Neurologia medico-chirurgica最新文献

The Current Status of Endovascular Treatment for Extracranial Vertebral Artery Stenosis in Japan: A Subanalysis of the Japanese Registry of Neuroendovascular Therapy 4. 日本颅外椎动脉狭窄的血管内治疗现状：日本神经血管内治疗注册的子分析 4.

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-09-26 DOI: 10.2176/jns-nmc.2024-0115

Satoru Fujiwara, Akira Ishii, Tsuyoshi Ohta, Nobuyuki Ohara, Michi Kawamoto, Koji Iihara, Hirotoshi Imamura, Yuji Matsumaru, Chiaki Sakai, Tetsu Satow, Shinichi Yoshimura, Nobuyuki Sakai

{"title":"The Current Status of Endovascular Treatment for Extracranial Vertebral Artery Stenosis in Japan: A Subanalysis of the Japanese Registry of Neuroendovascular Therapy 4.","authors":"Satoru Fujiwara, Akira Ishii, Tsuyoshi Ohta, Nobuyuki Ohara, Michi Kawamoto, Koji Iihara, Hirotoshi Imamura, Yuji Matsumaru, Chiaki Sakai, Tetsu Satow, Shinichi Yoshimura, Nobuyuki Sakai","doi":"10.2176/jns-nmc.2024-0115","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0115","url":null,"abstract":"Endovascular treatment (EVT) is a potential therapeutic option for extracranial vertebral artery (VA) stenosis; however, its efficacy or optimal procedures remain unknown. This study aimed to investigate the recent status of EVT for extracranial VA stenosis in Japan using a nationwide registry. We conducted a post hoc analysis of the Japanese Registry of Neuroendovascular Therapy 4 that enrolled patients who underwent EVT at 166 hospitals in Japan from 2015 to 2019. The outcomes of this study were as follows: procedural success indicating that the planned procedure was completed, modified Rankin Scale (mRS) score at 30 days, and procedure-related complications evaluated according to the procedure during EVT (percutaneous transluminal angioplasty vs. stenting and with or without the use of embolic protection devices [EPDs]). Of 308 eligible patients, 301 (95%) were treated for atherosclerotic stenosis, predominantly by stenting (74%). EPDs were used in 43%, primarily with the distal balloon (63%). The proportion of procedural success was 98%. Functional independence (mRS of 0-2) at 30 days was achieved in 80% of the total cohort, and there were no differences between patients treated with or without stenting or EPDs (74% vs. 82%, p = 0.12, and 80% vs. 80%, p = 0.93). Procedural complications occurred in 28 (9.1%) patients similarly in each group, with distal embolism and vessel dissection being common. In conclusion, EVT is a reasonable option for extracranial VA stenosis as a daily clinical practice. This study emphasizes the potential of EVT in managing extracranial VA stenosis and the need for further research to refine treatment strategies.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Frailty Risk on Functional Outcome after Aneurysmal Subarachnoid Hemorrhage: A Historical Cohort Study. 虚弱风险对动脉瘤性蛛网膜下腔出血后功能预后的影响：历史队列研究

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-09-26 DOI: 10.2176/jns-nmc.2023-0251

Yoshinori Yamamoto, Shinsuke Hori, Kenta Ushida, Yuka Shirai, Miho Shimizu, Yuki Kato, Ryo Momosaki

{"title":"Impact of Frailty Risk on Functional Outcome after Aneurysmal Subarachnoid Hemorrhage: A Historical Cohort Study.","authors":"Yoshinori Yamamoto, Shinsuke Hori, Kenta Ushida, Yuka Shirai, Miho Shimizu, Yuki Kato, Ryo Momosaki","doi":"10.2176/jns-nmc.2023-0251","DOIUrl":"https://doi.org/10.2176/jns-nmc.2023-0251","url":null,"abstract":"We evaluated the utility of the Hospital Frailty Risk Score (HFRS) as a predictor of adverse events post-hospitalization in a retrospective analysis of patients undergoing neurosurgical procedures due to aneurysmal subarachnoid hemorrhage (SAH). This historical cohort study analyzed the data of patients hospitalized with aneurysmal SAH (n = 1,343) between April 2014 and August 2020 who were registered in the JMDC database. We used HFRS to classify the patients into the low-frailty risk group (HFRS < 5) and high-frailty risk group (HFRS ≥ 5). The primary outcome was a modified Rankin Scale (mRS) score of 0-2 points at discharge. Of 1,343 patients, 1,001 (74.5%) and 342 (25.5%) were in the low- and high-frailty risk groups, respectively. A high-frailty risk was negatively associated with a mRS score of 0-2 at discharge (high-frailty risk group: odds ratio 0.4; 95% confidence interval [CI]: 0.3-0.6) and home discharge (high-frailty risk group: odds ratio 0.5; 95% CI: 0.4-0.7). A high-frailty risk was negatively associated with Barthel Index gain (high-frailty risk group: coefficient -10.4, 95% CI: -14.7 to -6.2) and had a longer length of stay (high-frailty risk group: coefficient 8.4, 95% CI: 5.1-11.7). HFRS could predict adverse outcomes during hospitalization of aneurysmal SAH patients.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spatial Cognition Ability in Surgeons Performing Endoscopic Endonasal Transsphenoidal Surgery. 执行内窥镜鼻内镜经蝶手术的外科医生的空间认知能力。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-09-26 DOI: 10.2176/jns-nmc.2024-0080

Juli Yamashita, Takeshi Okuda, Takayuki Tasaki, Jun C Takahashi

{"title":"Spatial Cognition Ability in Surgeons Performing Endoscopic Endonasal Transsphenoidal Surgery.","authors":"Juli Yamashita, Takeshi Okuda, Takayuki Tasaki, Jun C Takahashi","doi":"10.2176/jns-nmc.2024-0080","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0080","url":null,"abstract":"Endoscopic surgery, including endoscopic endonasal transsphenoidal surgery (ETSS), requires special psychomotor skills from surgeons. The learning curve in the acquisition of psychomotor skills varies among individuals, and studies about laparoscopy indicate that the difference can be predicted using spatial ability tests. We examined the association between the results of such tests and the learning curve in ETSS to determine the need for a personalized curriculum for ETSS skill training. A total of 30 fifth-year medical students from Kindai University School of Medicine (17 men, 13 women; mean age, 26 years) without ETSS experience completed the spatial orientation test (SOT) for the measurement of spatial visualization ability. They performed the dural incision task (DIT) twice on an ETSS training model for surgical psychomotor skill evaluation. The SOT scores (angle errors) exhibited substantial individual differences in spatial visualization ability, whereas the DIT scores significantly improved in the second trial (Wilcoxon signed-rank test, P = 0.0035). However, no significant difference was observed in the DIT scores between the smaller error and larger error groups of the SOT. The results indicated that two DIT trials were sufficient to acquire psychomotor skills for the DIT as the endoscope was almost fixed and learning only one viewpoint and line of sight combination was adequate. In conclusion, a personalized ETSS training program based on the trainee's spatial ability is not necessary for the DIT. Further research is warranted to determine the effect of spatial ability on more complex tasks, such as suturing in cranial base repair.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma. 全内窥镜脊柱手术治疗腰椎韧带瓣血肿。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-09-26 DOI: 10.2176/jns-nmc.2024-0086

Chia-Wei Chang, Ryoji Tominaga, Yasushi Oshima, Hiroki Iwai, Hirohiko Inanami, Hisashi Koga

{"title":"Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma.","authors":"Chia-Wei Chang, Ryoji Tominaga, Yasushi Oshima, Hiroki Iwai, Hirohiko Inanami, Hisashi Koga","doi":"10.2176/jns-nmc.2024-0086","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0086","url":null,"abstract":"Lumbar ligamentous flavum hematoma (LFH) is a relatively rare pathology, and it is difficult to differentiate it from other cystic lesions. Full-endoscopic spine surgery (FESS), an excellent approach for clear and magnified operative visual field since it allows saline irrigation and minimizes destruction of surrounding tissues, has been applied to the treatment. This study aims to present a case series of patients with lumbar LFH treated by FESS.This case series consists of 17 lumbar LFH cases treated by FESS between May 2018 and November 2021 at a single institution. Patient background and operative data were collected from their medical records. The numerical rating scale (NRS), Oswestry Disability Index (ODI), and European Quality of Life-5 Dimensions (EQ-5D) were recorded preoperatively and postoperatively.Elderly men tend to suffer from lumbar LFH at the L4/5 vertebral level. Discontinuity with facet joint was confirmed under endoscopic visualization in all 17 cases. Blood clots were also observed in all cases under endoscope. The mean operative time was 68.6 min without complication. The patients were discharged at average 1.4 days after FESS with significant improvement of NRS score (P < 0.001). ODI and EQ-5D scores 2-year postoperatively statistically improved (P < 0.001), and there was no recurrence during followup period.The operative outcomes of lumbar LFH treated by FESS were satisfactory. FESS excels not only in the diagnosis but also in the treatment of lumbar LFH.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Translational Research Platform for Malignant Central Nervous System Tumors. 恶性中枢神经系统肿瘤转化研究平台。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-09-15 Epub Date: 2024-08-06 DOI: 10.2176/jns-nmc.2024-0078

Kensuke Tateishi

引用次数: 0

Bacterial Meningitis Following Aneurysmal Subarachnoid Hemorrhage and Its Association with Cerebral Vasospasm. 动脉瘤性蛛网膜下腔出血后的细菌性脑膜炎及其与脑血管痉挛的关系

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-09-15 Epub Date: 2024-07-27 DOI: 10.2176/jns-nmc.2024-0076

Kunimasa Teranishi, Masanori Goto, Tadashi Sunohara, Masaomi Koyanagi, Junichi Takeda, Ryu Fukumitsu, Nobuyuki Fukui, Yuki Takano, Kota Nakajima, Yuji Naramoto, Yasuhiro Yamamoto, Rikuo Nishii, Satohiro Kawade, Takateru Takamatsu, Masanori Tokuda, Hikari Tomita, Mai Yoshimoto, Hirotoshi Imamura, Nobuyuki Sakai, Tsuyoshi Ohta

{"title":"Bacterial Meningitis Following Aneurysmal Subarachnoid Hemorrhage and Its Association with Cerebral Vasospasm.","authors":"Kunimasa Teranishi, Masanori Goto, Tadashi Sunohara, Masaomi Koyanagi, Junichi Takeda, Ryu Fukumitsu, Nobuyuki Fukui, Yuki Takano, Kota Nakajima, Yuji Naramoto, Yasuhiro Yamamoto, Rikuo Nishii, Satohiro Kawade, Takateru Takamatsu, Masanori Tokuda, Hikari Tomita, Mai Yoshimoto, Hirotoshi Imamura, Nobuyuki Sakai, Tsuyoshi Ohta","doi":"10.2176/jns-nmc.2024-0076","DOIUrl":"10.2176/jns-nmc.2024-0076","url":null,"abstract":"Aneurysmal subarachnoid hemorrhage (aSAH) is a critical condition with high in-hospital mortality rates. Delayed cerebral ischemia (DCI), a secondary complication associated with aSAH, can also contribute to morbidity and mortality. Although draining the hematoma from the subarachnoid space has been considered effective in preventing DCI, the placement of a drainage system could increase the risk of bacterial meningitis and ventriculitis. This study aimed to examine the association between meningitis following aSAH and the occurrence of DCI, focusing on the role of cerebral vasospasm. Patients who underwent endovascular coiling or surgical clipping for aSAH from April 2001 to March 2022 were included in this study, while those who did not undergo postoperative drainage were excluded. The patient's clinical characteristics, treatment modalities, and outcomes were then analyzed, after which logistic regression was used to assess the odds ratios (OR) for DCI. A total of 810 patients with aSAH were included in this study. Meningitis following aSAH was identified as an independent factor associated with DCI (odds ratio 5.0 [95% confidence intervals (CI) 2.3-11]). Other significant factors were female sex (odds ratio 1.5 [95% CI 0.89-2.5]) and surgical clipping (odds ratio 2.1 [95% CI 1.3-3.4]). This study demonstrated a significant association between meningitis following aSAH and the development of DCI, suggesting that the inflammatory environment associated with meningitis may contribute to cerebral vasospasm. Early recognition and treatment of meningitis in patients with aSAH could reduce the risk of DCI and improve patient outcomes.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of Percutaneous Endoscopic Transforaminal Discectomy, Chemonucleolysis, Microdiscectomy, and Microendoscopic Discectomy for Symptomatic Lumbar Disc Herniation: One-year Follow-up Clinical Results and Disc Degeneration. 经皮内窥镜经椎间孔椎间盘切除术、髓核溶解术、显微椎间盘切除术和显微内窥镜椎间盘切除术治疗症状性腰椎间盘突出症的比较：一年随访临床结果与椎间盘退化。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-09-15 Epub Date: 2024-07-27 DOI: 10.2176/jns-nmc.2023-0225

Masatoshi Morimoto, Kosuke Sugiura, Hiroaki Manabe, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Kosaku Higashino, Toshinori Sakai, Takashi Chikawa, Akihiro Nagamachi, Toru Maeda, Koichi Sairyo

{"title":"Comparison of Percutaneous Endoscopic Transforaminal Discectomy, Chemonucleolysis, Microdiscectomy, and Microendoscopic Discectomy for Symptomatic Lumbar Disc Herniation: One-year Follow-up Clinical Results and Disc Degeneration.","authors":"Masatoshi Morimoto, Kosuke Sugiura, Hiroaki Manabe, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Kosaku Higashino, Toshinori Sakai, Takashi Chikawa, Akihiro Nagamachi, Toru Maeda, Koichi Sairyo","doi":"10.2176/jns-nmc.2023-0225","DOIUrl":"10.2176/jns-nmc.2023-0225","url":null,"abstract":"This study compared the 1-year clinical outcomes and disc degeneration rates after transforaminal full-endoscopic lumbar discectomy (TF-FED), condoliase injection, open discectomy (OD), and microendoscopic discectomy (MED) for lumbar disc herniation (LDH). In total, 279 patients with LDH were divided into four treatment groups: TF-FED, OD, MED, and condoliase injection. Outcomes were evaluated on the basis of the complication rate, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), visual analog scale (VAS) scores, and the modified MacNab criteria. Surgical and hospital costs were assessed. Disc degeneration and endplate bone marrow edema were evaluated using magnetic resonance images. The mean postoperative JOABPEQ, VAS, or modified MacNab scores among the four groups had no significant differences. Additionally, the nerve injury or reoperation rate among the TF-FED, OD, and MED groups had no significant difference. However, the reoperation rate with condoliase injection was high because of residual disc herniation. Surgical and hospital costs were lower with condoliase injection and higher with OD and MED than those with TF-FED. With TF-FED and condoliase injection, the Pfirrmann grade progressed, and the disc height was significantly smaller than that with OD and MED. Endplate bone marrow edema was more common with condoliase injection and TF-FED. All groups had good outcomes. TF-FED and condoliase injection may reduce the burden of surgery because they can be performed under local anesthesia with little blood loss and low medical costs but tend to be associated with disc degeneration and endplate bone marrow edema. A randomized controlled study with a larger sample is needed.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Combination Technique of N-butyl-2-cyanoacrylate and Minimal Coils with Flow Control for Parent Artery Occlusion of a Giant Internal Carotid Artery Aneurysm: A Technical Note. N-丁基-2-氰基丙烯酸酯与带流量控制的微型线圈的组合技术用于巨大颈内动脉瘤的母动脉闭塞：技术说明。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-09-15 Epub Date: 2024-07-27 DOI: 10.2176/jns-nmc.2024-0046

Taketo Hanyu, Takashi Izumi, Takafumi Tanei, Masahiro Nishihori, Shunsaku Gotoh, Yoshio Araki, Kinya Yokoyama, Ryuta Saito

{"title":"A Combination Technique of N-butyl-2-cyanoacrylate and Minimal Coils with Flow Control for Parent Artery Occlusion of a Giant Internal Carotid Artery Aneurysm: A Technical Note.","authors":"Taketo Hanyu, Takashi Izumi, Takafumi Tanei, Masahiro Nishihori, Shunsaku Gotoh, Yoshio Araki, Kinya Yokoyama, Ryuta Saito","doi":"10.2176/jns-nmc.2024-0046","DOIUrl":"10.2176/jns-nmc.2024-0046","url":null,"abstract":"Parent artery occlusion for large or giant internal carotid artery aneurysms remains a necessary procedure in the era of flow diverters. Endovascular parent artery occlusion is currently performed using detachable balloons or coils, which are difficult to obtain or costly. At our institution, we have devised a technique for combining n-butyl-2-cyanoacrylate and coils with flow control to solve this problem. Patients who underwent parent artery occlusion for large or giant internal carotid artery aneurysms with a follow-up period of more than 12 months were included. Imaging outcomes were evaluated for complete or incomplete aneurysmal occlusion and with or without aneurysmal shrinkage. The clinical outcome was based on changes in the modified Rankin Scale. Ten patients (ten aneurysms) were included. Their average age and average follow-up period were 68.4 years and 36 months, respectively. Complete occlusion and favorable clinical outcome were observed in all cases. The parent artery occlusion using a combination of coils and n-butyl-2-cyanoacrylate with flow control technique is effective for both imaging and clinical outcomes.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Moyamoya Periventricular Choroidal Collateral Registry-A Multicenter Cohort Study of Moyamoya Disease with Choroidal Anastomosis: Study Protocol. Moyamoya 室周脉络膜侧支注册--一项关于脉络膜吻合的 Moyamoya 病的多中心队列研究：研究协议。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-09-07 DOI: 10.2176/jns-nmc.2024-0063

Takeshi Funaki, Susumu Miyamoto

引用次数: 0

Prevalence, Radiological, and Pathological Findings of Ossification and Calcification of the Lumbar Spinal Ligamentum Flavum: A Comparative Study with Thoracic Lesions. 腰椎韧带骨化和钙化的发病率、放射学和病理学发现：与胸椎病变的比较研究。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-09-07 DOI: 10.2176/jns-nmc.2024-0074

Takeaki Endo, Keisuke Takai, Takashi Komori, Yasuhiro Nakata

{"title":"Prevalence, Radiological, and Pathological Findings of Ossification and Calcification of the Lumbar Spinal Ligamentum Flavum: A Comparative Study with Thoracic Lesions.","authors":"Takeaki Endo, Keisuke Takai, Takashi Komori, Yasuhiro Nakata","doi":"10.2176/jns-nmc.2024-0074","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0074","url":null,"abstract":"This study aimed to determine the prevalence of lumbar ligamentum flavum lesions and identify correlations between radiological and pathological findings. We conducted an observational cross-sectional study of 349 patients (lumbar: n = 296, thoracic: n = 39, lumbar and thoracic: n = 14, mean age: 69 ± 12 years, male: 74%) who underwent posterior surgery for thoracolumbar spinal canal stenosis between January 2008 and April 2023 at our hospital.Computed tomography (CT) revealed that the prevalence of ligamentum flavum lesions defined as a high-density area with a CT value of 200 Hounsfield Unit or higher in the lumbar and thoracic spine was 47% (147/310) and 85% (45/53), respectively. CT showed that most patients had radiologically suspected ossification in the lumbar (90%) and thoracic spine (98%) than radiologically suspected calcification. Lumbar lesions were thinner than the thoracic lesions (2.5 vs 3.7 mm, p < 0.01). Pathological examinations were performed in specimens collected from 34 cases (lumbar: n = 13, thoracic: n = 21), and ossification was found in 62% (8/13) and 95% (20/21) of lumbar and thoracic lesions (p = 0.02), respectively. Lastly, ossification was confirmed pathologically in 72% (8/11) and 95% (19/20) of lumbar and thoracic lesions that showed ossification on imaging (p = 0.13), respectively. The literature review revealed that the prevalence of the lumbar ligamentum flavum lesions varied from 1.5 to 35% and the patient population was mostly asymptomatic.Collectively, we found that the prevalence of lumbar ligamentum flavum lesions in symptomatic patients was greater than previously reported. Histologically confirmed ossification was less common in lumbar lesions than in thoracic lesions.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0