Spinal Surgery最新文献

大脳皮質・脳幹-脊髄による姿勢と歩行の制御機構由大脑皮层、脑干-脊髓控制姿势和行走的机制

Spinal Surgery Pub Date : 2014-02-01 DOI: 10.2531/SPINALSURG.27.208

薫高草木

引用次数: 0

Stress Distribution and Construct Stability in an Experimental Cervical Open-Door Laminoplasty Model: —Three-dimensional Finite Element Analysis—@@@—有限要素解析法による検討— 实验性颈椎开门椎板成形术模型的应力分布和结构稳定性:三维有限元分析

Spinal Surgery Pub Date : 2013-08-25 DOI: 10.2531/SPINALSURG.27.139

H. Nagashima, K. Yuge, Ryusuke Taniyama, H. Takao, Hiroki Ohashi, Akira Isoshima, S. Tani, T. Abe

{"title":"Stress Distribution and Construct Stability in an Experimental Cervical Open-Door Laminoplasty Model: —Three-dimensional Finite Element Analysis—@@@—有限要素解析法による検討—","authors":"H. Nagashima, K. Yuge, Ryusuke Taniyama, H. Takao, Hiroki Ohashi, Akira Isoshima, S. Tani, T. Abe","doi":"10.2531/SPINALSURG.27.139","DOIUrl":"https://doi.org/10.2531/SPINALSURG.27.139","url":null,"abstract":"Background:Open-door cervical laminoplasty requires devices such as stay sutures(SS), laminar spacers(LS), and titanium mini-plates(TM)to keep the elevated lamina open. However, the significance and differences in the effects of each of these devices remain unclear. This study aimed at investigating the role of these devices, using a 3-dimensional finite element(FE)model. Methods:An FE bone model of the fifth cervical vertebra was constructed. Its lamina was elevated by guttering at the hinge site, simulating an open-door technique(G model). SS, LS, and TM were added to the G model, simulating laminoplasty with SS(SS model), LS(LS model), and TM (TM model), respectively. Compression loading force was applied to the elevated lamina in 2 directions of the horizontal plane, and the stress distribution response was analyzed. Results:The peak Mises stress which integrates the stresses in multiple directions into a unified vector was concentrated at the hinge region in the G and SS model. In the LS and TM model, the peak Mises stresses were observed in the connecting regions between the LS and the lateral mass, and the TM and the elevated lamina, respectively. The Mises stress in the hinge region was minimal in the LS model. Moreover, the bony peak Mises stress and the maximum deformation were minimal in the LS model. Conclusions:This stress distribution study clearly demonstrated that the placement of artificial implants such as LS and TM determined the stress concentration at the hinge region during laminoplasty with SS. The results of deformation studies showed that LS was best for stabilizing the elevated lamina. Based on this analysis, we suppose that the use of LS for stabilization of the hinge region might yield favorable results over other devices in open-door laminoplasty. (Received:September 27, 2012;accepted:March 6, 2013)","PeriodicalId":283326,"journal":{"name":"Spinal Surgery","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121409875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Patients with Spinal Ependymomas Attached to the Anterior Median Septum are at Risks for Postoperative Functional Impairment : A Correlating Analysis 附于前中隔的脊髓室管膜瘤患者有术后功能损害的风险:一项相关分析

Spinal Surgery Pub Date : 2013-08-25 DOI: 10.2531/SPINALSURG.27.153

S. Shimizu, K. Mii, D. Mishima, K. Fujii

{"title":"Patients with Spinal Ependymomas Attached to the Anterior Median Septum are at Risks for Postoperative Functional Impairment : A Correlating Analysis","authors":"S. Shimizu, K. Mii, D. Mishima, K. Fujii","doi":"10.2531/SPINALSURG.27.153","DOIUrl":"https://doi.org/10.2531/SPINALSURG.27.153","url":null,"abstract":"When operating on spinal ependymomas, careful dissection of tumors in the ventral attachment is important because the tumor-feeding arteries and the central vessels of the cord, both of which branch from the anterior spinal artery, are located close to the anterior median septum(AMS), which is an extension of the pia in the cord. In this study, we examined the clinical features of tumor attachment to the AMS. We divided 10 patients who underwent total removal of spinal ependymomas into 2 groups based on the ventral attachment of their tumors. In Group A(n=5), the tumor was attached to the AMS, and in Group B(n=5), it was not attached to the AMS. We recorded the patients’ modified McCormick grades at the time of admission, immediately, and 4 weeks after surgery. Pre-and postoperative changes in their functional status were evaluated by a deterioration/amelioration scoring system where 0=no change of grade, -1,-2=deterioration by 1 or 2 grades, and +1=improvement by 1 grade. We compared the scores recorded for Group A and B patients just after and 4 weeks after surgery. In addition, we compared the motor evoked potentials(MEPs), preoperative magnetic resonance imaging(MRI)results(proportion of the tumor to the cord, intratumoral cyst, and syrinx), and pathological findings(anaplastic changes and MIB-1 index)in the 2 groups. In group A, tight adhesion of the tumor to the AMS rendered selective division of the feeding arteries difficult. The mean deterioration/amelioration scores immediately and 4 weeks after surgery were -1.2(range 0 to -2)and -0.6(range +1 to -2), respectively in Group A. They were -0.8 (range 0 to -2)and +0.2(range +1 to -1) respectively in Group B. Four weeks after surgery, one patient of Group A was scored -2, whereas no patient of Group B had a score of -2. Both groups, manifested decreases in MEP amplitudes. There were no specific MRI and pathological findings pertinent to the pattern of a attachment to the septum. Tumors with adhesion to the AMS raise the risks of damage to the central vessels, tend to produce deterioration, and result in delayed postoperative recovery. Careful dissection that is based on an understanding of the anatomical relationship between the AMS and the central vessels and feeding arteries facilitates the safe detachment of these tumors from the AMS. (Received:October 15, 2012;accepted:April 8, 2013)","PeriodicalId":283326,"journal":{"name":"Spinal Surgery","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132872584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Evaluation and Treatment for Posture 姿势的评估和治疗

Spinal Surgery Pub Date : 2013-08-25 DOI: 10.2531/SPINALSURG.27.119

H. Takei

引用次数: 1

神経因性下部尿路機能障害(神経因性膀胱)の機序と治療の最新知識神経因性下部尿路機能障害(神経因性膀胱)の機序と治療の最新知識

Spinal Surgery Pub Date : 2013-04-25 DOI: 10.2531/SPINALSURG.27.4

友典山西, 智之内山, 美樹布施, 千晴山口

引用次数: 0

頭蓋頚椎移行部・上位頚椎のAVF, AVM 颅颈椎移行部、上位颈椎的AVF、AVM

Spinal Surgery Pub Date : 2012-08-25 DOI: 10.2531/SPINALSURG.26.171

辰志井上, 敬介高井, 康之三好, 卓也菅原, 俊宏高見