiation of radiation within the 5th to 6th week after surgery, and adjuvant temozolomide (TMZ) chemotherapy ≥6 cycles were favorable prognostic factors for overall survival (OS); GBMs in the left hemisphere, involvement of single lobe, methylation of MGMT promoter, and initiation of radiation within the 5th to 6th week after surgery were favorable prognostic factors for progression free survival (PFS) (all P<0.05). Moreover, multivariate Cox hazard regression analysis indicated that methylation of MGMT promoter, and initiation of radiation within the 5th to 6th week after surgery, and adjuvant TMZ chemotherapy ≥6 cycles were independent protective factors for OS, and GBMs in the left hemisphere, involvement of single lobe and methylation of MGMT promoter were independent protective factors for PFS in the GBM patients (all P<0.05).

Conclusion

The clinical and prognostic features are totally different between IDH mutant and wild-type GBM, and molecular detections are needed for the further pathological classification. Methylation of MGMT promoter is a primary marker of favorite prognosis for IDH wild-type GBM, and slightly delay in radiotherapy (the 5th to 6th week after surgery) can effectively improve the survival prognosis of IDH wild-type GBM.

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