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World neurosurgery 210건

  1. [해외논문]   Endoscopic Strategy in Surgical Treatment of Adult Idiopathic Bilateral Occlusion of the Foramen of Monro and Review of the Literature  

    Ebrahimzadeh, Kaveh (To whom correspondence should be addressed: Ehsan Nazari Maloumeh, M.D.) , Maloumeh, Ehsan Nazari , Samadian, Mohammad , Rezaei, Omidvar
    World neurosurgery v.115 ,pp. e610 - e619 , 2018 , 1878-8750 ,

    초록

    Background Endoscopic approach has been used increasingly for the surgical treatment of adult idiopathic bilateral occlusion of the foramen of Monro (AIOFM). The aim of this study is to assess and compare the results of this strategy with other surgical methods of treating AIOFM. Methods A retrospective study was performed to identify patients with AIOFM treated in our department from 2012 to 2017. We also performed a search of the literature to detect any case of AIOFM reported from 1980 to 2017 to provide a comprehensive assessment of the treatment of this condition. AIOFM was classified as 4 groups, including bilateral true stenosis of the foramen of Monro (FM), bilateral membrane occlusion of the FM, unilateral true FM stenosis with septum deviation, and unilateral membrane occlusion of the FM with septum deviation all assessed and discussed separately. Results We found four patients with AIOFM surgically treated with endoscopic procedures in our department between the years of 2012 to 2017 with an excellent outcome. Fourteen studies were also detected during our review of the literature, most of which involved treatment with neuroendoscopy and excellent outcomes. We found that neuroendoscopy could be the first-line strategy to treat all 4 types of AIOFM. Conclusions Endoscopic strategy is associated with excellent outcomes and fewer risks in treatment of all types of AIOFM; it is also less invasive compared with ventriculoperitoneal shunt insertion. Highlights Adult idiopathic bilateral occlusion of the Foramen of Monro could be best managed with endoscopic procedure. Endoscopic procedure is associated with lower risks compared to other surgical approaches. Endoscopic strategy is associated with a low risk of surgical morbidity and mortality.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

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  2. [해외논문]   Preoperative and Postoperative Headache in Patients with Intracranial Tumors  

    Ravn Munkvold, Bodil Karoline (The Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway ) , Sagberg, Lisa Millgå (Norwegian National Advisory Unit for Ultrasound and Image Guided Therapy, St. Olav's University Hospital, Trondheim, Norway ) , rd (Department of Neurosurgery, St. Olav's University Hospital, Trondheim, Norway ) , Jakola, Asgeir Store (Norwegian National Advisory Unit for Ultrasound and Image Guided Therapy, St. Olav's University Hospital, Trondheim, Norway) , Solheim, Ole
    World neurosurgery v.115 ,pp. e322 - e330 , 2018 , 1878-8750 ,

    초록

    Objective We sought to examine prevalence of headache in patients with histopathologically verified intracranial tumors scheduled for surgery and assess change in headache 1 and 6 months after surgical resection. Possible tumor-related and patient-related predictors for preoperative headache and early postoperative symptom relief were also explored. Methods The European Organization for Research and Treatment of Cancer has developed a quality-of-life questionnaire (EORTC QLQ-C30) with a brain cancer–specific module, QLQ-BN20, containing 20 questions rating symptoms the past week on an ordinal scale ranging from 1 to 4. Analyses are based on question 4 in this questionnaire. Results In this prospective population-based cohort study of 507 patients, we found that headache is a frequent symptom in patients with intracranial neoplasms. 52% reported some degree of preoperative headache, and the prevalence decreased to 43% and 30% 1 and 6 months postoperatively. 19% and 9% reported postoperative worsening or new headache 1 and 6 months after surgery. Younger age, female gender, and occipital tumor location were significant predictors for both preoperative headache and early postoperative relief. In addition, Karnofsky Performance Status Conclusions Headache is a common symptom in patients with intracranial tumors, especially in younger and female patients. Many patients experience improvement after surgery, and younger age, female gender, occipital tumor location, and functional dependence were identified as factors associated with early postoperative headache relief. Highlights Headache is a common symptom in patients with intracranial tumors, especially in younger and female patients. Occipital tumor location was identified as a tumor-related predictor for headache at baseline. Of patients with headache before surgical tumor resection, 60% and 70% reported improvement 1 and 6 months postoperatively. Occipital tumor location, younger, female, and KPS

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  3. [해외논문]   Outcomes After Off-Label Use of the Pipeline Embolization Device for Intracranial Aneurysms: A Multicenter Cohort Study  

    Zammar, Samer G. (Department of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA ) , Buell, Thomas J. (Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA ) , Chen, Ching-Jen (Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA ) , Crowley, R. Webster (Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois, USA ) , Ding, Dale (Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA ) , Griessenauer, Christoph J. (Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA ) , Hoh, Brian L. (Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, Florida, USA ) , Liu, Kenneth C. (Department of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA ) , Ogilvy, Christopher S. (Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA ) , Raper, Daniel M. (Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA ) , Singla, Amit (Lillian S. Wells Department of Neurosurgery, University of Flor) , Thomas, Ajith J. , Cockroft, Kevin M. , Simon, Scott D.
    World neurosurgery v.115 ,pp. e200 - e205 , 2018 , 1878-8750 ,

    초록

    Objective To examine outcomes of Pipeline embolization device (PED) use for treatment of intracranial aneurysms outside of U.S. Food and Drug Administration–approved indications. Methods Data from patients with aneurysms treated with off-label use of PED were pooled from 4 centers in a retrospective multicenter cohort study. Primary endpoints were decline in modified Rankin Scale score by at least 1 point and angiographic aneurysm occlusion at follow-up. Results The study cohort comprised 109 patients. Mean aneurysm size was 8.4 ± 7.4 mm, 20.2% of aneurysms were located in the posterior circulation, and 11.9% of aneurysms were ruptured. The most common reasons for off-label use were aneurysm size (50.5%), aneurysm location (25.7%), and both size and location (10.1%). Mean follow-up was 9 months. Complete occlusion was achieved in 82.5% of cases at last angiographic follow-up. Modified Rankin Scale score decline was found in 18.8% of cases. On univariate analysis, age, aneurysm size, aneurysm morphology, aneurysm location, reason for off-label use, and rupture status were not associated with clinical decline or aneurysm occlusion on angiography. On multivariate analysis, treatment of a ruptured aneurysm with PED was found to be an independent predictor of postoperative decline in modified Rankin Scale score, and size as the only reason for off-label PED use was found to be an independent predictor of complete occlusion on final angiography. Conclusions Off-label use of PED has a reasonable risk-to-benefit profile for appropriately selected aneurysms. Posterior circulation location and fusiform morphology do not appear to be associated with worse clinical or angiographic outcomes. Highlights Off-label use of PED is not fully established. Clinical and angiographic outcomes of off-label use of PED were examined. Complications associated with off-label use of PED were also examined.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  4. [해외논문]   The Outcomes of Pituitary Apoplexy with Conservative Treatment: Experiences at a Single Institution  

    Seo, Youngbeom (Department of Neurosurgery, Yeungnam University Hospital, Daegu, Republic of Korea ) , Kim, Yong Hwy (Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea ) , Dho, Yun-Sik (Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea ) , Kim, Jung Hee (Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea ) , Kim, Jin Wook (Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea ) , Park, Chul-Kee (Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea ) , Kim, Dong Gyu (Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea)
    World neurosurgery v.115 ,pp. e703 - e710 , 2018 , 1878-8750 ,

    초록

    Objective Pituitary apoplexy is an unpredictable complication caused by hemorrhage or infarction in a pituitary adenoma. We retrospectively analyzed the radiologic and clinical outcomes of patients with conservatively managed pituitary apoplexy. Methods A total of 32 patients who had undergone conservative treatment with high-dose corticosteroid replacement were enrolled in this study. This cohort study consisted of 20 male and 12 female patients. The median patient age was 60 years. Five patients had a previously diagnosed pituitary tumor, and one third of the patients had a history of hypertension. Results The median follow-up duration was 50 months. The median tumor volumes at the initial and final assessments were 2.75 cm 3 (range, 0.32–10.7 cm 3 ) and 0.64 cm 3 (range, 0–8.74 cm 3 ), respectively. Complete radiographic regression occurred in 9 of the 32 patients, partial regression occurred in 14 patients, and no change in size or progression occurred in 9 patients. Eighteen of the 32 patients had visual disturbances at the initial presentation; in this subgroup, 17 patients showed improvement over the course of the study. One patient had newly developed diplopia related to tumor progression. Nineteen of the 32 patients had ≥1 hormonal deficiency at the initial assessment, 8 of whom recovered to normal endocrine status. Three patients developed a new hormonal deficiency during the follow-up, and 3 patients experienced tumor recurrence. Conclusions This study showed the regression of tumors related to pituitary apoplexy, with favorable ophthalmologic and endocrinologic recovery. Conservative management should be considered in patients without severe or progressive neuro-ophthalmic deficits. Highlights We investigated the radiologic and clinical outcome of 32 patients with consertavtively treated pituitary apoplexy. Conservative management resulted in acceptable neuro-ophthalmic and endocrinologic outcomes. Tumor volume pattern within 1–3 three months after apoplexy might be an important prognostic factor of tumor regression. Conservative management should be considered if the visual disturbance has not deteriorated.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  5. [해외논문]   Cervical Spine and Cord Angle Mismatch in the Pathogenesis of Myelopathy  

    Tykocki, Tomasz (Department of Musculoskeletal, Spinal Unit, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom ) , du Plessis, Johannes (Department of Neuroradiology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom ) , Wynne-Jones, Guy (Department of Musculoskeletal, Spinal Unit, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom)
    World neurosurgery v.115 ,pp. e272 - e278 , 2018 , 1878-8750 ,

    초록

    Background Cervical myelopathy is a complex pathology and dynamic compression of the tethered cervical cord, which may be responsible for clinical symptoms. Methods Patients with cervical canal stenosis who had magnetic resonance imaging in flexion and extension positions were retrospectively reviewed. All cases were evaluated in Nurick grade. The cervical parameters—cervical cord (CC) angle, cervical lordosis, and spine/cord (S/C) angle ratio—were measured on the magnetic resonance imaging. Mean values of these parameters were compared between nonmyelopathic (Nurick grade 0) and myelopathic groups (Nurick grades 1–5). A multinomial ordinal logistic regression was used to predict outcome for Nurick grade using the CC angle, the cervical lordosis angle, and the S/C angle ratio as independent variables. Results A total of 65 patients (35 men) with the mean age of 58.6 ± 11.4 years were analyzed. A comparison of means between Nurick grade 0 against each of myelopathic grades 1–5 revealed significant differences only for the S/C angle ratio. A cumulative comparison between nonmyelopathic and myelopathic grades for the S/C angle ratio showed significant difference of 0.29 (1.16 ± 0.5 vs. 1.45 ± 0.6, respectively; P Conclusions A positive correlation between Nurick grade and cervical spine and cord angle mismatch was found. Highlights A mismatch between cervical spine and cord angle in flexion and extension positions was found to be correlated with the severity of myelopathy. More spine/cord angle ratio was associated with higher Nurick grade. A comparison between patients with and without myelopathiac also found a significant difference for spine/cord angle ratio. Mismatch between cervical spine and cord angulation in the dynamic positions may cause repetitive microtrauma of the spinal cord.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  6. [해외논문]   Can We Assess the Success of Surgery for Degenerative Spinal Diseases Using Patients' Recall of Their Preoperative Status?  

    Rodrigues, Ricardo (Faculty of Medicine, University of Porto, Porto, Portugal ) , Silva, Pedro Santos (Faculty of Medicine, University of Porto, Porto, Portugal ) , Cunha, Marisa (Faculty of Medicine, University of Porto, Porto, Portugal ) , Vaz, Rui (Faculty of Medicine, University of Porto, Porto, Portugal ) , Pereira, Paulo (Faculty of Medicine, University of Porto, Porto, Portugal)
    World neurosurgery v.115 ,pp. e768 - e773 , 2018 , 1878-8750 ,

    초록

    Background Patients' recall of their preoperative status is seldom used to assess surgical outcomes because of concerns about inaccuracy and bias. The present study aimed to measure the significance of this recall bias and its repercussion on patients' recollection of their preoperative status. Methods Patients submitted to surgery due to degenerative spine diseases over a 1-year period (n = 198) were included in this study. Each patient completed the EuroQol Five-Dimensional Questionnaire (including a visual analog scale), Core Outcome Measures Index (COMI) for neck (including neck pain and shoulder/arm pain numeric rating scale [NRS]), COMI back (including back pain and buttock/leg pain NRS), Neck Disability Index, and Oswestry Disability Index preoperatively. At 1 year after surgery, the patients were asked to complete 2 sets of the same questionnaires, one set regarding their postoperative status and the other set regarding their recall of their preoperative status. Results There was poor to moderate agreement between recalled and collected preoperative scores for all patient-reported outcome measures. Patients' recollection of their preoperative status was accurate for patients who underwent cervical spine surgery, but not for those who underwent lumbar spine surgery. Patients satisfied with the outcome after lumbar spine surgery recalled significantly worse scores compared with the actual preoperative scores. Conclusions Using patients' recall of their preoperative status may lead to overestimation of the effectiveness of surgery, particularly for lumbar spine surgery. The self-assessed effectiveness of surgery interferes with the recollection of baseline status. Highlights Cervical spine surgery recipients accurately recalled their preoperative status at 1 year after surgery. Lumbar spine surgery recipients recalled significantly worse scores compared with scores reported preoperatively. The effectiveness of surgery influences patients' recall bias. Data collected retrospectively are not likely to be accurate, especially in lumbar surgery recipients.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  7. [해외논문]   Transmuscular Ultrasonography of the Placement of Thoracolumbar Pedicle Screws: A Cadaveric Study  

    Xie, Cheng-Long (Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China ) , Huang, Qi-Shan (Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China ) , Wu, Long (Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China ) , Xu, Lei (Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China ) , Dou, Hai-Cheng (Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China ) , Wang, Xiang-Yang (Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China ) , Lin, Zhong-Ke (Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Chi)
    World neurosurgery v.115 ,pp. e360 - e365 , 2018 , 1878-8750 ,

    초록

    Background Transpedicular screw fixation has a biomechanical advantage of improving fusion rates. In posterior thoracolumbar immobilization, a large number of screws cause perforation to the pedicle or vertebral body. Radiography and computed tomography (CT) have been used to minimize this complication. The ability of ultrasound (US) to detect the pedicle breach during placement of the screw is unknown. The aim of this study was to evaluate the sensitivity of US for detecting breaches. Methods A B-type transducer was used to scan 216 titanium pins inserted into cadaveric pedicles. Of the pins, 180 were intentionally misplaced: 90 pins breached the lateral wall of the pedicle, and 90 pins pierced the anterior wall of the vertebral body. US images were reviewed by 3 examiners blinded to both the procedure and the corresponding CT findings. The perforation length of pins was measured by 3 radiologists on CT images. Results CT data were divided into 2 groups. In group 1 (perforation length 0–2 mm), sensitivity of US for detecting lateral wall and anterior wall perforation was 80.95% and 76.42%, respectively; in group 2 (perforation length 2–4 mm), sensitivity was 94.79% and 91.93%. Overall sensitivity of US to detect lateral wall and anterior wall perforation was 89.63% and 86.30%, respectively. The sensitivity of US for detecting perforation was greater in the lateral wall than in the anterior wall. Sensitivity of US was greater in group 2 than group 1 for both lateral and anterior perforation. Conclusions US can be applied to detect perforation of ≤4 mm. Use of US may improve patient safety. Highlights A transpedicular screw protruding >2 mm can cause damage to nearby blood vessels, spinal cord, or nerve roots. US can detect the pedicle screw protruding from the cortical bone of the vertebra. Pins protruding >1 mm from the cortical bone of the vertebra can be detected by US. The sensitivity of US for detecting perforation was greater in the lateral wall than in the anterior wall.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  8. [해외논문]   Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days  

    Safaee, Michael M. (Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA ) , Scheer, Justin K. (Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA ) , Ailon, Tamir (Department of Neurosurgery, The University of British Columbia, Vancouver, British Columbia, Canada ) , Smith, Justin S. (Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA ) , Hart, Robert A. (Department of Orthopedic Surgery, Oregon Health & Science University, Portland, Oregon, USA ) , Burton, Douglas C. (Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA ) , Bess, Shay (Denver International Spine Clinic, Presbyterian St. Luke's Medical Center, Rocky Mountain Hospital for Children, Denver, Colorado, USA ) , Neuman, Brian J. (Department of Orthopedic Surgery, The Johns Hopkins University, Baltimore, Maryland, USA ) , Passias, Peter G. (Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, New York, New York, USA ) , Miller, Emily (Department of Orthopedic Surgery, The Johns Hopkins University, Baltimore, Maryland, USA) , Shaffrey, Christopher I. , Schwab, Frank , Lafage, Virginie , Klineberg, Eric O. , Ames, Christopher P.
    World neurosurgery v.115 ,pp. e422 - e427 , 2018 , 1878-8750 ,

    초록

    Background Length of stay (LOS) after surgery for adult spinal deformity (ASD) is a critical period that allows for optimal recovery. Predictive models that estimate LOS allow for stratification of high-risk patients. Methods A prospectively acquired multicenter database of patients with ASD was used. Patients with staged surgery or LOS >30 days were excluded. Univariable predictor importance ≥0.90, redundancy, and collinearity testing were used to identify variables for model building. A generalized linear model was constructed using a training dataset developed from a bootstrap sample; patients not randomly selected for the bootstrap sample were selected to the training dataset. LOS predictions were compared with actual LOS to calculate an accuracy percentage. Results Inclusion criteria were met by 653 patients. The mean LOS was 7.9 ± 4.1 days (median 7 days; range, 1–28 days). Following bootstrapping, 893 patients were modeled (653 in the training model and 240 in the testing model). Linear correlations for the training and testing datasets were 0.632 and 0.507, respectively. The prediction accuracy within 2 days of actual LOS was 75.4%. Conclusions Our model successfully predicted LOS after ASD surgery with an accuracy of 75% within 2 days. Factors relating to actual LOS, such as rehabilitation bed availability and social support resources, are not captured in large prospective datasets. Predictive analytics will play an increasing role in the future of ASD surgery, and future models will seek to improve the accuracy of these tools. Highlights LOS is a critical period of recovery after ASD surgery. Predictive modeling allows for complex assessment and prediction of LOS. There are 40 variables that can predict LOS with 75% accuracy within 2 days. No such model for ASD surgery currently exists. Future work will allow for point-of-care assessment to assess LOS preoperatively.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

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  9. [해외논문]   Mid-Term Clinical and Radiological Outcomes After Kyphoplasty in the Treatment of Thoracolumbar Traumatic Vertebral Compression Fractures  

    Grelat, Michael (Department of Neurosurgery, Dijon University Hospital, Dijon, France ) , Madkouri, Rachid (Department of Neurosurgery, Dijon University Hospital, Dijon, France ) , Comby, Pierre-Olivier (Department of Neuroradiology, Dijon University Hospital, Dijon, France ) , Fahed, Elie (Department of Neurosurgery, Dijon University Hospital, Dijon, France ) , Lemogne, Brivael (Department of Neuroradiology, Dijon University Hospital, Dijon, France ) , Thouant, Pierre (Department of Neuroradiology, Dijon University Hospital, Dijon, France)
    World neurosurgery v.115 ,pp. e386 - e392 , 2018 , 1878-8750 ,

    초록

    Background The management of thoracolumbar posttraumatic compression fractures varies widely among centers, and there is no real consensus as to the optimum approach. The objective of our retrospective study was to detect the progression of vertebral kyphosis in nonosteoporotic patients treated by balloon kyphoplasty (KPB) who presented with recent compression fractures of the thoracolumbar region. Methods In this retrospective study, we investigated the evolution of vertebral and regional kyphosis in 77 patients treated by KPB for compression vertebral fractures (Magerl A) between 2007 and 2011. All treated patients, even those lost to follow-up, were included in our statistical analysis. Results In the 77 patients, a 2.4° deterioration of vertebral kyphosis ( P = 0.0004) and a 4.5° worsening of regional kyphosis ( P Conclusions The paucity of studies of posttraumatic vertebral compression fractures in the scientific literature explains the lack of consensus regarding the optimum treatment approach. Postoperative results with KPB favor vertebral and regional kyphosis stability. KPB remains indicated in this situation except in cases of for burst fracture. Highlights Balloon kyphoplasty is an efficient and reliable procedure in the management of compression fractures of the thoracolumbar junction. Vertebral and regional kyphosis shows a slight deterioration of correction over the time but without impact on clinical outcomes. Worse radiological results for the type of fracture A3-2 et A3-3.

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  10. [해외논문]   Quantitative Evaluation of Compressed L4-5 and S1 Nerve Roots of Lumbar Disc Herniation Patients by Diffusion Tensor Imaging and Fiber Tractography  

    He, Ai (Department of Medical Imaging, The First People's Hospital of Nanning, Nanning, China ) , Wang, Wen-Zheng (Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China ) , Qiao, Peng-Fei (Department of Urology, Guilin Medical University, Guilin, China ) , Qiao, Guo-Yong (Department of Orthopedics, Affiliated Hospital of Hebei University of Engineering, Handan, China ) , Cheng, Hao (Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China ) , Feng, Ping-Yong (Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China)
    World neurosurgery v.115 ,pp. e45 - e52 , 2018 , 1878-8750 ,

    초록

    Objective To delineate fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of compressed nerve roots in patients with lumbar disc herniation by diffusion tensor imaging and fiber bundle tracing and investigate the relationship between FA and ADC values and Swiss Spinal Stenosis Questionnaire and visual analog scale scores. Methods Twenty patients with lumbar disc herniation and 20 age- and sex-matched healthy volunteers were assessed using the Swiss Spinal Stenosis Questionnaire and visual analog scale. All subjects underwent conventional sagittal T1-weighted and T2-weighted magnetic resonance imaging, axial T2-weighted imaging, and diffusion tensor imaging and fiber tractography. Results In 20 patients with lumbar disc herniation, there were 31 nerve roots involved (9/31 L4, 15/31 L5, and 7/31 S1). Mean Swiss Spinal Stenosis Questionnaire scores of patients were 53.55% ± 11.91%, and mean visual analog scale scores were 5.96 ± 1.64. FA values of lumbar nerve roots were 0.332 ± 0.014 in healthy volunteers. FA values of compressed lumbar nerve roots were 0.251 ± 0.022, significantly lower than FA values of contralateral noncompressed nerve roots and lumbar nerve roots of healthy volunteers. ADC values of lumbar nerve roots were 1.763 ± 0.075 in healthy volunteers. ADC values of compressed lumbar nerve roots were 2.090 ± 0.078, significantly higher than ADC values of contralateral noncompressed nerve roots and lumbar nerve roots of healthy volunteers. Conclusions Fiber tractography is capable of delineating microstructural changes of lumbosacral nerve roots, and radiculopathy in lumbar disc herniation is associated with significant changes in FA and ADC values. Highlights We delineated FA and ADC values of compressed nerve roots in patients with lumbar disc herniation patients by DTI. Relationships between FA and ADC values and Japanese Orthopaedic Association scale and VAS scores were investigated. Fiber tractography can delineate microstructural changes of lumbar nerve roots. FA and ADC values exhibit significant changes in lumbar disc herniation.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

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