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Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations. 远外侧经椎间孔单侧双门静脉内镜下腰椎间盘切除术治疗上腰椎间盘突出症。
IF 3.8 2区 医学
Neurospine Pub Date : 2025-03-01 Epub Date: 2025-03-31 DOI: 10.14245/ns.2550058.029
Jin Seop Hwang, Sang Hyub Lee, Dain Jeong, Jae-Won Jang, Yong Eun Cho, Dong-Geun Lee, Choon Keun Park, Chung Kee Chough
{"title":"Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations.","authors":"Jin Seop Hwang, Sang Hyub Lee, Dain Jeong, Jae-Won Jang, Yong Eun Cho, Dong-Geun Lee, Choon Keun Park, Chung Kee Chough","doi":"10.14245/ns.2550058.029","DOIUrl":"https://doi.org/10.14245/ns.2550058.029","url":null,"abstract":"<p><strong>Objective: </strong>The upper lumbar region has distinctive anatomical characteristics that contribute to the challenges of performing discectomy. We introduce far-lateral transforaminal unilateral biportal endoscopic (UBE) lumbar discectomy for central or paracentral disc herniations in the upper lumbar region.</p><p><strong>Methods: </strong>We conducted retrospective review of the patients who underwent a far-lateral transforaminal UBE lumbar discectomy at our institution from January 2018 to September 2024. The electronic medical records, operative records, and radiologic images of the patients were reviewed.</p><p><strong>Results: </strong>A total of 27 patients underwent far-lateral transforaminal UBE lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. The patient had a mean age of 54.0 ± 13.7 years. Operation was performed at the L1-2 level in 3 patients (11.1%), L2-3 in 9 patients (33.3%), and L3-4 in 15 patients (55.6%). The patients were followed-up for a mean of 27.7 ± 19.3 months. The Oswestry Disability Index was significantly decreased from 36.3 ± 6.8 preoperatively to 3.7 ± 3.3 at last follow-up (p < 0.001). The visual analogue scale (VAS) back was significantly decreased from 7.8 ± 0.9 preoperatively to 3.1 ± 0.6 postoperative day 2 (p < 0.001). The VAS leg was significantly decreased from 8.1 ± 0.8 preoperatively to 2.3 ± 0.7 postoperative day 2 (p < 0.001).</p><p><strong>Conclusion: </strong>The far-lateral transforaminal UBE lumbar discectomy would be a viable surgical option for upper lumbar disc herniations.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"14-27"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Risk Factors for "Adjacent-Level Ossification Development" Other Than Short Plate-to-Disc Distance and Clinical Implications for Adjacent-Segment Pathology. 除了短钢板到椎间盘的距离外,“邻接水平骨化发展”的危险因素及其对邻接节段病理的临床意义。
IF 3.8 2区 医学
Neurospine Pub Date : 2025-03-01 Epub Date: 2025-03-31 DOI: 10.14245/ns.2448832.416
Sang Hun Lee, Micheal Raad, David B Cohen, Khaled M Kebaish, Lee H Riley Iii
{"title":"Risk Factors for \"Adjacent-Level Ossification Development\" Other Than Short Plate-to-Disc Distance and Clinical Implications for Adjacent-Segment Pathology.","authors":"Sang Hun Lee, Micheal Raad, David B Cohen, Khaled M Kebaish, Lee H Riley Iii","doi":"10.14245/ns.2448832.416","DOIUrl":"https://doi.org/10.14245/ns.2448832.416","url":null,"abstract":"<p><strong>Purpose: </strong>To identify factors associated with adjacent-level ossification development (ALOD) after anterior cervical discectomy and fusion (ACDF) and associated clinical outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed records of 140 adults who underwent primary ACDF for degenerative disc disease. We compared patients with and without ALOD after ACDF. Radiographic measurements and factors associated with ALOD were assessed preoperatively and at minimum 24-month follow-up. Clinical outcomes were incidence of clinical adjacent-segment pathologies (CASP), revision surgery, and patient-reported outcomes.</p><p><strong>Results: </strong>Factors associated with both cranial and caudal ALOD were short plate-to-disc distance (PDD), adjacent-segment kyphosis, hyperlordotic ACDF causing junctional segment kyphosis, and preoperative ossification of the anterior longitudinal ligament (OALL). Mean final adjacent-segment range of motion (ROM) was less in those with cranial ALOD (6.9° ± 2.8°) than in those without cranial ALOD (12° ± 4.2°) (p < 0.01). Mean final adjacent-segment ROM was also less in those with caudal ALOD (5.5° ± 2.4º) than in those without caudal ALOD (8.2º ± 3.7º) (p < 0.01). The incidence of CASP-required surgery was higher in those with caudal ALOD (p = 0.02) but no different in those with cranial ALOD (p = 0.69) compared with those without ALOD.</p><p><strong>Conclusion: </strong>Factors associated with ALOD were a kyphotic segment adjacent to ACDF, hyperlordotic fusion, preoperative OALL, and short PDD. ALOD was associated with less segmental ROM and, for those with caudal but not cranial ALOD, higher incidence of revision surgery for CASP.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"194-201"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Transforaminal Endoscopic Thoracic Discectomy Is More Cost-Effective Than Microdiscectomy for Symptomatic Disc Herniations. 经椎间孔内窥镜胸椎椎间盘切除术治疗症状性椎间盘突出比显微椎间盘切除术更具成本效益。
IF 3.8 2区 医学
Neurospine Pub Date : 2025-03-01 Epub Date: 2025-03-31 DOI: 10.14245/ns.2449414.707
Junseok Bae, Pratyush Shahi, Sang-Ho Lee, Han-Joong Keum, Ju-Wan Seok, Yong-Soo Choi, Jin-Sung Kim
{"title":"Transforaminal Endoscopic Thoracic Discectomy Is More Cost-Effective Than Microdiscectomy for Symptomatic Disc Herniations.","authors":"Junseok Bae, Pratyush Shahi, Sang-Ho Lee, Han-Joong Keum, Ju-Wan Seok, Yong-Soo Choi, Jin-Sung Kim","doi":"10.14245/ns.2449414.707","DOIUrl":"https://doi.org/10.14245/ns.2449414.707","url":null,"abstract":"<p><strong>Objective: </strong>To analyze costs and cost-effectiveness of transforaminal endoscopic thoracic discectomy (TETD) for the treatment of symptomatic thoracic disc herniation (TDH) and compare it with open microdiscectomy (MD).</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent TETD or MD for symptomatic TDH and had a minimum follow-up of 1 year. Cost analysis included direct costs (primary and secondary hospital costs), indirect costs (lost wages due to work absence), total costs (direct + indirect), and cost-effectiveness (cost per quality-adjusted life year [QALY] and incremental cost-effectiveness ratio [ICER]). Clinical outcomes included patient-reported outcome measures (Oswestry Disability Index [ODI], 36-item Short Form health survey [SF-36]), QALY gained, and reoperation and readmission rates at 1 year. TETD and MD groups were compared for outcome measures.</p><p><strong>Results: </strong>A total of 111 patients (57 TETD, 54 MD) were included. The direct ($6,270 TETD vs. $7,410 MD, p < 0.01), indirect costs ($1,250 TETD vs. $1,450 MD, p < 0.01), total costs ($7,520 TETD vs. $8,860 MD, p < 0.01), and cost per QALY ($31,333 TETD vs. $44,300 MD, p < 0.01) were significantly lower for TETD compared to MD. ICER of TETD was found to be -$33,500. At 1 year, TETD group showed significantly greater improvement in ODI (46% vs. 36%, p < 0.01) and SF-36 (64% vs. 53%, p < 0.01) and significantly greater QALY gained (0.24 vs. 0.2, p < 0.01) compared to MD group. No significant difference was found in reoperation and readmission rates.</p><p><strong>Conclusion: </strong>TETD demonstrated significantly better clinical outcomes, lower overall costs, and better cost-effectiveness than MD in appropriately selected patients of symptomatic TDH.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"118-127"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
A Commentary on "Comparative Analysis of Romosozumab Versus Vertebroplasty With Denosumab: Efficacy, Safety, and Secondary Bone Mineral Density Outcomes". 关于“Romosozumab与Denosumab椎体成形术的比较分析:疗效、安全性和继发性骨密度结果”的评论。
IF 3.8 2区 医学
Neurospine Pub Date : 2025-03-01 Epub Date: 2025-03-31 DOI: 10.14245/ns.2550298.149
Toshihiko Inui
{"title":"A Commentary on \"Comparative Analysis of Romosozumab Versus Vertebroplasty With Denosumab: Efficacy, Safety, and Secondary Bone Mineral Density Outcomes\".","authors":"Toshihiko Inui","doi":"10.14245/ns.2550298.149","DOIUrl":"https://doi.org/10.14245/ns.2550298.149","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"78-80"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Impact of Paraspinal Muscle Degeneration on Surgical Outcomes and Radiographical Sagittal Alignment in Adult Spinal Deformity: A Multicenter Study. 脊柱旁肌退变对成人脊柱畸形手术结果和矢状位线的影响:一项多中心研究。
IF 3.8 2区 医学
Neurospine Pub Date : 2025-03-01 Epub Date: 2025-03-31 DOI: 10.14245/ns.2449174.587
Jun Ouchida, Yoshinori Morita, Sadayuki Ito, Naoki Segi, Ippei Yamauchi, Tokumi Kanemura, Tetsuya Ohara, Taichi Tsuji, Ryuichi Shinjyo, Shiro Imagama, Hiroaki Nakashima
{"title":"Impact of Paraspinal Muscle Degeneration on Surgical Outcomes and Radiographical Sagittal Alignment in Adult Spinal Deformity: A Multicenter Study.","authors":"Jun Ouchida, Yoshinori Morita, Sadayuki Ito, Naoki Segi, Ippei Yamauchi, Tokumi Kanemura, Tetsuya Ohara, Taichi Tsuji, Ryuichi Shinjyo, Shiro Imagama, Hiroaki Nakashima","doi":"10.14245/ns.2449174.587","DOIUrl":"https://doi.org/10.14245/ns.2449174.587","url":null,"abstract":"<p><strong>Objective: </strong>This multicenter study aimed to evaluate the impact of paravertebral muscles (PVMs) degeneration, particularly fat infiltration, on preoperative sagittal imbalance, and postoperative complications and sagittal alignment change in patients with adult spinal deformity (ASD).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 454 patients who underwent ASD surgery across 5 institutions. Patients were classified into 2 groups based on paraspinal muscle fat infiltration on MRI: those with significant infiltration (FI-PVM(+)) and those with minimal or no infiltration (FI-PVM(-)). Propensity score matching was performed to adjust for demographic factors and preoperative radiographical parameters. Spinopelvic parameters were assessed preoperatively, postoperatively, and at a 2-year follow-up. Mechanical complications were compared between the groups.</p><p><strong>Results: </strong>The FI-PVM(+) group showed greater sagittal vertical axis (86.4 ± 57.5 vs. 51.8 ± 59.2, p < 0.001) preoperatively and required more extensive surgical correction with a significantly greater number of fused vertebral levels (7.3 ± 3.7 vs. 6.7 ± 3.7, p < 0.039). After propensity score matching, both groups showed significant improvement in spinopelvic alignment postoperatively, maintained throughout the 2-year follow-up. However, the FI-PVM(+) group demonstrated a trend toward a higher incidence of distal junctional kyphosis (6.3% vs. 0.9%, p = 0.070) and exhibited significantly greater decrease in pelvic tilt postoperatively (4.3° ± 7.6° vs. 1.3° ± 8.2°, p = 0.006).</p><p><strong>Conclusion: </strong>Fat infiltration in PVM is associated with increased surgical complexity and a higher risk of mechanical complications. Preoperative assessment of muscle quality, along with targeted rehabilitation and closer postoperative monitoring, may be crucial for improving long-term outcomes in ASD surgery.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"30-37"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Open Versus Minimally Invasive Spine Surgery in the Treatment of Single-Level Degenerative Lumbar Spondylolisthesis: An AO Spine Global Cross-Sectional Study. 开放与微创脊柱手术治疗单节段退行性腰椎滑脱:AO脊柱整体横断面研究。
IF 3.8 2区 医学
Neurospine Pub Date : 2025-03-01 Epub Date: 2025-03-31 DOI: 10.14245/ns.2448902.451
Luca Ambrosio, Sathish Muthu, Samuel K Cho, Micheal S Virk, Juan P Cabrera, Patrick C Hsieh, Andreas K Demetriades, Stipe Ćorluka, S Tim Yoon, Gianluca Vadalà
{"title":"Open Versus Minimally Invasive Spine Surgery in the Treatment of Single-Level Degenerative Lumbar Spondylolisthesis: An AO Spine Global Cross-Sectional Study.","authors":"Luca Ambrosio, Sathish Muthu, Samuel K Cho, Micheal S Virk, Juan P Cabrera, Patrick C Hsieh, Andreas K Demetriades, Stipe Ćorluka, S Tim Yoon, Gianluca Vadalà","doi":"10.14245/ns.2448902.451","DOIUrl":"https://doi.org/10.14245/ns.2448902.451","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess global trends in the use of open surgery versus minimally invasive surgery (MIS) for the treatment of single-level L4-5 degenerative lumbar spondylolisthesis (DLS).</p><p><strong>Methods: </strong>A cross-sectional online survey issued by the AO Spine Knowledge Forum Degenerative was conducted among AO Spine members between July and September 2023. Participants were presented with 3 clinical cases of L4-5 grade 1 DLS, each with varying degrees of stenosis and instability. The survey captured surgeon demographics and preferences for open versus MIS approaches. Statistical analysis, including chi-square tests and logistic regression, was performed to explore associations between surgical choices and surgeon demographics.</p><p><strong>Results: </strong>A total of 943 surgeons responded, with 479 completing the survey. Open surgery was the preferred approach in all 3 cases (58.8%, 57.3%, and 42.4%, respectively), particularly in cases involving central and bilateral foraminal stenosis. MIS was the second most common choice, particularly for unilateral foraminal stenosis with mild instability (38.8%). Surgeons' preferences varied significantly by region, age, and fellowship training, with younger and fellowship-trained surgeons more likely to prefer MIS.</p><p><strong>Conclusion: </strong>The study highlights the continued predominance of open surgery for DLS, especially in complex cases, despite the growing acceptance of MIS. Significant regional and demographic variations in surgical preferences suggest the need for tailored guidelines and standardized training protocols to optimize patient outcomes. Future research should focus on the long-term efficacy of these approaches and the impact of evolving technologies on surgical decision-making.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"40-47"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Endoscopic Transforaminal Thoracic Decompression for Removal of a Giant Calcified Thoracic Disc Herniation. 内镜下经椎间孔胸椎减压术治疗巨大钙化胸椎间盘突出症。
IF 3.8 2区 医学
Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2449064.532
Mazda Farshad, Christoph Johannes Laux, Lukas Zingg, Florian Wanivenhaus
{"title":"Endoscopic Transforaminal Thoracic Decompression for Removal of a Giant Calcified Thoracic Disc Herniation.","authors":"Mazda Farshad, Christoph Johannes Laux, Lukas Zingg, Florian Wanivenhaus","doi":"10.14245/ns.2449064.532","DOIUrl":"https://doi.org/10.14245/ns.2449064.532","url":null,"abstract":"<p><p>To demonstrate the preoperative workup, surgical planning and execution of transforaminal endoscopic thoracic discectomy (TETD) for a giant calcified disc herniation. Surgeries for symptomatic thoracic disc herniations are rare and challenging. The main goal is to achieve sufficient decompression with minimal manipulation of the spinal cord. Conventional surgical techniques may have significant approach-related morbidities and often require additional stabilization. The full endoscopic transforaminal technique is the least invasive approach so far. A 73-year-old female patient with progressive gait disturbance and paraparesis received radiological imaging which revealed a giant calcified thoracic disc herniation at the level T11-12. The preoperative workup, planning and execution of TETD is demonstrated in detail. This report represents a typical educational case of a giant calcified thoracic disc herniation, treated by TETD.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"21 4","pages":"1116-1118"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Predicting Neck Dysfunction After Open-Door Cervical Laminoplasty - A Prospective Cohort Patient-Reported Outcome Measurement Study. 预测开放式颈椎板成形术后的颈部功能障碍——一项前瞻性队列患者报告的结果测量研究。
IF 3.8 2区 医学
Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2448620.310
Chiu-Hao Hsu, Wei-Wei Chen, Meng-Yin Ho, Chin-Chieh Wu, Dar-Ming Lai
{"title":"Predicting Neck Dysfunction After Open-Door Cervical Laminoplasty - A Prospective Cohort Patient-Reported Outcome Measurement Study.","authors":"Chiu-Hao Hsu, Wei-Wei Chen, Meng-Yin Ho, Chin-Chieh Wu, Dar-Ming Lai","doi":"10.14245/ns.2448620.310","DOIUrl":"10.14245/ns.2448620.310","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the predictive factors for neck pain and cervical spine function after laminoplasty for degenerative cervical myelopathy (DCM) using K-means for longitudinal data (KML).</p><p><strong>Methods: </strong>In this prospective cohort study, we collected clinical and radiographic data from patients with DCM who underwent cervical laminoplasty. A novel index of surgical outcome, \"neck function,\" which comprises neck pain and cervical spine function according to the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire, was proposed. We treated surgical outcomes as longitudinal rather than cross-sectional data and used KML for analysis. Patients were categorized as having good or poor outcomes based on the KML graph of neck pain and cervical spine function.</p><p><strong>Results: </strong>From 2016 to 2020, 104 patients underwent laminoplasty for DCM; however, 35 patients were excluded because of loss to follow-up or incomplete data. The authors found that central canal stenosis (odds ratio [OR], 17.93; 95% confidence interval [CI], 1.26-254.73; p=0.03) and preoperative neck pain (OR per 1 point increase=1.49; 95% CI, 1.12-1.99; p=0.006) were 2 negative predictive factors and that a positive K-line during flexion was a positive predictive factor (OR, 0.11; 95% CI, 0.01-0.87; p=0.036) for neck function after laminoplasty.</p><p><strong>Conclusion: </strong>Central canal stenosis, preoperative neck pain and a K-line during flexion were found to be predictive of postoperative neck pain and cervical spine function after laminoplasty. To achieve better surgical outcomes for neck function, the authors suggest the utilization of these determinants as a guiding framework for the selection of surgical approaches for DCM.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"21 4","pages":"1053-1065"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Transforaminal Lumbar Endoscopic Discectomy: A Novel Alternative for Management of Lumbar Disc Herniation in Patients With Rheumatoid Arthritis? 经椎间孔腰椎内窥镜椎间盘切除术:类风湿关节炎患者腰椎间盘突出症治疗的新选择?
IF 3.8 2区 医学
Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2448634.317
Stylianos Kapetanakis, Constantinos Chaniotakis, Paschalis Tsioulas, Nikolaos Gkantsinikoudis
{"title":"Transforaminal Lumbar Endoscopic Discectomy: A Novel Alternative for Management of Lumbar Disc Herniation in Patients With Rheumatoid Arthritis?","authors":"Stylianos Kapetanakis, Constantinos Chaniotakis, Paschalis Tsioulas, Nikolaos Gkantsinikoudis","doi":"10.14245/ns.2448634.317","DOIUrl":"10.14245/ns.2448634.317","url":null,"abstract":"<p><strong>Objective: </strong>Lumbar disc herniation (LDH) represents an increasingly encountered condition in patients with rheumatoid arthritis (RA). The aim of the present study is to assess the progress of health-related quality of life following transforaminal endoscopic lumbar discectomy (TELD) for LDH in patients suffering from RA.</p><p><strong>Methods: </strong>Seventy-four patients, scheduled to undergo elective TELD for LDH, were prospectively enrolled in the study. Group A included 36 otherwise healthy individuals and group B 38 patients complementarily diagnosed with RA according to the 2010 ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) criteria. The Medical Outcomes Study 36-item Short Form health survey (SF-36) was selected for the outcome assessment at baseline and postoperatively, at selected intervals at 6 weeks, 3, 6, and 12 months postoperatively.</p><p><strong>Results: </strong>Group A presented statistically significantly higher scores in all SF-36 domains and all selected intervals (p<0.001), except for mental health parameter. All aspects of SF-36 questionnaire significantly improved postoperatively (p<0.001) and in each group independently. Nevertheless, the absolute improvement between consecutive time intervals did not differ significantly between the 2 groups.</p><p><strong>Conclusion: </strong>Patients diagnosed with RA who undergo TELD for LDH demonstrate statistically significant improvement in their health status, as measured by SF-36 questionnaire, one year after the procedure. This improvement is comparable with normal individuals.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"21 4","pages":"1210-1218"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
O-Arm Navigation-Guided Unilateral Biportal Endoscopic Decompression of Far-Out Syndrome. o臂导航引导单侧双门静脉内镜减压治疗远出综合征。
IF 3.8 2区 医学
Neurospine Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.14245/ns.2449140.570
Rohit Akshay Kavishwar, YiHao Liang, Dongeon Lee, Jaehwan Kim, Maria Pedraza, Jin-Sung Kim
{"title":"O-Arm Navigation-Guided Unilateral Biportal Endoscopic Decompression of Far-Out Syndrome.","authors":"Rohit Akshay Kavishwar, YiHao Liang, Dongeon Lee, Jaehwan Kim, Maria Pedraza, Jin-Sung Kim","doi":"10.14245/ns.2449140.570","DOIUrl":"10.14245/ns.2449140.570","url":null,"abstract":"<p><p>The main aim of this video article is to demonstrate the combined use of O-arm navigation and unilateral biportal endoscopy (UBE) to manage far-out syndrome (FOS). In FOS there is entrapment and compression of the fifth lumbar nerve beyond the foramen and between L5 transverse process and the sacral ala at the lumbosacral junction. Conventional microscopic decompression using a paraspinal approach had been the gold standard for its management. However, the surgery is technically challenging due to the deep location of the pathology and intricate anatomy of extraforaminal space. There have been some published reports of unsatisfactory outcomes with microscopic decompression for FOS. We decided to integrate navigation with UBE to increase precision for the management of FOS. A 70-year-old female presented to us with chief complaint of left lower limb radiculopathy since 1 year. She also complained of numbness and paresthesias in her left leg and foot. She was unable to walk for more than 10 minutes due to pain. Her magnetic resonance imaging scan revealed compression of left L5 nerve root in the extraforaminal region. UBE decompression via paraspinal approach was performed for her under O-arm navigation. She experienced immediate relief of her symptoms in the postoperative period. O-arm-navigation-guided UBE is an effective and safer alternative to microsurgical decompression for the management of FOS. This video demonstrates the step-by-step implementation of O-arm navigation with endoscopy and its precise execution.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"21 4","pages":"1149-1153"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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