Neurologia medico-chirurgica最新文献_第10页

Epidemiological Study of Metastatic Brain Tumors in Miyazaki Prefecture: A Regional 10-year Survey in Southern Japan. 宫崎县转移性脑肿瘤流行病学研究：日本南部地区十年调查

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-02-15 Epub Date: 2024-01-10 DOI: 10.2176/jns-nmc.2023-0085

Go Takeishi, Shinji Yamashita, Fumitaka Matsumoto, Kiyotaka Saito, Takashi Watanabe, Takumi Yoneyama, Takuji Hinoura, Hajime Ohta, Kiyotaka Yokogami, Yoshiki Kuroda, Hideo Takeshima

{"title":"Epidemiological Study of Metastatic Brain Tumors in Miyazaki Prefecture: A Regional 10-year Survey in Southern Japan.","authors":"Go Takeishi, Shinji Yamashita, Fumitaka Matsumoto, Kiyotaka Saito, Takashi Watanabe, Takumi Yoneyama, Takuji Hinoura, Hajime Ohta, Kiyotaka Yokogami, Yoshiki Kuroda, Hideo Takeshima","doi":"10.2176/jns-nmc.2023-0085","DOIUrl":"10.2176/jns-nmc.2023-0085","url":null,"abstract":"Advances in cancer treatment have improved the survival of patients with cancer, with a concomitant increase in the proportion of patients with metastatic brain tumors (MBTs). In this study, we used cancer registries established in Japan after 2016 and available patient data by organ in order to conduct an accurate epidemiological study. To the best of our knowledge, this is the first study to report on the detailed epidemiological data on MBT at the prefectural level in Japan using the Miyazaki Brain Tumor Database and Miyazaki Cancer Registry. This study included 425 new cases of MBTs diagnosed in Miyazaki Prefecture from 2007 to 2016. As per our findings, the most frequent primary tumor in Miyazaki Prefecture was found to be in the lung (49.4%), followed by colon/rectum/anus (9.4%) and breast (8.5%). Among patients with MBTs, 59.1% were males, a number closely similar to that of Japan, as shown in the Japanese Brain Tumor Registry (55.5%). The median age at diagnosis was 68 and 63 years in Miyazaki Prefecture and Japan, respectively. Although more patients were symptomatic in Miyazaki Prefecture than in Japan (88.5% vs. 15.5%), fewer patients opted for surgery (33.6% vs. 61.9%), probably because of their advanced age at diagnosis. As per the findings of this study, the annual incidence rate of new MBTs (i.e., ratio of the number of new cancer registrations to that of new MBT patients in Miyazaki Prefecture) was at 0.41%. The number of tumor sites in MBTs was independent of the total number of cancers per organ. Considering the expansion of cancer registries worldwide, including those on brain tumors, further epidemiological analysis of MBTs is deemed warranted.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"87-92"},"PeriodicalIF":1.9,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10918454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139417589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Information-guided Surgery Centered on Intraoperative Magnetic Resonance Imaging Guarantees Surgical Safety with Low Mortality. 以术中磁共振成像为中心的信息引导手术保证了手术的安全性和低死亡率。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-02-15 Epub Date: 2024-01-10 DOI: 10.2176/jns-nmc.2022-0340

Shunsuke Tsuzuki, Yoshihiro Muragaki, Masayuki Nitta, Taiichi Saito, Takashi Maruyama, Shunichi Koriyama, Manabu Tamura, Takakazu Kawamata

{"title":"Information-guided Surgery Centered on Intraoperative Magnetic Resonance Imaging Guarantees Surgical Safety with Low Mortality.","authors":"Shunsuke Tsuzuki, Yoshihiro Muragaki, Masayuki Nitta, Taiichi Saito, Takashi Maruyama, Shunichi Koriyama, Manabu Tamura, Takakazu Kawamata","doi":"10.2176/jns-nmc.2022-0340","DOIUrl":"10.2176/jns-nmc.2022-0340","url":null,"abstract":"Neurosurgery is complex surgery that requires a strategy that maximizes the removal of tumors and minimizes complications; thus, a safe environment during surgery should be guaranteed. In this study, we aimed to verify the safety of brain surgery using intraoperative magnetic resonance imaging (iMRI), based on surgical experience since 2000. Thus, we retrospectively examined 2,018 surgical procedures that utilized iMRI performed in the operating room at Tokyo Women's Medical University Hospital between March 2000 and October 2019. As per our data, glioma constituted the majority of the cases (1,711 cases, 84.8%), followed by cavernous hemangioma (61 cases, 3.0%), metastatic brain tumor (37 cases, 1.8%), and meningioma (31 cases, 1.5%). In total, 1,704 patients who underwent glioma removal were analyzed for mortality within 30 days of surgery and for reoperation rates and the underlying causes within 24 hours and 30 days of surgery. As per our analysis, only one death out of all the glioma cases (0.06%) was reported within the 30-day period. Meanwhile, reoperation within 30 days was performed in 37 patients (2.2%) due to postoperative bleeding in 17 patients (1.0%), infection in 12 patients (0.7%), hydrocephalus in 6 patients (0.4%), cerebrospinal fluid (CSF) leakage in 1 patient, and brain edema in 1 patient (0.06%). Of these, 14 cases (0.8%) of reoperation were performed within 24 hours, that is, 13 cases (0.8%) due to postoperative bleeding and 1 case (0.06%) due to acute hydrocephalus. Mortality rate within 30 days was less than 0.1%. Thus, information-guided surgery with iMRI can improve the safety of surgical resections, including those of gliomas.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"57-64"},"PeriodicalIF":1.9,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10918452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139417590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Usefulness of Robotic Stereotactic Assistance (ROSA^®) Device for Stereoelectroencephalography Electrode Implantation: A Systematic Review and Meta-analysis. 机器人立体定向辅助（ROSA®）设备在立体脑电图电极植入中的实用性：系统回顾与元分析》。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-02-15 Epub Date: 2024-01-15 DOI: 10.2176/jns-nmc.2023-0119

Anukoon Kaewborisutsakul, Mikhail Chernov, Suguru Yokosako, Yuichi Kubota

{"title":"Usefulness of Robotic Stereotactic Assistance (ROSA®) Device for Stereoelectroencephalography Electrode Implantation: A Systematic Review and Meta-analysis.","authors":"Anukoon Kaewborisutsakul, Mikhail Chernov, Suguru Yokosako, Yuichi Kubota","doi":"10.2176/jns-nmc.2023-0119","DOIUrl":"10.2176/jns-nmc.2023-0119","url":null,"abstract":"The aim of this study was to systematically review and meta-analyze the efficiency and safety of using the Robotic Stereotactic Assistance (ROSA®) device (Zimmer Biomet; Warsaw, IN, USA) for stereoelectroencephalography (SEEG) electrode implantation in patients with drug-resistant epilepsy. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was carried out. Overall, 855 nonduplicate relevant articles were determined, and 15 of them were selected for analysis. The benefits of the ROSA® device use in terms of electrode placement accuracy, as well as operative time length, perioperative complications, and seizure outcomes, were evaluated. Studies that were included reported on a total of 11,257 SEEG electrode implantations. The limited number of comparative studies hindered the comprehensive evaluation of the electrode implantation accuracy. Compared with frame-based or navigation-assisted techniques, ROSA®-assisted SEEG electrode implantation provided significant benefits for reduction of both overall operative time (mean difference [MD], -63.45 min; 95% confidence interval [CI] from -88.73 to -38.17 min; P < 0.00001) and operative time per implanted electrode (MD, -8.79 min; 95% CI from -14.37 to -3.21 min; P = 0.002). No significant differences existed in perioperative complications and seizure outcomes after the application of the ROSA® device and other techniques for electrode implantation. To conclude, the available evidence shows that the ROSA® device is an effective and safe surgical tool for trajectory-guided SEEG electrode implantation in patients with drug-resistant epilepsy, offering benefits for saving operative time and neither increasing the risk of perioperative complications nor negatively impacting seizure outcomes.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"71-86"},"PeriodicalIF":2.4,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10918457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Direction-selective Resistance to Cerebrospinal Fluid Flow as the Cause of Syringomyelia. 脑脊液流向选择性阻力是鞘膜积液症的病因。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-02-15 Epub Date: 2024-01-15 DOI: 10.2176/jns-nmc.2023-0149

Han Soo Chang

{"title":"Direction-selective Resistance to Cerebrospinal Fluid Flow as the Cause of Syringomyelia.","authors":"Han Soo Chang","doi":"10.2176/jns-nmc.2023-0149","DOIUrl":"10.2176/jns-nmc.2023-0149","url":null,"abstract":"The pathophysiology of syringomyelia remains poorly understood. Two prevailing challenges stand out: the need for a comprehensive understanding of its diverse types and the yet-to-be-explained mechanism of cerebrospinal fluid (CSF) retention in the syrinx despite its higher pressure than that in the adjacent subarachnoid space. Expanding on our previous proposal that direction-selective resistance to subarachnoid CSF flow drives syringomyelia genesis, this study uses a computer model to explore this mechanism further. We developed a computer simulation model to study spinal CSF dynamics, employing a lumped parameter approach with multiple compartments. This model replicated the to-and-fro movement of CSF in the spinal subarachnoid space and within an intraspinal channel. Subsequently, a direction-selective resistance-opposing only the caudal subarachnoid CSF flow-was introduced at a specific location within the subarachnoid space. Following the introduction of the direction-selective resistance, a consistent pressure increase was observed in the intraspinal channel downstream of the resistance. Importantly, this increase in pressure accumulated with every cycle of to-and-fro CSF flow. The accumulation results from the pressure drop across the resistance, and its effect on the spinal cord matrix creates a pumping action in the intraspinal channel. Our findings elucidate the mechanisms underlying our hypothesis that a direction-selective resistance to subarachnoid CSF flow causes syringomyelia. This comprehensively explains the various types of syringomyelia and resolves the puzzle of CSF retention in the syrinx despite a pressure gradient.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"93-99"},"PeriodicalIF":1.9,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10918455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Synergistic Interaction of Thyroid Autoantibodies and Ring Finger Protein 213 Variant in Moyamoya Disease. 甲状腺自身抗体与环指蛋白213变异在烟雾病中的协同作用

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-01-15 Epub Date: 2023-12-06 DOI: 10.2176/jns-nmc.2023-0169

Thiparpa Thamamongood, Shoko Hara, Hiroyuki Akagawa, Motoki Inaji, Yoji Tanaka, Tadashi Nariai, Taketoshi Maehara

{"title":"Synergistic Interaction of Thyroid Autoantibodies and Ring Finger Protein 213 Variant in Moyamoya Disease.","authors":"Thiparpa Thamamongood, Shoko Hara, Hiroyuki Akagawa, Motoki Inaji, Yoji Tanaka, Tadashi Nariai, Taketoshi Maehara","doi":"10.2176/jns-nmc.2023-0169","DOIUrl":"10.2176/jns-nmc.2023-0169","url":null,"abstract":"Recently, thyroid autoantibodies were found to be associated with moyamoya disease (MMD). The ring finger protein 213 (RNF213) p.R4810K variant represents the most important susceptibility genotype of this disease, but its relationship with thyroid autoantibodies remains to be elucidated. Thus, in this study, we aimed to evaluate the clinical relevance of thyroid autoantibodies in each RNF213 genotype in patients with MMD. Included in this study were patients with MMD without a thyroid disease history and in euthyroid status; they were then classified into the mutated or nonmutated based on the RNF213 p.R4810K genotype and positive or negative based on thyroid autoantibody (thyroperoxidase and thyroglobulin) levels. Clinical data of each group were thereafter evaluated. Among the 209 patients, the mutated RNF213 p.R4810K variant and positive thyroid autoantibodies were detected in 155 and 41 patients, respectively. Positive thyroid autoantibodies were found to be more common in the nonmutated patients than in the mutated patients (31.5% vs. 15.5%; P = 0.011). In the mutated patients, as compared to autoantibody-negative patients, autoantibody-positive patients were determined to be more likely to have advanced disease with posterior cerebral artery involvement (54.2% vs. 29.0%; P = 0.017), white matter infarction (58.3% vs. 37.6%; P = 0.046), and a higher modified Rankin Scale at last visit (16.7% vs. 3.1%; P = 0.021). These results suggest that thyroid autoantibodies can act as an immunity inducer in patients with MMD lacking the susceptibility gene RNF213 p.R4810K variant. Moreover, the simultaneous presence of thyroid autoantibodies and the variant seems to aggravate the disease, which indicates synergy between thyroid autoantibodies and the variant.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"43-49"},"PeriodicalIF":1.9,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10835577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Platelet-derived Growth Factor Activates Pericytes in the Microvessels of Chronic Subdural Hematoma Outer Membranes. 血小板衍生生长因子激活慢性硬膜下血肿外膜微血管中的周细胞。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-01-15 Epub Date: 2023-11-30 DOI: 10.2176/jns-nmc.2023-0079

Mao Yokota, Koji Osuka, Yusuke Ohmichi, Mika Ohmichi, Chiharu Suzuki, Masahiro Aoyama, Kenichiro Iwami, Satoru Honma, Shigeru Miyachi

{"title":"Platelet-derived Growth Factor Activates Pericytes in the Microvessels of Chronic Subdural Hematoma Outer Membranes.","authors":"Mao Yokota, Koji Osuka, Yusuke Ohmichi, Mika Ohmichi, Chiharu Suzuki, Masahiro Aoyama, Kenichiro Iwami, Satoru Honma, Shigeru Miyachi","doi":"10.2176/jns-nmc.2023-0079","DOIUrl":"10.2176/jns-nmc.2023-0079","url":null,"abstract":"Angiogenesis is one of the growth mechanisms of chronic subdural hematoma (CSDH). Pericytes have been implicated in the capillary sprouting during angiogenesis and are involved in brain ischemia and diabetic retinopathy. This study examined the pericyte expressions in CSDH outer membranes obtained during trepanation surgery. Eight samples of CSDH outer membranes and 35 samples of CSDH fluid were included. NG2, N-cadherin, VE-cadherin, Tie-2, endothelial nitric oxide synthase (eNOS), platelet-derived growth factor (PDGF) receptor-β (PDGFR-β), a well-known marker of pericytes, phosphorylated PDGFR-β at Tyr751, and β-actin expressions, were examined using western blot analysis. PDGFR-β, N-cadherin, and Tie-2 expression levels were also examined using immunohistochemistry. The concentrations of PDGF-BB in CSDH fluid samples were measured using enzyme-linked immunosorbent assay kits. NG2, N-cadherin, VE-cadherin, Tie-2, eNOS, PDGFR-β, and eNOS expressions in CSDH outer membranes were confirmed in all cases. Furthermore, phosphorylated PDGFR-β at Tyr751 was also detected. In addition, PDGFR-β, N-cadherin, and Tie-2 expressions were localized to the endothelial cells of the vessels within CSDH outer membranes by immunohistochemistry. The concentration of PDGF-BB in CSDH fluids was significantly higher than that in cerebrospinal fluid. These findings indicate that PDGF activates pericytes in the microvessels of CSDH outer membranes and suggest that pericytes are crucial in CSDH angiogenesis through the PDGF/PDGFR-β signaling pathway.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"50-55"},"PeriodicalIF":1.9,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10835575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effectiveness of Keyhole Clipping of Unruptured Intracranial Aneurysms Detected by "Brain Dock" in Healthy Japanese Adults. “脑码头”检测未破裂颅内动脉瘤锁孔夹闭术在日本健康成年人中的疗效。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-01-15 Epub Date: 2023-11-08 DOI: 10.2176/jns-nmc.2023-0157

Toru Yoshiura, Satoru Takeuchi, Terushige Toyooka, Arata Tomiyama, Kojiro Wada, Yasuaki Nakao, Takuji Yamamoto, Kentaro Mori

{"title":"Effectiveness of Keyhole Clipping of Unruptured Intracranial Aneurysms Detected by \"Brain Dock\" in Healthy Japanese Adults.","authors":"Toru Yoshiura, Satoru Takeuchi, Terushige Toyooka, Arata Tomiyama, Kojiro Wada, Yasuaki Nakao, Takuji Yamamoto, Kentaro Mori","doi":"10.2176/jns-nmc.2023-0157","DOIUrl":"10.2176/jns-nmc.2023-0157","url":null,"abstract":"In Japan, brain docking has enhanced the detection of unruptured intracranial aneurysms in healthy adults. At our institution, surgical clipping is the first-line treatment for unruptured intracranial aneurysms (UIA). In this study, the differences in neurological and radiological outcomes, as well as cognitive and psychological results, between standard clipping and keyhole clipping for these aneurysms detected via brain docking were evaluated. The study included 131 aneurysms detected via \"brain dock.\" Of these, 65 were treated with keyhole clipping surgery (keyhole clipping group), and 66 were treated with standard clipping surgery (standard clipping group). Evaluations at 3 months included the National Institutes of Health Stroke Scale, modified Rankin Scale, Mini-Mental State Examination, Hasegawa's Dementia Scale-revised, Beck Depression Inventory, Hamilton Rating Scale for Depression, and radiological abnormalities. The mean operative time and postoperative hospitalization period were significantly shorter in the keyhole clipping group than in the standard clipping group (p < 0.001). Between the groups, no significant differences in postoperative neurological complications or radiological abnormalities were found. The keyhole clipping group demonstrated slightly but significantly better Beck Depression Inventory and Hamilton Rating Scale for Depression scores than the standard clipping group (Beck Depression Inventory, p = 0.046; Hamilton Rating Scale for Depression, p < 0.01). Both the Beck Depression Inventory and Hamilton Rating Scale for Depression scores at 3 months were significantly enhanced (p < 0.001) in the keyhole clipping group. These findings propose that keyhole clipping could be considered a new therapeutic option for small UIA detected via brain docking.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"28-35"},"PeriodicalIF":1.9,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10835578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Differentiation between Anterior and Posterior Roots Using Compound Muscle Action Potential in Intradural Extramedullary Spinal Tumor Surgery. 利用复合肌动作电位在硬膜内髓外脊柱肿瘤手术中鉴别前后根。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-01-15 Epub Date: 2023-11-30 DOI: 10.2176/jns-nmc.2023-0135

Naoyuki Harada, Yuki Sakaeyama, Yutaka Fuchinoue, Mitsuyoshi Abe, Sayaka Terazono, Chie Matsuura, Shuhei Kubota, Masataka Mikai, Nobuo Sugo, Kunio Sugiyama, Kosuke Kondo, Masaaki Nemoto

{"title":"Differentiation between Anterior and Posterior Roots Using Compound Muscle Action Potential in Intradural Extramedullary Spinal Tumor Surgery.","authors":"Naoyuki Harada, Yuki Sakaeyama, Yutaka Fuchinoue, Mitsuyoshi Abe, Sayaka Terazono, Chie Matsuura, Shuhei Kubota, Masataka Mikai, Nobuo Sugo, Kunio Sugiyama, Kosuke Kondo, Masaaki Nemoto","doi":"10.2176/jns-nmc.2023-0135","DOIUrl":"10.2176/jns-nmc.2023-0135","url":null,"abstract":"This study aims to determine the cutoff values for the compound muscle action potential (CMAP) stimulus in anatomically identified anterior (motor nerve) and posterior roots (sensory nerve) during cervical intradural extramedullary tumor surgery. The connection between CMAP data from nerve roots and postoperative neurological symptoms in thoracolumbar tumors was compared with data from cervical lesions. The participants of the study included 22 patients with intradural extramedullary spinal tumors (116 nerve roots). The lowest stimulation intensity to the nerve root at which muscle contraction occurs was defined as the minimal activation intensity (MAI) in the CMAP. In cervical tumors, the MAI was measured after differentiating between the anterior and posterior roots based on the anatomical placement of the dentate ligament and nerve roots. The MAIs for 20 anterior roots in eight cervical tumors were between 0.1 and 0.3 mA, whereas those for 19 posterior roots were between 0.4 and 2.0 mA. The cutoff was <0.4 mA for both the anterior and posterior roots, and sensitivity and specificity were both 100%. In thoracolumbar tumors, the nerve root was severed in 12 of 14 cases. All MAIs were determined to be at the dorsal roots as their scores were higher than the cutoff and did not indicate motor deficits. The MAIs of the anatomically identified anterior and posterior root CMAPs were found to have a cutoff value of <0.4 mA in the cervical lesions. Similar MAI cutoffs were also applicable to thoracolumbar lesions. Thus, CMAP may be useful in detecting anterior and posterior roots in spinal tumor surgery.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"36-42"},"PeriodicalIF":1.9,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10835576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Erratum. 勘误。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-01-01 DOI: 10.2176/jns-nmc.er.2023-0069

引用次数: 0

Guidelines for Awake Surgery. 清醒手术指南。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-01-01 DOI: 10.2176/jns-nmc.2023-0111

引用次数: 0