Neurologia medico-chirurgica最新文献

Stepwise Improvement of Cerebral Hemodynamics in Staged Angioplasty for Carotid Artery Stenosis. 分阶段血管成形术治疗颈动脉狭窄时脑血流动力学的逐步改善

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-25 DOI: 10.2176/jns-nmc.2024-0142

Fumiaki Oka, Takayuki Oku, Akiko Kawano, Koki Okazaki, Takuma Nishimoto, Mototsugu Shimokawa, Hideyuki Ishihara

{"title":"Stepwise Improvement of Cerebral Hemodynamics in Staged Angioplasty for Carotid Artery Stenosis.","authors":"Fumiaki Oka, Takayuki Oku, Akiko Kawano, Koki Okazaki, Takuma Nishimoto, Mototsugu Shimokawa, Hideyuki Ishihara","doi":"10.2176/jns-nmc.2024-0142","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0142","url":null,"abstract":"Staged angioplasty (SAP) is used as an alternative to preventing cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS), particularly among patients with compromised cerebral haemodynamics. Although SAP is presumed to prevent CHS by gradually restoring cerebral blood flow (CBF), few studies have examined haemodynamic changes, and none have evaluated CBF during the chronic phase of SAP. In the present study, in addition to the clinical outcome of SAP, we measured both resting CBF and cerebrovascular reactivity (CVR) throughout all stages of SAP, including the chronic phase, using quantitative N-isopropyl-p-[I-123] iodoamphetamine (123I-IMP) single-photon emission computed tomography (SPECT) and evaluated the effects of SAP on cerebral haemodynamics. In total, 28 patients underwent SAP. Among them, 19 had a successful procedure. Nine received stenting at the first stage of the procedure because of inadequate dilatation. Patients who underwent SAP had a lower incidence of hyperperfusion than those who underwent stenting at the first stage (5.3% vs. 33.3%). Nevertheless, the results did not significantly differ (p = 0.08). In an analysis limited to the patients who underwent successful SAP, the resting CBF was unchanged except for immediately after the first stage, on the other hand, the CVR increased at each stage. After the first stage, 14 (74%) patients recovered from the steal phenomenon. After the second stage, the CVR normalised. SAP may help to improve cerebral haemodynamics gradually. Consequently, it has the potential to prevent CHS or hyperperfusion among patients with severely impaired CVR, which is a significant risk factor for CHS.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710641","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

Clinical Outcomes of Carotid Artery Stenting for Carotid Artery Stenosis in Maintenance Hemodialysis Patients. 颈动脉支架植入术治疗维持性血液透析患者颈动脉狭窄的临床效果。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-25 DOI: 10.2176/jns-nmc.2024-0193

Shuki Okuhara, Tomoaki Murakami, Shingo Toyota, Kosei Okochi, Koichi Nakashima, Kazuhiro Tohara, Shuhei Yamada, Takamune Achiha, Maki Kobayashi, Haruhiko Kishima

{"title":"Clinical Outcomes of Carotid Artery Stenting for Carotid Artery Stenosis in Maintenance Hemodialysis Patients.","authors":"Shuki Okuhara, Tomoaki Murakami, Shingo Toyota, Kosei Okochi, Koichi Nakashima, Kazuhiro Tohara, Shuhei Yamada, Takamune Achiha, Maki Kobayashi, Haruhiko Kishima","doi":"10.2176/jns-nmc.2024-0193","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0193","url":null,"abstract":"Most previous large studies of carotid artery stenting (CAS) in maintenance hemodialysis patients are old-era, do not describe the types of stents and method of protection, and their effectiveness is unknown. CAS has progressed remarkably, and tailor-made CAS is now possible in hemodialysis patients according to the lesion. We aimed to analyze the outcomes of CAS in maintenance hemodialysis patients treated in our institution.We retrospectively investigated the data of patients who underwent elective CAS in our institution between January 2012 and April 2023. Firstly, we verified the outcomes of CAS in maintenance hemodialysis patients. Secondly, the outcomes of CAS in maintenance hemodialysis patients were compared with CAS in nondialysis patients during the same period.During the study period, 212 patients with carotid stenosis underwent CAS. Among these, 18 patients undergoing maintenance hemodialysis were identified for analysis. All 18 patients underwent lesion-specific tailor-made CAS. All 18 patients were technically successfully stented with good vasodilation and improvement in stenosis. No symptomatic cerebral infarction occurred within 30 days after CAS. There was no difference between dialysis and nondialysis patients in the risk of symptomatic complications and death occurring within 30 days after surgery. There was a higher risk of hemorrhagic complications not associated with prognosis in the dialysis group (23.1% vs 1.0%, P = 0.0047). No in-stent restenosis (>50% stenosis) and ipsilateral cerebral infarction at 1 year occurred during follow-up.CAS in hemodialysis patients may be safe and effective.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710622","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

Safety and Selection Criteria of Single-joint Hybrid Assistive Limb for Upper Limb Paralysis After Stroke: A Phase I Trial. 单关节混合辅助肢体治疗中风后上肢瘫痪的安全性和选择标准：一期试验

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-25 DOI: 10.2176/jns-nmc.2024-0137

Hiroshi Ohmae, Taku Matsuda, Maki Fujimoto, Yuka Nakanowatari, Megumi Yamada, Nori Sato, Kimiko Umemura, Ryoma Morigaki, Tetsuya Matsuura, Yasushi Takagi

{"title":"Safety and Selection Criteria of Single-joint Hybrid Assistive Limb for Upper Limb Paralysis After Stroke: A Phase I Trial.","authors":"Hiroshi Ohmae, Taku Matsuda, Maki Fujimoto, Yuka Nakanowatari, Megumi Yamada, Nori Sato, Kimiko Umemura, Ryoma Morigaki, Tetsuya Matsuura, Yasushi Takagi","doi":"10.2176/jns-nmc.2024-0137","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0137","url":null,"abstract":"Robotic rehabilitation is a high-intensity intervention for upper limb paralysis after a stroke. This study explored the safety and feasibility of using a single-joint hybrid assistive limb (HAL-SJ) exoskeletal device for upper limb paralysis in patients with acute stroke. In total, 11 patients with stroke (6 with moderate paralysis and 5 with severe paralysis) were enrolled between October 2021 and October 2023 in a stroke care unit. The patients underwent HAL training 3 times a week for 6 sessions. No serious adverse events related to HAL-SJ occurred, and participants demonstrated significant improvements in the Fugl-Meyer Assessment Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) (pre- vs. post-intervention; p < 0.05). The minimal clinically important difference (MCID) for FMA-UE was surpassed in 5 patients (83.3%) with moderate paralysis and 2 (40.0%) with severe paralysis. Regarding ARAT, 4 patients (66.7%) with moderate paralysis exceeded the MCID, whereas none (0.0%) with severe paralysis did. These findings suggest that HAL-SJ is both safe and feasible, particularly for individuals with moderate paralysis.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710636","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 Clazosentan on Vasospasm Reduction and Functional Recovery after Aneurysmal Subarachnoid Hemorrhage. 克拉唑生坦对动脉瘤性蛛网膜下腔出血后血管痉挛缓解和功能恢复的影响

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-25 DOI: 10.2176/jns-nmc.2024-0204

Sosho Kajiwara, Takayuki Kawano, Yu Hasegawa, Yukihiko Nakamura, Kiyohiko Sakata, Jin Kikuchi, Masaru Hirohata, Motohiro Morioka

{"title":"Impact of Clazosentan on Vasospasm Reduction and Functional Recovery after Aneurysmal Subarachnoid Hemorrhage.","authors":"Sosho Kajiwara, Takayuki Kawano, Yu Hasegawa, Yukihiko Nakamura, Kiyohiko Sakata, Jin Kikuchi, Masaru Hirohata, Motohiro Morioka","doi":"10.2176/jns-nmc.2024-0204","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0204","url":null,"abstract":"In every hospital in Japan, until 2022, the primary treatment for preventing delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) involved a combination of ozagrel sodium (Oz), fasudil hydrochloride (Fs), cilostazol, and statins. However, with the approval of clazosentan in January 2022, it has been used as a first-choice drug more frequently. Despite this shift, limited evidence exists regarding the use of clazosentan as the first choice for DCI prevention. In this study, we analyzed the efficacy and outcomes of these two treatments in aSAH patients. Patients treated with Oz+Fs were enrolled between January 2014 and March 2022. In April 2022, clazosentan was prescribed to prevent DCI. Clinical data were collected, and propensity-score matching was conducted based on the clazosentan group. The primary endpoint was the functional outcome at discharge and 6-12 months after admission; the secondary endpoints were the incidence of cerebral vasospasm (CV) and DCI. In this study, 221 patients were included, and 27 were selected from both groups after matching. The incidence of CV was significantly lower in the clazosentan group (11.1% vs. 55.6%, p<0.01), and the incidence of DCI tended to be lower in the clazosentan group (3.7% vs. 25.9%, p=0.05). No significant difference was observed in the primary endpoint of functional outcome at discharge; however, a significant improvement in functional outcome was observed in the clazosentan group at 6 months (96.3% vs. 70.4%, p<0.05). Clazosentan significantly reduced the incidence of CV and improved functional outcomes in patients with aSAH compared to Oz+Fs.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710632","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

Validity of E-PASS Score for Evaluating Perioperative Minor Complications Associated with Carotid Endarterectomy. 评估颈动脉内膜剥脱术围手术期轻微并发症的 E-PASS 评分的有效性

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-25 DOI: 10.2176/jns-nmc.2024-0035

Yutaka Morishima, Masahito Kawabori, Yoichi M Ito, Masayuki Gekka, Koji Furukawa, Yoshimasa Niiya, Miki Fujimura

{"title":"Validity of E-PASS Score for Evaluating Perioperative Minor Complications Associated with Carotid Endarterectomy.","authors":"Yutaka Morishima, Masahito Kawabori, Yoichi M Ito, Masayuki Gekka, Koji Furukawa, Yoshimasa Niiya, Miki Fujimura","doi":"10.2176/jns-nmc.2024-0035","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0035","url":null,"abstract":"Carotid endarterectomy (CEA) is conducted to reduce the risk of cerebral infarction; therefore, a low complication rate is highly required. To predict long-term morbidity and mortality, various scoring systems have been considered; nonetheless, a model that can be utilized to estimate nonmajor temporary complications and minor complications is currently lacking. To evaluate the occurrence rate of perioperative complications in various surgical domains, the E-PASS (Estimation of Physiological Ability and Surgical Stress) score is employed. This study was carried out to investigate the utility of the E-PASS score as a predictive factor for the risk of minor complications in patients undergoing CEA. The retrospective analysis was performed for 104 consecutive series of CEA procedures carried out at Otaru Municipal Hospital. The correlation between E-PASS and the rate of minor complications was examined. Sensitivity and specificity were used to construct a receiver operating characteristic curve, and the area under the curve (AUC) was calculated for accuracy. Postoperative minor complications occurred in eight cases (7.7%), including six vagal nerve injuries and two pneumonia cases. Three categorical data-preoperative risk score, surgical stress scores, and comprehensive risk score (CRS) -showed a good relationship with the postoperative minor complication. Among them, CRS presented the highest sensitivity and specificity, as indicated by an AUC of 0.68. The CRS cutoff value was calculated as -0.068, with a 1.7% postoperative minor complication rate for those lower than -0.068 and 14.0% for those higher than -0.068. The E-PASS score was effective for evaluating and predicting postoperative minor complications in patients with CEA procedures.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710645","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

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 : 2024-11-15 Epub 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":"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":" ","pages":"387-394"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","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 4.6 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-15 Epub 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":"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":" ","pages":"409-417"},"PeriodicalIF":4.6,"publicationDate":"2024-11-15","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 4.6 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-15 Epub 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":"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":" ","pages":"395-400"},"PeriodicalIF":4.6,"publicationDate":"2024-11-15","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 4.6 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-15 Epub 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":"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":" ","pages":"401-408"},"PeriodicalIF":4.6,"publicationDate":"2024-11-15","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

Relevance of Lumbar Subcutaneous Edema and Local Lordosis. 腰部皮下水肿与局部后凸的相关性

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-06 DOI: 10.2176/jns-nmc.2024-0187

Kazuma Doi, Toshiyuki Okazaki, Kazunori Shibamoto, Satoshi Tani, Junichi Mizuno

引用次数: 0