Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Risk factors for moderate disturbance of consciousness in patients with unilateral chronic subdural hematoma","authors":"Adrian Liebert ,&nbsp;Thomas Eibl ,&nbsp;Thomas Bertsch ,&nbsp;Hans-Herbert Steiner ,&nbsp;Karl-Michael Schebesch ,&nbsp;Leonard Ritter","doi":"10.1016/j.inat.2025.101992","DOIUrl":"10.1016/j.inat.2025.101992","url":null,"abstract":"<div><h3>Objective</h3><div>Chronic subdural hematoma (CSDH) patients usually present with mild symptoms; however, a subset of patients presents with disturbance of consciousness (DOC). We analyzed clinical and radiographic factors, which could influence the level of consciousness in CSDH patients before surgery.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed consecutive unilateral CSDH patients, who were surgically treated in our department from 2018 to 2023. We compared a group of patients with moderate DOC (group 1), defined as a Glasgow Coma Scale (GCS) 9–13, with a control group of awake but symptomatic patients (GCS &gt; 13, group 2). Clinical and radiographic parameters were analyzed in bivariate and multivariate analyses.</div></div><div><h3>Results</h3><div>41 (12.9 %) patients presented with GCS 9–13 and 276 patients with GCS &gt; 13. In bivariate analysis, radiographic parameters, like greater mean midline shift (p &lt; 0.001), homogenous hypodense type (p = 0.017), additional temporal (p &lt; 0.001) and occipital (p &lt; 0.001) location, “acute-to-chronic” (p = 0.002) and “acute-on-chronic” (p = 0.049) forms were more frequent in group 1. The trabecular hematoma subtype was less common in group 1 (p = 0.002). INR (p = 0.004) and CRP values (p = 0.003) in the preoperative blood sample were significantly higher in group 1. History of ischemic stroke and intake of statins were more common in group 1 (p = 0.033, p = 0.04; resp.). In the multivariate analysis, midline shift (p = 0.033), occipital location (p = 0.005) and history of ischemic stroke (p = 0.046) remained significant.</div></div><div><h3>Conclusion</h3><div>We could identify factors which contribute to DOC in CSDH patients. Among those are greater midline shift, occipital location and history of ischemic stroke as independent risk factors.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 101992"},"PeriodicalIF":0.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizure in a child with cerebellopontine angle tumour","authors":"Emmanuel Garba Sunday ,&nbsp;Eno-Abasi Garba Sunday ,&nbsp;Piel Panther Kuol ,&nbsp;Ignatius N. Esene ,&nbsp;Abdulbasit Opeyemi Muili ,&nbsp;Nwafuluaku Emmanuel Chukwudi ,&nbsp;Mubarak Jolayemi Mustapha ,&nbsp;Yao Christian Hugues Dokponou ,&nbsp;Nourou Dine Adeniran Bankole ,&nbsp;Alvan-Emeka K. Ukachukwu","doi":"10.1016/j.inat.2025.101990","DOIUrl":"10.1016/j.inat.2025.101990","url":null,"abstract":"<div><h3>Background</h3><div>Cerebellopontine angle (CPA) tumours in paediatric patients are rare. Cerebellar seizures are infrequent and scarcely discussed. Only one case of paediatric cerebellar seizure due to a CPA tumour is available in the literature.</div></div><div><h3>Methods</h3><div>We present a 4-year-old girl with features of cerebellar seizure and fever, who was initially managed for febrile convulsion for 8 months at various private facilities. We also conduct a comprehensive search of English-language medical literature on PubMed, Google Scholar, and grey literature using free Google search with the appropriate keywords.</div></div><div><h3>Results</h3><div>Twenty-three English-language medical literature were published, with 25 cases whose age at presentation ranged from 1 day to 122 months and male: female ratio of 1.18:1. Only one child with cerebellar seizure had CPA tumour, while the rest variously originated from the cerebellum, brainstem or within the fourth ventricle. The age at surgery ranged between one month to 122 months.</div></div><div><h3>Conclusion</h3><div>Cerebellar seizures should prompt consideration of posterior fossa lesions as a possible cause, provided there are no supratentorial lesions.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 101990"},"PeriodicalIF":0.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restorative neurostimulation for chronic low back pain using ReActiv8® in a patient with a large lumbar disc herniation","authors":"Dirar Aldabek ,&nbsp;Christian Schürer ,&nbsp;Michael Luchtmann","doi":"10.1016/j.inat.2024.101988","DOIUrl":"https://doi.org/10.1016/j.inat.2024.101988","url":null,"abstract":"<div><p>This case report presents the therapeutic effect of restorative neurostimulation (ReActiv8®) on chronic low back pain (CLBP) in a 44-year-old male, where the primary etiology was not lumbar disc herniation (LDH). Despite presenting with LDH at L4-L5, clinical evaluations suggested lumbar microinstability and multifidus muscle dysfunction as the main contributors to his pain, without radicular symptoms. The patient had a 12-year history of CLBP, resistant to conventional treatments like physiotherapy, medications, and epidural injections. Opting for a minimally invasive approach, he underwent implantation of ReActiv8®, focusing on rehabilitating the impaired multifidus muscle. Over a 12-month therapy period, significant improvements were noted in pain levels, functionality, and quality of life, leading to a full return to work. Interestingly, follow-up imaging showed not only a substantial reduction in pain but also an unexpected resolution of the LDH at L4-L5, enhanced lumbar lordosis, and improved disc hydration, despite minor progressing Modic changes. This case underlines the potential of restorative neurostimulation in CLBP management, especially when the pain origin is non-discogenic. It emphasizes the importance of accurate pain source identification in CLBP treatment and suggests further research into the efficacy and applicability of neurostimulation in similar clinical scenarios.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"37 ","pages":"Article 101988"},"PeriodicalIF":0.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751924000343/pdfft?md5=f3d94bb509aaa6db1f8c7590be315671&pid=1-s2.0-S2214751924000343-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140948783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical dexamethason effectiveness combined with surgical intervention in patients suffering from chronic subdural hematoma","authors":"Hosein Safari ,&nbsp;Masoud Zeinali ,&nbsp;Pooyan Alizadeh ,&nbsp;Davood Mahmoudi","doi":"10.1016/j.inat.2024.101984","DOIUrl":"https://doi.org/10.1016/j.inat.2024.101984","url":null,"abstract":"<div><h3>Background</h3><p>A chronic subdural hematoma (CSDH) is one of the most common neurosurgery operations. This study aimed to evaluate the effect of topical corticosteroids combined with surgery in patients with CSDH.</p></div><div><h3>Materials and Methods</h3><p>The present study is a clinical trial study on patients referred to hospitals associated with Ahvaz University of Medical Sciences with chronic subdural hematoma in 2019. Patients requiring surgical drainage of chronic subdural hematoma who met the inclusion criteria underwent open craniotomy surgery on the side of the hematoma. A drain was placed in the open craniotomy site. On the third day after the operation, before removing the drain, 40 mg of methylprednisolone sodium succinate was injected through the drain into the subdural space, after which the drain was pulled entirely. Patients were evaluated with the Markwalder Grading Scale (MGS) on the third day, third month, and sixth month after surgery for improved or worsened neurological symptoms. Also, in the third and sixth months after surgery, the patients underwent Computerized Tomography Scan imaging and were checked for recurrence.</p></div><div><h3>Results</h3><p>32 patients with CSDH entered the study, including 28 men and four women, with a mean age of 71.62 ± 9.85 years. Moreover, 87.5 % had a unilateral chronic subdural hematoma (uCSDH), and 12.5 % had a bilateral chronic subdural hematoma (bCSDH). Left and right uCSDHs had the same frequency (43. 8 %). After surgery, 26 patients had no postoperative complications, and six patients experienced pneumocephalus.</p></div><div><h3>Conclusion</h3><p>Topical dexamethasone injection through the potential CSDH cavity can result in desirable outcomes.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"37 ","pages":"Article 101984"},"PeriodicalIF":0.4,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751924000306/pdfft?md5=bf22c12f610365fdca47f61c4fb657b6&pid=1-s2.0-S2214751924000306-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebellopontine angle epidermoid cyst presenting with only trigeminal neuralgia: A retrospective study at the single-center in Vietnam","authors":"Phuoc Trong Do ,&nbsp;Chung Kim Nguyen ,&nbsp;Viet-Thang Le","doi":"10.1016/j.inat.2024.101987","DOIUrl":"https://doi.org/10.1016/j.inat.2024.101987","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the influence of clinical and imaging characteristics on the outcome of microsurgery treatment for cerebellopontine angle (CPA) epidermoid cyst (EC) presenting only with trigeminal neuralgia (TN).</p></div><div><h3>Methods</h3><p>A retrospective observational study describing 42 cases of CPA epidermoid cyst presenting only with TN n CPA for 10 years from 2011 to 2021 with the mean follow-up period was 37 months (range, 6–60 months). This study is the largest research with a long follow-up period reported so far worldwide for ECs with only TN symptom. We analyzed the clinical-radiological records of all the patients who met the rigorous requirements to find the distinct features of these tumors.</p></div><div><h3>Results</h3><p>The mean age was 40.1 ± 4.7 years. The time from symptom onset to surgery was 8.6 ± 3.9 months. Symptoms of multiple branches of the 5th nerve appeared in 71.4 %, the most common was V2V3 accounting for 42.9 %. Most of the tumors were located limited in the CPA, accounting for 66.7 %. Total resection reached 90.5 %. The effectiveness of pain relief of microsurgery reached 97.6 %, Barrow Neurological Institute (BNI) score I reached 73.8 % and pain relief was 23.8 %. The postoperative neurologic deficit was 14.3 %.</p></div><div><h3>Conclusion</h3><p>CPA epidermoid cysts presenting with TN as the sole symptom have favorable characteristics for total removing the tumor compared with other tumors in the remaining group. Total removing the tumor with the support of continuous intraoperative electromyography monitoring and decompressing the 5th nerve was ideal; it will not only increase the symptom improvement but also have a low rate of postoperative complications.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"37 ","pages":"Article 101987"},"PeriodicalIF":0.4,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751924000331/pdfft?md5=baffea07f25ad52835ea95d7bb1ad5d9&pid=1-s2.0-S2214751924000331-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140807257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teta injury at the craniovertebral junction: A case report","authors":"Shuvro Saha,&nbsp;Rafiqul Islam,&nbsp;Rashidul Hasan,&nbsp;Pulak Kumar Biswas","doi":"10.1016/j.inat.2024.101986","DOIUrl":"10.1016/j.inat.2024.101986","url":null,"abstract":"<div><p>Neck or craniovertebral penetrating injury by in situ teta, used for fishing, is an extremely rare neurosurgical emergency. In this article, we present the management of such a case in Dhaka Medical College Hospital. This case report will emphasize the presentation, investigations, surgical, and other supportive management.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"38 ","pages":"Article 101986"},"PeriodicalIF":0.4,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221475192400032X/pdfft?md5=db37197adb84002743eaef39dc62cbcf&pid=1-s2.0-S221475192400032X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and management of vertebral artery dissection without definitive imaging features: A single center cohort study","authors":"Hironori Fukumoto ,&nbsp;Takashi Morishita ,&nbsp;Koichiro Takemoto ,&nbsp;Hiromasa Kobayashi ,&nbsp;Dai Kawano ,&nbsp;Yoshinobu Horio ,&nbsp;Mitsutoshi Iwaasa ,&nbsp;Tooru Inoue ,&nbsp;Hiroshi Abe","doi":"10.1016/j.inat.2024.101985","DOIUrl":"https://doi.org/10.1016/j.inat.2024.101985","url":null,"abstract":"<div><h3>Background</h3><p>Management of vertebral artery dissection (VAD), which is difficult to diagnose definitively on imaging, is a clinical concern. The aim of this study was to clarify the clinical characteristics of VAD without definitive imaging features and evaluate our clinical decisions and their consequences.</p></div><div><h3>Methods</h3><p>We searched our database to identify patients with VAD registered between January 2008 and December 2021. We performed a retrospective chart review to obtain detailed clinical information and compared the clinical characteristics and radiological findings between patients with definitive VAD and those with non-definitive VAD by radiological findings at the initial evaluation.</p></div><div><h3>Results</h3><p>Of 188 patients (mean age 52.7 ± 12.3 years, 121 male), 127 had definitive VAD. Patients in the definitive group had a younger average age and a high rate of intramural hematoma, while those in the non-definitive group were more likely to have a history of hypertension. Overall, the prognosis was good for the majority (n = 163), and there was no significant difference in the prognosis between two groups. Especially, the prognosis of non-definitive VAD patients without stroke was favorable.</p></div><div><h3>Conclusions</h3><p>Cases of non-definitive VAD are likely to be complicated by atherosclerotic changes. Therefore, clinicians should carefully evaluate the potential etiologies based on the clinical history and imaging data to provide patients with the optimal treatment options. Identification of IMH was an important factor to make a definitive diagnosis, and the vessel wall imaging is a useful imaging modality for the purpose.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"37 ","pages":"Article 101985"},"PeriodicalIF":0.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751924000318/pdfft?md5=7464850b7ef00224a19d6ce5d2930c4e&pid=1-s2.0-S2214751924000318-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140649590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type Id versus type IId three-level hybrid surgery for the treatment of noncontiguous cervical spondylosis: A finite element analysis","authors":"Jiang Huang ,&nbsp;Xiangyao Sun ,&nbsp;Qingming Zhang ,&nbsp;Li Cao ,&nbsp;Yuqi Liu ,&nbsp;Zelong Song ,&nbsp;Wei Tang ,&nbsp;Siyuan Sun ,&nbsp;Juyong Wang","doi":"10.1016/j.inat.2024.101983","DOIUrl":"https://doi.org/10.1016/j.inat.2024.101983","url":null,"abstract":"<div><p>The objective of the research is to simulate different forms of three-level hybrid surgeries, aiming to establish a foundational reference for the selection of suitable treatment strategies for multilevel noncontiguous cervical degenerative disease (CDD). For the development of precise finite element models (FEMs), this study utilized computed tomography (CT) data. Two cross-segment surgical approaches were primarily investigated: C3/4 cervical disc arthroplasty (CDA), C5/6 anterior cervical discectomy and fusion (ACDF), and C6/7 ACDF in the type Id model; C3/4 CDA, C5/6 CDA, and C6/7 ACDF in the type IId model. The follower load technique was employed to apply an initial axial load of 73.6 N at the motion center. Subsequently, a moment of 1.0 Nm was introduced at the center of the C2 vertebra to simulate the overall motion of the model. In contrast to type IId, type Id exhibited lower average intervertebral disc pressure in C4/5 across various motions. The average intervertebral disc pressure in C2/3 was higher in type Id compared to type IId in flexion and axial rotation, whereas the reverse was observed in lateral bending. Type IId exhibited notably lower facet joint contact stresses during extension in C2/3 and C4/5 when compared to type Id. Type Id has a better protective effect on IS, and can significantly reduce the average pressure of the intervertebral disc in IS compared with type IId. Type IId has a significant protective effect on the post-column structure of non-fused segments.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"37 ","pages":"Article 101983"},"PeriodicalIF":0.4,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221475192400029X/pdfft?md5=ceda8185bc4b7215f9c602260d0902d0&pid=1-s2.0-S221475192400029X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140552452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A large extruded L5-S1 disc causing progressive compression and neurological deficits(CES) with slow recovery after surgery","authors":"Mehdi Mahmoodkhani,&nbsp;Majid Rezvani,&nbsp;Mehdi Shafiei,&nbsp;Amir Mahabadi,&nbsp;Navid Askariardejani","doi":"10.1016/j.inat.2024.101982","DOIUrl":"https://doi.org/10.1016/j.inat.2024.101982","url":null,"abstract":"<div><p>A 40-year-old male presented with progressive paresthesia and weakness of the lower limbs and sphincter dysfunction. He had a history of low back pain and disk herniation from five years ago. Magnetic resonance imaging (MRI) revealed a very large mass-like lesion at L5-S1 segments, and computed tomography (CT) showed destruction of L5 lamina. While the main diagnosis was a large extruded disc, the possibility of extradural masses such as chordoma was also considered. The patient was immediately started on corticosteroid therapy and underwent laminectomy and discectomy surgery to remove the large free fragment compressing the neural elements. The patient reported feeling improvement in his feet and perineum one day after surgery, but follow-up examinations one and three months after surgery described incomplete recovery in sphincter function. This case highlights the importance of considering other possible diagnoses based on physical examination and imaging findings, even when the initial diagnosis seems clear, and emphasizes the need for timely intervention in cases of spinal cord compression to prevent permanent damage to the neural elements.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"37 ","pages":"Article 101982"},"PeriodicalIF":0.4,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751924000288/pdfft?md5=1a8b65057542c6ef8ccb547ad5480ebb&pid=1-s2.0-S2214751924000288-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140633228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone density measured on sagittal reconstructed CT is highly correlated with axial CT but both measurements are only moderately correlated with DEXA T-scores","authors":"Shivam N. Upadhyaya ,&nbsp;Charles H. Crawford III ,&nbsp;Grant O. Schmidt ,&nbsp;Derek Arrington ,&nbsp;John R. Dimar II ,&nbsp;Steven D. Glassman ,&nbsp;Jeffrey L. Gum ,&nbsp;Amer H. Ahmad ,&nbsp;Leah Y. Carreon","doi":"10.1016/j.inat.2024.101980","DOIUrl":"https://doi.org/10.1016/j.inat.2024.101980","url":null,"abstract":"<div><h3>Background</h3><p>During the preoperative evaluation of a patient being considered for spinal surgery, Dual-energy x-ray absorptiometry (DEXA) has been traditionally used to diagnose poor bone mineral density (BMD) as a risk factor. As ordering a DEXA can add cost and delay diagnosis, spine surgeons have more recently began to use Hounsfield Units (HU) measured on computed tomography scans (CT) as a measure of BMD. The aim of our study was to evaluate associations between DEXA and HU on lumbar spine CT scans.</p></div><div><h3>Methods</h3><p>Forty-two patients (32 female, 10 male, mean age = 67.7 years) with DEXA and lumbar spine CT scans performed within one year of each other were identified. DEXA T-scores were collected from the hip, forearm and L1-L4. HU was determined using the maximum region of interest within the cancellous area in the mid-vertebral body from L1-L4 in the sagittal and axial planes.</p></div><div><h3>Results</h3><p>Using the lowest T-score, 8 (19 %) cases were osteoporotic and 25 (60 %) were osteopenic. Statistically significant differences in HU were seen in osteoporotic cases (Axial HU = 59.2, Sagittal HU = 61.1, p = 0.006) compared to osteopenic (Axial HU = 119.8, Sagittal HU = 122.9) and normal cases (Axial HU = 141.2, Sagittal HU = 142.3). There were moderate associations between the spine T-scores and CT HUs (Axial HU:r² = 0.50, Sagittal HU:r² = 0.49, p &lt; 0.001), weak associations between the Axial HU (r² = 0.48, p &lt; 0.000) and Sagittal HU (r² = 0.48, p &lt; 0.000) with hip T-scores, and no correlations with forearm T-scores. There were strong associations between Axial HU and Sagittal HU (r² = 0.98, p &lt; 0.001).</p></div><div><h3>Clinical relevance</h3><p>The results of the current study show a strong association between the sagittal and axial vertebral HU measurements, which supports the clinical use of either measurement technique. The weak correlation between T-scores and HU is consistent with prior studies and warrants future studies to determine which modality will better predict postoperative mechanical failures in patients undergoing spinal surgery.</p></div><div><h3>Level of Evidence</h3><p>III.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"37 ","pages":"Article 101980"},"PeriodicalIF":0.4,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751924000264/pdfft?md5=e2b2c07243c64ae65a8b312482b842bd&pid=1-s2.0-S2214751924000264-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140209016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}