Neurologia medico-chirurgica最新文献_第3页

Epilepsy in Patients with Gliomas. 胶质瘤患者的癫痫。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-07-15 Epub Date: 2024-06-05 DOI: 10.2176/jns-nmc.2023-0299

Takuro Ehara, Fumiharu Ohka, Kazuya Motomura, Ryuta Saito

引用次数: 0

Preventing Post-incisional Dural Shrink in Craniotomy: Introducing the "Roll-up Technique". 防止开颅手术后硬脑膜萎缩：介绍 "卷起技术"。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-07-15 Epub Date: 2024-06-05 DOI: 10.2176/jns-nmc.2023-0247

Yuki Yasuoka, Ushio Yonezawa, Shinya Nabika, Takeshi Takayasu, Akira Taguchi, Naohiko Ohbayashi, Fumiyuki Yamasaki, Nobutaka Horie

{"title":"Preventing Post-incisional Dural Shrink in Craniotomy: Introducing the \"Roll-up Technique\".","authors":"Yuki Yasuoka, Ushio Yonezawa, Shinya Nabika, Takeshi Takayasu, Akira Taguchi, Naohiko Ohbayashi, Fumiyuki Yamasaki, Nobutaka Horie","doi":"10.2176/jns-nmc.2023-0247","DOIUrl":"10.2176/jns-nmc.2023-0247","url":null,"abstract":"Dural dryness makes suturing difficult during dural closure after craniotomy. In this case, dural plasty is often performed using a membrane taken from the surrounding tissue (e.g., fascia or periosteum) or an artificial replacement membrane. Herein, we introduce our novel \"roll-up technique\" to reduce the utilization of substitute membranes and explore its effectiveness in dural closure. We retrospectively examined the medical records of 50 patients who underwent craniotomy for the first time for supratentorial intracranial lesions between 2015 and 2022. Furthermore, we divided them into two groups: (1) the conventional technique group, which consisted of patients in whom the dura mater was flipped after incision and protected with a moistened gauze (n = 23), and (2) the roll-up technique group, which consisted of patients in whom the dura mater was incised in a U shape, rolled up, and protected with a moist gauze (n = 27). After surgery, we compared the success rates of primary closure, operating time, craniotomy area, and percentage of complications (e.g., cerebrospinal fluid [CSF] leakage or infection) between the groups. Dural closure without dural substitutes using the roll-up technique had a higher success rate than that using the conventional technique (26/27 [96.3%] cases vs. 14/23 [60.9%] cases; P = 0.003). Postoperative CSF leakage or infection did not occur, and no statistically significant difference was observed in the operating time between the groups (P = 0.247). The roll-up technique for dural closure may effectively prevent post-incisional dural shrink after craniotomy.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262463","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

Clinical Characteristics and Outcomes of Aneurysmal Subarachnoid Hemorrhage Patients Who Live Alone. 独居动脉瘤性蛛网膜下腔出血患者的临床特征和预后。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-07-15 Epub Date: 2024-06-05 DOI: 10.2176/jns-nmc.2024-0024

Joji Inamasu, Masashi Fujisawa, Mizuto Sato, Takahiro Miyata

{"title":"Clinical Characteristics and Outcomes of Aneurysmal Subarachnoid Hemorrhage Patients Who Live Alone.","authors":"Joji Inamasu, Masashi Fujisawa, Mizuto Sato, Takahiro Miyata","doi":"10.2176/jns-nmc.2024-0024","DOIUrl":"10.2176/jns-nmc.2024-0024","url":null,"abstract":"It has been shown that living alone is one of the risk factors for unfavorable outcomes in ischemic stroke patients, mostly due to delay in receiving appropriate treatment. A single-center retrospective observational study was conducted to evaluate whether living alone was associated with unfavorable outcomes in aneurysmal subarachnoid hemorrhage (SAH) patients. Among 451 SAH patients admitted to our institution between January 2013 and December 2022, 43 patients who lived alone had sustained SAH at home (group A) and 329 patients who lived with family had sustained SAH at home (group F). The mortality rate (46.5% vs. 29.8%, p = 0.04) and a tendency for having unfavorable outcomes were higher in group A than in group F. The incidence of concomitant hydrocephalus was significantly higher in the former (37.2% vs. 21.3%, p = 0.03). Group A was further classified to the Able to Call (n = 15, group AC) and Unable to Call (n = 28, group UC) subgroups based on their ability to call for help by themselves. Group AC tended to have favorable outcomes (27% vs. 4%, p = 0.04). Treatment to obliterate a ruptured aneurysm had particularly been challenging in group UC, in which the accurate time of onset often remained unidentifiable: Their overall mortality was as high as 57% and their capability to undergo surgical/interventional treatment was only 67%. Perioperative complications resulting from delayed presentation had been common. Considering the present finding that most of those who lived alone could not call for help, further effort is warranted to facilitate early detection of those patients.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262419","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

Ictal Semiology Important for Electrode Implantation and Interpretation of Stereoelectroencephalography. 对电极植入和立体脑电图解读非常重要的直视半影学。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-06-15 Epub Date: 2024-05-08 DOI: 10.2176/jns-nmc.2023-0265

Katsuya Kobayashi, Akio Ikeda

{"title":"Ictal Semiology Important for Electrode Implantation and Interpretation of Stereoelectroencephalography.","authors":"Katsuya Kobayashi, Akio Ikeda","doi":"10.2176/jns-nmc.2023-0265","DOIUrl":"10.2176/jns-nmc.2023-0265","url":null,"abstract":"Scalp video-electroencephalography (video-EEG) monitoring should be analyzed thoroughly to preoperatively evaluate stereoelectroencephalography (SEEG). Formulating the working hypotheses for the epileptogenic zone (EZ) considering \"anatomo-electroclinical correlations\" is the most crucial step, which determines the placement of SEEG electrodes. If these hypotheses are insufficient, precise EZ identification may not be achieved during SEEG recording.In ictal semiology analysis, temporal and spatial patterns with reference to ictal EEG changes are emphasized. In frontal lobe epilepsy, seizures often begin with relatively widespread synchronous activity, and complex motor symptoms manifest within seconds. Due to the wide area involved and intense interhemispheric connectivity, a comprehensive evaluation is often required. Hypotheses are formulated on the basis of the motor symptoms and emotional manifestations that are related to the prefrontal cortices. In temporal lobe epilepsy, EEG onset often precedes clinical onset. Propagation from the EZ to locations within and outside of the temporal lobe is examined from both the EEG and semiological standpoint. The characteristics of contralateral versive seizures, contralateral tonic seizures, and frequent focal onset bilateral tonic-clonic seizures indicate a higher risk of temporo-perisylvian epilepsy. In parietal/occipital lobe epilepsy, despite that some symptoms result from activity in the immediate vicinity, stronger connectivity with other regions usually contributes to the generation of prominent ictal semiology. Hence, multilobar electrode placement is often useful in practice. For insular epilepsy, it is important to understand the anatomy, function, and networks between other regions. A semiological approach is one of the most important clues for electrode implantation and interpretation of SEEG.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892258","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

Which Theory of Cerebrospinal Fluid Production and Absorption Do Neurosurgeons Teach to Medical Students? Survey from Medical Universities in Japan, 2022. 神经外科医生向医学生传授的脑脊液生成和吸收理论是什么？日本医科大学调查，2022 年。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-06-15 Epub Date: 2024-05-08 DOI: 10.2176/jns-nmc.2023-0277

Natsumi Fujii, Sadahiro Nomura, Hiroshi Izuma, Hideyuki Ishihara

{"title":"Which Theory of Cerebrospinal Fluid Production and Absorption Do Neurosurgeons Teach to Medical Students? Survey from Medical Universities in Japan, 2022.","authors":"Natsumi Fujii, Sadahiro Nomura, Hiroshi Izuma, Hideyuki Ishihara","doi":"10.2176/jns-nmc.2023-0277","DOIUrl":"10.2176/jns-nmc.2023-0277","url":null,"abstract":"Several new studies have been conducted on cerebrospinal fluid (CSF) dynamics. Our educational guidelines, the Model Core Curriculum for Medical University, recommend access to the best current information. However, we do not know whether or when to introduce changes to this concept.We surveyed which theory of CSF dynamics taught to students by neurosurgeons. The old theory is the bulk flow theory, and the new theory explains that CSF is produced from the choroid plexus and capillaries; CSF then pulsates and drains into the venous and lymphatic systems through newly discovered pathways.Old and new theories were taught to 64.8% and 27.0% of students, respectively. The reason for teaching the old theory was to help them understand the pathogenesis of noncommunicating hydrocephalus (77.1%), whereas the reason for teaching the new theory was to teach the latest knowledge (40.0%). Physicians who wished to teach the new theory in the near future accounted for 47.3%, which was higher than those who would teach the new theory in 2022 (27.0%), and those who still wished to teach the old theory in the near future accounted for 43.2%.An education policy on CSF dynamics will be established when we interpret ventricular enlargement and its improvement by third ventriculostomy in noncommunicating hydrocephalus based on the new theory. The distributed answers in the survey shared that it is difficult to teach about CSF dynamics and provided an opportunity to discuss these issues.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892288","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

Immediate Effects, Detailed Clinical Outcomes, and Prognostic Factors of Chemonucleolysis Using Condoliase for Lumbar Disc Herniation. 使用Condoliase进行腰椎间盘突出症螯合术的立竿见影效果、详细临床结果和预后因素

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-06-15 Epub Date: 2024-05-08 DOI: 10.2176/jns-nmc.2024-0009

Yushi Sakamoto, Seiichiro Naruo, Tomonori Ozaki, Shogo Tahata, Toru Fujimoto, Tatsuya Abe

{"title":"Immediate Effects, Detailed Clinical Outcomes, and Prognostic Factors of Chemonucleolysis Using Condoliase for Lumbar Disc Herniation.","authors":"Yushi Sakamoto, Seiichiro Naruo, Tomonori Ozaki, Shogo Tahata, Toru Fujimoto, Tatsuya Abe","doi":"10.2176/jns-nmc.2024-0009","DOIUrl":"10.2176/jns-nmc.2024-0009","url":null,"abstract":"Chemonucleolysis utilizing condoliase is a minimally invasive treatment for lumbar disc herniation (LDH) aimed at reducing intervertebral disc pressure and enhancing symptoms. In this study, lower limb pain was measured using the numeric rating scale (NRS) the day after treatment and 1 and 3 months after treatment. Prognostic factors were assessed, categorizing participants into an improvement group (I-group) for NRS lower limb pain scores of ≥3.5 and a non-improvement group (N-group) for scores of <3.5. This study included a total of 225 patients treated between April 2020 and March 2023. The mean age was 46.5 ± 16.5 years, with 151 males. The mean duration of illness was 6.2 ± 8.52 months. As of the day after treatment, 60 cases were classified into the I-group, 118 cases at 1 month after surgery, and 152 cases at 3 months after surgery. The disease duration before treatment was significantly shorter in the I-group at 1 (8.19 ± 8.74 [I-group] vs. 5.17 ± 8.04 [N-group] months) and 3 months (8.51 [I-group] ± 7.35 vs. 5.69 ± 8.87[N-group] months) after treatment. The comparison of baseline leg pain NRS shows a difference in leg pain NRS in the I-group when compared on the day after treatment (6.02 ± 2.64 [I-group] vs. 7.50 ± 1.79 [N-group]), 1 (5.13 ± 2.69 [I-group] vs. 7.58 ± 1.66 [N-group]), and 3 months (4.42 ± 2.70 [I-group] vs. 7.34 ± 1.77 [N-group]). Chemonucleolysis using condoliase for LDH can improve symptoms the day after treatment and can be a minimally invasive treatment to avoid surgery.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892285","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

Consideration of Brain CT Imaging Standard for Mild Head Injuries. 考虑轻微头部损伤的脑 CT 成像标准。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-06-15 Epub Date: 2024-05-08 DOI: 10.2176/jns-nmc.2023-0297

Takahiro Kumagawa, Ryo Otaki, Takeshi Maeda, Katsunori Shijo, Atsuo Yoshino

{"title":"Consideration of Brain CT Imaging Standard for Mild Head Injuries.","authors":"Takahiro Kumagawa, Ryo Otaki, Takeshi Maeda, Katsunori Shijo, Atsuo Yoshino","doi":"10.2176/jns-nmc.2023-0297","DOIUrl":"10.2176/jns-nmc.2023-0297","url":null,"abstract":"It has been reported that various clinical criteria indicate computed tomography (CT) examination for mild head injury (MHI). However, the decision to perform CT for MHI largely depends on the physician. Data on severe head injuries is available in sources such as the Japan Neurotrauma Data Bank, but only a few data has been collected on MHI. A total of 1688 patients with MHI (Glasgow Coma Scale 14 and 15) treated at our hospital from June 2017 to May 2019 were reviewed. CT was performed in 1237 patients (73.28%), and intracranial hemorrhage was detected in 50 patients. Three patients deteriorated, and all were surgically treated. Statistical analysis of the presence or absence of acute intracranial hemorrhage and \"risk factors for complications of intracranial lesions in MHI\" showed significant differences in unclear or ambiguous accident history (p = 0.022), continued post-traumatic amnesia (p < 0.01), trauma above the clavicles including clinical signs of skull fracture (skull base or depressed skull fracture) (p = 0.012), age <60 years (p < 0.01), coagulation disorders (p < 0.01), and alcohol or drug intoxication (p < 0.01). The 453 patients who did not satisfy these risk factors included only one patient with intracranial hemorrhage, so the negative predictive value was 99.78%. This study shows that the \"risk factors for complications of intracranial lesions in MHI\" are effective criteria for excluding acute intracranial hemorrhage and CT should be actively considered for patients with the above factors that showed significant differences.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892257","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

Changes in Intervertebral Disc Properties after Intradiscal Injection of Condoliase for Painful Lumbar Disc Herniation. 椎间盘内注射 Condoliase 治疗腰椎间盘突出症后椎间盘属性的变化

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-06-15 Epub Date: 2024-05-08 DOI: 10.2176/jns-nmc.2023-0302

Tatsuya Ohtonari, Kyohei Sakai, Yosuke Furukawa, Yasushi Takeda

{"title":"Changes in Intervertebral Disc Properties after Intradiscal Injection of Condoliase for Painful Lumbar Disc Herniation.","authors":"Tatsuya Ohtonari, Kyohei Sakai, Yosuke Furukawa, Yasushi Takeda","doi":"10.2176/jns-nmc.2023-0302","DOIUrl":"10.2176/jns-nmc.2023-0302","url":null,"abstract":"The detailed changes in disc properties after intradiscal injection of condoliase remain controversial. At 3 and 9 months after administration, radiographic changes in discs were investigated. A total of 41 patients (men, 25; median age, 46 years) who underwent regular follow-up magnetic resonance imaging at 3 and 9 months after administration without additional invasive therapy were retrospectively investigated. The intensity changes of the nucleus pulposus based on the Pfirrmann disc grading system, midsagittal disc height, and maximum protrusion length of herniation were assessed. In addition, disc height changes were compared between 24 patients aged <50 years (young group) and 17 patients aged ≥50 years (over 50s group). The overall mean disc heights were 9.1, 7.5, and 7.6 mm preoperatively, at 3 months, and at 9 months, respectively, with a significant reduction at 3 months (P < 0.001) and no significant changes thereafter. The mean maximum protrusion length of herniation significantly and gradually decreased. The overall proportions of Pfirrmann disc grades after administration were equivalent between 3 and 9 months. However, the recovery from Pfirrmann disc grades IV to III was confirmed in 8 of 17 cases (47.1%) between 3 and 9 months, whereas 6 of 20 cases (30.0%) showed a decline from III to IV. Patients in the young group with pretreatment disc height >11 mm had the greatest reduction in disc height than the over 50s group. In conclusion, the clinical outcomes in the over 50s group were comparable to those in the young group after injection of condoliase, whereas young patients with higher disc were more susceptible to disc height reduction.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892246","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

Prevalence and Severity of Positional Posterior Plagiocephaly and Positional Posterior Brachycephaly in Children and Adolescents in Japan. 日本儿童和青少年位置性后颅畸形和位置性后颅畸形的患病率和严重程度。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-05-15 Epub Date: 2024-03-04 DOI: 10.2176/jns-nmc.2023-0216

Nobuyuki Akutsu, Junji Koyama, Atsufumi Kawamura, Takashi Sasayama

{"title":"Prevalence and Severity of Positional Posterior Plagiocephaly and Positional Posterior Brachycephaly in Children and Adolescents in Japan.","authors":"Nobuyuki Akutsu, Junji Koyama, Atsufumi Kawamura, Takashi Sasayama","doi":"10.2176/jns-nmc.2023-0216","DOIUrl":"10.2176/jns-nmc.2023-0216","url":null,"abstract":"This study aimed to assess the prevalence, severity, and natural history of positional posterior plagiocephaly (PPP) and positional posterior brachycephaly in Japan. We conducted a cross-sectional study of pediatric patients, ranging from 0 to 15 years old, evaluated for head trauma with negative computed tomography (CT) findings. The cranial vault asymmetry index (CVAI) was calculated using CT images at the superior orbital rim. Asymmetry according to CVAI values was subcategorized as follows: mild (3.5%-7%), moderate (7%-12%), and severe (>12%). The results were analyzed according to different age groups: group 1, 2-23 months (54 patients); group 2, 2-6 years (123 patients); and group 3, 7-15 years (123 patients). Overall, 300 patients were included (109 [36.3%] girls and 191 [63.7%] boys). The overall prevalence of PPP in the 300 patients was 46.7% (140 patients). PPP prevalence decreased consistently with age group: group 1, 57.4%; group 2, 47.2%; and group 3, 41.5%. Severe asymmetry was seen in all age groups. The overall mean cephalic index (CI) was 85.2. Cephalic index scores decreased consistently with age: group 1, 87.4; group 2, 85.1; and group 3, 84.3. The prevalence of PPP in Japan was higher than that reported in other countries. Although there was an overall decrease in the prevalence and severity of PPP with increasing patient age, PPP does not necessarily resolve spontaneously in all children. Furthermore, severe asymmetry was seen across all age groups.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022224","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

Differences in the Demographics and Clinical Characteristics between the Ossification of the Posterior Longitudinal Ligament and Ossification of the Ligamentum Flavum in Patients Who Underwent Thoracic Spinal Surgery for Compressive Myelopathy. 因压迫性脊髓病而接受胸椎手术的患者中，后纵韧带骨化与黄韧带骨化在人口统计学和临床特征方面的差异。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-05-15 Epub Date: 2024-02-26 DOI: 10.2176/jns-nmc.2023-0137

Shinsuke Yoshida, Sho Nakamura, Kazuo Saita, Soichi Oya, Satoshi Ogihara

{"title":"Differences in the Demographics and Clinical Characteristics between the Ossification of the Posterior Longitudinal Ligament and Ossification of the Ligamentum Flavum in Patients Who Underwent Thoracic Spinal Surgery for Compressive Myelopathy.","authors":"Shinsuke Yoshida, Sho Nakamura, Kazuo Saita, Soichi Oya, Satoshi Ogihara","doi":"10.2176/jns-nmc.2023-0137","DOIUrl":"10.2176/jns-nmc.2023-0137","url":null,"abstract":"Ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF) are related diseases associated with the ossification of spinal ligaments that can occasionally lead to thoracic myelopathy. We retrospectively analyzed the clinical data of 34 consecutive patients who underwent thoracic spinal surgeries for OPLL and/or OLF at our hospital between July 2010 and June 2022, and statistically compared data between patients with thoracic OPLL (TOPLL; n = 12) and those with thoracic OLF (TOLF; n = 22). The mean age of the TOPLL group was significantly lower than that of the TOLF group (53.7 vs. 68.4 years). The TOPLL group exhibited a greater female predominance than the TOLF group (58.3% vs. 18.2%). The median body mass index of the TOPLL group was significantly higher than that of the TOLF group (33.0 vs. 26.0 kg/m2). Patients with TOPLL significantly required instrumented fusion and repetitive surgical intervention more than those with TOLF (83.3% vs. 9.1%; 50.0% vs. 0.0%). Although neurological deterioration just after the intervention was more common in patients with TOPLL (41.7% vs. 4.6%), no difference was observed in thoracic Japanese Orthopaedic Association score and recovery rate in the chronic phase between TOPLL and TOLF. The TOPLL group had a younger onset, female dominance, and a greater degree of obesity when compared with the TOLF group. The surgery for TOPLL is challenging, considering that it requires long-range decompression and fusion, subsequent operations, careful management, and long-term follow-up, when compared to TOLF, which necessitates only simple decompression.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972855","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